This guidance addresses rationale, risk-based scenarios, practical considerations prior to adoption of the self-testing products, quality assurance, safety and ethical considerations, and data management considerations for COVID-19 self-testing. The Africa CDC recommends the use of rapid antigen sel...f-testing within two key scenarios. The first includes testing for case identification within scenarios with a high risk of infection, including symptomatic cases and contacts of a confirmed case. The second scenario involves general screening within scenarios of low or unknown risk exposure allowing for self-care such as before gatherings with at-risk individuals and prior to participation in events involving members of different households. Within these scenarios, a positive test result indicates likelihood of current infection, while a negative test result indicates a lower risk of active infection, though it does not rule out infection altogether. All positive cases should be managed following the national COVID-19 management protocol of Member States.ssur
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The chapter Dementia in Latin America and the Caribbean: Prevalence, Incidence, Impact, and Trends over Time, is part of the publication series titled “Decade of Healthy Aging: situation and challenges”. This document aims to provide an outline of the current situation in Latin America and the C...aribbean in respect of the prevalence and incidence of dementia and its impact on the health status of older people. As dementia is a significant global health problem which also has social and economic impacts this document highlights the importance of monitoring dementia in the region. The document evidences that dementia is one of the main contributors to dependence and disability in older people in Latin America and the Caribbean and, although its prevalence and incidence increase exponentially with age, it is not part of normal aging. Alzheimer’s disease is the most common dementia, and there is no cure for this condition, but with timely diagnosis is possible to ameliorate symptoms. It is important to assess what are the needs of people leaving with dementia and their families and to integrate dementia risk reduction strategies in pre-existing strategies for other non-communicable diseases. As shown in the report, despite the huge burden dementia is still underdiagnosed, and it is fundamental to better monitor its prevalence, incidence and the different societal impact that dementia can have. For that, it is crucial to promote the use of harmonized methodologies to address this information in a broader number of studies and countries in the region. This can contribute to the generation of direct actions to decrease dementia risk and lead to healthier lives for people with dementia and their families.
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Fetal alcohol spectrum disorders (FASD) represent a range of physical, mental, and behavioral disabilities caused by alcohol use during pregnancy, or prenatal alcohol exposure (PAE). FASDs are considered to be one of the leading preventable causes of developmental disability. Despite its high preval...ence, FASD is often misdiagnosed or underdiagnosed, making interventions more challenging or delayed.
his publication was initially developed for use in Spanish-speaking countries of the Americas and is intended to serve as a training workbook for providers of various disciplines to learn about the fundamentals of diagnosing FASD and to apply them to several case scenarios. It also discusses ethical implications of diagnosing FASD to the mother and child. Target audiences include physicians, psychologists, allied health professionals, social workers, and other providers that may encounter individuals affected by FASD. It is ideally used as a supplement for in-person training by experts in the fields of dysmorphology, epidemiology, and neuropsychology.
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These guidelines are applicable to all biomedical, social and behavioural science research for health conducted in India involving human participants, their biological material and data.
The purpose of such research should be: i. directed towards enhancing knowledge about the human condition while ...maintaining sensitivity to the Indian cultural, social and natural environment; ii. conducted under conditions such that no person or persons become mere means for the betterment of others and that human beings who are participating in any biomedical and/or health research or scientific experimentation are dealt with in a manner conducive to and consistent with their dignity and well-being, under conditions of professional fair treatment and transparency; and iii. subjected to a regime of evaluation at all stages of the research, such as design, conduct and reporting of the results thereof.
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Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD.
The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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This gender analysis was conducted to understand the different risks and vulnerabilities but also opportunities and skills for Rohingya and host community women, men, boys and girls. Data collection was conducted over three weeks from 8 April to 29 April 2018. The work aimed to identify the differen...t needs, concerns, risks and vulnerabilities of women, girls, boys and men in both Rohingya refugee communities and host communities in the Cox’s Bazar district of Bangladesh. The analysis shows various gaps in the humanitarian response for both communities, especially in terms of accountability, communication with affected communities and disaster preparedness, but also in equitable access to services, in particular for women and girls, and especially for the Rohingya community. The key findings are presented below, along with recommendations for action.
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Following a radiation incident such as an improvised nuclear device (IND) detonation, state and local response authorities will need to establish one or more population monitoring and decontamination facilities to assess
people for radioactive exposure, contamination, and the need for
decontamin...ation or other medical follow-up. These facilities are known as community reception centers (CRCs). The basic services offered at a CRC include the following: screening people for radioactive contamination, assisting people with washing or decontamination, registering people for subsequent follow-up, and prioritizing people for further care. This guide
describes the function of each station of a CRC and provides a question bank and other information to guide data collection at each station. A question bank format was chosen to provide the user the ability to tai
lor the data collection tool to fit a particular incident and/or locality.
The CRC data collection tool is designed for CRC staff to fill out the information collected from the individual being assessed.
