Sci Rep. 2016; 6: 25920. Published online 2016 May 16. doi: 10.1038/srep25920
Some 32% of internally displaced persons (IDPs) in Ukraine suffer from post-traumatic stress disorder (PTSD) as a result of the conflict in the east.
Among the 2,203 respondents surveyed across Ukraine, the study also found a high prevalence of mental disorders such as depression (22%) and anxiety ...(17%), particularly among women. This has a significant effect on family and community relations, the ability to work or even do basic tasks such as walking.
Moreover, the study noted that 74% of respondents in need of psychiatric care do not receive it, mainly due to a high cost of mental healthcare and medicine.
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This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused in name, it offers integration-oriented assessment,... design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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People younger than 20 years comprise 35% of the global population and 40% of the global population of least-developed nations. The number of children - neonates, infants, children, and adolescents up to 19 years of age - who need pediatric palliative care (PPC) each year may be as high as 21 millio...n. Another study found that almost 2.5 million children die each year with serious health related suffering and that more than 98% of these children are in low- and middle-income countries (LMICs) (3). While estimates differ, there is no doubt that there is an enormous need for prevention and relief of suffering among children - for PPC.
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The second edition of the WHPCA Global Atlas of Palliative Care was launched during World Hospice & Palliative Care Day 10 October. The Atlas is an update of the original WHPCA/WHO Global Atlas of Palliative care at the end of life published in 2014. It is full of useful facts and figures to support... palliative care advocacy and development. In this edition we have switched from using the WHO methodology for need for palliative care to the evolving Lancet Commission on Palliative Care and Pain Relief methodology. As a result the number of people needing palliative care has gone from 40 million per year to almost 57 million and more accurately reflects the need for palliative care globally models of palliative care worldwide? What resources are devoted to palliative care? What is the way forward?
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Risk Communication and Community Engagement messages
Guidelines on post-exposure prophylaxis for HIV and the use of co-trimoxazole prophylaxis for HIV-related infections among adults, adolescents, and children: recommendations for a public health approach : December 2014 supplement to the 2013 Consolidated guidelines on the use of antiretroviral drugs... for treating and preventing HIV infection.
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“Preferred product characteristics” (PPCs) are key tools to incentivize and guide the development of urgently needed health products. Some of the vector control interventions deployed in complex emergencies and in response to natural disasters – namely insecticide-treated nets (ITNs) and indoo...r residual spraying (IRS) – have already met identified public health needs in more stable settings; other tools such as insecticide-treated tarpaulins have been specifically designed for this use case. Given the diverse mix of existing and potential new interventions and the considerable gaps in the associated evidence base, this PPC aims to clearly articulate the unmet public health needs for tools designed to control malaria transmission in complex emergencies and in response to natural disasters.
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Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to i...mprove medication adherence was cost-effective.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o...r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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Published: November 24, 2020 https://doi.org/10.1371/journal.pbio.3000938
Climate change is expected to have complex effects on infectious diseases, causing some to increase, others to decrease, and many to shift their distributions. There have been several important advances in understanding the ...role of climate and climate change on wildlife and human infectious disease dynamics over the past several years. This essay examines 3 major areas of advancement, which include improvements to mechanistic disease models, investigations into the importance of climate variability to disease dynamics, and understanding the consequences of thermal mismatches between host and parasites. Applying the new information derived from these advances to climate–disease models and addressing the pressing knowledge gaps that we identify should improve the capacity to predict how climate change will affect disease risk for both wildlife and humans.
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In 2017, $37.4 billion of development assistance was provided to low- and middleincome countries to maintain or improve health. This amount is down slightly compared to 2016, and since 2010, development assistance for health (DAH) has grown at an annualized rate of 1.0%. While global development ass...istance for health has seemingly leveled off, global health spending continues to climb, outpacing economic growth in many countries. Total health spending for 2015, the most recent year for which data are available, was estimated to be $9.7 trillion (95% uncertainty interval: 9.7–9.8)*, up 4.7% (3.9–5.6) from the prior year, and accounted for 10% of the world’s total economy. With some sources of health spending growing and other types remaining steady, and with major variations in spending from country to country, it is more important than ever to understand where resources for health come from, where they go, and how they align with health needs. This information is critical for planning and is a necessary catalyst for change as we aim to close the gap on the unfinished agenda of the Millennium Development Goals (MDGs) and move forward toward universal health coverage (UHC) in the Sustainable Development Goals (SDGs) era.
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The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin...gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig...nity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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