Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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Le projet de recherche intitulé « SMS4Care » est un projet mis en oeuvre par l’ONG camerounaise dénommée « M.A.SANTE » dans la région de l’Extrême-Nord Cameroun, en collaboration avec la Délégation régionale de la Santé Publique, l’Université de Johns
Hopkins et le Ministère de... la Santé Publique. Ce projet est mis en oeuvre dans sa phase pilote, dans 4 Districts de santé de la région à savoir Mada, Makary, Goulfey et Kousseri, avec pour objectif de tester la faisabilité de la mise en place d’une surveillance à base communautaire des maladies et des indicateurs démographiques en utilisant le Smart phone. Tel que planifié
dans l’agenda, 2 sessions de formation ont été organisées avec pour but de renforcer les capacités des relais communautaires dans la détection des cas et la transmission des données par SMS. Ces formations se sont déroulé les 4 et 6 février 2015 dans les districts de santé de Makary et Kousseri.
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This guideline for the prevention and control of chikungunya fever
(CF) is intended for use by all peripheral health workers in the Region and
is based on the strategy outlined above. This document will focus mainly
on preventing, predicting and detecting outbreaks, and after detection,
investig...ating and containing them.
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Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e200460, 2022
Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness..., increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.
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"Le Manuel de l’OMS pour la gestion de l’aspect santé publique des accidents chimiques a pour objet de passer en revue l’ensemble des principes et des rôles qui sont ceux de la santé publique dans la gestion des accidents et des situations d’urgence d’origine chimique. Tout en apportant... ce type d’information pour chaque phase du cycle de gestion des situations d’urgence, notamment en ce qui concerne la prévention, les plans d’urgence, la préparation, la détection et l’alerte, l’intervention et le rétablissement de la situation, les auteurs admettent que la gestion des accidents et des situations d’urgence de nature chimique nécessite une approche pluridisciplinaire et plurisectorielle et que le secteur de la santé est susceptible de jouer un rôle complémentaire influent, voire le rôle de chef de file, aux différents stades du processus de gestion. Le manuel s’adresse notamment aux professionnels de la santé publique et de la protection de l’environnement ainsi qu’à tous ceux qui sont partie prenante à la gestion des accidents de nature chimique."
Also available in english and spanish
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The UNHCR Cholera Response Plan (October 2022 – March 2023) outlines efforts to combat the cholera outbreak in Lebanon, which was declared in October 2022. The plan, led by the Ministry of Public Health with support from UNHCR, WHO, UNICEF, and NGOs, focuses on prevention, response, and surveillan...ce. Key actions include oral cholera vaccination campaigns, rapid diagnostics, strengthening healthcare facilities, and improving hygiene and sanitation in high-risk refugee settlements and collective shelters. The response also emphasizes risk communication and community engagement to raise awareness and ensure early detection. The plan targets 120,000 individuals and requires $8.5 million in funding to provide life-saving support and containment measures.
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Procédures de gestion clinique standard.
La maladie à virus Ebola (MVE) est une maladie multisystémique potentiellement mortelle qui entraîne souvent une hypovolémie, une acidose métabolique, une hypoglycémie et une défaillance multi-viscérale. L'épidémie prolongée de MVE en Afrique de... l'Ouest en 2013-2016 a permis une évolution dans le domaine des soins telle qu'à la fin de l'épidémie, de nombreux patients ont pu recevoir des soins de support individualisés et optimisés, dont la réanimation hydro-électrolytique, le contrôle des symptômes, la surveillance biologique en laboratoire et au chevet de la glycémie et des électrolytes, la prise en charge des défaillances d’organe, ainsi que la détection et le traitement rapides des co-infections, contribuant ainsi à une réduction de la mortalité.
Toutefois, le niveau des soins varie considérablement d'un centre de traitement Ebola (CTE) à l'autre, au cours de la même épidémie, ainsi que d’une épidémie à l’autre
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Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201...6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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Le Groupe spécial mondial de lutte contre le choléra (GTFCC) a lancé Mettre fin au choléra : Une feuille de route mondiale pour 2030 (la Feuille de route mondiale. Cette stratégie vise à réduire de 90 % le nombre de décès dus au choléra dans le monde et à mettre fin à la maladie dans a...u moins 20 pays d’ici 2030. Elle est organisée selon trois axes principaux :
• assurer une détection et une réponse précoces pour contenir les épidémies
• adopter une approche multisectorielle pour prévenir et contrôler le choléra dans les
points chauds
• mettre en place un mécanisme de coordination efficace de l’appui technique, la
mobilisation des ressources et des partenariats aux niveaux local et mondial.
