La enfermedad de Chagas, también llamada tripanosomiasis americana, sigue siendo endémica en 21 países de América Latina. Sin embargo, como consecuencia de las migraciones, la urbanización, la intensificación del turismo, la modificación de las estrategias agrícolas y el cambio climático, l...a enfermedad ha traspasado el marco rural y el ámbito latinoamericano que le dieron identidad durante decenios, y ha logrado instalarse en la periferia de las ciudades del área endémica y en países de América del Norte, Europa, Asia y Oceanía y transformarse en un problema de salud pública global. Teniendo en cuenta que el Chagas afecta a poblaciones en situación de pobreza en las que produce graves consecuencias para la salud y la economía de las personas infectadas, y que los recursos orientados a fomentar el desarrollo de proyectos de investigación, estrategias de control y planes de atención médica a los pacientes detectados son escasos, la Organización Mundial de la Salud (OMS) incorporó esta enfermedad al grupo de enfermedades infecciosas desatendidas (EID) en el año 2005. Se reconoce actualmente la naturaleza multidimensional de la enfermedad de Chagas, cuya caracterización contempla una intrincada trama de aspectos socioculturales, políticos, biológicos, ambientales y sanitarios. Parte sustancial de todo ello radica en el carácter zoonótico de la endemia y la consiguiente imposibilidad de su erradicación. Por ende, resulta muy complicada la construcción de la ruta crítica para enfrentar esta enfermedad, con la aspiración o el objetivo de su eliminación como problema de salud pública. El propósito de esta guía es ofrecer a los Estados Miembros un instrumento que permita actualizar y estandarizar los procesos de evaluación del control, verificación de la interrupción de la transmisión, y validación de la eliminación de la enfermedad de Chagas como problema de salud pública, en consonancia con: a) la Estrategia y plan de acción para la prevención, el control y la atención de la enfermedad de Chagas; b) el Plan de acción para la eliminación de las enfermedades infecciosas desatendidas y las medidas posteriores a la eliminación 2016-2022; c) el Plan de acción sobre entomología y control de vectores 2018-2023; d) guías o procedimientos operativos estandarizados existentes para la verificación o validación de la eliminación de otras enfermedades infecciosas desatendidas (EID) como la oncocercosis, la filariasis linfática y el tracoma, y e) Enfermedades tropicales desatendidas. Prevención, control, eliminación, erradicación.
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National Guidelines on Nutrition, Care, Support, and Treatment (NCST) for Adolescents and Adults
These guidelines are intended to:
• Establish a consistent set of nutrition interventions and recommendations aimed at managing and preventing undernutrition and overnutrition in adolescents and ad...ults, with a focus on people with HIV/AIDS and tuberculosis (TB) patients.
• Provide simple and clear guidance to service providers and managers on how to implement the nutrition interventions and recommendations at the various health care delivery contact points.
• Provide a framework for policymakers and development partners to use when planning nutrition interventions for adolescent and adults.
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In January 2021, the World Health Organization (WHO) published a new road map to address the burden of disease and death imposed by neglected tropical diseases (NTDs). The end of the first year of the 2021-2030 NTD road map is an opportunity to take stock of where we stand and how we plan to move fo...rward.
Considerable progress has been made since 2012 when the first road map was adopted. As of 6 June 2022, forty-six countries have eliminated at least one NTD, while 600 million people no longer require treatment because they are no longer exposed to risks associated with the pathogens that previously harmed them. In some cases, diseases that have plagued humanity for centuries, such as sleeping sickness and Guinea worm disease, are at an all-time low. Less tangible, but also important, there has been significant progress in the way NTDs are viewed. Additionally, the disruptive impact of the COVID-19 pandemic on NTD programmes is evident.
This brochure is the first in a series of advocacy briefs for the new NTD road map presenting highlights of success and challenges towards attaining the 2030 goals.