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The report focuses on several key areas where health outcomes are falling short, and provides insight into ways in which countries can improve the situation for their children and adolescents. Areas in focus include mental health, overweight/obesity and adolescent risk-taking behaviour.
The report ...shows, for example, that:
- mental health remains a neglected subject – only one quarter of countries are collecting data on the number of children treated by a mental health professional;
- half of countries do not regulate the marketing of food to children, despite the fact that childhood obesity rates are high across the Region and physical activity rates are low;
- almost half of countries have no policy that affects the availability of unhealthy foods at school;
- 2 in 5 girls and 1 in 3 boys who are having sex do not protect themselves; and
one third of countries do not offer legal access to contraception without parental consent for those under 18 years of age.
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Whole-genome sequencing (WGS) provides a vast amount of information and the highest possible resolution for pathogen subtyping. The application of WGS for global surveillance can provide information on the early emergence and spread of AMR and further inform timely policy development on AMR control.... Sequencing data emanating from AMR surveillance may provide key information to guide the development of rapid diagnostic tools for better and more rapid characterization of AMR, and thus complement phenotypic methods. This document addresses the applications of WGS for AMR surveillance, including the benefits and limitations of current WGS technologies
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A practical handbook. This Health Cluster Guide (2nd edition, 2020) provides practical advice on how WHO, Health Cluster Coordinators and partners can work together during a humanitarian crisis to achieve the aims of reducing avoidable mortality, morbidity and disability, and restoring the delivery ...of and equitable access to preventive and curative health care.
It highlights key principles of humanitarian health action and how coordination and joint efforts among health and other sector actors can increase the effectiveness and efficiency of health interventions and promote better health outcomes. It draws on Inter-Agency Standing Committee and other expert guidance and includes lessons from field experience in acute and protracted crises.
The coordination principles and practice presented in Health Cluster Guide are equally valid for coordinators and members of health sector groups that seek to achieve effective health action in countries where the cluster approach has not been formally adopted.
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Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr...oteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.
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This report on progress achieved in the WHO European Region and Member States in implementing the European food and nutrition action plan 2015–2020 presents selected epidemiological data on the nutritional status of populations throughout the Region and on implementation of policies recommended in... regional and global frameworks to promote healthy nutrition and prevent obesity. The data contained in the report are derived from the responses of Member States to the WHO Global nutrition policy review questionnaire.
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This report presents country, regional and global estimates of low birth weight for 2000, together with a detailed description of the methods used in calculating the estimates. Some limited data on trends are also included. The limitations of low-birth-weight data are described and recommendations a...re made for further improvements in the data for this important indicator of health.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Birth defect has been an emerging major cause of child mortality in the region. Scarcity of the birth defects information hampers policy decisions and control measures at national level. In order to create evidence for action for birth defects prevention in the region, WHO-SEARO in collaboration wit...h CDC, USA has developed and launched a regional electronic database on birth defects. This surveillance database allows data collection on newborn health, birth defects and stillbirths cases and provides real time information at hospitals and national level.
Training of the hospital health staffs and data managers in the birth defects surveillance network; at regional, national and at hospital levels is recognized as essential for expansion of this database and to assure quality of data. A two days training module for hospital based birth defects surveillance was developed using a guide for operation and facilitator guide.
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Trypanosoma cruzi is the etiological agent of Chagas disease (CD), considered one of the most important parasitic infections in Latin America. Between 25 and 90 million humans are at infection risk via at least one of multiple infection mechanisms. Under natural conditions, the principal transmissio...n modes are transplacental or via one of more than 140 hematophagous triatomine bugs (Reduviidae: Triatominae). Triatomines acquire the parasite from mammal reservoirs due to their obligate blood-feeding (albeit triatomines can also feed on non-reservoir vertebrates such as birds and reptiles). The disease burden for CD in the Latin America and Caribbean region, based on disability-adjusted life-years (DALYs), is at least five times greater than that of malaria, and is approximately one-fifth that of HIV/AIDS. In recent decades, CD has extended to other continents outside natural reservoir or vector distributions due to human migration, with a minimum estimated 10 million individuals infected worldwide.
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa...ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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This report makes clear that there is a path to end AIDS. Taking that path will help ensure preparedness to address other pandemic challenges, and advance progress across the Sustainable Development Goals. The data and real-world examples in the report make it very clear what that path is. It is not... a mystery. It is a choice. Some leaders are already following the path—and succeeding. It is inspiring to note that Botswana, Eswatini, Rwanda, the United Republic of Tanzania and Zimbabwe have already achieved the 95–95–95 targets, and at least 16 other countries (including eight in sub-Saharan Africa) are close to doing so.
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The document explains why vector control is important in national programmes and describes the preparation of a tailor-made vector control plan for national programmes. It outlines entomological procedures for regular and specific vector control and how data should be analysed for better overall und...erstanding of filarial transmission and vectors. The document will also be useful for teaching personnel in lymphatic filariasis programmes about the use and value
of entomological procedures in overall epidemiological appraisal in the context of
elimination
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