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The health impact of radiological and nuclear emergencies can last for decades. Lessons learned from past radiological and nuclear accidents have demonstrated that the mental health and psychosocial consequences can outweigh the direct physical health impacts of radiation exposure. International rad
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iation emergency preparedness and response standards outline provisions for mitigating these effects. Yet, practical guidance for addressing the mental health and psychosocial aspects of radiation emergencies remains scarce.
This framework aims to promote integration between the MHPSS and radiation protection fields. It is intended for officials and specialists involved in radiation emergency planning and risk management as well as MHPSS experts working in health emergencies.
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BMJ Global Health, Vol.5 No. 12Spatial subdivision of the camp (‘sectoring’) was able to ‘flatten the curve’, reducing peak infection by up to 70% and delaying peak infection by up to several months. The use of face masks coupled with the efficient isolation of infected individuals reduced t
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he overall incidence of infection, and sometimes averted epidemics altogether. These interventions must be implemented quickly in order to be maximally effective. Lockdowns had only small effects on COVID-19 dynamics.
Conclusions
Agent-based models are powerful tools for forecasting the spread of disease in spatially structured and heterogeneous populations. Our findings suggest that feasible interventions can slow the spread of COVID-19 in a refugee camp setting, and provide an evidence base for camp managers planning intervention strategies. Our model can be modified to study other closed populations at risk from COVID-19 or future epidemics.
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8 January 2021
Sequencing enabled the world to rapidly identify SARS-CoV-2 and develop diagnostic tests and other tools for outbreak management. Continued genome sequencing supports the monitoring of the disease’s spread and evolution of the viru
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s. Accelerated integration of genome sequencing into the practices of the global health community is required if we want to be better prepared for the future threats. This document provides guidance for laboratories on maximizing the impact of SARS-CoV-2 sequencing now and other emerging pathogens in the future.
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This guide provides an overview of the major elements that must be considered before, during and after the implementation of antigen-detecting rapid diagnostic tests (Ag-RDTs) for SARS-CoV-2. This guide is complementary to policy guidance issued by the World Health Organization (WHO). The guide may
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appeal to a range of audiences including Ministries of Health, donors, public and private organizations/agencies acting as implementing partners and community based and civil society organizations with experience working on health, especially organizations familiar with similar testing campaigns for other disease programmes like HIV and malaria
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The WHO Regional Office for Europe has established the Childhood Obesity Surveillance Initiative in more than half the countries in the Region for routine monitoring of the policy response to the emerging obesity epidemic. The aim of the Initiative
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is to measure trends in overweight and obesity in children aged 6.0–9.9 years to get a clear understanding of the epidemic and to allow inter-country comparisons. This document outlines the common protocol agreed for use in the Initiative.
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The COVID-19 pandemic and subsequent public health guidance to reduce the spread of the diseasehave wide-reaching implications for children’s health and wellbeing. Furthermore, paediatric emergency departments(EDs) have rapidly adapted provision of care in
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response to the pandemic. This qualitative study utilized insight frommultidisciplinary frontline staff to understand the changes in paediatric emergency healthcare utilization duringCOVID-19 the experiences of working within the restructured health system.
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5 May 2021
This Information Note is intended to assist national TB programmes and health personnel worldwide to maintain essential tuberculosis (TB) services during the COVID-19 pandemic and in the recovery phase. It is important that recent progress made in TB prevention and care is not reversed b
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y COVID-19. The WHO Global TB Programme, along with WHO regional and country offices, developed this note in response to questions received from Member States and other partners since the start of the pandemic. The note includes references to other published WHO information products relevant to TB practitioners. WHO continues to monitor the situation closely for any changes that may influence this note and will issue updates should any factors change.
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The report shows that older people are not getting the healthcare treatments they desperately need. The COVID-19 response has disrupted services for non-communicable diseases such as cancer and diabetes, communicable diseases such as malaria, and mu
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ch-needed services for mental health. Combined with a loss of income, many older people are unable to get the medicines they need.
