The Plan of Action for Malaria Elimination 2021-2025 has been developed in consultation with countries and regional partners as a framework of reference to guide the efforts of countries and the contributions of donors and partners towards elimination of the disease in the Americas. The Plan subscri...bes to the goals and pillars of the WHO Global Technical Strategy against Malaria 2016-2030 (GTS), while presenting key elements to address the specific challenges of the Region. The document seeks to guide national plans and promote an inter-programmatic- intersectoral approach, and joint efforts between countries and partners. The Plan is also the reference framework for PAHO technical cooperation in malaria in the period 2021-2025. The goals to be achieved require changes in action against malaria that must occur at the operations level and for which regulatory and policy adjustments are required from the national levels. Thus, the Plan promotes a systematic action of detection, diagnosis and response, which must be massively implemented and monitored programmatically. A main element of change is action aimed at recognizing the need to address key malaria foci in each country with specific, information-based operational solutions. The Plan of Action seeks to promote these changes in malaria programs in the countries and through the interactions among all actors. The model proposed in this plan is based on a cross-functional dialogue and interconnections across the lines of action (SL). Strategic lines 1, 2 and 3, which correspond to the three pillars of the WHO/GTS, complement each other, and are not designed to function independently. The idea of the consolidated supportive elements - strengthened health systems, strategic planning, financing, partnerships, advocacy, and operational research (SL 4) is to provide the platform, operational structures and alliances for the more specific malaria interventions presented in strategic lines 1, 2 and 3.
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Entretanto, à luz da possível introdução de um caso suspeito relacionado ao COVID-19 na Região das Américas, a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) recomenda que os Estados-membros garantam sua identificação oportuna, o envio de amostras a laborat...rios nacionais ou de referência e a implementação do protocolo de detecção molecular do COVID-19, dependendo da capacidade do laboratório. Até à data, o potencial patogênico e a dinâmica de transmissão do COVID-19 não são completamente claros. Por esta razão e à luz do conhecimento de outros vírus semelhantes (MERS-CoV, SRA-CoV), é necessário manter e reforçar as medidas de biossegurança e os equipamentos de proteção individual para o trabalho com amostras suspeitas de infecção com patógenos respiratórios.
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Muitos países já demonstraram que a transmissão por COVID- 19 de uma pessoa para outra pode ser desacelerada ou interrompida. Essas ações salvaram vidas e deram ao restante do mundo mais tempo para se preparar para a chegada da COVID-19: prontidão dos sistemas de resposta a emergências; aumen...to da capacidade de detecção e assistência aos pacientes; garantia de espaço, insumos e equipes necessárias nos hospitais, e desenvolvimento de intervenções médicas que salvam vidas. Todos os países devem urgentemente tomar as medidas necessárias para desacelerar a disseminação e evitar que seus sistemas de saúde fiquem sobrecarregados, em função de pacientes gravemente doentes por COVID-19.
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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base...d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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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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A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some E...uropean countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.
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Dengue is a significant public health problem. There are four dengue virus serotypes identified; however, its diagnosis is difficult due to the existence of many viruses, bacteria, and parasites producing the same clinical presentation, being present in the same geographical area and even producing ...coinfections. Therefore, determining whether a person has, had, or is infected with dengue virus is of great importance. In order to do so, direct and indirect laboratory tests have been developed to identify the virus or part of its structure that generally detects the antibody response. These techniques are used for diagnosis, epidemiological studies, monitoring, assessment and production of vaccines and antivirals, etc. They range from the use of cell cultures, animal models, inoculation by insects, and serology tests to the use of detection molecular tests and quantification of genetic material that are described in this chapter herein, a brief explanation of this methodology, its strengths and weaknesses, and its application in the dengue research.
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Journal of Clinical TB and other Mycobacterial Diseases
uberculosis (TB) in the gastrointestinal tract or peritoneum is an uncommon condition in clinical practice. Its rarity, combined with its nonspecific presentations, makes this kind of extrapulmonary tuberculosis difficult to diagnose as it can... mimic other inflammatory or malignant conditions. Delays in treatment and frequent misdiagnosis can lead to hazardous complications. In countries like Ecuador where the disease is endemic, TB should always be considered in the differential diagnosis of a patients who present with nonspecific abdominal symptoms. In these scenarios, laparoscopy can be an invaluable tool when used with sufficiently high clinical awareness and adequate training.
Case presentation
We present the case of a 37-year-old female patient from Ecuador with a 1-year history of abdominal pain, nausea, intermittent vomits, night sweats, and weight loss. After clinical evaluation and a laparoscopic intervention, abdominal TB was detected and promptly treated. Antituberculosis chemotherapy was initiated, and the patient successfully reco
High clinical awareness is imperative when approaching abdominal TB due to its wide spectrum of clinical symptoms and its rarity. Early detection and prompt treatment are critical to minimize the possibility of hazardous complications.
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The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to ...sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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The CDC Self-Study Modules on Tuberculosis are a series of nine educational modules divided into two courses. The first course (Modules 1–5) provides fundamental information about tuberculosis, while the second course (Modules 6–9) offers more specific program-related details. These modules are ...designed for healthcare providers and other professionals who want to expand their knowledge of tuberculosis through self-study.
The modules cover topics such as transmission, pathogenesis, epidemiology, targeted testing, diagnosis, treatment, infection control, patient management, patient rights, contact investigations, and outbreak response. Some modules also offer the opportunity to earn continuing education credits.
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The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio...ns such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing TB patients. When appropriately implemented, the activity is cost effectiv...e, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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MMWR. Recommendations and Reports:
December 16, 2005 / 54(RR15);49-55
High variability in the definition and interpretation of organized cancer screening needs to be addressed systematically. Moreover, the relevance of the current practice of categorizing screening programmes dichotomously into organized or non-organized needs to be revisited in the context of conside...rable heterogeneity that exists in the delivery of cancer screening in the real world. We aimed to identify the essential and desirable criteria for organized cancer screening that serve as a charter of best practices in cancer screening.
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Since the emergence of COVID 19 in December 2019, various public health responses measures have been implemented to control the pandemic. Among measures taken by the Africa CDC was the launch of PACT initiative to accelerate COVID 19 testing. Key to the initiative is the engagement of Community Heal...th Workers (CHWs) in risk communication and community engagement (RCCE), surveillance activities for early case identification, contacts tracing and in facilitating referrals for testing and continuum of care.
As of 31 May 2021, Through PACT support, over 17154 CHWs have been trained and locally deployed in 24 AU Member states. The PACT supported CHWs visited more than 2,568,654 households for community engagement activities, active case search and contact tracing, identified 1,618,601 Contacts, 710,167 COVID 19 suspect cases based on the standard case definition and facilitated referrals for 553053 (78%) suspect cases for testing. These efforts were crucial for early identification and isolation of cases in limiting further transmission.
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