Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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The world’s climate is changing. There is scientific consensus that since 1980 global temperatures have increased by almost 1°C. Most people experience climate change through extreme weather events, new and re-emerging infectious disease, and the long term effects of sea level rise, impoverishmen...t and armed conflict. This 30 minute film describes the range of morbidity and mortality of climate change related phenomena in six countries around the world.
The film describes the ways in which climate change will have – is already having – significant effects on human health. These effects are unequally distributed in terms of geographic location, social status, access to power or resources, and benefit from energy.
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poo...rly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ...diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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The document titled "Fason pou Gen Laviktwa sou Kolera" (How to Achieve Victory over Cholera) provides comprehensive guidelines on the clinical presentation and management of cholera, particularly in the context of the 2010 Haiti outbreak. It emphasizes rapid rehydration as a lifesaving measure, det...ailing protocols for both oral rehydration solutions (ORS) and intravenous (IV) fluids. The document outlines appropriate antibiotic treatments based on patient categories, underscores the importance of proper sanitation, and offers strategies for effective outbreak control. Additionally, it provides guidance on recognizing severe dehydration and the necessity of immediate medical intervention to reduce mortality associated with cholera.
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The article "The Rising Burden of Non-Communicable Diseases in the Americas and the Impact of Population Aging" examines how the aging population in the Americas is contributing to the growing burden of non-communicable diseases (NCDs), despite improvements in disease prevention and health care. Usi...ng data from the World Health Organization and the United Nations, the study analyzes trends in population growth, aging, and NCD-related mortality and disability rates from 2000 to 2019 across 33 countries.
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Microorganisms . 2022 Jul 14;10(7):1427.
Chagas disease (CD) is endemic in about 21 countries of the Americas. The disease has spread to recently Chagas-free regions, mainly due to migration, and can now also be diagnosed in countries such as the USA, Canada, many European and some African, eastern... Mediterranean and western Pacific countries. About 6 million people are infected and 70 million live with a daily risk of infection. Although many efforts have been made to control the disease, and some improvements were achieved, still, less than about 1% of the infected have access to diagnosis and treatment. This causes high morbidity and mortality rates with more than 12,000 deaths per year
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The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio...ns such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
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Non-communicable diseases (NCDs) pose a substantial threat to many health systems, especially in low-income and middle-income countries (LMICs) where they are already overstretched. In the past few decades, deaths from NCDs in LMICs have spiked, whereas numbers in high-income countries have stabilis...ed. Worryingly, a large proportion of deaths from NCDs (29%) in LMICs occur among people younger than 60 years compared with the proportion in high-income countries (13%). This finding has been attributed to poor access to effective and equitable health-care services in most LMICs. The threat of NCDs in LMICs was recognised by the UN 2011 High-Level Meeting, and is now featured in Sustainable Development Goal 3 in the form of reducing premature mortality from NCDs by one-third before 2030. Cardiovascular diseases (CVDs) are the leading cause of deaths from NCDs (ie, 48% of all NCDs deaths). Therefore, substantial reductions in CVDs will have a major impact on reducing the overall burden of NCDs globally. The good news is that most CVDs can be prevented by addressing the key underlying behavioural risk factors, such as physical inactivity, unhealthy diet, tobacco use, and harmful use of alcohol, through population-wide approaches. Among individuals with or at high risk of CVD, early detection and effective management with appropriate counselling and medicines can reduce cardiovascular deaths substantially.
The importance of effective treatment for CVD has been recognised in the Global NCD Action Plan 2013–20, for which one of the nine global targets is that at least 50% of eligible individuals should receive drug therapy and counselling to prevent heart attacks and strokes by 2025.5 Although admirable, this is a hard target to achieve given that secondary prevention strategies in LMICs are often unaffordable or unavailable.
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Welcome to the online course on the basics of tobacco product regulation. Although tobacco use is a major public health problem, tobacco products are one of the few openly available consumer products that are virtually unregulated in many countries for contents, emissions and design features. In rec...ent years, health authorities have become increasingly interested in the potential of tobacco product regulation to reduce the morbidity and mortality associated with tobacco use. However, barriers to implementing appropriate regulation include limited understanding of common approaches or best practices, and a lack of adequate resources and/or technical capacity. Duration app. 3 hours
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Diabetes is a major public health problem in the Americas and worldwide, demanding special attention and integrated response. It is estimated that more than 62 million adults are living with diabetes in the Americas. The projections show that diabetes prevalence will continue to increase to at least... 2025. Its steady rise has been mainly due to the high prevalence of risk factors, especially overweight/obesity and physical inactivity. Diabetes also is one of the leading causes of mortality and disability worldwide and across our Region.
