Interim Guidance. This document provides guidance for: screening and triage of pregnant women in the context of an Ebola outbreak; infection prevention and control (IPC) precautions for pregnant women at risk of EVD transmission during childbirth and complication management; management of pregnant... EVD cases, contacts and survivors; lactation and Ebola virus disease.
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The synthesis looked across the evaluations and reviews as mentioned above to draw lessons and conclusions across the different contexts. The synthesis aims to identify:
recurrent issues, patterns and trends, and promising initiatives and lessons learned from existing programming including main...streaming in how UNHCR prevents, mitigates and responds to the risks of SGBV;
institutional management and leadership for SGBV in UNHCR;
factors which are contributing to success, including sustainability of services, and those which are inhibiting it;
the extent to which questions on SGBV are part of UNHCR evaluations of emergency responses;
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Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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This handbook presents basic content and tips for implementing a school-based risk reduction programme. It is organised into five modules: its importance; approach and process; activities to benefit children up to five years old; activities for students aged 5–17; and activities for young people a...nd volunteers aged 17–24.
A generic framework for school-based risk reduction initiatives is illustrated in a diagram on p.10. The Comprehensive School Safety framework suggests a series of continuing activities that include: identifying the hazards in and around a school; conducting drills; preparing contingency and disaster management plans by involving parents, teachers and students; and building on the capacities of an institution and individuals to cope with the challenges during an unforeseen event. It also consists of three pillars: safe learning facilities; school disaster management; and risk reduction and resilience education.
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Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of drug-resistant TB has been developed and forms part of the Five Year National Strateg...ic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols
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Lao People’s Democratic Republic (Lao PDR), also referred to as Laos, or Lao, is exposed to natural disasters such as flooding, typhoons, cyclones, drought, and earthquakes. The country is vulnerable to recurrent, sudden-onset and slow onset natural disasters with flooding, storms and typhoons hav...ing a large effect on the population. The country remains highly vulnerable to agricultural shocks and natural disasters.
Lao has established Community Based Disaster Risk Reduction (CBDRR) practices as a result of the many natural disasters the country faces. CBDRR is implemented at the village level to enhance community preparedness and to decrease village vulnerabilities to disasters.
Lao established the National Disaster Management Committee (NDMC) as its national disaster management platform and the National Disaster Management Office (NDMO) to be responsible for DRM (Disaster Risk Management) and DRR activities in the country.
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The purpose of this document is to provide a comprehensive overview of existing institutional arrangement for disaster management in Myanmar at all levels with an aim to make information available to all stakeholders involved in disaster risk management in Myanmar.
This algorithm shows the main actions for contacts of probable or confirmed 2019-nCoV cases. Implementation may be modified depending on the risk assessment for individual cases and their contacts by public health authorities.
This document provides guidance on the implementation of the shielding approach in camps and camp-like settings for refugees and internally displaced persons. It is intended for the displaced community itself, humanitarian actors and camp coordination / management authorit...ies.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV‑2) causing coronavirus disease 2019 (COVID-19) has reached pandemic levels;
Patients with cardiovascular (CV) risk factors and established cardiovascular disease (CVD) represent a vulnerable population when suffering from COVID-19;
Patien...ts with cardiac injury in the context of COVID-19 have an increased risk of morbidity and mortality
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Technical Note
Recently, the approach to hazardous events has undergone a considerable shift, away from reactive activities focused on managing and responding to events and towards a more proactive process of emergency and disaster risk management (DRM). The ultimate goal of this shift in focus is ...to prevent new and reduce existing disaster risks, a process known as disaster risk reduction (DRR), while strengthening individual, community, societal and global resilience.
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A Public Health EOC (PHEOC) serves as a hub for coordinating the preparation for, response to, and recovery from public health emergencies. The preparation includes planning, such as risk and resource mapping, development of plans and procedures, and training and exercising. The response includes al...l activities related to investigation, response and recovery. The PHEOC also serves as a hub for coordinating resources and information to support response actions during a public health emergency and enhances communication and collaboration among relevant stakeholders.
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Countries across the world are facing diverse epidemiological situations with varying response
capacities and access to life saving tools. The World Health Organization (WHO) recommends that national authorities continue to apply a risk-based approach when implementing measures related to COVID-19... and international travel while respecting the dignity, human rights and fundamental freedoms of travellers. This approach should consider the risk posed by travel for the importation and exportation of cases in the context of the evolving epidemiology, including the emergence and circulation of virus variants of concern; the expansion of the COVID-19 vaccination roll-out; and lessons learned while responding to the pandemic, including on the early detection and management of cases and the application of public health and social measures.
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The Strategic Tool for Assessing Risks (STAR) offers a comprehensive, easy-to-use toolkit and approach to enable national and subnational governments to rapidly conduct a strategic and evidence-based assessment of public health risks for planning and prioritization of health emergency preparedness a...nd disaster risk management activities. This guidance describes the principles and methodology of STAR to enhance its adaptation and use at the national or subnational levels.
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The Food and Agriculture Organization of the United Nations (FAO) launched a new Framework for Environmental and Social Management (FESM) to ensure that both people and the environment are protected from any potential impacts of FAO programmes and projects.
“This Framework ensures that our proj...ects do both “no harm” and support the transformation to more efficient, more inclusive, more resilient and more sustainable agrifood systems by upholding the highest international standards for risk management,” FAO Director-General QU Dongyu explained during a virtual event.
