Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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1st edition.
Unitaid’s report describes a slate of new devices that can more efficiently identify dangerously ill children so that they can be treated immediately. These tools make it easier to recognize danger signs, and support integrated approaches to reducing childhood deaths from the three ...greatest childhood killers: malaria, pneumonia and diarrhoea.
The report also highlights tests that can determine whether or not a child has an illness that can be treated with antibiotics. Viral infections are a common cause of childhood fevers, but cannot be cured with antibiotics. Although many children seeking care at clinics have fever, three-quarters by some estimates, only a small fraction of those have an illness that can be treated with an antimalarial or antibiotic drug
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A companion to the Child Friendly Schools Manual
WASH in Schools aims to improve the health and learning performance of school-aged children – and, by extension, that of their families – by reducing the incidence of water and sanitation-related diseases. Every child friendly school r...equires appropriate WASH initiatives that keep the school environment clean and free of smells and inhibit the transmission of harmful bacteria, viruses and parasites.
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A survey was conducted in countries in all six WHO regions and focused on the building blocks that are considered prerequisites to combat antimicrobial resistance: a comprehensive national plan, laboratory capacity to undertake surveillance for resistant microorganisms, access to safe, effective ant...imicrobial medicines, control of the misuse of these medicines, awareness and understanding among the general public and effective infection prevention and control programmes.
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The 2007 Rwanda Service Provision Assessment (RSPA) was a national representative survey conducted in 538 health facilities throughout Rwanda. The survey covered hospitals, health centers, dispensaries and
health posts, including all public facilities such as government and government-assisted heal...th facilities. The 2007 RSPA used interviews with health service providers and clients and observations of provider client consultations to obtain information on the capacity of facilities to provide quality services and the existence of functioning systems to support quality services. The areas addressed were the overall facility
infrastructure, maternal and child health, reproductive health, tuberculosis, malaria services; and services for sexually transmitted infections and HIV/AIDS. The objective was to assess the strengths and
weaknesses of the infrastructure and systems supporting these services, and to assess the adherence to standards in the delivery of services.
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CORE Group has developed a module to improve preparedness for and response of communities in countries at risk of a cholera epidemic. The module consists of four lesson plans with accompanying flipcharts, intended to be delivered through community health workers. The lessons target mothers and careg...ivers of children under age five, a group that is at particular risk of death if infected. The module shares information about symptoms and risks; what families can do to prevent infection; how, when, and where to seek care; and what actions to take in the aftermath of an outbreak.
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Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and that undernutrit...ion at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
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Antimicrobial resistance represents a big threat to public health. The Centers for Disease Control and Prevention (CDC) estimate that every year two million Americans are infected with a (multi-)drug resistant bacterium, resulting in 23,000 deaths. The WHO has repeatedly drawn attention to this majo...r health issue. In the worst-case scenario, we will shortly run out of effective antibiotics. Surgery and cancer therapy will then become very dangerous due to the risk of infection associated with such treatments. (Organ) transplantation will become close to impossible as the immunosuppression necessary for transplant patients makes them highly vulnerable to infections. Some infections we can easily treat today could turn deadly. It is therefore conceivable that infectious diseases once again become the leading cause of death as in early 20th century.
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El informe anual de la vigilancia de la resistencia a los antibióticos de los países participantes de la Región de las Américas se discute y analiza con el fin de tomar medidas para el perfeccionamiento continuo de la calidad de los datos, y su utilidad en la orientación a los clínicos para el... uso racional de los antibióticos.Inicialmente la vigilancia estaba dirigida a bacterias entéricas: Salmonella, Shigella y Vibrio cholerae, desde 1997. A partir de2000, se incluyeron otras especies que se encuentran en la comunidad y en los hospitales.La información suministrada por cada país es un consolidado de la información obtenida de diversos centros asistenciales y, en ocasiones, áreas geográficas diferentes, por lo que su valor epidemiológico es limitado. Sin embargo, no puede subestimarse la importancia de esta información como indicador de tendencia ni como justificación técnica de la necesidad de implementar medidas para la prevención y control de la resistencia a los antimicrobianos
REVISTA DE PATOLOGIA TROPICAL
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Tuberculosis (TB) is an infectious disease that usually affects the lungs, though it can affect any organ in the body. It can develop when bacteria spread through droplets in the air. TB can be fatal, but in many cases, TB is preventable and treatable. This report examines the human rights impact of... the prevalence of Tuberculosis (TB) and Multi-drug-resistant tuberculosis (MDR-TB) among the Indigenous San peoples of Namibia. Combining political economy and root-cause methodology, the report explores the socioeconomic factors that make the San vulnerable to TB and limit their access to adequate health services.
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The overall goal of surveillance, case investigation and contact tracing in this context is to stop human-to-human transmission to control the outbreak. The key objectives of surveillance and case investigation are to rapidly identify cases and clusters in order to provide optimal clinical care; to ...isolate cases to prevent further transmission; to identify, manage and follow up contacts to recognize early signs of infection; to protect frontline health workers; to identify risk groups; and to tailor effective control and prevention measures.
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This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aimed particularly at district health care providers. A... comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech...anisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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About six to seven million people worldwide, mostly in Latin America, are estimated to be infected with
Trypanosoma cruzi, the parasite that causes Chagas disease (WHO data from 2021). Chagas disease is
found mainly in endemic areas of 21 Latin American countries. Chagas disease was once entirely
...
confined to rural areas but in the last decades, due to population movements, most infected people live
in urban settings and the disease has spread to other continents. The burden of disease is due to its
chronic progression with people still suffering years later after initial infection.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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This resource pack was developed for the country offices of the World Health Organization and national Public Health institutions, as an overview of the key information needed for advising their Member States in response to questions raised on human health due to influenza outbreaks or detections in... animals. It assembles the available information from WHO, FAO and WOAH, on recommendations and guidelines on influenza that might be relevant to a country experiencing detections or outbreaks of influenza in animals or facing suspicion of human infections with animal-origin influenza viruses. This resource pack updates the information provided in the Summary of Key Information Practical to Countries Experiencing Outbreaks of A(H5N1) and Other Subtypes of Avian Influenza, published in 2016. Additionally, the scope of this current document was broadened to address the risks to public health from all animal influenza viruses, not only avian influenza. Links to existing resources were updated and new resources were added where available.
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Terminology used to describe the transmission of pathogens through the air varies across scientific disciplines, organizations and the general public. While this has been the case for decades, during the coronavirus disease (COVID-19) pandemic, the terms ‘airborne’, ‘airborne transmission’ a...nd ‘aerosol transmission’ were used in different ways by stakeholders in different scientific disciplines, which may have contributed to misleading information and confusion about how pathogens are transmitted in human populations.
This global technical consultation report brings together viewpoints from experts spanning a range of disciplines with the key objective of seeking consensus regarding the terminology used to describe the transmission of pathogens through the air that can potentially cause infection in humans.
This consultation aimed to identify terminology that could be understood and accepted by different technical disciplines. The agreed process was to develop a consensus document that could be endorsed by global agencies and entities. Despite the complex discussions and challenges, significant progress was made during the consultation process, particularly the consensus on a set of descriptors to describe how pathogens are transmitted through the air and the related modes of transmission. WHO recognizes the important areas where consensus was not achieved and will continue to address these areas in follow-up consultations.
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There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the relationship is complex, and new or updated data are... constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr...ies, most mpox infections in humans result from a primary animal-to-human transmission. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or through close contact during and after birth.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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