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The Western Pacific Region is the largest and most diverse region in the world, made up of 37 countries and territories in the Pacific, Oceania and parts of Asia, with a population of more than 1.9 billion people stretching over an area from China and Mongolia in the north to New Zealand in the sout
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h. In 1999, 22 countries and territories in the Pacific joined together and launched the Pacific Programme to Eliminate Lymphatic Filariasis. Shortly after, the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000. In 2004, 12 countries in the Asia subregion of the Western Pacific Region and Southeast Asian Region joined and developed the Mekong-Plus Strategic Plan for Elimination of Lymphatic Filariasis. Since then, significant efforts have been made by all endemic countries, with annual mass drug administration (MDA) as a principal strategy, through strong partnership with the WHO and other donors and partners. As a result, by the end of 2019, 10 of 22 endemic countries in the region, including 8 of 16 countries in the Pacific and 2 countries in the Asia subregion, achieved WHO validation for elimination of lymphatic filariasis (LF) as a public health problem. All the other countries are either progressing with post-MDA surveillance or accelerating efforts by adoption of the new triple drug therapy strategy and enhancement of MDA campaigns to tackle persistent transmission. Some 85% of the originally endemic implementation units have stopped MDA and the number of people requiring MDA for LF in the Western Pacific Region was reduced by 72% from 2000 to 2018. This paper reviews the progress, key success factors and remaining challenges and indicates the way forward to achieve LF elimination in the Western Pacific Region.
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti
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ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update
Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al.
African Journal of Thoracic and Critical Care Medicine
(2021)
CC
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support
...
optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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The World Health Organization's Eastern Mediterranean Regional Office (WHO EMRO) highlights the significant health and social consequences of harmful alcohol use. Excessive alcohol consumption is linked to over 200 diseases and injuries, including liver cirrhosis, pancreatitis, various cancers, hemo
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rrhagic stroke, and hypertension. Globally, it results in approximately 3.3 million deaths annually, surpassing fatalities from HIV/AIDS, violence, or tuberculosis. In the Eastern Mediterranean Region, while overall alcohol consumption is low, there is a concerning rise among adolescents and young adults, with patterns of heavy episodic drinking posing significant health risks. In response, the WHO has developed a global strategy to reduce the harmful use of alcohol, aiming to improve health and social outcomes by decreasing disease and death associated with alcohol consumption.
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The World Health Organization (WHO) launched the SAFER initiative in 2018 to address the global health and societal challenges posed by alcohol-related harm. The initiative outlines five key strategies aimed at reducing alcohol consumption and its associated consequences. These include strengthening
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restrictions on alcohol availability by implementing and enforcing policies to limit its accessibility and advancing drink-driving countermeasures, such as low blood alcohol concentration limits and random breath testing, to reduce alcohol-impaired driving incidents.
Additionally, SAFER emphasizes facilitating access to screening, brief interventions, and treatment for individuals with alcohol use disorders, ensuring that healthcare systems are equipped to provide effective support. Another core strategy is enforcing comprehensive bans or restrictions on alcohol advertising, sponsorship, and promotion to minimize its influence, particularly on vulnerable populations such as youth. Finally, the initiative advocates raising alcohol prices through excise taxes and pricing policies to make it less affordable and thereby reduce consumption.
By implementing these evidence-based, cost-effective measures, the SAFER initiative aims to reduce the global burden of alcohol-related deaths and disabilities, fostering healthier societies worldwide.
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The National Strategic Plan on Malaria Prevention and Elimination Period 2021 – 2025 seeks to build on the previous national successes of the National Institute of Malariology, Parasitology, and Entomology (NIMPE) while addressing current challenges to reduce the overall burden of malaria in the S
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outhern and Central provinces and to initiate elimination activities in remaining focal areas of transmission throughout the country. The overall targets proposed to be reached by 2025 are:
Reduce malaria morbidity rate to below 0.015/1,000 population
Reduce malaria mortality rate to below 0.002/100,000 population
Eliminate malaria in 55 provinces
Ensure no malaria outbreaks
To address the urgent threat of drug resistance, Viet Nam has committed to accelerate efforts to eliminate locally-acquired P. falciparum by 2023.
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More and more countries are completing their epidemiological mapping of trachoma in suspected
endemic districts and are preparing to distribute Zithromax® in those districts where the prevalence of
“trachomatous inflammation – follicular” (TF) is above 5% among children aged 1-9 years. Mass
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drug
administration (MDA) is normally at the district level and targets the whole population with Zithromax®
tablets to those 5 years old and above; Zithromax® suspension for children between 6 months and 5
years of age; and tetracycline eye ointment 1% for infants up to 6 months old.
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Albania National Drug Report 2017
European Monitoring Centre for Drugs and Drug Addiction; Instituti Shendetit Public
European Monitoring Centre for Drugs and Drug Addiction; Instituti Shendetit Public
(2017)
C2
The Trends and Developments report presents a top-level overview of the drug phenomenon in Europe, covering drug supply, use and public health problems as well as
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drug policy and responses. Together with the online Statistical Bulletin and 30 Country Drug Reports, it makes up the 2019 European Drug Report package.
Available in different languages: http://www.emcdda.europa.eu/publications/edr/trends-developments/2019_en
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The SAARC Member States have more than an estimated 2.0 million TB cases accounting for close to one-third of the total cases of TB in the world. India alone had almost one-fifth of the global disease burden due to TB. India, Pakistan and Bangladesh followed by Afghanistan are the major contributors
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of disease burden of TB in the SAARC Region. They are countries that have a dubious distinction of being on the list of 22 TB High Disease Countries in the world.
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