The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules
- Essential Care and Practice that includes general guid...elines and Iminterventions and implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use
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Also available in English.
Esta nueva edición del Informe sobre control del tabaco en la Región de las Américas presenta la situación actual y las tendencias de la epidemia del tabaquismo en la Región de las Américas, así como de la aplicación de seis medidas efectivas para combatirla conoc...idas como el paquete de medidas MPOWER. El informe cuenta con las contribuciones de autores invitados, quienes comparten sus puntos de vista sobre temas de alto interés para la Región, como es el Protocolo para la Eliminación del Comercio Ilícito de Productos de Tabaco, la regulación de nuevos (y viejos) productos y lecciones aprendidas. El informe incluye además una sección con perfiles de país, en la que se muestra el estado de aplicación de las seis medidas en cada uno de los 35 Estados Miembros de la Región.
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During the past five decades, the incidence of dengue has increased 30-fold. Some 50–100 million new infections are estimated to occur annually in more than 100 endemic countries, with a documented further spread to previously unaffected areas; every year hundreds of thousands of severe cases ari...se, including 20 000 deaths; 264 disability-adjusted life years per million population per year are lost , at an estimated cost for ambulatory and hospitalized cases of US$ 514–1394, often affecting very poor populations. The true numbers are probably far worse, since severe underreporting and misclassification of dengue cases have been documented.
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Review
Drake AL et al. Journal of the International AIDS Society 2019, 22:e25271 http://onlinelibrary.wiley.com/doi/10.1002/jia2.25271/full | https://doi.org/10.1002/jia2.25271
Research Article
PLOS ONE | https://doi.org/10.1371/journal.pone.0190785 January 10, 2018
The aim of this paper is to investigate how doctors working in primary health care in Latin American address patients with common mental disorders and to investigate how stigma can affect their clinical decisions
PLoSONE 13(11):e0206440.https://doi.org/10.1371/journal.pone.0206440
The report focuses on antibacterial resistance (ABR) in common bacterial pathogens. There is a major gap in knowledge about the magnitude of this problem. Antimicrobial resistance (AMR) threatens the effective revention and treatment of an ever-increasing range of infections caused by bacteria, para...sites, viruses and fungi. This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally. It examines the information on AMR, in particular antibacterial resistance (ABR), at country level worldwide.
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América Latina y el Caribe se ha convertido en el epicentro de la pandemia de enfermedad por coronavirus (COVID-19) y encabeza las estadísticas mundiales de casos. La pandemia ha devenido en una inédita crisis económica y social y, si no se toman medidas urgentes, podría transformarse en una cr...isis alimentaria, humanitaria y política. Tanto para las acciones de control de la pandemia como para las etapas de reactivación y reconstrucción, es imprescindible aumentar la inversión pública en salud hasta alcanzar los parámetros recomendados, de modo de asegurar el fortalecimiento de los sistemas de salud, ampliando y reconfigurando los servicios de salud de calidad, con un enfoque de atención primaria de salud, y abordar de manera inmediata y acelerada las necesidades de salud insatisfechas, reducir inequidades y mejorar las condiciones de acceso a servicios esenciales, incluida la protección financiera.
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Organizing and Delivering High Quality Care for Chronic Noncommunicable Diseases in the Americas
Esta investigacion construire y evalua la cascada de atención de la tuberculosis pulmonar en la población indígena del departamento del Cauca (Colombia) e identifica las brechas existentes. Este es el primer estudio en Colombia que analiza la cascada de atención de la TB en población indígena.... Lo anterior cobra relevancia para la toma de decisiones a nivel local y aporta evidencia sobre este tema.
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Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los... años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination.
This checklist is for any organization or person supporting the routine use of evidence in
the process of policy-making. Evidence-informed policy-making (EIPM) is essential for achieving the Sustainable Development Goals (SDGs) and universal health coverage (UHC). Its importance is emphasized in WH...O’s Thirteenth General Programme of
Work 2019–2023 (GPW13). This checklist was developed by the WHO Secretariat of Evidence-Informed Policy Network (EVIPNet) to assist its Member countries in institutionalizing EIPM. Government agencies (i.e. the staff of the Ministry of Health),
knowledge intermediaries and researchers focused on strengthening EIPM will find in this checklist some key steps and tools to help their work. While the health sector is a key target group for EVIPNet, this tool can be applied by stakeholders from
different social sectors
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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