Leishmaniose cutanée : un important problèmede santé
La leishmaniose cutanée est une maladie potentiellement grave et défigurante. Les personnes atteintes de leishmaniose cutanée ont une ou plusieurs lésions durables sur la peau, le plus souvent sans fièvre ni symptômes généraux. L'impac...t de la leishmaniose cutanée sur la propagation de la pauvreté est important, car le traitement est coûteux et donc inabordable ou implique une grande perte d’argent.
Le coût du traitement et de la mise en œuvre de stratégies de prévention nécessite un investissement considérable de ressources financières et humaines. La leishmaniose cutanée est un problème de santé publique majeur dans la Région de l'OMS pour la Méditerranée orientale. Des nouveaux cas apparaissent dans des zones précédemment indemnes de la maladie. Plus de 100 000 nouveaux cas de leishmaniose cutanée sont notifiés chaque année à l'OMS par les pays de la Région, mais les estimations relatives à l'incidence réelle sont de trois à cinq fois plus élevées car de nombreux patients ne consultent jamais un médecin ou un professionnel de santé et les cas ayant reçu un diagnostic de leishmaniose cutanée ne sont pas toujours notifiés aux autorités sanitaires.
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This publication represents a key step forward in translating Control of the leishmaniases (WHO Technical Report Series, No. 949) into a more practical tool for health personnel directly involved in the case management of cutaneous leishmaniasis. With this manual, countries will have, for the first ...time, standardized diagnosis and treatment protocols, case definitions and indicators to enable them to easily track progress on cutaneous leishmaniasis case management across the Region. It will provide support to professionals in charge of cutaneous leishmaniasis, in order to alleviate the suffering of affected populations from this appalling disfiguring and stigmatizing neglected tropical disease.
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The boundaries and names shown and the designations used on this map do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities,
or concerning the delimitation of its fr...ontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement.
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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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To support its R&D activities on Chagas disease, DNDi launched the Chagas Clinical Research Platform (CCRP). The platform brings together partners, experts, and stakeholders to provide support for evaluation and development of new treatments for Chagas disease. The patient-centred platform aims to f...acilitate clinical research, provide a forum for technical discussions, develop a critical mass of expertise, and strengthen institutional research capacities. In addition, it identifies and reviews priority needs, works towards standardization of methodology to assess drug efficacy and reviews alternatives for using current approved drugs (new schemes, doses, combination) and special scenarios (resistance).
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Two adjectives raise an issue for communicators working on Chagas disease (CD): “invisible and silent”. Two adjectives that can be ascribed to other neglected tropical diseases (NTD), but which are part of the essence of CD. Bringing CD out of its situation of neglect and oblivion is a mission e...ntrusted mainly to the world of communication as well as of science, politics and financial resources. However, communication has not always been considered among the priorities in the approach to the disease, except in valuable exceptions, some of which we have seen in the preceding article.
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Les progrès remarquables réalisés dans la lutte contre la forme à T. b. gambiense reposent sur le dépistage et le traitement curatif, une stratégie qui interrompt la transmission en réduisant le réservoir de parasites chez l’être humain. Parfois, cette
approche a été combinée avec des... activités de lutte antivectorielle. L’objet de ces lignes directrices est donc de la plus haute importance pour la poursuite des progrès en vue de l’élimination de la THA.
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Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is traditionally acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae, but in recent years also appears increasingly to be transmitted by eating fish or other aquatic anima...ls. The worm typically emerges through the skin on a lower limb of the host 1 year after infection, causing pain and disability.
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Leishmaniasis is a spectrum of disease caused by the infection of protozoan parasite Leishmania mainly affecting the antigen presenting cell of the host. The disease is although considered as neglected tropical disease still it is not completely eradicated. Majority of the issues related to the ther...apeutic approach is due to increased cytotoxicity of the drugs, less effectiveness, high cost and occurrence of drug resistance. Therefore, recent advancement in the field of parasitology has taken into consideration of the specific arms of immunity which can be triggered with the help of natural products, synthetic molecules or parasite specific ligands which helps in the restoration of host protective immunity and recovery from the infection. Therefore, in this review, we have highlighted the recent advancement in the field of Leishmania research taken into consideration of the therapeutic perspective. We have shown that apart from therapeutic potential of the available drugs and vaccination approach, the immune-therapy are emerging as the modern regime of treatment where the effectiveness of the therapy is significantly increased and making it safer and promising.
