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La meningitis es una enfermedad mortal y debilitante; golpea rápidamente, conlleva graves consecuencias sanitarias, económicas y sociales, y afecta a personas de todas las edades y en todos los países del mundo. La meningitis bacteriana puede provocar epidemias, ocasionar la muerte en 24 horas y
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dejar a una de cada cinco personas afectadas, con discapacidad permanente después de la infección. Muchos casos de meningitis y defunciones conexas son prevenibles mediante vacunación, pero los progresos para derrotar a la meningitis están rezagados respecto de otras enfermedades prevenibles mediante vacunación.
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Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los
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años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
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e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp
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onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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The Lancet Published Online
October 8, 2021 https://doi.org/10.1016/ S0140-6736(21)02143-7
More than two years since the first SARS-CoV-2 infections were reported, the COVID-19 pandemic remains an acute global emergency. In this Strategic Preparedness, Readiness and Response plan for 2022, WHO sets out a number of key strategic adjustments that, if implemented rapidly and consistently at
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national, regional, and global levels, will enable the world to end the acute phase of the pandemic.
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Les infections au SRAS-CoV-2 chez les enfants et les adolescents provoquent une maladie moins grave et moins de décès que chez les adultes. Bien qu'une évolution moins grave de l'infection soit un résultat positif, on s'inquiète du fait que des symptômes légers aient pu conduire à moins de t
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ests, ce qui a entraîné un nombre moins important de cas identifiés de COVID-19 chez les enfants. Si les enfants présentant des symptômes légers ou inexistants transmettent la maladie, ils peuvent agir comme des vecteurs de transmission au sein de leur communauté. Il est essentiel de comprendre les symptômes, l'infectivité et les modes de transmission du SRAS-CoV-2 chez les enfants et les adolescents pour développer, adapter et améliorer les mesures de contrôle du COVID-19 à tous les âges. Ce document est un résumé des connaissances actuelles concernant l'acquisition et la transmission de l'infection par le SRAS-CoV-2 et les symptômes de la maladie COVID-19 chez les enfants et les adolescents. Il vise à éclairer les décisions, en fonction des contextes locaux, sur la meilleure façon de maintenir ouvertes les écoles, les jardins d'enfants et les crèches et sur les conseils à appliquer en matière de mixité intergénérationnelle.
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Resource platform
Orientations provisoires
9 août 2021
Le présent document vise à décrire un ensemble minimal d'activités de surveillance recommandées au niveau national pour détecter et surveiller la prévalence relative des variantes du SRAS-CoV-2 et à présenter un ensemble d'activités pour la caractér
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isation et l'évaluation du risque que présentent ces variantes. k posés par ces variants. Un ensemble d'indicateurs est également fourni pour normaliser la surveillance et la déclaration publique de la circulation des variants.
Ce document est principalement destiné aux autorités de santé publique nationales et infranationales et aux partenaires qui soutiennent la mise en œuvre de la surveillance des variantes du SRAS-CoV-2.
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Временные рекомендации
9 августа 2021 г.
Цель данного документа - описать минимальный набор мероприятий по эпиднадзору, рекомендуемых на национальном уровне для вы
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вления и мониторинга относительной распространенности вариантов SARS-CoV-2, и наметить набор мероприятий для характеристики и оценки риска, создаваемого этими вариантами. Также приводится набор показателей для стандартизации мониторинга и публичной отчетности о циркуляции вариантов.
Документ предназначен в первую очередь для национальных и субнациональных органов здравоохранения и партнеров, поддерживающих внедрение эпиднадзора за вариантами SARS-CoV-2.
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Orientaciones provisionales
9 de agosto de 2021
El presente documento tiene por objeto describir un conjunto mínimo de actividades de vigilancia recomendadas a nivel nacional para detectar y supervisar la prevalencia relativa de las variantes del SRAS-CoV-2 y esbozar un conjunto de actividades pa
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ra la caracterización y evaluación del riesgo que plantean estas variantes. También se ofrece un conjunto de indicadores para normalizar la vigilancia y la notificación pública de la circulación de variantes.
El documento está dirigido principalmente a las autoridades de salud pública nacionales y subnacionales y a los socios que apoyan la aplicación de la vigilancia de las variantes del SRAS-CoV-2
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Climate change triggers mounting food insecurity, poverty and displacement in Africa
The coronavirus disease 2019 (COVID-19) pandemic has created a global and gendered crisis that is compounding existing inequalities and disproportionately affecting girls and women. Emerging evidence from the COVID-19 crisis in 2020 shows school closures, disruptions in essential services and rising
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poverty contributed to girls’ increased risk of female genital mutilation (FGM). School closures limited the monitoring and reporting of cases of FGM. Rising household monetary poverty may have contributed to families adopting negative coping mechanisms, including having girls undergo FGM as a precursor to marriage to reduce household costs. A report from the United Nations Population Fund (UNFPA) estimates 2 million additional cases of FGM by 2030 due to the pandemic.
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The 10 recommendations in the COP26 Special Report on Climate Change and Health propose a set of priority actions from the global health community to governments and policy makers, calling on them to act with urgency on the current climate and health crises.
The recommendations were developed in
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consultation with over 150 organizations and 400 experts and health professionals. They are intended to inform governments and other stakeholders ahead of the 26th Conference of the Parties (COP26) of the United Nations Framework Convention on Climate Change (UNFCCC) and to highlight various opportunities for governments to prioritize health and equity in the international climate movement and sustainable development agenda. Each recommendation comes with a selection of resources and case studies to help inspire and guide policymakers and practitioners in implementing the suggested solutions
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HIV drug resistance strategies focus on prevention through adherence and treatment optimization, surveillance to monitor resistance trends, and innovation in new drugs and diagnostics. Key approaches include implementing national action plans, strengthening laboratory capacity for monitoring, and pr
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oviding comprehensive care, especially for vulnerable populations
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Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS aborda o uso de hidroxicloroquina para prevenção da COVID-19. Segue-se a publicação de uma análise sistemática e NMA que reuniu dados de seis estudos com 6.059 participantes que não tinham COVID-
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19 e receberam hidroxicloroquina. Três estudos envolveram participantes que tiveram uma exposição conhecida a uma pessoa com infecção por SARS-CoV-2. Em resposta à divulgação dos dados de estudos, o GDG da OMS desenvolveu recomendações sobre a hidroxicloroquina, um agente anti-inflamatório que atua por meio do bloqueio dos receptores Toll-like, reduzindo a ativação das células dendríticas. É usada para tratar a artrite reumatoide e o lúpus eritematoso sistêmico. Tem um efeito antiviral contra muitos vírus in vitro, inclusive o SARS-CoV-2, mas não foi demonstrado um efeito antiviral clinicamente útil para nenhuma infecção viral.
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According to the latest available estimates, more than 1 in 7 adolescents aged 10–19 is estimated to live with a diagnosed mental disorder globally. Almost 46,000 adolescents die from suicide each year, among the top five causes of death for their age group. Meanwhile, wide gaps persist between me
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ntal health needs and mental health funding. The report finds that about 2 per cent of government health budgets are allocated to mental health spending globally.
The full report , excecutive summary, brief reports are available in English, French, Spanish and Arabic athttps://www.unicef.org/reports/state-worlds-children-2021?utm_source=referral&utm_medium=media&utm_campaign=sowc-web
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