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Most neglected tropical diseases (NTDs) occur in remote areas of low- and middle-income countries, where health systems are often poorly developed. Therefore, these neglected patients generally lack access to quality preventive, diagnostic, and therapeutic care [1]. The difficulty to access NTD-ende...mic areas, challenging logistics, and the lack of skilled human resources in these areas are also major obstacles to conduct clinical research. We had to face these when conducting a good clinical practice/good clinical laboratory practice (GCP/GCLP)-compliant clinical study in eastern Sudan, a well-known endemic area for visceral leishmaniasis and other NTDs. We share here the challenges related to study preparation and implementation of this GCP/GCLP study that investigated the causes of persistent fever in a rural hospital located in Gedaref State in eastern Sudan. We think this type of paper may be of interest for researchers planning to conduct a clinical trial in a resource-limited setting as well as for funders of such research.
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Based on scientific evidence, expert consensus and country experiences, the WHO core components for infection prevention and control (IPC) are the foundation for establishing or strengthening effective programmes at the national and facility level.
These new guidelines on core components of infecti...on prevention and control (IPC) at the national and acute health care facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC.
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Esta guía rápida sobre la adaptación de los programas de resistencia a los antimicrobianos (TAP, por su sigla en inglés) se ha elaborado para ayudar los países a iniciar y ejecutar proyectos para enfrentar la propagación de la resistencia a los antimicrobianos en sus territorios. La resistenci...a a los antimicrobianos es un problema complejo, con muchos factores que afectan su aparición y propagación, por lo que resulta difícil abordarlo. La guía rápida del proceso de TAP está diseñada para ayudar a los grupos de trabajo de TAP a nivel nacional a aplicar un enfoque de estudio del comportamiento para formular intervenciones apropiadas y factibles a fin de comenzar a combatir la resistencia a los antimicrobianos en sus contextos. La guía proporciona un panorama general de la resistencia a los antimicrobianos y el proceso de TAP, y conduce a los usuarios a lo largo de cinco etapas para evaluar la factibilidad, adquirir una comprensión referencial de los problemas, priorizar los temas que han de tratarse, formular estrategias y ejecutar y evaluar las intervenciones. La guía viene acompañada del Conjunto de Herramientas de TAP. Ejercicios, herramientas y plantillas para facilitar su plan de intervenciones a medida contra la resistencia a los antimicrobianos, que contiene ejercicios y recursos para facilitar cada etapa de formulación del proyecto.
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La violencia contra las mujeres y las niñas es generalizada en la Región de las Américas, y tiene enormes consecuencias para su salud y bienestar, así como el de sus familias y sus comunidades. Se trata de un costo inaceptable que puede ser prevenido mediante acciones basadas en la evidencia, pr...omovidas por las políticas y los protocolos del sector de la salud, y la colaboración con otros sectores. El presente informe es el primero de su tipo y representa un hito importante para la Región. Se basa específicamente en los compromisos asumidos por los Estados Miembros en la Estrategia y plan de acción sobre el fortalecimiento del sistema de salud para abordar la violencia contra la mujer. El informe ofrece un análisis de los esfuerzos para avanzar en la prevención de la violencia contra las mujeres en la Región por medio de políticas de salud, protocolos clínicos, planes multisectoriales y otros enfoques relevantes. La atención a este tema es oportuna, ya que la pandemia de COVID-19 ha dado más visibilidad a esta esfera de trabajo. En este informe se ofrece información crucial sobre los esfuerzos llevados a cabo en la Región, de los cuales se puede aprender y utilizar el conocimiento extraído en el futuro para prevenir y responder a la violencia contra las mujeres y las niñas en todo el mundo.
