This Guide responds to requests from practitioners and country teams who have learned about the Nurturing care framework and want to understand how to adapt health and nutrition services to be supportive of nurturing care and strengthen caregivers’ capacity.
Despite the significant role of vector control in national leishmaniasis control programmes, the programmatic community perceives vector control as the weakest component of leishmaniasis control strategies in terms of resources, scientific evidence of the usefulness of interventions and capacity for... quality-assured implementation. Therefore, the main objective of this manual is to provide practical tools, techniques and procedures to strengthen sand fly control and surveillance in order to improve implementation of leishmaniasis control programmes. The manual provides a rationale for programme managers in different geographical regions on the types of vector control interventions to be used in different epidemiological and environmental settings and also how to measure their impact.
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Abstract: Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public health. A plethora of information concerning the chronic phase of human Chaga...s disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss the current status of acute Chagas disease cases globally, the immunological findings related to the acute phase and their possible influence in disease outcome, and reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV invection management.
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Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi...nes.
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Trachoma, caused by particular serovars of Chlamydia trachomatis, is the leading
infectious cause of blindness. Infection is transmitted within ocular and nasal secretions that are passed from person to person on fingers, fomites (such as clothing) and eye-seeking flies (particularly Musca sorbens)....
Ophthalmic infection is associated with an inflammatory conjunctivitis known as “active trachoma”. Repeated episodes of active trachoma can scar the eyelids. In some individuals this leads to trachomatous trichiasis (TT), in which one or more eyelashes on the upper
eyelid touch the eye. TT is extremely painful. It can be corrected surgically, but, if left untreated, may lead to corneal opacification, resulting in vision impairment and blindness.
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A key component of elimination is to reduce the number
of unmanaged trachomatous trichiasis cases to less than
1 per 1,000 population in affected areas. This will require
not only a large increase in the number of surgeries
performed, but also improvements in the quality of surgery
and in the e...fficiency of surgery provision programs. It also
will require that we make special efforts to reach out to
women and the most marginalized populations, who are
disproportionally affected by trichiasis (TT).
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Le secteur de la santé a beaucoup évolué au cours des 20 dernières années. Les innovations technologiques ainsi que notre connaissance des maladies ont contribué à allonger l’espérance de vie au 20ème siècle. Cependant, l’un des plus grands défis
aujourd’hui n’est pas de rester a...u fait des procédures cliniques les plus récentes ou des équipements de haute technologie dernier cri, mais plutôt d’améliorer la sécurité des soins dispensés dans des environnements complexes, sous pression et où la
rapidité d’action joue un grand rôle. Dans ce type d’environnements, les choses peuvent souvent mal tourner. Des événements indésirables surviennent. Des dommages non intentionnels, mais graves, affectent des patients dans le cadre de
la pratique clinique habituelle ou consécutivement à une décision clinique.
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This fourth annual report monitors global progress towards the 2023 target for global elimination of industrially produced trans-fatty acids (TFA), highlighting achievements during the past year (October 2021 – September 2022). Countries are responding to the World Health Organization (WHO) call t...o action by putting into place best-practice TFA policies. Mandatory TFA policies are currently in effect for 3.4 billion people in 60 countries (43% of the world population); of these, 43 countries have best-practice policies in effect, covering 2.8 billion people (36% of the world population).
Over the past year, several additional countries took action to eliminate industrially produced TFA: best-practice policies came into effect in India in January 2022, Uruguay in May 2022 and Oman in July 2022. Best-practice policies were passed in Bangladesh in November 2021 (to come into effect in December 2022) and in Ukraine in September 2020 (to come into effect in October 2023), best-practice TFA policies are projected to pass soon in Mexico, Nigeria and Sri Lanka.
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Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD...) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical exposure to infection is crucial for assessing progress and for und...erstanding the priorities to achieve these milestones.
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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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Chagas disease caused by Trypanosoma cruzi is a public health issue in Latin America. This highly diverse parasite is divided into at least seven discrete typing units (DTUs) TcI-TcVI and Tcbat. Some DTUs have been associated with geographical distribution in epidemiological scenarios and clinical m...anifestations, but these aspects remain poorly understood. Many studies have focused on studying the parasite and its vectors/hosts, using a wide variety of genetic markers and methods. Here, we performed a systematic review of the literature for the last 20 years to present an update of DTUs distribution in the Americas, collecting ecoepidemiological information. We found that the DTUs are widespread across the continent and that there is a whole gamma of genetic markers used for the identification and genotyping of the parasite. The data obtained in this descriptor could improve the molecular epidemiology studies of Chagas disease in endemic regions.
