The sixteenth meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases (STAG-NTD) was held as a hybrid meeting, 27–28 September 2022.
Dr Ren Minghui, Assistant Director-General, Universal Health Coverage/Communicable and Noncommunicable Diseases, welcomed participan...ts to the meeting. He said the World Health Organization’s Department of Control of Neglected Tropical Diseases (WHO/NTD) was in a state of transition. Following the death of the late esteemed Director Dr Mwelecele Ntuli Malecela earlier in the year, Dr Gautam Biswas had taken over as Acting Director but would soon retire; the appointment of a new Director was under way. Owing to rotation of STAG-NTD members, this would be the last meeting for some and the first meeting for several new participants. The work however would continue with the same commitment. Discussions over the next two days would focus on critical issues regarding recovery of NTD services following the disruptions caused by coronavirus disease (COVID-19), which had impacted many health services worldwide. He looked forward to receiving the advice and guidance of STAG-N
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For the molecular diagnosis of Chagas disease by real-time PCR (polymerase chain reaction), optimization of diagnostic accuracy is desirable. The detection limit of real-time PCR assays for the diagnosis of Trypanosoma cruzi in human serum is affected by various influences including the choice of th...e nucleic acid extraction assay. In this study, three nucleic acid extraction assays were compared regarding their influence on the sensitivity of a T. cruzi-specific real-time PCR with 62 reference sera containing T. cruzi target DNA (deoxyribonucleotide acid). More than 95% of the positive sera were correctly identified after all three nucleic acid extraction strategies with a detection rate ranging from 96.8% (60/62) for the worst assay to 100% (62/62) for the best one. A matched pairs analysis for the comparison of the cycle threshold (Ct) values obtained with the 59 reference samples with positive real-time PCR results after all three nucleic acid extraction schemes indicated differences in a range of about 3 Ct steps. Summarized, all three compared nucleic acid extraction schemes were basically suitable for T. cruzi-specific PCR from serum with some minor differences. However, in the case of low quantities of circulating parasite DNA in the serum of a patient with Chagas disease, even minor effects can make a difference in the individual diagnosis.
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Theodor Bilharz, a German professor of anatomy and chief of surgery at the Kasr El Ani Hospital of Cairo from 1850, first identified an infective organism, Distomum hematobium in 1851, which was renamed Schistosoma haematobium in 1858. It arose from a cestode worm, Hymenoleptis nana, lying in the sm...all colon of an Egyptian patient. He also discovered a trematode worm at the same time from an autopsy, thought to be the cause of urinary Schistosomiasis. Bilharz died from typhoid fever in 1862 at the age of 37. The Theodor Bilharz Research Institute in Giza, Egypt, stands as a tribute to him today. F. Milton published the first recorded peer-reviewed article report on Schistosomiasis in 1914.
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Conflicts and disasters, including pandemics, affect women and men in all their diversity differently, and women and girls often suffer the most. Crisis-related hardships combine and compound pre-existing disadvantages, for example, they often cause women’s working conditions to worsen while incre...asing their overall workload and care responsibilities. At the same time, crises can give rise to changes that enable women to take up roles that were previously available only to men, and crises can open opportunities to address existing gender-based discrimination and violations of rights.
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The domestic regulation of public health emergencies (PHEs) is inextricably linked to the regulation of other types of disaster. PHEs are usually governed at least partly by general disaster and emergency laws. Moreover, there is significant overlap in the legal mechanisms used to respond to PHEs an...d other types of disaster, including the declaration of a state of disaster or emergency and the use of emergency powers. Even where PHEs are regulated by separate instruments, those instruments must surmount many of the same policy and practical challenges as general disaster laws, such as finely balancing competing considerations (e.g. speedy response versus due process), facilitating the coordination of a multitude of actors, and protecting the most vulnerable within society. Finally, many contemporary developments in disaster risk management (DRM), such as a greater emphasis on risk reduction and preparedness, are just as pertinent to PHEs as to other types of disaster.
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On 6 February at 4:17 am, a 7.8 degrees magnitude earthquake struck southern Turkey near Syria’s
northern border. The US Geological Survey said the earthquake was centered about 33 km (20 miles)
from Gaziantep, a major city and provincial capital. Tremors were felt as far away as Lebanon, Greece...,
Palestine, and the island of Cyprus. Another big earthquake was felt on the same day at around 1:24
pm local time, largely in the same affected areas. Aftershocks will continue to shake the area as fault
lines adjust to such a huge initial tremor. There’s even a risk—albeit a small one—of an aftershock
bigger than the original quake.
