Brucellosis is widespread in both humans and livestock in many developing countries. The authors have performed a series of epidemiological studies on brucellosis in agro-pastoral areas in Tanzania since 2015, with the aim of the disease control. Previously, the potential of a community-based brucel...losis control initiative, which mainly consisted of the sale of cattle with experience of abortion and vaccinating calves, was assessed as being effective and acceptable based on a quantitative approach. This study was conducted to investigate the feasibility of community-based brucellosis control program using participatory rural appraisals (PRAs) and key-informant interviews. Four PRAs were performed together with livestock farmers and livestock and medical officers in 2017. In the PRAs, qualitative information related to risky behaviors for human infection, human brucellosis symptoms, willingness to sell cattle with experience of abortion, and willingness to pay for calf vaccination were collected, and a holistic approach for a community-based disease control project was planned. All of the communities were willing to implement disease control measures. To avoid human infection, education, especially for children, was proposed to change risky behaviors. The findings of this study showed that community-based disease control measures are promising.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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This guideline covers road-traffic-related air pollution and its links to ill health. It aims to improve air quality and so prevent a range of health conditions and deaths.
Current evidence that the climate is changing is overwhelming. Impacts of climate change and variability are being observed: more intense heat-waves, fires and floods; and increased prevalence of food- water- and vector-borne diseases. Climate change will put pressure on environmental and health det...erminants, such as food safety, air pollution and water quantity and quality. A climate-resilient future depends fundamentally on reducing greenhouse gas emissions. Limiting warming to below 2 °C requires transformational technological, institutional, political and behavioural changes: the foundations for this are laid out in the Paris Agreement of December 2015. The health sector can lead by example, shifting to environmentally friendly practices and minimizing its carbon emissions. A climate-resilient future will increasingly depend on managing and reducing climate change risks to protect health. In the near term, this can be enhanced by including climate change in national health programming and creating climate-resilient health systems.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama...nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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The practical guidance in the operational handbook aims to inform the development or revision of national policies and related implementation guidance on the management of TB in children and adolescents under programmatic circumstances and at different levels of the health system. The operational ha...ndbook can also help countries adequately plan for the uptake of interventions to better address the specific needs of children and adolescents with or at risk of TB. It can contribute to national efforts to build capacity among national and subnational programme managers and among health workers at all levels of the health care system.
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There is a broad consensus nowadays that the Earth is warming up as a result of greenhouse gas emissions caused by anthropogenic activities. It is also clear that current trends in the fields of energy, development and population growth will lead to continuous and ever more dramatic climate change. ...This is bound to affect the fundamental prerequisites for maintaining good health: clean air and water, sufficient food and adequate housing. The planet will warm up gradually, but the consequences of the extreme weather conditions such as frequent
storms, floods, droughts and heat-waves will have sudden onset and acute repercussions. It is widely accepted that climate change will have an impact on the spread of infectious diseases in Europe, which is likely to bring about new public health risks in the majority of cases. Transmission of infectious diseases depends on a number of factors, including climate and environmental elements. Foodborne and waterborne diseases, for instance, are associated with high temperatures. Disease-transmitting vectors (e.g. mosquitoes, sandflies and ticks) are highly sensitive to climate conditions, including temperature and humidity; their geographical distribution will widen as climate conditions change, potentially allowing them to spread into regions where they are not currently able to live.
The primary purpose of this manual on climate change and infectious diseases is to raise the awareness and the level of knowledge of health workers at national, regional and local levels in the former Yugoslav Republic of Macedonia on the health risks associated with climate change and infectious diseases. This manual was devel-
oped as part of the WHO Regional Office for Europe project, Protecting health from climate change: a seven–country initiative, implemented with financial support from the German Federal Ministry for the Environment, Nature Conservation and Nuclear Safety.
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Energy use in the home is a vital and ubiquitous feature of human society. Energy
is used for a wide variety of purposes, including cooking, space heating, light-
ing, small-scale income generation, various household tasks, and entertainment.
The biosphere underlies the whole sustainable development concept, as the layer on
which society and the economy rely. Nature and biodiversity fuel the natural cycles
and life-support systems of the planet, on which humanity ultimately depends.
This brief summarizes the lessons learned across Europe on the redevelopment of contaminated sites as a part of urban planning and renewal. Specifically, it aims to provide information on the health and environmental impacts to be considered during site redevelopment projects, and to identify good p...ractice and relevant local experiences to support effective, healthy and sustainable redevelopment of contaminated sites. As such, this brief offers key messages to support the work of local decision-makers, planners, practitioners, researchers and civil society organizations.
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This document offers public health guidance for the prevention and control of COVID-19 in reception centres, and other temporary accommodation facilities, in the context of the mass influx of Ukrainian people into the European Union (EU), the European Economic Area (EEA) and the Republic of Moldova.
Lancet Planet Health 2019; 3: 469–77
Lancet Planet Health 2020; 4: e271–79
Int J Hyg Environ Health. 2019 Jun; 222(5): 765–777. doi: 10.1016/j.ijheh.2019.05.004;
To develop updated estimates in response to new exposure and exposure-response data of the
burden of diarrhoea, respiratory infections, malnutrition, schistosomiasis, malaria, soil-transmitted helminth
infec...tions and trachoma from exposure to inadequate drinking-water, sanitation and hygiene behaviours
(WASH) with a focus on low- and middle-income countries.
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Children without access to safe water are more likely to die in infancy -- and throughout childhood -- from diseases caused by
water-borne bacteria, to which their small bodies are more vulnerable.
Emerging evidence and experience to inform risk management in a warming world
Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change. ...Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an...d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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Climate change has important implications for the health and futures of children and young people, yet they have little power to limit its harm, making them vulnerable to climate anxiety. This is the first large-scale investigation of climate anxiety in children and young people globally and its rel...ationship with perceived government response.
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