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In this video we take a look at Public Health – the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. Public health focuses on improving the health of a population and preventing
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health problems before they happen. It is a broad field and covers a range of topics such as air pollution, epidemiology, communicable disease control, risk assessment and health promotion. We’ll take a look at what public health is, how it is different to clinical medicine, who is responsible for doing it and how it’s done!
more
The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to
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sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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With this World Health Day, WHO is drawing attention to a group of diseases that are spread by insects and other vectors, the heavy health and economic burdens they impose, and what needs to be done to reduce these burdens. Many of these diseases have been historically confined to distinct geographi
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cal areas, but this situation has become more fluid due to a host of ills, including climate change, intensive farming, dams, irrigation, deforestation, population movements, rapid unplanned urbanization, and phenomenal increases in international travel and trade. The control of vector-borne diseases can make a major contribution to poverty reduction, as it precisely targets the poor
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This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national TB response in accelerating efforts towards elimination. The document will also be inform
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ative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
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This core package of materials provides a comprehensive introduction to the FAST strategy: a focused approach to stopping TB spread in congregate settings. In English, FAST stands for:
Finding TB cases
Actively,
Separating safely, and
Treating effectively.
FAST focuses health care w
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orkers on the most important TB transmission control intervention: effective treatment.
FAST can also be extrapolated to national policy where it serves as a framework for allocating resources to interventions that will have the greatest impact on reducing TB transmission.
This core package is composed of a booklet, job aids, posters, and a button which serves as a visual reminder to staff and patients of the importance of this strategy in TB control. FAST can be implemented in both general and TB specific medical settings.
For full package visit: https://drtbnetwork.org/fast-tb-infection-control-strategy-core-package
more
This core package of materials provides a comprehensive introduction to the FAST strategy: a focused approach to stopping TB spread in congregate settings. In English, FAST stands for:
Finding TB cases
Actively,
Separating safely, and
Treating effectively.
FAST focuses health care workers on
...
the most important TB transmission control intervention: effective treatment.
FAST can also be extrapolated to national policy where it serves as a framework for allocating resources to interventions that will have the greatest impact on reducing TB transmission.
This core package is composed of a booklet, job aids, posters, and a button which serves as a visual reminder to staff and patients of the importance of this strategy in TB control. FAST can be implemented in both general and TB specific medical settings.
For full package visit: https://drtbnetwork.org/fast-tb-infection-control-strategy-core-package
more
For full publication see: https://drtbnetwork.org/mdr-tb-patient-education-flipchart
This tool can be used to educate new patients about TB and MDR-TB. The healthcare provider should review the material together with the patient. A treatment supporter can also use this flipchart at community lev
...
el to reinforce the concepts covered.
Major concepts covered in the flipchart:
TB is a contagious disease, which means it can be spread from person to person.
TB generally lives in the lungs, but it can also infect other parts of the body.
If TB is left untreated, it can kill the patient.
TB can be cured with the right medicine.
The flipchart can be adapted and modified as needed. The Mongolian Anti-Tuberculosis Association has adapted the flipchart for use in physician counseling training and in training of community health workers providing home-based care.
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This strategy defines the World Health Organization (WHO) vision and framework for supporting Member States to accelerate the development, implementation and monitoring of their National Action Plan for Health Security (NAPHS) from 2022 to 2026. The National Action Plan for Health Security (NAPHS)
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are critical to ensure national capacities in health emergency prevention, preparedness, response and recovery are planned, built, strengthened and sustained in order to achieve national, regional and global health security and therefore keep the world safe, serve the vulnerable and promote health.
The strategy promotes, where existing, the use of existing national action plans for health security and not necessary the creation of an additional unique plan. This will avoid duplication and ensure maximum efficiency in domestic resourcing and operationalization efficiency while harnessing external buy-in to support national health priorities.
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Significant progress has been made in the eradication of three priority diseases in the African Region, as a result of extensive collaboration between the Regional Office, WHO country offices and countries. For example, in August 2020, the region was certified free of wild poliovirus. In the area of
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neglected tropical diseases, Guinea worm disease is on the verge of eradication, and 12 member states are within reach of being certified as having eradicated yaws by the end of this year.
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A concept (leaflet)
This document outlines the concept of a stimulus package for rabies elimination. The aim of a stimulus package is to catalyse rabies control by starting community projects, building local capacity and using success to genera ... te momentum for growth. Governments could apply for a package, which would provide technical and material support to run small, successful rabies control projects. These in turn build evidence for the feasibility of larger scale elimination, generate enthusiasm foaction and promote investment for sustainability and up scaling. Data reporting in return for the packages would allow the documentation of successes and lessons learnt to benefit global elimination efforts more broadly. more
This document outlines the concept of a stimulus package for rabies elimination. The aim of a stimulus package is to catalyse rabies control by starting community projects, building local capacity and using success to genera ... te momentum for growth. Governments could apply for a package, which would provide technical and material support to run small, successful rabies control projects. These in turn build evidence for the feasibility of larger scale elimination, generate enthusiasm foaction and promote investment for sustainability and up scaling. Data reporting in return for the packages would allow the documentation of successes and lessons learnt to benefit global elimination efforts more broadly. more
This technical briefing paper details the construction and setup of medical isolation facilities in support of infectious disease outbreak responses.
This guide can be used to train medical officers to ensure BP is measured for all adults visiting the OPD, treat all patients with high BP, initiate treatment as per protocol, counsel patients for follow-up, refer patients to local care, and report data.
This guide can be used to train ANM staff in the field to succeed in their role in the hypertension program. It teaches how to screen patients correctly, register and follow-up with patients, retrieve defaulters, record patient visits, and to report data
This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy
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2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030.
The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities.
Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy.
This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
...
3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more
WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for
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hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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This document aims to encourage countries to develop and implement policies to maintain and strengthen IPC programmes and measures in health care facilities in the context of the current ongoing transmission of the SARS-CoV-2, with recognition that epidemiological trends may vary and the risk of tra
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nsmission of other pathogens.
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