Le syndrome respiratoire aigu provoqué par le coronavirus-2 (SARS-CoV-2), initialement décrit en Chine, est responsable
de la pandémie que nous connaissons actuellement sous le nom de coronavirus disease 2019 ou COVID-19. L'épidémie de
coronavirus a été déclarée « urgence de santé publi...que mondiale » par l'Organisation mondiale de la santé (OMS) le 30 janvier 2020 . L'Afrique a été atteinte plus tard que les autres continents, mais à la date du 3 mai, tous les pays africains
avaient notifié au moins un cas. À la date du 09 juin 2020, l'Afrique comptait près de 200 000 cas confirmés, plus de
5000 décès, avec 25 pays ayant plus de 1000 cas actifs. Les patients atteints par ce virus peuvent développer des symptômes allant jusqu'à l'insuffisance respiratoire aiguë sévère
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Leptospirosis is a perplexing conundrum for many. In the existing literature, the pathophysiological mechanisms pertaining to leptospirosis is still not understood in full. Considered as a neglected tropical zoonotic disease, leptospirosis is culminating as a serious problem worldwide, seemingly exi...sting as co-infections with various other unrelated diseases, including dengue and malaria. Misdiagnosis is also common as non-specific symptoms are documented extensively in the literature. This can easily lead to death, as the severe form of leptospirosis (Weil’s disease) manifests as a complex of systemic complications, especially renal failure. The virulence of Leptospira sp. is usually attributed to the outer membrane proteins, including LipL32. With an armament of virulence factors at their disposal, their ability to easily adhere, invade and replicate within cells calls for a swift refinement in research progress to establish their exact pathophysiological framework. As an effort to reconstitute the current knowledge on leptospirosis, the basis of leptospiral infection, including its risk factors, classification, morphology, transmission, pathogenesis, co-infections and clinical manifestations are highlighted in this review. The various diagnostic techniques are also outlined with emphasis on their respective pros and cons.
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Les présentes lignes directrices ont pour objet de préparer les pays d’endémie à arrêter l’AMM à l’issue du traitement, à passer à la surveillance post-thérapeutique ainsi qu’à confirmer l’interruption de la transmission à l’issue de la phase 2 et à débuter la surveillance p...ost-élimination.
Le but est de fournir un outil actualisé pour atteindre et vérifier l’élimination de la
transmission d’Ovolvulus à l’issue des programmes d’élimination de l’onchocercose qui utilisent principalement l’AMM.
Les objectifs sont de :
• formuler des recommandations basées sur des preuves à l’intention des prestataires de soins et des décideurs en matière de politique pour démontrer et confirmer l’interruption de la transmission d’O. volvulus avant, pendant et après la surveillance post-thérapeutique ;
• informer les utilisateurs finaux des procédures nécessaires pour vérifier l’élimination de l’onchocercose humaine.
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The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly re...placing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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Nigeria reported its first case of COVID-19 at the end of February 2020 and subsequently experienced
four waves, with peaks in June 2020 and January, August and December 2021. The COVID-19 pandemic
severely impacted the economy of Nigeria and caused disruption of health services nationwide. During... the crisis, many Nigerians failed to access routine health
services due to decreased income and lockdown
restrictions. The most significant service disruptions
were in maternal and newborn health, vaccination,
sick childcare, family planning and noncommunicable
disease treatment services (1). Pregnant women
were anxious about contracting COVID-19 during
2020, and as a result, many avoided attending health
facilities for antenatal (ANC) and postnatal care (PNC).
Disruptions in the medical supply chain and diversion
of resources to COVID-19 management impacted on
essential health services. Health workers were often
unable to go to work because of transport disruptions
or illness
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En 2014, le taux de mortalité maternelle au Cambodge était estimé à 170 décès pour 100 000 naissances vivantes, et le taux de mortalité néonatale à 18 décès pour 1000 naissances vivantes, selon l’enquête démographique et de santé menée au Cambodge en 2014 . Ces chiffres signifient q...ue le Cambodge a atteint les cibles des Objectifs du Millénaire pour le Développement (OMD) en 2015 pour la mortalité maternelle, la mortalité néonatale et d’autres indicateurs majeurs de la santé de la
mère, du nouveau-né et de l’enfant tels que les accouchements avec l’assistance de personnel qualifié, les accouchements dans des établissements de santé, les deuxièmes consultations de soins prénatals (ANC2+), les accouchements par césarienne et le ratio d’établissements d’orient
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Les conflits et les guerres ont des effets catastrophiques sur la santé et le bien-être des nations, et ils ont considérablement évolué au cours des dernières décennies. Avec la forte augmentation des crises humanitaires, y compris de la violence urbaine, de plus en plus de gens sont touchés... pendant des périodes plus longues par des interruptions des services élémentaires, devenues une triste réalité.
Les interventions sanitaires et les approches novatrices face aux défis que posent les
crises humanitaires peuvent sauver des vies et atténuer les conséquences des conflits
pour les civils.