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This study compared clinical and autopsy findings for three asbestos-related diseases (asbestosis, mesothelioma and lung cancer) in former asbestos mineworkers, and explored factors that influenced agreement between clinical and autopsy findings using data from two compensation systems. In South Afr...ica, statutory compensation for occupational lung diseases in mineworkers makes provisions for autopsy examinations of the cardio-respiratory organs at the National Institute for Occupational Health (NIOH) in Johannesburg. In addition, the Johannesburg-based Asbestos Relief Trust and Kgalagadi Relief Trust (the “Trusts”) compensate individuals with defined asbestos-related diseases who worked in or lived near qualifying asbestos mining or processing operations. The Trusts also compensate dependents of deceased qualifying mineworkers and therefore encourage statutory autopsies for the detection of previously undiagnosed asbestos-related disease or disease that may have progressed to higher compensation grades.
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Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse a...nd misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
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Fact sheet Cholera in Creole
The cholera factsheet provides key information on prevention, symptoms, and treatment. It emphasizes hygiene, safe food handling, and water treatment through boiling, filtering, or disinfection. Cholera, a severe diarrheal disease from contaminated water, causes dehydra...tion and can be fatal if untreated. Symptoms include watery diarrhea, vomiting, and weakness. Treatment focuses on rapid rehydration with oral rehydration solutions (ORS) and continued feeding. The guide also covers safe waste disposal, emergency latrines, and burial practices to prevent spread. It aims to educate communities on cholera prevention, early detection, and life-saving care.
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The course will cover the topics related to antimicrobial resistance with basic definitions and overview on antimicrobials their use and the emergence and spread of resistance. The course will guide you through the concepts and the importance of resistance spread and dissemination and how that happ...ens. It will show you how bacteria become resistant and which mechanisms they might use for this. And as part of the course you will also receive some training in methods for antimicrobial susceptibility testing (AST) and detection of specific resistance in the microbiological laboratories with the basic methods available and with focus on the obtention of good quality results which can be interpreted and used for different purposes.
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Dengue is the fastest spreading, mosquito-borne viral infectious disease worldwide, with remarkable morbidity and mortality. In the past decades, profound contributions have been made towards understanding its epidemiology, including disease burden and distributions, risk factors, and control and pr...evention practices. Dengue continues to disseminate to new areas, including high latitude regions, and a new serotype (dengue virus serotype 5) has been identified. Vaccine research has made new progress, in which the licensed yellow fever and dengue virus quadrivalent chimeric vaccine is now under further safety assessment. In disease surveillance, because of its operational simplicity, rapidity, capability, and utility as an indicator of disease severity, dengue virus NS1 antigen detection has great promotion and application value among primary health care institutions. Vector control progress has driven new breakthroughs in biotechnology, including Wolbachia-infected Aedes and genetically modified Aedes. Both Aedes variants have been used to block transmission of the dengue virus through population replacement and suppression. In the future, vector control should still be pursued as a key measure to prevent transmission, along with anti-viral drug and vaccine research.
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Par ailleurs l’existence d’éléments épidémiologiques en faveur d’une sous-estimation du nombre réel de cas de COVID-19 et de l’existence d’une transmission communautaire soutenue dans une zone géographique pour lesquels les deux critères ci-dessus ne sont pas observés pourra être ...prise en compte dans la décision de l’inclure dans la liste des zones d’exposition à risque (par exemple : un taux de mortalité parmi les cas confirmés beaucoup plus élevé qu’attendu ; la détection de cas exportés depuis cette zone dans plusieurs pays ; une proportion importante des cas confirmés sans historique de voyage/séjour dans une zone d’exposition à risque ni contact identifié avec un cas confirmé de COVID-19).
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The purpose of this TPP is to communicate the minimum and ideal characteristics desired to meet the need for discriminating low levels of risk for transmission, i.e. targeted prevalence thresholds in the surveyed areas. An in vitro diagnostic test is needed for the detection of analyte(s) specific t...o Wuchereria bancrofti, Brugia malayi, and Brugia timori to aid in the surveillance of defined geographic areas as to whether infection and/or transmission potential has increased (recrudescence) or decreased (elimination of transmission).
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April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t...he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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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.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant...imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit...y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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