A Summary is available in Russian and Arabic
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Measures to strengthen primary health-care systems in low- and middle-income countries
Etienne V Langlois, Andrew Mc Kenzie, Helen Schneider & Jeffrey W Mecaskey
World Health Organization
(2020)
C_WHO
Primary health care offers a cost–effective route to achieving universal health coverage (UHC). However, primary health-care systems are weak in many low- and middle-income countries and often fail to provide comprehensive, people-centred, integrated care. We analysed the primar
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y health-care systems in 20 low- and middle-income countries using a semi-grounded approach. Options for strengthening primary health-care systems were identified by thematic content analysis. We found that: (i)despite the growing burden of noncommunicable disease, many low- and middle-income countries lacked funds for preventive services; (ii)community health workers were often under-resourced, poorly supported and lacked training; (iii)out-of-pocket expenditure exceeded 40% of total health expenditure in half the countries studied, which affected equity; and (iv)health insurance schemes were hampered by the fragmentation of public and private systems, underfunding, corruption and poor engagement of informal workers. In 14 countries, the private sector was largely unregulated. Moreover, community engagement in primary health care was weak in countries where services were largely privatized. In some countries, decentralization led to the fragmentation of primary health care. Performance improved when financial incentives were linked to regulation and quality improvement, and community involvement was strong. Policy-making should be supported by adequate resources for primary health-care implementation and government spending on primary health care should be increased by at least 1% of gross domestic product. Devising equity-enhancing financing schemes and improving the accountability of primary health-care management is also needed. Support from primary health-care systems is critical for progress towards UHC in the decade to 2030.
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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB patients. When appropriately implemented, the activity is cost effectiv
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e, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical di
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sease is varied and depends on the interaction of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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Healthy communities rely on well-functioning ecosystems. They provide clean air, fresh water, medicines and food security. They also limit disease and stabilize the climate. But biodiversity loss is happening at unprecedented rates, impacting human
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health worldwide, according to a new state of knowledge review of the Convention on Biological Diversity (CBD) and WHO.
The report synthesizes the available information on the most important inter-linkages between biodiversity, ecosystem stability, and epidemic infectious diseases such as the Ebola virus; and the connection between biodiversity, nutritional diversity and health. It also covers the potential benefits of closer partnerships between conservation and health, from improved surveillance of infectious diseases in wildlife and human populations, to promoting access to green spaces to promote physical activity and mental health. It also highlights the many areas in which further research is needed.
The Joint report hopes to provide a useful reference for the Sustainable Development Goals and post-2015 development agenda, which represents an unique opportunity to promote integrated approaches to biodiversity and health by highlighting that biodiversity contributes to human well-being, and highlighting that biodiversity needs protection for development to be sustainable.
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Interim guidance, 26 October 2021
This interim guidance has been developed on the basis of the advice issued by the Strategic Advisory Group of Experts (SAGE) on Immunization at its meeting on 5 October 2021.
SAGE said moderately and severely immunocompromised persons should be offered an addition
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al dose of all WHO approved vaccines “since these individuals are less likely to respond adequately to vaccination following a standard primary vaccine series and are at high risk of severe COVID-19 disease.”
People aged 60 and older who received the Sinovac and Sinopharm vaccines should get a third dose too, the experts added, though use of other vaccines may also be considered depending on supply and access.
“When implementing this recommendation, countries should initially aim at maximizing 2-dose coverage in that population, and thereafter administer the third dose, starting in the oldest age groups”, they said.
SAGE has also reviewed a vaccine developed by Indian company Bharat Biotech and will issue a policy recommendation after WHO greenlights it for emergency use.
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Containment strategies: lessons from early COVID-19 responses in five African countries
World Health Organization WHO, Regional Office of Africa; AHOP
WHO Regional Office for Africa
(2021)
C_WHO
The number of COVID-19 cases is on the rise again, with South Africa nearing half of all confirmed cases in the WHO African Region. Threats of new variants loom and low vaccination coverage raises questions on the future of the response to COVID-19.