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This document compiles the recommendations made by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) to help professionals in charge of vector control programs in Latin America and the Caribbean at the national, subnational, and local level update their knowledge in... order to make evidence-based decisions on the most appropriate control measures for each specific situation. IVM can be used for surveillance and control or for elimination of VBDs and can help reduce the development of insecticide resistance through the rational use of these products. This document provides instructions for fulfillment of the 2008 PAHO mandate set forth in CD 48/13 (Integrated Vector Management).
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El presente documento reúne un conjunto de recomendaciones formuladas por la Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) para ayudar, a los profesionales encargados de los programas de control de vectores de Latinoamérica y el Caribe a nivel nacional, ...subnacional y local, a actualizar y tomar decisiones basadas en la evidencia sobre las medidas de control más apropiadas para cada situación específica. El MIV puede utilizarse cuando la meta es la vigilancia y el control o la eliminación (dependiendo de la situación específica) de las ETV y puede contribuir a reducir el desarrollo de la Resistencia a los insecticidas mediante el uso racional de estos productos. Este documento contiene las instrucciones para llevar a cabo el mandato de la OPS del 2008 sobre el control integrado de vectores (resolución CD48.R8, documento CD48/13) y, en particular, complementa una serie de guías de la OMS publicadas en el 2012
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Lymphatic filariasis (LF) infection if untreated results in fluid accumulation in the limbs or breasts (lymphedema) or genitalia (hydrocele) that is painful and causes great discomfort. Morbidity management and disability prevention (MMDP) strategies such as surgery for hydrocele, treatment of acute... attacks and management of lymphedema are necessary for the management of the advanced stages of LF. However, very few countries including Zambia, have adequate information on the health beliefs and health seeking behavior of communities living in endemic areas towards MMDP services for LF. This study sought to explore community and health provider perspectives towards MMDP services for LF in a highly endemic region, Luangwa District, Zambia, between February and April 2019.
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This report provides a review and analysis of the research landscape for three diseases – Chagas disease, human African trypanosomiasis and leishmaniasis – that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease re...ference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations.
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About six to seven million people worldwide, mostly in Latin America, are estimated to be infected with
Trypanosoma cruzi, the parasite that causes Chagas disease (WHO data from 2021). Chagas disease is
found mainly in endemic areas of 21 Latin American countries. Chagas disease was once entirely
...
confined to rural areas but in the last decades, due to population movements, most infected people live
in urban settings and the disease has spread to other continents. The burden of disease is due to its
chronic progression with people still suffering years later after initial infection.
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The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs). This work is described in the NTD ...road map 2021–2030, WHO’s blueprint to drive global efforts in the fight against NTDs in the context of the United Nations Sustainable Development Goals. These goals encompass a vision of a world population for whom equality of opportunity and of health are fundamental.
Within this context, and during the two years since the launch of the road map (2021–2022), progress has been made. Nevertheless, hindrances towards achieving the targets for 2030 have arisen and work to overcome these obstacles continues. These endeavours have also revealed the scale of the task still facing the global NTD community.
Disruption as a result of the COVID-19 pandemic has continued to afflict longstanding and new programmes alike, while other entrenched issues have re-emerged in new and challenging ways. The global NTD community is also confronted with a changing, multi-dimensional funding landscape as donors reassess priorities and adapt to new ways of working, as well as a challenging and unpredictable international context. As a result, progress in controlling, eliminating or eradicating NTDs has not been as far-reaching as expected.
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This guideline for the prevention and control of chikungunya fever
(CF) is intended for use by all peripheral health workers in the Region and
is based on the strategy outlined above. This document will focus mainly
on preventing, predicting and detecting outbreaks, and after detection,
investig...ating and containing them.
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he Pan American Health Organization (PAHO) would like to thank the group that developed these guidelines for the tremendous work, quick response, and commitment they demonstrated in this process. We would like to especially recognize the following doctors: Roberto Chuit, Jaime Altcheh, Alejandro Luq...uetti, Faustino Torrico, and Juan Carlos Villar, for sharing their extensive expertise on the subject; Ariel Izcovich, Juan Criniti, Ana Marcela Torres, and Ludovic Reveiz, for methodological coordination; and Roberto Salvatella and Luis Castellanos for promoting this initiative.
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