Chapter 10 of Pediatric Surgery: This chapter provides an overview of some of the challenges when providing anaesthesia care for children in Africa. The chapter reviews
the cardiac, respiratory, and renal differences of children in comparison to adults. Additionally, it addresses preoperative asses...sment, including guidelines for nothing by mouth (NPO, or nil per os), general and regional anaesthesia, intraoperative monitoring, airway management, and postoperative care
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The FCHV program focuses on family planning, maternal/neonatal and child health.
Vitamin A distribution program. The activity of FCHV is contributing to Nepal’s goal of reducing the total fertility rate and under five mortality and maternal mortality rates.
The purpose of this guide is to provide basic information for Federal disaster responders and other service providers who may be deployed or otherwise assigned to provide or coordinate services in American Indian/Alaska Native (AI/AN) communities.
This guide is intended to serve as a general briefi...ng to enhance cultural competence while providing services to AI/AN communities. (Cultural competence is defined as the ability to function effectively in the context of cultural differences.) A more specific orientation or training should be provided by a member of the particular AI/AN community
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This toolkit aims to provide you with a brief introduction of what SA and its core principles are, and how you as a student can apply several of the existing tools for your own school to really make a difference.
French, Spanish and Arabic Version available: https://ifmsa.org/social-acc...ountability/
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Research Article | Aim: This study aimed to find the most common stressors facing the adolescents in the Gaza Strip, to explore the types and severity of the traumatic experiences, and to estimate the prevalence rate of post-traumatic events.
J Trauma Crit Care 2017 Volume 1 Issue 2 pp-25-33
Census Report Volume 4-E
As no census has been undertaken in over 30 years, many aspects of the demographic situation in the country were unknown. For instance, before the Census it was thought that the country had a population of about 60 million, but the 2014 Census showed that the population... (including an estimate for under-enumeration) was 51,486,253 persons, around 8.5 million less than the previous estimate.
In the 1983 census, 35,307,913 persons were recorded. Therefore between 1983 and 2014, the population increased by 46 per cent. With an average annual population growth rate of 0.89 per cent between 2003 and 2014, Myanmar is one of the slowest growing countries in Southeast Asia.
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Census Report Volume 4-L
Myanmar’s 2014 Census enumerated 4.5 million people aged 60 and over and by 2050 Myanmar is projected to have 13 million people in this age group.
Myanmar’s population has aged between 1973 and 2014; while the total population increased at an annual rate of 1....4 per cent, the population aged 60 and over increased annually by 2.4 per cent. Within the older population, the oldest age group, those over 80 years old, has been growing much faster than those aged 60-79. In 2014, the urban population was slightly older than the rural population. This is the result of a more rapid decline in urban fertility, offset by net migration to urban areas by youth and young adults.
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Over the period 2015 to 2019, scaling up a package of selected nutrition-specific and nutrition sensitive interventions to cover 90 per cent of Sudan would:
- Reduce the under-five mortality rate to 49/1,000 live births
- Reduce the prevalence of stunting to 25 per cent
- Reduce the ...prevalence of wasting (global acute malnutrition – GAM) to 6 per cent
- Increase exclusive breastfeeding to 63 per cent
- Reduce iron deficiency anaemia among pregnant women to 26 per cent.
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DHS Further Analysis Reports No. 90 - In Rwanda, between 2005 and 2010, there have been radical declines in the desired number of children, actual fertility, and child mortality along with a large increase in contraceptive prevalence. This study reviews trends in some of these measures. Multivariate... analyses evaluate the relative importance for
the desired number of children of years of schooling, wealth, urban residence, media exposure, child mortality, and attitudes toward gender equality. Variations in reproductive preferences, the total fertility rate, and unmet need for family planning are mapped for the 30 districts of Rwanda. The explanations for the rapid changes in reproductive attitudes and behavior are clearly related to the concerns of the country, the rapid rate of population growth, and its implications for economic development and reproductive health.
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Le NCPI a été rempli au cours du 1er trimestre 2014 par une équipe technique de 17 personnes responsabilisées en sous-groupes pour les parties A, B et UA. Les réponses aux différentes questions se sont référées à celles de NCPI de 2012 pour permettre une meilleure logique. La responsabilit...é générale pour collecter et soumettre les informations requises dans le NCPI partie
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Antibiotics and other antimicrobial agents are invaluable life savers, particularly in resource-limited countries where infectious diseases are abundant. Both uncomplicated and severe infections are potentially curable as long as the aetiological agents are susceptible to the ...antimicrobial drugs. The rapid rate with which antimicrobial agents are becoming ineffective due to resistance acquired as a result of unchecked overuse and misuse threatens to undo the benefit of controlling infections. The evidence for resistant microorganisms, many times to more than a single antimicrobial agent, has been observed globally. In Tanzania, there is evidence in the form of few scattered studies conducted in different parts of the country in a multitude of settings including health care facilities, the community, domesticated animals and wild animals
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Induced abortion is permitted in Burkina Faso only to save the life and protect the health of a
pregnant woman, or in cases of rape, incest, and severe fetal impairment. As a result, the vast
majority of women who end unintended pregnancies do so in secrecy, out of fear of prosecution
and to avoi...d the social stigma that surrounds this practice. Most clandestine abortions are carried
out in unsafe conditions that jeopardize women’s health and sometimes their lives. This report
presents estimates of the number and rate of induced abortions that occurred in Burkina Faso in
2008 and 2012; reports levels of unintended pregnancy (the major reason that women seek
abortions in the first place); and describes some of the adverse consequences of unsafe abortion
for women, their families and society.
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A module from the suite of health service capacity assessments in the context of the COVID-19 pandemic, Interim guidance 20 October 2020. This assessment tool covers the following aspects:
area distribution;
surface availability versus foreseen occupancy rate;
patient and staff flow...s;
ventilation requirement per specific areas;
visitors’ area and visitor flow; and
surge capacity.
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More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how... the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions.
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To assess the impact of the COVID-19 pandemic on health and HIV expenditure, UNAIDS carried out a modelling study on fiscal space for health and HIV. From a sample of 28 countries, three countries—the Democratic Republic of the Congo, Jamaica, and Lesotho—were selected to capture health and HIV ...expenditure impacts across countries with especially marked differences in burdens of disease (including HIV prevalence), HIV donor dependency, level of economic development, and geographic location. While the three-country sample is too small to permit findings to be generalized to other countries, these analyses are useful for informing UNAIDS’ work to identify some policy positions to minimize the COVID-19 pandemic’s impact on the HIV response.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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Asia remained the world’s most disaster-hit region from weather, climate and water-related hazards in 2023. Floods and storms caused the highest number of reported casualties and economic losses, whilst the impact of heatwaves became more severe, according to a new report from the World Meteorolog...ical Organization (WMO).
The State of the Climate in Asia 2023 report highlighted the accelerating rate of key climate change indicators such as surface temperature, glacier retreat and sea level rise, which will have major repercussions for societies, economies and ecosystems in the region.
In 2023, sea-surface temperatures in the north-west Pacific Ocean were the highest on record. Even the Arctic Ocean suffered a marine heatwave.
Asia is warming faster than the global average. The warming trend has nearly doubled since the 1961–1990 period.
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Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa...l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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