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Guillain-Barre Syndrome (GBS) is an acute autoimmune polyradiculoneuropathy that often follows an antecedent infection. Leishmaniasis is a zoonosis due to a flagellate protozoan of the Leishmania genus and transmitted by the sandfly. Here we report a 15 years old teenager who presented with an ascen...ding installation of the motor deficit in three weeks associated with dysphonia and swallowing disorders. The physical examination showed a flaccid proximo-distal quadriparesis, akinesthesia, apallesthesia and cutaneous lesions on the forehead, wrist and calf that appeared two months earlier. The HIV serology was negative and cerebrospinal fluid examination was normal. The electroneuromyography showed a reduction in motor and sensitive amplitudes with an increase in distal latencies and F waves in the upper limbs and segmental and focal conduction blocks. Parasitological examination of the dermal juice around the edges of the skin lesions revealed amastigote forms of leishmaniasis. The evolution was favorable with only symptomatic treatment.
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WHO promotes the inclusion of foodborne trematodiases among the targets of preventive chemotherapy interventions. With the aim of providing access to quality medicines, WHO has negotiated with Novartis Pharma AG whereby Novartis donates triclabendazole for the treatment of fascioliasis and paragonim...iasis in endemic countries. WHO collects applications from ministries of health and medicines are shipped free of charge.
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The purpose of this guide is to provide practical advice for health staff undertaking infectious disease preparedness and response activities to ensure that access to safe abortion care (SAC) is maintained when an infectious disease outbreak occurs. It is an operational guide which can serve to supp...ort health actors to maintain SAC services during outbreaks and ensure that necessary SAC considerations are integrated within outbreak responses; it is not a clinical guide. The locational focus of this document is humanitarian and fragile settings; however, recommendations may apply to infectious disease outbreaks in all low-resource populations. This guide is intended to complement Sexual and Reproductive Health and Rights During Infectious Disease Outbreaks: Operational Guidance for Humanitarian and Fragile Settings.
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Ce guide a pour objectif de fournir des conseils pratiques à destination du personnel de santé entreprenant des activités de préparation et de réponse aux maladies infectieuses afin de maintenir l’accès à des Soins d’Avortement sans Risque (SAR) durant une épidémie de maladie infectieus...e. Il s’agit d’un guide pratique destiné à aider les acteurs du secteur de la santé à garantir le maintien des services de Soins d’Avortement sans Risque (SAR) pendant les épidémies et à veiller à ce que les considérations nécessaires en matière de Soins d’Avortement sans Risque soient intégrées à la riposte à l’épidémie; il ne s’agit pas d’un guide clinique. Ce document se concentre sur les situations de crise humanitaire et les contextes fragiles, toutefois les recommandations peuvent s’appliquer aux épidémies de maladies infectieuses auprès des populations à faibles ressources. Ce guide est prévu en complément du document: Santé et droits en matière de sexualité et de procréation durant les épidémies de maladies infectieuses: orientations de mise en oeuvre pour les situations de crise humanitaire et les contextes fragiles.
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The objectives of the meeting were:
1. To update the current status of the disease transmission, country capacities and plans for tackling the disease.
2. To understand the epidemiology including disease distribution and risk, the models
for estimating under-detection, the geographical variati...ons of in clinical presentation,
the roles of domestic and wild animal reservoirs and the subsequent different
transmission patterns and control approaches, including vector control.
3. To update current research and development efforts for improving diagnostic and
treatment tools.
4. To define the goals for achieving the control of r-HAT, the need for a multisectoral
approach and to discuss the strategy for controlling r-HAT and the coordination
mechanisms.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan (GAP). With a limited number of new antibiotics in the developmental pipeline, many countries are in the process of establishing strategies for anti...microbial stewardship (AMS). Within each country, different healthcare challenges have
contributed to AMR. This has also shaped individual AMS strategies and policies. In South Africa (SA), there is a high burden of infectious diseases, mainly of bacterial origin. In addition, SA also has the highest number of people living with
human immunodeficiency virus (HIV) globally. According to the 2019 statistics, there are approximately 7.97 million people living with HIV in SA. Together with this, SA has the fourth largest tuberculosis population globally.
