This case study in Chile focused on the following two strategic levers of the WHO/UNICEF PHC Operational Framework during the implementation period 2022–2023: “Political Commitment and Leadership” and “Governance and Policy Frameworks”. This included examining how support from the three le...vels of the Organization (WHO headquarters, Pan American Health Organization (PAHO)/WHO Regional Office for the Americas and PAHO/WHO Chile Country Office) has been coordinated and operationalized. The case study also explored how, through these two strategic levers, catalytic actions have been planned and implemented in relation to other operational levers, in particular “Models of care”.
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L'article "Témoignages de mères face au choléra" sur ReliefWeb présente les récits de mères haïtiennes dont les enfants ont été touchés par le choléra. Il met en lumière les défis auxquels ces familles sont confrontées, en particulier dans les régions où l'accès aux soins de santé ...et aux infrastructures sanitaires est insuffisant. L'article souligne la vulnérabilité accrue des enfants malnutris face au choléra et insiste sur l'importance des mesures de prévention ainsi que sur la nécessité d'un accès à l'eau potable et à des soins médicaux adéquats.
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Ces recommandations temporaires sont émises à l’intention des États Parties qui font face à une transmission du virus de la mpox (MPXV), y compris, sans que cette liste soit exhaustive, ceux touchés par une transmission communautaire persistante et ceux où l’on observe des groupes de cas o...u des cas sporadiques d’infection par le clade Ib du MPXV liés à des voyages.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence...-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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Cardiovascular diseases are the world’s leading cause of disability and death. Such diseases were responsible in 2019 for an estimated 18.6 million deaths globally and 957,000 deaths in the United States.
The Country Cooperation Strategy (CCS) is a medium-term strategic framework for cooperation between WHO and countries and outlines a shared agenda with priority areas of work for five years. The aim of this CSS is to define medium term vision for
WHO technical cooperation with the State of Eritrea ...for a 5-year period, 2023-2027, in support of the country’s Health Sector Strategic and Development Plan III (HSSDPIII) 2022-2026 aimed at improving the health status of its people
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Human strongyloidiasis is a chronic parasitic disease caused by infection with Strongyloides stercoralis, a soil-transmitted helminth that is estimated to infect 300–600 million people worldwide. This neglected tropical disease (NTD) is endemic globally, predominately in the South-East Asia, Afric...an and Western Pacific regions, and in South and Central America. Strongyloidiasis has a wide range of clinical presentations, including subclinical disease, symptomatic disease (often with diarrhoea, abdominal pain and urticaria) and a rare but deadly complication of hyperinfection with disseminated disease. The feared complication of disseminated strongyloidiasis can occur in the setting of immunocompromising conditions (e.g. human T-cell lymphotropic virus type 1 infection and malignancies) or immunosuppressive medications (e.g. steroids) and has an estimated case-fatality rate exceeding 60%. The standard treatment for chronic S. stercoralis infection is oral medication with ivermectin.
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Flyer 10 Steps to Mental Health
The One Health (OH) High-Level Expert Panel (OHHLEP) of the Quadripartite Organizations defined OH as an integrated, unifying approach that aims to sustainably balance and optimize the health of people, animals and ecosystems.”
It recognizes the health of humans, domestic and wild animals, plan...ts, and the wider environment (including ecosystems) are closely linked and interdependent [1]. The Tripartite which comprised the Food and Agriculture Organization (FAO) of the United Nations (UN), the World Health Organization (WHO), and the World Organisation for Animal Health (WOAH) later became the Quadripartite organizations when the United Nations Environment Programme (UNEP) joined the OH alliance in 2022. There are Global and Regional Quadripartite Secretariats consisting of officials of headquarters and regional offices, respectively.
Over the years, the Tripartite/Quadripartite organizations and other partner agencies have developed several OH assessment and operational tools to support Member States in assessing their core capacities to achieve compliance with the requirements of international standards such as the International Health Regulations 2005 (IHR), WOAH’s Terrestrial and Aquatic Animal Health Codes, World Trade Organization’s Sanitary and Phytosanitary Measures (WTO-SPS), FAO/WHO Codex standards, etc. Technical areas that the existing tools currently support include progress monitoring, coordination and collaboration mechanisms, and capacity building for prevention, detection, preparedness, and response to health threats emerging at human-animal-environment interface. More OH B operational tools are in the pipeline.
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The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa.
The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment
and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts.
The recommendations in these guidelines are:
1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5%
(conditional recommendation: moderate-quality evidence).
2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence).
3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence).
4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence).
Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities.
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WHO has identified climate change as one of the greatest health threats of the 21st century and air pollution as the single largest environmental health risk. Noncommunicable diseases (NCDs), including cardiovascular diseases, diabetes, chronic respiratory disease and cancer, are the leading causes ...of death in the European Region and globally, the latter rate being 74%
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung function testing in this group of patients and the wi...de variety of conditions that can phenotypically present with asthma-like symptoms.
This article provides an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions.
The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence.
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This publication aims to provide an overview of the state of developmental monitoring in selected countries across the Europe and Central Asia region (ECAR), to document the existing evidencebased approaches and models for developmental monitoring and to identify the key considerations necessary to ...guide discussions around introducing and enhancing developmental monitoring as a part
of primary health care.
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"Tackling Noncommunicable Diseases (NCDs), risk factors and mental health during the time of COVID-19" is a series of high-level strategic discussions on transforming the approach to noncommunicable diseases, its risk factors and mental health as a result of the pandemic in terms of strengthening he...alth systems and services, responding to emergencies, investing to transform the NCD, RF and MH agenda, optimizing partnerships, among others, with a focus on big picture thought leadership.
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The Noncommunicable Diseases Country Profiles 2018 by the World Health Organization (WHO) provides an in-depth look at the burden of noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes across WHO Member States. It includes data on NCD m...ortality, risk factors like tobacco use, unhealthy diets, physical inactivity, and excessive alcohol consumption, as well as country-specific responses and health system capacities to manage and prevent NCDs.
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The increasing prevalence of childhood asthma in the developed world is a cause for concern. A so-called Western lifestyle has been the factor most commonly cited to explain this worrying increase in asthma prevalence. Early studies in a limited number of African countries showed a very low rural pr...evalence of childhood asthma, especially where children lived according to a traditional lifestyle. These same studies showed that asthma was not uncommon in urbanized African children. There has been an
increasing tendency over the past 20 years for those in rural communities to move to the large urban centers. This article analyses the urban-rural differences and factors that influence the development of asthma in susceptible children.
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Сборник информации о том, как родители могут способствовать благополучию детей и снижению стресса
Asthma is the most common chronic illness of childhood. The prevalence is rising and the mortality and morbidity from asthma are unacceptably high in South Africa. This article emphasizes the importance to make a correct diagnosis based, most importantly, on the clinical history and supported by inv...estigations. Further, the appropriate drug and device must be chosen to achieve good asthma control. It explains that patients must be followed up regularly and their asthma control must be assessed so that the treatment can then be adjusted according to the level of control. Additionally, Asthma education and adherence are important components of management of the condition.
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The Department of Noncommunicable Diseases and Mental Health (NMH) is responsible for promoting, coordinating, and implementing technical cooperation activities related to the prevention, control, and surveillance of noncommunicable diseases, all forms of malnutrition, mental health, neurological an...d substance use disorders, including their risk factors. It also promotes policies and strategies related with disabilities and rehabilitation, road safety, as well as prevention of and response to violence in all its forms.
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