Many African countries were amongst the most rapid to respond to the emerging threat of COVID-19, implementing large-scale interventions at very early stages of their epidemic. As demonstrated in this document using very simple models, this rapid mobilization and timeliness of implementing control m...easures is likely to be an important determinant of their success. Indeed, as these measures were relaxed, subsequent waves of disease have been observed in many countries including South Africa, Kenya, Tunisia, Morocco, Sudan and the Democratic Republic of Congo (DRC) where such waves have severely impacted the health system by straining the supply of oxygen and ICU beds and inflicting a heavy toll on healthcare workers, often necessitating the re-imposition of control measures.
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- Module 1: Understanding modelling approaches for sexual, reproductive, maternal, newborn, child and adolescent health, and nutrition
Coronavirus disease 2019 (COVID-19) has a wide range of documented effects. It directly causes death and disability for some people infected. However, disruption to... essential health services, resources allocated to mitigation and therefore away from essential health service delivery, and the overall impact on the economy and society must also be considered within the response to COVID-19. Understanding the magnitude of all of these effects is an essential part of developing mitigation polices.
Several epidemiological models have been created to assess the potential impact of disruptions to essential health services caused by COVID-19 on morbidity and mortality from conditions other than COVID-19 illness. This guide presents models that have been used to assess these indirect impacts. The effects have been studied in various settings, using a variety of models.
The guide is intended for people who need to understand what the models say, their construction and their underlying assumptions, or need to use models and their outcomes for planning and programme development and to support policy decisions for a country or region.
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This article looks at the Baseline Standards developed by the International Society for Paediatric
Oncology (SIOP) for paediatric oncology nursing care in low- and middle-income countries. The
Baseline Standards lay the foundation for effective care and address barriers such as inadequate
staffin...g levels, lack of support, limited access to nurse education and unsafe nursing environments.
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Front. Med., 27 November 2020 | https://doi.org/10.3389/fmed.2020.594728. The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; workin...g conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.
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Over the past two decades, Afghanistan has depended on international donor support to fund essential services like health care. But this donor support has been falling for years and will likely to continue do so—perhaps precipitously—following the announcement by United States President Joe Bide...n that the US will withdraw all US forces from Afghanistan by September 11, 2021. This decline in funding has already had a harmful—and life-threatening—impact on the lives of many Afghan women and girls, as it affects access to, and quality of, health care.
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On February 29, 2020, the United States and the Taliban signed an agreement outlining a phased withdrawal of US forces from Afghanistan in exchange for Taliban commitments not to allow attacks on the US or its allies from Afghan territory. The troop withdrawal is expected to take place in parallel w...ith negotiations between representatives from the Afghan government and other Afghan political groups and Taliban leaders aimed at achieving a political settlement after decades of armed conflict.
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Weekly epidemiological record; Relevé épidémiologique hebdomadaire 10 SEPTEMBER 2021, 96th YEAR / 10 SEPTEMBRE 2021, 96e ANNÉE No 36, 2021, 96, 421–444
In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti...on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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One of the most important ways we feel we can help to reduce the burden of cancer in Africa is to work with African cancer advocacy organisations to help educate and advocate about cancer in their countries. To this end in 2010 we designed with our partners, 13 posters for use in Africa
giving heal...th and lifestyle tips on how to avoid cancer and highlighting the early warning sign and symptoms of common cancers in Africa
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Each year more than one million women are diagnosed with breast cancer worldwide over half of whom will die from the disease. Breast cancer is the most common cancer and the leading cause of cancer death for women
Phil. Trans. R. Soc. B (2010) 365, 2959–2971; doi:10.1098/rstb.2010.0143.
Agricultural ecosystems provide humans with food, forage, bioenergy and pharmaceuticals and are essential to human wellbeing. These systems rely on ecosystem services provided by natural ecosystems, including pollination, b...iological pest control, maintenance of soil structure and fertility, nutrient cycling and hydrological services. Preliminary assessments indicate that the value of these ecosystem services to agriculture is enormous and often underappreciated. Agroecosystems also produce a variety of ecosystem services, such as regulation of soil and water quality, carbon sequestration, support for biodiversity and cultural services. Depending on management practices, agriculture can also be the source of numerous disservices, including loss of wildlife habitat, nutrient runoff, sedimentation of waterways, greenhouse gas emissions, and pesticide poisoning of humans and non-target species. The tradeoffs that may occur between provisioning services and other ecosystem services and disservices should be evaluated in terms of spatial scale, temporal scale and reversibility. As more effective methods for valuing ecosystem services become available, the potential for ‘win–win’ scenarios increases. Under all scenarios, appropriate agricultural management practices are critical to realizing the benefits of ecosystem services and reducing disservices from agricultural activities.
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This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20...20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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Brazilian media and science communicators must understand the main characteristics of misinformation in social media about COVID-19, so that they can develop attractive, up-to-date and evidence-based content that helps to increase health literacy and counteract the spread of false information.
Why bold action against inequalities is needed to en AIDS, stop COVID-19 and prepare for future pandemics
Global and Regional Data 1 December 2021; The 90–90–90 targets were missed, but not by much. At the end of 2020, 84% of people living with HIV knew their HIV status, 87% of people living with HIV who knew their HIV status were accessing antiretroviral therapy, and 90% of people on treatment were... virally suppressed.
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