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Prevention remains the key strategy in most sub-Saharan countries. Five National Centres (NCs) from the African Health Observatory Platform on Health Systems and Policies (AHOP), based in Ethiopia, Kenya, Nigeria, Rwanda and Senegal, reflect on lessons to be learnt from their containment responses in the initial phases. They construct timelines to highlight the policies and challenges associated with introducing a range of public health containment measures and
discuss the extent to which these measures continue to be valuable given the ever-changing nature of the pandemic.
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Left unabated, climate change will have catastrophic effects on the health of present and future generations. Such effects are already seen in Europe, through more frequent and severe extreme weather events, alterations to water and food systems, and changes in the environmental suitability for infe
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ctious diseases. As one of the largest current and historical contributors to greenhouse gases and the largest provider of financing for climate change mitigation and adaptation, Europe’s response is crucial, for both human health and the planet. To ensure that health and
wellbeing are protected in this response it is essential to build the capacity to understand, monitor, and quantify health impacts of climate change and the health co-benefits of accelerated action.
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Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to complement the development of a global plan, as ar
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ticulated in the WHO’s draft resolution EB134/37 “Combating antimicrobial resistance including antibiotic resistance”, adopted by theWorld Health Assembly in May 2014. The overuse of antimicrobials is driving resistance. A return to appropriate, targeted antimicrobial use in humans, animals and the environment is critical if we are to conserve the antimicrobial armamentarium. Various interventions have been put in place to address antimicrobial resistance in South Africa. However, these are insufficient to effectively tackle the threat faced by the country. The strengths of the current system are outweighed by its weaknesses.
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Contact tracing and quarantine in the context of COVID-19: interim guidance, 6 July 2022
recommended
Contact tracing for COVID-19 is the process of identifying, assessing, and managing people who have been exposed to someone who has been infected with the SARS-CoV-2 virus, while quarantine is the separation of contacts from other people after exposure to a probable or confirmed case of SARS-CoV-2 i
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nfection. In the context of growing global population immunity from COVID-19 vaccination and past SARS-CoV-2 infection, WHO recommends that identification, contact, quarantine and follow-up should be prioritized for individuals at high risk who have been in contact with a confirmed or probable case of SARS-CoV-2 infection, rather than targeting all contacts. This updated guidance also introduces shorter recommended quarantine periods, including the ability to further shorten quarantine through the use of testing. National and local health authorities should use risk-based approaches to contact tracing and quarantine that include reviewing and adjusting to their local circumstances and disease epidemiology, population immunity, their health system’s capacities, and risk tolerance.
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Emergency medical teams (EMTs) play an important role in strengthening health service networks in terms of their strategies and tactics for planning mass vaccination programs, especially in remote or under-resourced areas or those overwhelmed by COVID-19. EMTs experience deploying in remote areas an
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d handling operational challenges to ensure their response even under the most austere conditions will be of great support in facing the technical and logistical challenges to timely and equitable access to vaccines at the local level.
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Known avoidable environmental risks to health cause at least 12.6 million deaths every year, and account for about one quarter of the global burden of disease (2016 data) (1). Air pollution alone causes about 7 million
deaths a year, placing it amo
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ng the top global risks to health (2). Global environmental challenges are on the rise, including climate change, rapid urbanization and increased resistance to drugs.
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Brucellosis is widespread in both humans and livestock in many developing countries. The authors have performed a series of epidemiological studies on brucellosis in agro-pastoral areas in Tanzania since 2015, with the aim of the disease control. Pr
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eviously, the potential of a community-based brucellosis control initiative, which mainly consisted of the sale of cattle with experience of abortion and vaccinating calves, was assessed as being effective and acceptable based on a quantitative approach. This study was conducted to investigate the feasibility of community-based brucellosis control program using participatory rural appraisals (PRAs) and key-informant interviews. Four PRAs were performed together with livestock farmers and livestock and medical officers in 2017. In the PRAs, qualitative information related to risky behaviors for human infection, human brucellosis symptoms, willingness to sell cattle with experience of abortion, and willingness to pay for calf vaccination were collected, and a holistic approach for a community-based disease control project was planned. All of the communities were willing to implement disease control measures. To avoid human infection, education, especially for children, was proposed to change risky behaviors. The findings of this study showed that community-based disease control measures are promising.
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