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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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American cutaneous leishmaniasis (CL) is a severely understudied and neglected“disease of poverty” widespread throughout Peru. Transmission dynamics of CL are complex, requiring sandfly vectors and mammalian reservoir hosts to maintain the pathogen in a local environment whereby incidental hosts... (people) can become infected. We employed a One-Health approach to understand CL transmission in rapidly changing region of northern Peru. We describe the characteristics of 529 CL positive patients from four participating clinics. Using conditional logistic regression, we assessed risk factors of CL for residents of small urban areas through a matched case-control study with 63 patients who had visited one of the same clinics for CL (cases) or other medical reasons (controls). We later enrolled 343 households as part of a community based study occurring in 15 urban and rural areas of Soritor. We
found 256 positive humans (n= 914) as tested via the Montenegro Skin Test; we found 11 positive dogs (n = 236) via an immunofluorescence antibody test. Our results suggest that most- if not all- of CL transmission is occurring in rural areas and that urban women and urban children engage in many high risk activities typically attributed to men. We find evidence that prevalence of past infection is highest among rural residents and men. We believe dogs are unlikely Leishmania reservoirs in either rural or urban settings. It remains unknown if the high number of MST positive children in rural areas is a result of peridomestic or intradomestic transmission.
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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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The full-scale invasion of Ukraine has caused a deterioration in the level of access to health-care services and medicines in the country, particularly for people living in regions close to the front line and areas that are not partially or fully controlled by the Government of Ukraine, and for peop...le who have been internally displaced. Cost and time constraints involved in getting to and from health facilities, as well as limited transportation options were the main barriers to accessing essential health-care services. At the same time, the findings show that the country’s health system remains resilient and that overall access to health services is fairly high.This report is based on data collected through a quantitative cross-sectional survey of self-reported health needs of the general population in Ukraine. It presents results of the first round survey conducted in September 2022 and could help to address the specific health-care needs of the population groups concerned.
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The Operational guide: use of referral laboratories for the analysis of foodborne hazards in the Pacific aims to strengthen the food analysis capacity of Pacific Island countries and areas by identifying national and reference laboratories capable of testing for priority foodborne hazards. The Pacif...ic Island countries and areas are often vulnerable to food safety incidents and emergencies due to their geographical distribution and dependence on food imports. The guide outlines key considerations for selecting referral laboratories and submitting samples to them, enabling continuous improvement of food safety systems and providing safe food for all. The target audiences are health and food safety authorities.
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Children with disabilities are particularly vulnerable in humanitarian settings, yet they are often not able to access the services and protection they need. While multiple factors create these barriers, a major cause is how data about children with disabilities is collected and mapped. Data collect...ion processes often exclude or underrepresent the views of children with disabilities and thier caretakers. When the experiences of children with disabilities and their caretakers are not defined and collected, they become excluded from mainstreamed protective services, which are meant to serve all children. Children with disabilities also do not get the specialised interventions they need.
This guidance note explores how to use qualitative methods to create more robust assessment processes to ensure more effective programming and services for children with disabilities. This note provides promising practices for engaging with children with disabilities and includes sample tools that can be tailored to fit the needs of a particular assessment process. The note also explores the importance of thoughtful cross-sectoral responses so that children with disabilities, and their families, are carefully considered in areas like water, sanitation, and hygiene (WASH), education, health, and nutrition, and therefore receive the holistic support they need and deserve.
This note is intended for a broad audience of relevant child protection actors, including practitioners, coordination groups, researchers, and donors. The information is not limited to one type of humanitarian setting, geographic region, or culture. As a result, the practices and guidance should be adapted to each specific context, ideally in partnership with well-informed local actors, such as representatives from local organisations for persons with disabilities.
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UNFPA has been implementing programming for women and girls through Women Friendly Health Spaces (WFHSs), which provide access to critical services, information and support. The WFHS is providing: psychosocial counseling services; awareness raising sessions on PSS in the community; and life skills &... vocational training opportunities. The WFHS also facilitates referral to other services including Psychosocial Counseling Centers (PSCCs).