Les équipes médicales qui interviennent lors de conflits armés et dans d’autres
environnements dangereux sont fréquemment confrontées à de graves menaces pour
leur sécurité et leur sûreté. Elles doivent surmonter ces difficultés pour avoir accès
aux patients, d’autant plus qu’elles se heurtent parfois à la réticence des populations
auprès desquelles elles interviennent et qui sont parties au conflit.
Une riposte médicale fondée sur des principes se compose d’interventions cliniques
et opérationnelles inspirées et respectueuses de normes fondamentales, qui mettent
l’accent sur la qualité, la sécurité et la protection dans l’intérêt des patients.
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Chagas disease (American trypanosomiasis) is endemic in 21 countries of the Americas, where control is largely focused on elimination of the domestic insect vectors (Triatominae) coupled with measures to extend and improve the screening of blood donors in order to avoid tranfusional transmission. Th...rough national programmes and multinational initiatives coordinated by WHO-PAHO, much has been accomplished in these domains in terms of reducing transmission. Attention now turns to consolidating the successes in interrupting transmission, and improved treatment for those already infected and those who may become affected in the future. This article, based on technical discussions at the "Epidemiological and Sociological Determinants of Chagas Disease, Basic Information to Establish a Surveillance and Control Policy " meeting in Rio de Janeiro, is designed to open the debate on appropriate strategies for continuation of the successful initiatives against Chagas disease.
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Leishmaniases are a group of diseases of zoonotic importance caused by over 20 species of protozoa of the genus Leishmania, in which domestic dogs are considered to be the main reservoir for the disease. However, the involvement of other vertebrates as reservoirs for these parasites has also been in...vestigated. Therefore, the objective of the present study was to carry out a systematic review with meta-analysis on occurrences of leishmaniasis in equids. The case reports described animals with cutaneous symptoms of leishmaniasis (papules, nodules, ulcers or crusts) that regressed spontaneously, located mainly on the head and limbs, from which three species of protozoa were identified in the lesions: Leishmania braziliensis, Leishmania infantum and Leishmania siamensis. In turn, the meta-analysis showed a combined prevalence of 25%, although with high heterogeneity among the studies, which was attributed to the use of different methods for diagnosing the disease. Leishmaniasis in equids is a benign disease but it should be included in the differential diagnosis of cutaneous diseases among these species. Seroepidemiological studies are important in investigating and monitoring suspected exposure of these hosts to the parasite, especially in endemic areas. However, there is also a need to standardize diagnostic methods.
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Violence against women and girls is widespread in the Region of the Americas, resulting in enormous consequences for the health and wellbeing of women and girls, their families and communities. These costs are unacceptable and they can be prevented through evidence-based action, including the health... sector through its policies and protocols, as well as in collaboration with other sectors. This report remains the first of its kind and is a major milestone for the Region. It is specifically informed by the commitments of Member States in the regional Strategy and Plan of Action on Strengthening the Health System to Address Violence against Women. The report provides an analysis of efforts to advance the prevention of violence against women through health policies, clinical protocols, multisectoral plans and related approaches across the Americas. Attention to this topic is timely, as the COVID-19 pandemic has created new visibility for this area of work. This report offers critical information on efforts in the Region that can be learned from and used to build upon in the future to prevent and respond to violence against all women and girls everywhere.
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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical man...ifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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Il s’agit du premier rapport d’une collection de l’OMS intitulée De l’intention à l’action, qui vise à renforcer la base de données probantes sur l’impact de la participation significative et à combler le manque d’approches normalisées pour permettre la participation significativ...e fonctionnelle. À cette fin, la collection De l’intention à l’action a été pensée comme plateforme pour que les personnes avec une expérience vécue ainsi que les organisations et institutions à la pointe sur ces questions puissent échanger sur les solutions, les difficultés et les pratiques prometteuses relatives à cet objectif transversal. Elle vise également à fournir des récits et des modèles puissants, ainsi que des données probantes dans la perspective de la quatrième réunion publique de haut niveau des Nations Unies sur les MNT, qui devrait se tenir en 2025, et en vue d’atteindre les objectifs de développement durable (ODD) à l’horizon 2030.
À cette fin, le présent rapport comprend six études de cas impliquant douze personnes avec une expérience vécue d’affections diverses. Ces études de cas analysent les dynamiques de pouvoir et la réorientation des pouvoirs en faveur des individus avec une expérience vécue, la prise de décision éclairée et les connaissances en matière de santé, la participation communautaire à l’échelle des réseaux et des systèmes de santé globaux, l’expérience vécue comme donnée probante et expertise, l’exclusion et l’importance de la participation des groupes qui sont marginalisés, ainsi que la défense d’une cause et les droits humains.
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Ce rapport inclut des analyses tirées des consultations régionales informelles menées dans la Région africaine, dans les Caraïbes et en Amérique du Nord, dans la Région européenne, dans la Région de la Méditerranée orientale, en Amérique latine ainsi que dans la Région de l’Asie du Su...d-Est, auxquelles s’ajoutent trois rencontres organisées dans la Région du Pacifique occidental. Il analyse les similitudes globales, les nuances régionales et les priorités mises en avant dans les six Régions de l’OMS pour la participation significative des personnes avec une expérience vécue.