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Accessed on 06.03.2022
Air pollution is contamination of the indoor or outdoor environment by any chemical, physical or biological agent that modifies the natural characteristics of the atmosphere. Household combustion devices, motor vehicles, industrial facilities and forest fires are common sou...rces of air pollution. Pollutants of major public health concern include particulate matter, carbon monoxide, ozone, nitrogen dioxide and sulfur dioxide. Outdoor and indoor air pollution cause respiratory and other diseases and is an important source of morbidity and mortality.
Air pollution kills an estimated seven million people worldwide every year. WHO data shows that almost all of the global population (99%) breathe air that exceeds WHO guideline limits containing high levels of pollutants, with low- and middle-income countries suffering from the highest exposures. WHO is supporting countries to address air pollution.
From smog hanging over cities to smoke inside the home, air pollution poses a major threat to health and climate. The combined effects of ambient (outdoor) and household air pollution cause millions of premature deaths every year, largely as a result of increased mortality from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.
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A large meta-analysis of observational studies that provided the basis for the recent makeover of global recommendations for multidrug-resistant tuberculosis (MDR-TB) treatment shows that newer and repurposed drugs produced better outcomes and fewer deaths than older treatments.
The meta-analysis... of 50 studies involving 12,000 patients from 25 countries, published yesterday in The Lancet, found that bedaquiline, linezolid, levofloxacin, and moxifloxacin were associated with greater treatment success and reduced mortality compared with the previously recommended first-line treatments, while clofazimine and carbapenem antibiotics were associated with significantly improved treatment outcomes (but not reduced mortality)
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The WHO Cholera Vaccine Position Paper (August 2017) highlights the importance of oral cholera vaccines (OCVs) as a key tool in outbreak response and prevention, alongside water, sanitation, and hygiene (WASH) measures. It recommends OCVs for high-risk populations, endemic areas, and humanitarian cr...ises, emphasizing their effectiveness in reducing cases and mortality. The paper discusses two types of OCVs (Dukoral®, Shanchol™, Euvichol®) and supports the WHO-managed vaccine stockpile for rapid deployment in cholera-prone regions.
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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The WHO Guide on Cholera Control in Complex Emergencies provides key steps for preparedness, prevention, and response to cholera and other diarrheal diseases in crisis situations. It highlights the importance of early warning systems, rapid response, and coordination among health agencies. The guide... outlines measures for case management, water sanitation, hygiene promotion, and outbreak containment, particularly in refugee camps and disaster-affected areas. It emphasizes community involvement, surveillance, and proper health infrastructure to reduce mortality and control disease spread in vulnerable populations.
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The Epidemic Preparedness and Response Plan for Cholera in Syria (November 2015) outlines strategies to prevent, detect, and manage cholera outbreaks in the country, where poor water and sanitation conditions, displacement, and damaged healthcare infrastructure increase the risk of disease spread. T...he plan aims to reduce morbidity and mortality through early detection, rapid response, and coordinated interventions. It is divided into four key phases: the Pre-Epidemic Phase, which includes risk assessment, resource mapping, stockpiling medical supplies, training health workers, and raising community awareness; the Alert Phase, which focuses on surveillance, laboratory confirmation, and mobilization of rapid response teams; the Epidemic Phase, which involves case management, infection control, environmental measures such as water chlorination and improved sanitation, and public awareness campaigns; and the Post-Epidemic Phase, which evaluates the response effectiveness and identifies lessons to improve future preparedness. The plan emphasizes multi-sectoral coordination, strengthening health surveillance, and ensuring timely intervention to control and prevent cholera outbreaks in vulnerable communities.
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The document provides a comprehensive overview of malaria, covering its global impact, transmission, symptoms, diagnosis, treatment, prevention strategies, and the role of public health interventions—especially in high-risk regions like sub-Saharan Africa—to reduce its incidence and mortality.
The World Health Organization's malaria fact sheet provides an overview of malaria, a life-threatening disease caused by Plasmodium parasites transmitted through the bites of infected female Anopheles mosquitoes. It highlights that malaria is preventable and curable, yet remains a significant glo...bal health challenge. Key statistics from 2023 indicate an estimated 263 million malaria cases and 597,000 deaths worldwide, with the WHO African Region bearing the majority of this burden. The fact sheet details transmission methods, symptoms, at-risk populations, diagnostic approaches, treatment options—including the use of artemisinin-based combination therapies (ACTs)—and preventive measures such as insecticide-treated nets (ITNs) and indoor residual spraying (IRS). It also discusses the impact of malaria on vulnerable groups like children under five and pregnant women, and outlines WHO's global response strategies aimed at reducing malaria incidence and mortality rates.
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