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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to
...
sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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Achieving financial risk protection for the whole population requires significant financing for health. Health systems in low- and middle-income countries (LMIC) are plagued with persistent underfunding, and recent reductions in official development assistance have been registered. To create fiscal
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space for health, the pursuit of efficiency gains and exploring innovative health financing for health seem attractive. This paper sought to synthesize available evidence on the nature of innovative health financing instruments, mechanisms and policies implemented in Africa. We further reviewed the factors that hinder or facilitate implementation, the lessons learnt on the structure, the development process and the implementation.
more
The 2024 World Malaria Report shows that the malaria burden remains overwhelmingly concentrated in Africa. The continent accounted for 94% of global cases and 95% of malaria-related deaths in 2023. Although the number of malaria cases increased glob
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ally from 204 million in 2000 to 246 million in 2023, the number of deaths declined from 805,000 to 569,000. Children under five are still the most affected group, accounting for 76% of malaria deaths in Africa. A few countries, particularly Nigeria and the Democratic Republic of the Congo, carry the highest burden. Since 2000, Africa has significantly reduced malaria incidence and mortality, averting over 1.7 billion cases and 12 million deaths. Nevertheless, malaria continues to pose a significant health challenge, necessitating ongoing action and investment.
more
The scale of West Africa’s Ebola epidemic has been attributed to the weak health systems of affected countries,
their lack of resources, the mobility of communities and their inexperience in dealing with Ebola. This briefing for African Affairs a
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rgues that these explanations lack important context. The briefing examines responses to the outbreak and offers a different set of explanations, rooted in the history of the region and the political economy of global health and development. To move past technical discussions of “weak” health systems, it highlights how structural violence has contributed to the epidemic. As part of this, local people – their beliefs, concerns and priorities – have been marginalised. Both the crisis response and post-Ebola ‘reconstruction’ will be strengthened by acknowledgment of its long term structural underpinnings and from a more collaborative inclusion of local people.
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WHO South-East Asia Journal of Public Health, April 2017, 6(1) 8 pp. 211 kB
WHO Regional Office for Africa
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observat
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ions are as follows:
In 2018, 487 (12.5%) of the 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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A guide to facilitating community-managed disaster risk reduction in the Horn of Africa.
This manual describes how to help communities implement disaster risk reduction activities. It was written for development workers and community-based organiza
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tions in the Horn of Africa, but practitioners can use it to implement activities around the world
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Special Issue: Special Education in Sub-Saharan Africa | This special issue of our Communication*Support*World*Network*Newsletter attempts to share practical ideas and information about special education for children with disabilities in sub-Saharan
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Africa. Our intent is to begin a dialogue among those interested in this important topic, and to promote an increased exchange of ideas, approaches, information, resources, and promising practices.
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Ebola Virus Disease Outbreak Response Plan in West Africa July to December 2014. Annex 1
Integrating Clinical Research into Epidemic Response: The Ebola Experience
Gerald Keusch, Keith McAdam, Patricia Cuff, Michelle Mancher, and Emily R. Busta
National Academies of Sciences, Engineering, and Medicine
(2017)
C1
The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separat
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e outbreaks were identified in the Democratic Republic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014–2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak.
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Response to the tropical cyclone in southern Africa
Ebola virus disease outbreak in the Democratic Republic of the Congo
Meningitis outbreak in Togo
Lassa fever outbreak in Liberia.
IN NUMBERS
60 MILLION people affected globally at present.
32 MILLION people food insecure in Southern Africa.
10.2 MILLION people in Ethiopia need emergency food assistance.
50 PERCENT crop losses in Haiti due to El Niño-influenc
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ed drought.
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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low
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-income and middle-income countries to hypothesise potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
more
Previous crises, such as the Ebola virus disease (EVD) in West Africa in 2014, indicate the direct impact movement restrictions and disease containment efforts have on food availability, access, utilization and violence – particularly gender-based
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violence (GBV). The importance of maintaining and upscaling food security interventions for the most vulnerable populations, alongside the health sector’s efforts to avert disease spread, is therefore undeniable. The COVID-19 outbreak in South Sudan threatens to paralyze an already fragile food system and negatively impact more than 6.5 million people in South Sudan who remain vulnerable. At the same time, the core national capacities for prevention, preparedness and response for public health events is limited, and the healthcare system has been weakened by years of conflict, poor governance and low investments.
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Finding community-led solutions to COVID-19
recommended
An interagency guidance note on working with communities in high density settings to plan local approaches to preventing and managing COVID-19. This guidance note is intended for anyone involved in COVID-19 risk communication and community engagement (RCCE) efforts in complex and fragile settings in
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Africa.
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This article describes WHO's efforts to combat a cholera outbreak in South Sudan in July 2017. The organization received 500,000 doses of oral cholera vaccine (OCV) and was working with South Sudan's Ministry of Health to launch a vaccination campaign from July 28 to August 3, 2017. At the time, the
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country had reported 17,785 cholera cases and 320 deaths since the outbreak began in June 2016. The vaccination campaign targeted four counties with high transmission rates: Tonj East, Kapoeta South, Kapoeta North, and Kapoeta East. South Sudan was implementing an integrated approach to control cholera, combining patient care, surveillance, social mobilization, water and sanitation improvements, and vaccination. The article notes that approximately 6 million people in South Sudan were facing starvation, with food insecurity and drought exacerbating the risk of cholera spread as people resorted to using contaminated water sources.
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This paper looks at the status of tuberculosis (TB) advocacy
communication and social mobilization (ACSM) activities in selected
national TB control programmes in the WHO African Region. The
findings are from an assessment of TB ACSM activities in Ghana, Kenya,
Lesotho, Malawi and South
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Africa.
Disease control, issue 15
The African health monitor
Accessed November 2017
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Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus
A wide variety of health events ranging in severity may occur related to air transport, requiring different responses or, perhaps, no response at all.
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The target audience for this guidance document includes the national focal points (NFP) for the IHR and public health authorities at PoE, as well as national aviation regulatory authorities, airport operators and personnel, aircraft operators, air crew and other stakeholders involved in air transport and emergency preparedness and response to public health events
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Uganda hosts approximately 1.1 million refugees making it Africa’s largest refugee hosting country and one of the five largest refugee hosting countries in the world. Most recently, throughout 2016- 2018, Uganda was impacted by three parallel emer
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gencies from South Sudan, the Democratic Republic of the Congo (DRC), and Burundi. In view of the on-going conflicts and famine
vulnerabilities in the Great Lakes Region, more refugee influxes and protracted refugee situations are anticipated in the foreseeable future. The unprecedented mass influx of refugees into Uganda in 2016-2018 has put enormous pressure on
the country’s basic service provision, in particular health and education services. Refugees share all social services with the local host communities. The refugee hosting districts are among the least developed districts in the country, and thus the additional refugee population is putting a high strain on already limited resources.
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