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Violence against women and girls is widespread in the Region of the Americas, resulting in enormous consequences for the health and wellbeing of women and girls, their families and communities. These costs are unacceptable and they can be prevented through evidence-based action, including the health... sector through its policies and protocols, as well as in collaboration with other sectors. This report remains the first of its kind and is a major milestone for the Region. It is specifically informed by the commitments of Member States in the regional Strategy and Plan of Action on Strengthening the Health System to Address Violence against Women. The report provides an analysis of efforts to advance the prevention of violence against women through health policies, clinical protocols, multisectoral plans and related approaches across the Americas. Attention to this topic is timely, as the COVID-19 pandemic has created new visibility for this area of work. This report offers critical information on efforts in the Region that can be learned from and used to build upon in the future to prevent and respond to violence against all women and girls everywhere.
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More than 700 000 people lose their life to suicide every year. A core foundation of suicide prevention is the timely registration and regular monitoring of suicide and self-harm. Surveillance data can be used to show important progress towards reaching global targets, such as reducing the suicide r...ate by one third by 2030 as articulated in the UN SDGs and in the WHO Mental Health Action Plan 2013-2030. However, there are considerable discrepancies in the quality of data on suicide and self-harm globally. The aim of this training manual is to equip fieldworkers and supervisors with the skills to collect and manage data on suicide and self-harm in the community via key informants, health-care facilities and police records. In doing so, the value and overall goal is to strengthen the surveillance of suicide and self-harm in communities, particularly in LMICs and hard-to-reach communities where CRVS systems are weak or absent.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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This report provides insight into the work that UNFPA has been doing to tackle FGM across borders in these border areas, where country offices are implementing a wide range of initiatives to address the issue. The information provided in this report is structured into four pillars, namely those list...ed in the regional action plan to eliminate cross-border FGM endorsed by the Governments that participated in the interministerial meeting on ending cross-border FGM held in 2019.
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This training guide is designed to enable participants to understand the human rights perspective on migration, and how human rights laws and standards can be operationalized to make migration safer and an empowering experience for all. It provides an introduction to related principles and issues an...d is designed for persons with limited knowledge of human rights or migration.
The training guide contains session plans for the trainer and is supported by sample slide presentations and associated materials, including activities and handouts for participants, which are available electronically as individual components.
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El proyecto “Abordar las Enfermedades Infecciosas Desatendidas (EID) y las arbovirosis en el Chaco Paraguayo” ejecutado en el period 2017-2018 en el Chaco paraguayo por el Ministerio de Salud Pública y Bienestar Social de Paraguay (MSPyBS) con la cooperación técnica de la Representación en e...l Paraguay de la Organización Panamericana de la Salud/ Organización Mundial de la Salud (OPS/OMS) tiene como propósito generar evidencias sobre la capacidad de respuesta del país en esta zona geográfica, a fin de que permita establecer estrategias e intervenciones para fortalecer las capacidades existentes y facilite la toma de acciones oportunas para la prevención, el control y/o eliminación de este conjunto de enfermedades a la luz de los compromisos enmarcados en los Objetivos de Desarrollo Sostenible 2030, la Política Nacional de Salud 2030 y el Plan Estratégico de la OPS/OMS 2014-2019. El proyecto pretende lograr la implementación de un ambicioso sistema de vigilancia integrada (vigilancia epidemiológica, vigilancia de laboratorio y vigilancia entomológica) que proporcione datos de manera oportuna y eficaz para hacer frente a las arbovirosis y a las EID endémicas, como son en Paraguay la enfermedad de Chagas, leishmaniosis, helmintiasis transmitidas por el suelo, teniasis/cisticercosis, la lepra y de forma estratégica se ha incluido al dengue.
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Nigeria reported its first case of COVID-19 at the end of February 2020 and subsequently experienced
four waves, with peaks in June 2020 and January, August and December 2021. The COVID-19 pandemic
severely impacted the economy of Nigeria and caused disruption of health services nationwide. During... the crisis, many Nigerians failed to access routine health
services due to decreased income and lockdown
restrictions. The most significant service disruptions
were in maternal and newborn health, vaccination,
sick childcare, family planning and noncommunicable
disease treatment services (1). Pregnant women
were anxious about contracting COVID-19 during
2020, and as a result, many avoided attending health
facilities for antenatal (ANC) and postnatal care (PNC).