The Framework, which includes key elements of a people-centered approach and establishes environmental and social performance requirements for FAO programming, is also intended to ensure that all stakeholders, including local and indigenous communities, have ample opportunities to actively participate in projects’ activities and to voice their concerns about them.
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Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the
South of the United States. It is an important cause of early mortality and morbidity, and it is associated with poverty and stigma. A third of
the cases evolve into chronic... cardiomyopathy and gastrointestinal disease. The infection is transmitted vertically and by blood/organ
donation and can reactivate with immunosuppression. Case identification requires awareness and screening programmes targeting the
population at risk (women in reproductive age, donors, immunocompromised patients). Treatment with benznidazole or nifurtimox is most
effective in the acute phase and prevents progression to chronic phase when given to children. Treating women antenatally reduces but does
not eliminate vertical transmission. Treatment is poorly tolerated, contraindicated during pregnancy, and has little effect modifying the
disease in the chronic phase. Screening is easily performed with serology. Migration has brought the disease outside of the endemic
countries, where the transmission continues vertically and via blood and tissue/organ donations. There are more than 32 million migrants
from Latin America living in non-endemic countries. However, the infection is massively underdiagnosed in this setting due to the lack of
awareness by patients, health authorities and professionals. Blood and tissue donation screening policies have significantly reduced
transmission in endemic countries but are not universally established in the non-endemic setting. Antenatal screening is not commonly
done. Other challenges include difficulties accessing and retaining patients in the healthcare system and lack of specific funding for the
interventions. Any strategy must be accompanied by education and awareness campaigns directed to patients, professionals and policy
makers. The involvement of patients and their communities is central and key for success and must be sought early and actively. This review
proposes strategies to address challenges faced by non-endemic countries
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Noncommunicable diseases (NCDs) are responsible for 81% of all deaths in the region of the Americas, of which 34% befall prematurely in people between 30- 69 years old. The burden of theses diseases and their common risk factors jeopardize the health systems to provide adequate management, as well a...s to implement customized policies and interventions. The PAHO/WHO STEPwise approach to NCD risk factor surveillance (STEPS) is a simple, sequential, standardized method for collecting, analyzing, and disseminating data on key NCD risk factors in countries in adults from 18 to 69 years old. This survey covers key modifiable risk factors: tobacco use, alcohol use, physical inactivity, and unhealthy diet, as well as key biological risk factors: overweight and obesity, raised blood pressure, raised blood glucose, and abnormal blood lipids. STEPS is a household survey that gathers information on the risk factors through a face-to-face interview (step 1), simple physical measurements (step 2), and collection of urine and blood samples for biochemical analysis (step 3). Every step has a core set of questions, measurements, and expanded sets depending on the countries' needs and interests. It also has optional modules. Implementing STEPS allows the comparability of data within and between countries due to its standardized data collection. It also helps health services plan public health priorities and monitors and evaluates population-wide interventions. It is designed to help countries build and strengthen their capacity to conduct surveillance. STEPS captures 11 of the 25 indicators outlined in the NCD Global Monitoring Framework relating to 7 of the nine global targets.
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The Africa Centres for Disease Control and Prevention (Africa CDC) Biosafety and Biosecurity Initiative was launched by the Africa CDC in April 2019 with the aim of strengthening the African Union (AU) Member States’ biosafety and biosecurity systems and enabling them to comply with national and i...nternational requirements for biosafety and biosecurity including the International Health Regulations (IHR) (2005), the Biological Weapons Convention (BWC), and United Nations Security Council Resolution (UNSCR) 1540 and the multi-country Global Health Security Agenda (GHSA). The World Health Organization (WHO) Joint External Evaluation (JEE) and the Global Health Security Index report confirmed the known capacity gaps in biosafety and biosecurity among Africa Union Member (AU).
The regional consultations by Africa CDC conducted between 2019-2021 highlighted the deficiency or limited availability of standardized and regionally recognized training programs in the continent, limiting biosafety and biosecurity capacity building efforts in the region. In response, Africa CDC working with AU Member States developed a home grown, implementable and accessible professional training and certification program that is both recognized and endorsed by AU Member States. The Regional Training and Certification Program for Biosafety and Biosecurity Professionals, for African Biosafety and Biosecurity Professionals (RTCP-BBP) has four (4) areas of specialization, namely
- Selection, Installation, Maintenance and Certification of Biological Safety Cabinets
- Biorisk Management
- Design and Maintenance of Facilities Handling High Risk Pathogens (Biocontainment Engineering)
- Biological Waste management
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This Urban Flood Risk Handbook: Assessing Risk and Identifying Interventions is a roadmap for conducting an urban flood risk assessment in any city in the world. It includes practical guidance for a flood risk assessment project, covering the key hazard and risk modeling stages as well as the evalua...tion of different flood-mitigating infrastructure intervention options and management of the project. The Handbook has been developed based on lessons learned from implementing urban flood risk assessments around the world in a diversity of contexts. It is intended for a wide variety of practitioners: project managers, city officials, and anyone else interested in conducting a strategic study of a city's flood risk and developing potential solutions for it. We expect this Handbook tocontribute to the understanding of urban flood risk, make this specialized knowledge more accessible to a wider public, and support the process of building cities that are not only capable of withstanding floods but also provide safe, inclusive, and sustainable environments for all their residents.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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