Il s’agit du deuxième rapport d’une collection de l’OMS intitulée De l’intention à l’action, qui doit servir à constituer une série de ressources pour renforcer la base de données probantes sur l’impact de la participation significative, qui est pour le moment limitée, et à combler le manque d’approches normalisées pour mettre en oeuvre la participation significative. À cette fin, la collection De l’intention à l’action a été pensée comme plateforme pour que les personnes avec une expérience vécue ainsi que les organisations et institutions à la pointe sur ces questions puissent échanger sur les solutions, les difficultés et les pratiques prometteuses relatives à cet objectif transversal. Elle vise également à fournir des récits et des modèles puissants, ainsi que des données probantes dans la perspective de la quatrième réunion publique de haut niveau des Nations Unies sur les MNT, qui devrait se tenir en 2025, et en vue d’atteindre les objectifs de développement durable (ODD) à l’horizon 2030.
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Colombia is characterized by a fragile and prolonged humanitarian context marked by recurrent multi-hazards affecting its territories and combined with severe structural and systemic challenges within the health system. Recent shocks, including the
COVID-19 pandemic, growing violence within the Col...ombian territories and along the border with Venezuela (Bolivarian Republic of), and repetitive hydro-meteorological disasters over the last 12 months aggravate such chronic challenges.
In 2022, the number of people in need of humanitarian assistance increased by 300 000 due to deteriorating indicators of maternal and child mortality, pregnancy in adolescent girls, human immunodeficiency virus (HIV), suicides, sexually transmitted
infections (STIs), gender-based and sexual violence, and communicable diseases. increasing population trends, primarily due to mass migration movements and the persistence of armed conflicts, create access barriers to essential health services, mobility restrictions, and forced displacement, further impacting the health, lives, and well-being of populations in vulnerable situations. In many territories, geographical distance to health facilities and attacks against medical missions hinder providing appropriate healthcare.
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Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in failure to provide adequate, accessible and quality m...aternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
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Timely, reliable and complete information on financial resources in the health sector is critical for sound policy making and planning, particularly in developing countries where resources are both scarce and unpredictable. Health resource tracking has a long history and has seen renewed interest mo...re recently as pressure has mounted to improve accountability for the attainment of the health Millennium Development Goals. We review the methods used to track health resources and recent experiences of their application, with a view to identifying the major challenges that must be overcome if data availability and reliability are to improve.
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Background and aims: Current coverage of mental health care in low- and middle-income countries is limited, not only in terms of access to services but also in terms of financial protection of persons in need of care and treatment. This is especially pertinent considering the established relationshi...p between mental illness and poverty and the need to ensure the financial risk protection of persons with mental disorders and their families as part of country's efforts to attain universal health coverage. This study set out to review the health and socio-economic contexts of Nigeria as well as to generate strategies for sustainable mental health financing that will be feasible, within the specific context of the country.
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This important research emphasises that many governments are not meeting spending goals, and in many countries the financing gaps are so great that, even if they met the spending goals, expenditure would still fall short of what is needed (expenditure would cover only 64% of estimated future funding... requirements, leaving a gap of around a third of the total US$7·9 billion needed). Quantification of the gaps in domestic spending encourages us to consider whether the amount of funding is appropriate and how much more could and should be done to fight HIV/AIDS. The important question of how governments make allocation choices also comes to the forefront. The aim of this Comment is to draw attention to the many dimensions that contribute to the complexity of these decisions on health resource allocation.
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The ongoing COVID-19 pandemic has shown that public financial management (PFM) should be an integral part of the response. Effectiveness in financing the health response depends not only on the level of funding but also on the way public funds are allocated and spent, this is determined by the PFM r...ules, and how money flows to health service providers. So far, early assessments have shown that PFM systems ranged from being a fundamental enabler to acting as a roadblock in the COVID-19 health response. While service delivery mechanisms have been extensively documented throughout the pandemic, the underlying PFM mechanisms of the response also merit attention. To highlight the importance of PFM in health emergency contexts, this rapid review analyses various country PFM experiences and identifies early lessons emerging from the financing of the health response to COVID-19. The assessment is done by stages of the budget cycle: budget allocation, budget execution, and budget oversight. Identifying lessons from the varying PFM modalities used to finance the response to COVID-19 is fundamental both for health policy-makers and for finance authorities to prepare for future health emergencies.
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Since the 1970s, voluntary contributions have become an increasingly important component of WHO's budget. As voluntary contributions tend to be earmarked for donor-specified programmes and projects, there are concerns that this trend has diverted focus away from WHO's strategic priorities, made coor...dination and attaining coherence more difficult, undermined WHO's democratic structures and given undue power to a handful of wealthy donors. In the past few years, the WHO Secretariat has pushed for donors to increase the amount of flexible funding they provide.
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