Disruptions in the medical supply chain and diversion
of resources to COVID-19 management impacted on
essential health services. Health workers were often
unable to go to work because of transport disruptions
or illness
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Le Nigéria a signalé son premier cas de COVID-19 vers fin février 2020. Le pays a ensuite connu quatre vagues de
contaminations avec des pics en juin 2020, janvier 2021, août 2021 et décembre 2021. La pandémie de COVID-19
a eu de graves conséquences sur l’économie du Nigéria et a entra...né une perturbation des services de santé
dans l’ensemble du pays. Pendant la crise, de nombreux Nigérians n’ont pu accéder aux services de santé courants
en raison d’une baisse de revenus et des restrictions liées aux confinements. Les services de santé de la mère
et du nouveau-né, les services de vaccination, de soins aux enfants malades, de planification familiale et de
traitement des maladies non transmissibles ont été les plus perturbés
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The Global vector control response 2017–2030 (GVCR) provides a new strategy to strengthen vector control worldwide through increased capacity, improved surveillance, better coordination and integrated action across sectors and diseases.
In May 2017, the World Health Assembly adopted resolutio...n WHA 70.16, which calls on Member States to develop or adapt national vector control strategies and operational plans to align with this strategy.
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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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Little progress has been made since the 1960s and 1970s to widen the therapeutic arsenal against Trypanosoma cruzi, the causative pathogen of Chagas disease, which remains a frustrating and perplexing infectious disease. This chapter focuses on the strategic and operational challenges in the clinica...l drug development of a novel antitrypanosomal agent for Chagas disease. The various elements that contribute to a robust assessment of treatment effect including dose selection, choice of patient population, trial methodology, endpoint measures, and regulatory perspectives are discussed. The learnings herein should serve as resource to help researchers and other stakeholders optimize their clinical development plans and speed delivery of new medicines to patients with Chagas disease.
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L'objectif de ce projet pilote est de mitiger l’ampleur et l’impact de flambées de choléra à grande échelle en République démocratique du Congo (RDC). Avec 13 000 cas suspects et 236 décès notifiés depuis le début de l’année 2022, le choléra demeure un problème de santé publique ...en RDC. La mise en œuvre d’un plan d'action anticipatoire, qui consiste en des interventions ciblées dans les domaines de l'eau, de l'assainissement, de l’hygiène et de la santé, sera accompagnée d'un programme d'apprentissage complet visant à comprendre l'efficacité, adaptabilité et la dimension éthique du projet pilote.
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The Practical manual on laboratory strengthening, 2022 update provides practical guidance on implementation of WHO recommendations and best practices for TB laboratory strengthening. It is an updated version of the GLI Practical Guide to Laboratory Strengthening published in 2017 and provides the la...test practical guidance on use of newly recommended diagnostics as well as guidance in key technical areas, including quality assurance and quality management systems, specimen collection and registration, procurement and supply-chain management, diagnostic connectivity, biosafety, data management, human resources, strategic planning, and model algorithms. The key changes are:
inclusion of recent or updated WHO recommendations for tests to diagnose TB and detect drug resistance;
alignment with the latest WHO critical concentrations for phenotypic drug-susceptibility testing (DST) and the new definitions of pre-XDR-TB and XDR-TB;
updated information on building quality-assured TB testing and management capacity using the Stepwise Laboratory Quality Improvement Process Towards Accreditation (SLIPTA) approach (Score-TB package1);
updated information on assessing, analysing and optimising TB diagnostic networks; and
updated information on the use of next-generation sequencing (NGS) to detect mutations associated with drug resistance for surveillance purposes.
The document also provides references to resources and tools relevant for work on laboratory strengthening.
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