Other important challenges include poverty, malnutrition, a high burden of non-communicable diseases, and a dire shortage of trained healthcare professionals (e.g. clinicians, pharmacists, and nurses).
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Le pian fait partie d’un groupe d’infections bactériennes chroniques que l’on désigne couramment par le terme « tréponématoses endémiques ». Ces maladies sont dues à des bactéries spiralées appartenant au genre Treponema, qui comprend aussi la syphilis endémique (béjel) et la pinta.... Le pian est la plus courante de ces trois infections.
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La dracunculose est rarement mortelle, mais les personnes touchées peuvent souffrir d’invalidité pendant plusieurs semaines, voire plusieurs mois. La maladie sévit dans des communautés rurales défavorisées et isolées qui sont essentiellement tributaires de points d’eau stagnante superfici...els non aménagés, comme des étangs, pour s’approvisionner en eau de boisson.
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Principaux faits
D’après les estimations, 6 à 7 millions de personnes dans le monde sont infectées par Trypanosoma cruzi (T. Cruzi), le parasite responsable de la maladie de Chagas. La plupart de ces personnes vivent en Amérique latine.
La transmission à l’être humain se fait principalem...ent, en Amérique latine, par l’intermédiaire d’un insecte appelé triatome, qui peut être porteur de T. cruzi.
Parmi les autres modes de transmission de la maladie de Chagas, figurent : la transmission orale (par voie alimentaire), la transfusion de sang ou de produits sanguins, la transmission mère-enfant (congénitale), la transplantation d’organes et les accidents de laboratoire.
La maladie de Chagas ne touchait auparavant que des zones rurales de la Région des Amériques, et surtout de l’Amérique latine. Ces dernières décennies, toutefois, les mouvements de population ont fait que la plupart des personnes infectées sont des habitants de zones urbaines (urbanisation) et que la maladie s’est propagée à d’autres continents (où T. cruzi se transmet par des voies non vectorielles).
L’infection à T. cruzi est curable si un traitement est instauré rapidement après l’infection.
Chez les personnes infectées de façon chronique, un traitement antiparasitaire peut éventuellement prévenir ou enrayer la progression de la maladie, et éviter sa transmission, notamment de la mère à l’enfant.
Jusqu’à 30 % des personnes infectées de façon chronique présentent des troubles cardiaques, et jusqu’à 10 % d’entre elles souffrent de troubles digestifs et/ou neurologiques, ce qui peut imposer un traitement particulier.
Les principales méthodes de prévention de la maladie de Chagas en Amérique latine sont la lutte antivectorielle ainsi que d’autres stratégies visant à réduire la transmission vectorielle.
Dans le monde entier, le dépistage sanguin joue un rôle crucial dans la prévention de l’infection par transfusion ou transplantation d’organes.
Il est essentiel de détecter et de traiter l’infection chez les femmes et les filles en âge de procréer, ainsi que de soumettre tout nouveau-né et ses frères et sœurs à un dépistage dans le cas où la mère est infectée et n’a jamais reçu de traitement antiparasitaire.
Certains facteurs socio-économiques et environnementaux influent fortement sur la maladie de Chagas, dont la propagation et les différentes dimensions interdépendantes justifient la nécessité de mettre en œuvre des stratégies de lutte multisectorielles.
Quelques pays ont mis en place la notification et la surveillance des cas aigus et chroniques et des voies de transmission actives, qui sont essentielles à la lutte contre la maladie de Chagas.
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Glaucoma is a leading cause of irreversible blindness globally. In Malawi, glaucoma accounts for 15.8% of the blindness among people aged 50 years and above. Blindness from glaucoma is preventable with early detection and timely treatment. However, glaucoma management remains a challenge to eye care... providers due to its asymptomatic progression.
These guidelines inform eye care providers about the requirements for early detection of glaucoma, and the appropriate assessment and management of glaucoma patients. The guidelines also demonstrate the need for ophthalmologists to work with secondary-level eye care providers. With
glaucoma being a permanently blinding condition, it is vital to ensure that all eye care providers are adequately equipped with skills and resources for the early detection and management of glaucoma.
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