The aim of this guidance note is to provide an overview of approaches on how to successfully integrate adolescent and youth (A&Y) programming into the WFHSs. UNFPA activities for women’s and girl’s protection in health facilities aim to protect women and girls including child marriage. Given that vulnerable women and girls in Afghanistan continue to access health facilities, particularly for reproductive health and maternal health services, it is crucial to provide support for survivors in the same location to improve access to essential psychosocial and protection support for women and girls. To support the integration of A&Y in the WFHS programming each WFHS will be supported by two full time Youth Educators. A female Youth Educator who will be working within the WFHS and a male Youth Educator who will be working in the community. The role of the Youth educators is to increase A&Y awareness and knowledge on living healthy lifestyles and ensuring a referral system to services in existing facilities.
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Development finance institutions owned by European governments and the World Bank Group are spending hundreds of millions of dollars on expensive for-profit hospitals in the Global South that block patients from getting care, or bankrupt them, with some even imprisoning patients who cannot afford th...eir bills. At the height of the COVID-19 pandemic, some of these same hospitals denied entry to patients suffering from the virus or sold intensive care beds at eyewatering prices to the highest bidder. These development institutions have woefully inadequate safeguards, invest via a complex web of tax-avoiding financial intermediaries, and offer little to zero evidence on the impacts their investments are having. Oxfam is calling on rich-country governments and the World Bank Group to immediately halt their spending on for-profit private healthcare, and for an urgent independent investigation to be conducted into all active and historic investments.
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The Global Burden of Disease (GBD) 2010 Study has published disability-adjusted life year (DALY) data
at both regional and country levels from 1990 to 2010. Concurrently, the Institute for Health Metrics and Evaluation
(IHME) has published estimates of development assistance for health (DAH) at th...e country-disease level for this
same period of time.
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Corruption is embedded in health systems. Throughout my life—as a researcher, public health worker, and a Minister of Health—I have been able to see entrenched dishonesty and fraud. But despite being one of the most important barriers to implementing universal health coverage around the world, c...orruption is rarely openly discussed. In this Lecture, I outline the magnitude of the problem of corruption, how it started, and what is happening now. I also outline people's fears around the topic, what is needed to address corruption, and the responsibilities of the academic and research communities in all countries, irrespective of their level of economic development. Policy makers, researchers, and funders need to think about corruption as an important area of research in the same way we think about diseases. If we are really aiming to achieve the Sustainable Development Goals and ensure healthy lives for all, corruption in global health must no longer be an open secret.
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Refugee children with disabilities experience a reality of exclusion and marginalisation that makes them among the most vulnerable displaced persons in the world. Excluded from participation in social activities and access to school, not only because of their disability, but especially because of so...cial, cultural, and political barriers that prevent them from enjoying the same opportunities as their peers.
Daniela Bruni, a specialist in education in emergency contexts, who has overseen JRS’s related projects for the past two years, has developed a guide on inclusive education.
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Neglected tropical diseases (NTDs) are a category of chronic, disabling, and at times disfiguring diseases and conditions that occur most commonly in the setting of extreme poverty. Historically, NTDs have received less attention and funding when compared to other diseases occurring in the same regi...ons of the world. Several NTDs have internationally agreed upon targets for their control, elimination, and eradication. Nineteen countries in the WHO African Region have successfully eliminated at least one NTD, however recent gap analyses identified moderate to severe gaps across technical, strategy and service delivery, and enabling factors. This report summarizes the findings of a scoping review of published literature undertaken to highlight control, elimination, and eradication efforts towards NTDs across the WHO African Region over the last 30 years.
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WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen...t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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The Mekong Malaria Elimination (MME) programme is an initiative aimed at supporting Greater Mekong Subregion (GMS) countries – Cambodia, Lao People's Democratic Republic, Myanmar, Thailand, Viet Nam, and Yunnan (China) – in achieving the goal of malaria elimination by 2030. Data for this epidemi...ological summary were compiled from country reports. Between January and March 2024, 22 632 malaria cases were reported. During that period, GMS countries recorded 28% fewer cases, with P. falciparum + mixed and P. vivax cases declining by 50% and 23%, respectively. Meanwhile, testing declined by 21% when compared to the same period in 2023.
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