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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-lim
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ited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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The document "Diabetes and Ramadan: Practical Guidelines 2021," published by Elsevier, provides updated guidance for managing diabetes during Ramadan fasting. Developed by the International Diabetes Federation (IDF) and the Diabetes and Ramadan (DAR) International Alliance, the guidelines address ke
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y aspects for individuals with diabetes who choose to fast, including risk assessment, blood glucose monitoring, insulin and medication adjustments, and the management of special populations (such as pregnant women, the elderly, and those with chronic conditions). Emphasis is placed on individualized patient education before Ramadan to ensure safe fasting practices and minimize risks like hypoglycemia and hyperglycemia.
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Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in
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reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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Global Trends: Forced Displacement in 2023
recommended
At the end of 2023, an estimated 117.3 million people worldwide were forcibly displaced due to persecution, conflict, violence, human rights violations and events seriously disturbing the public order. The latest Global Trends report, published in June 2024, provides key statistical trends on forc
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ed displacement. It includes the latest official statistics on refugees, asylum-seekers, internally displaced and stateless people, as well as the number of refugees who have returned home
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid
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ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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RESULTS: Between 76 and 97% of the PHCS offered RMCAH services before the lockdown. Except in antenatal, delivery and adolescent care, there was a decline of between 2 and 6% in all the services during the lockdown and up to 10% decline after the lockdown with variation across and within States. Dur
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ing the lockdown. Full-service delivery was reported by 75.2% whereas 24.8% delivered partial services. There was a significant reduction in clients' utilization of the services during the lockdown, and the difference between States before the pandemic, during, and after the lockdown. Reported difficulties during the lockdown included stock-out of drugs (25.7%), stock-out of contraceptives (25.1%), harassment by the law enforcement agents (76.9%), and transportation difficulties (55.8%). Only 2% of the PHCs reported the availability of gowns, 18% had gloves, 90.1% had hand sanitizers, and a temperature checker was available in 94.1%. Slightly above 10% identified clients with symptoms of COVID-19.
CONCLUSIONS: The large proportion of PHCs who provided RMCAH services despite the lockdown demonstrates resilience. Considering the several difficulties reported, and the limited provision of primary protective equipment more effort by the government and non-governmental agencies is recommended to strengthen delivery of sexual and reproductive health in primary health centres in Nigeria during the pandemic.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc
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e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI
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
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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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Objective: The study aimed to describe the current epidemiological, clinical and immunological profile of newly
detected HIV - positive patients in Northern Benin by 2016. Methods: It was a prospective study conducted from May 2 to
October 31, 2016 on three main sites of care of people living with
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HIV (PLHIV) in the department of Borgou in Benin. All
new cases of HIV infection have been systematically and comprehensively recruited. Initial epidemiological, clinical and
immunological data were collected using a questionnaire. These data were entered and analyzed using the Epi Info 7 software.
Results: In total, 185 adults (68 male and 117 female) newly screened HIV positive were included in this study. The middle age
was 36.2 ± 10.9 years and the sex ratio was 0.6 One hundred and thirty-five patients (73%) were between 25 and 50 years old.
In terms of the profession, 132 patients (71.3%) were engaged in liberal activities (craftmen, traders and retailers). The
majority was schooled (113 or 61.1%) and resided in urban areas (146 or 79%). One hundred and sixteen patients lived in
couple (62.7%) with an average monthly income estimated at 70 US Dollars. Clinically, 123 patients (66.5%) were in WHO
stage III. The body mass index was over 18.5 kg/m2 in 124 patients (67%). The median number of TCD4 lymphocytes was
254.5 cells/ml and 25 patients (13.5%) had a number of CD4 over 500 cells/ml. HIV1 was really predominant (97.8%). Most
patients (152 or 82.2%) had been screened for clinical suspicion. Conclusion: HIV infection in Benin remains the prerogative
of young, female, educated and poor people. Screening is delayed and hence the need to develop innovative strategies for early
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An interdisciplinary approach to address global health challenges such as the Covid-19 pandemic, climate change, loss of biodiversity, human migration has been framed by the One Health approach. This approach is promoted at global level by the Tripartite of the World Health Organisation, the World A
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nimal Health Organisation, the Food and Agriculture Organisation of the United Nations, recently joint by the United National Environment Program to form the Quadripartite. The German government through its Ministry of Economic Cooperation and Development supports this approach with its One Health strategy and investment in several technical cooperation projects.
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This comprehensive reference document is intended for those responsible for training in SMC (Seasonal Malaria Chemoprevention). It assumes that SMC will be implemented using the Community Health Worker strategy.
El documento presenta un marco estratégico de la Organización Mundial de la Salud para la gestión de riesgos relacionados con emergencias y desastres en el sector de la salud. Destaca que estos eventos (como epidemias, desastres naturales o conflictos) tienen un impacto significativo en la salud,
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los sistemas sanitarios y el desarrollo de la sociedad. El marco propone un enfoque integral y proactivo basado en la prevención, la preparación, la respuesta y la recuperación, al tiempo que subraya la importancia de la colaboración entre diferentes sectores y actores. Su objetivo principal es reducir los riesgos para la salud, fortalecer la resiliencia de las comunidades y los sistemas de salud, y mejorar la seguridad sanitaria a nivel mundial.
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This document by Medicines for Malaria Venture (MMV) highlights the significant burden of malaria on children worldwide, emphasizing the need for effective prevention, diagnosis, and treatment strategies. It reviews current challenges and progress in combating pediatric malaria, advocating for conti
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nued research and investment to reduce malaria-related morbidity and mortality in children, especially in high-burden regions.
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Le nouvel afflux de réfugiés de la République Centrafricaine (RCA), souligne le caractère cyclique de la crise humanitaire, avec des afflux qui tendent à se répéter tous les quatre ans et qui remettent profondément en cause la manière de répondre. Le conflit et l'insécurité en RCA contin
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uent de provoquer des déplacements forcés importants, tant à l'intérieur de la RCA que vers les pays voisins, surtout concernant la République Démocratique du Congo (RDC).
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This report is documenting the global incidence of attacks and threats against health workers, facilities, and transport around the world. The report cites 806 incidents of violence against or obstruction of health care in 43 countries and territories in ongoing wars and violent conflicts in 2020, r
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anging from the bombing of hospitals in Yemen to the abduction of doctors in Nigeria. Attacks -- including killings, kidnappings, and sexual assaults, as well as destruction and damage of health facilities and transports -- compounded the threats to health in every country as health systems struggled to prepare for and respond to the outbreak of the COVID-19 pandemic.
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