Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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The purpose of these guidelines is to give practical advice to doctors so that all services and models of care used by doctors and health workers are encouraged to consider the use of telemedicine as a part of normal practice. These guidelines will assist the medical practitioner in pursuing a sound... course of action to provide effective and safe medical care founded on current information, available resources, and patient needs to ensure patient and provider safety.
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The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-friendly and easy-to-navigate online platform.
The WHO guidelines for malaria bring together the Organization’s most up-to-date recommendations for malaria in one user-frie...ndly and easy-to-navigate online platform. The Guidelines supersedes 2 previous WHO publications: the Guidelines for the treatment of malaria, third edition and the Guidelines for malaria vector control. Recommendations on malaria will continue to be reviewed and, where appropriate, updated based on the latest available evidence. Any updated recommendations will always display the date of the most recent revision in the MAGICapp platform. With each update, a new PDF version of the consolidated guidelines will also be available for download on the WHO website.
This version of the Guidelines includes an updated recommendation for malaria vaccines, new recommendations on the use of near-patients qualitative and semiquantitative G6PD tests to guide anti-relapse treatment of P. vivax and P. ovale, updated recommendations on primaquine and the recommendation on the use of tafenoquine. It replaces the versions published on 16 February 2021, 13 July 2021, 18 February 2022, 31 March 2022, 3 June 2022, 25 November 2022, 14 March 2023 and 16 October 2023.
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An 82 percent funding gap is putting the lives of 2.5 million people in north-west Syria at risk this winter.
The first cholera case in north-west Syria was confirmed on 19 September. See below for the latest updates.
On 17 September, at least six airstrikes were reported in Idleb, 10 ...km away from the road used by the 7th cross-line convoy. One man was injured.
On 27 September, an airstrike reportedly hit in the vicinity of five IDP camps in Idleb, near the Bab AlHawa border crossing, injuring a woman, child and seven men.
HNAP recorded 19,545 new internal displacements in north-west Syria in September – the highest record so far in 2022 - largely driven by the deteriorating economy.
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This 10th edition of the Institute for Health Metrics and Evaluation’s annual Financing Global Health report provides the most up-to-date estimates of development assistance for health, domestic spending on health, health spending on two key infectious diseases – malaria and HIV/AIDS – and fut...ure scenarios of health spending. Several transitions in global health financing inform this report: the influence of economic development on the composition of health spending; the emergence of other sources of development assistance funds and initiatives; and the increased availability of disease-specific funding data for the global health community. For funders and policymakers with sights on achieving 2030 global health goals, these estimates are of critical importance. They can be used for identifying funding gaps, evaluating the allocation of scarce resources, and comparing funding across time and countries.
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The report and an accompanying series of studies show the global uptake of the World Health Organization (WHO) Surgical Safety Checklist in its first ten years since its launch and recommend ways the Checklist can be more effectively used to improve surgical safety for millions at risk.
The report ...found that uptake has been remarkably positive: the Checklist has been adopted in almost 90% of operating rooms in countries with a high Human Development Index (HDI), a country-level measure of health, education, and standard of living. It was referenced by at least 139 (70%) of the world's countries and is included as a national standard by the health ministries of at least 20 countries. The Checklist has also had beneficial qualitative impact, introducing a culture of safety and improved communication within surgical teams, increasing patient trust, and improving job satisfaction.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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SCOPING QUESTION: In the management of prescription opioid dependence, does supervised dosing with a long-acting opioid medication result in less opioid use and related harms than non-prescription, detoxification or usual care?
One of the most important ways we feel we can help to reduce the burden of cancer in Africa is to work with African cancer advocacy organisations to help educate and advocate about cancer in their countries. To this end in 2010 we designed with our partners, 13 posters for use in Africa
giving heal...th and lifestyle tips on how to avoid cancer and highlighting the early warning sign and symptoms of common cancers in Africa
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This guidance addresses rationale, risk-based scenarios, practical considerations prior to adoption of the self-testing products, quality assurance, safety and ethical considerations, and data management considerations for COVID-19 self-testing. The Africa CDC recommends the use of rapid antigen sel...f-testing within two key scenarios. The first includes testing for case identification within scenarios with a high risk of infection, including symptomatic cases and contacts of a confirmed case. The second scenario involves general screening within scenarios of low or unknown risk exposure allowing for self-care such as before gatherings with at-risk individuals and prior to participation in events involving members of different households. Within these scenarios, a positive test result indicates likelihood of current infection, while a negative test result indicates a lower risk of active infection, though it does not rule out infection altogether. All positive cases should be managed following the national COVID-19 management protocol of Member States.ssur
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Fetal alcohol spectrum disorders (FASD) represent a range of physical, mental, and behavioral disabilities caused by alcohol use during pregnancy, or prenatal alcohol exposure (PAE). FASDs are considered to be one of the leading preventable causes of developmental disability. Despite its high preval...ence, FASD is often misdiagnosed or underdiagnosed, making interventions more challenging or delayed.
his publication was initially developed for use in Spanish-speaking countries of the Americas and is intended to serve as a training workbook for providers of various disciplines to learn about the fundamentals of diagnosing FASD and to apply them to several case scenarios. It also discusses ethical implications of diagnosing FASD to the mother and child. Target audiences include physicians, psychologists, allied health professionals, social workers, and other providers that may encounter individuals affected by FASD. It is ideally used as a supplement for in-person training by experts in the fields of dysmorphology, epidemiology, and neuropsychology.
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv...e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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The WHO Living guideline: Drugs to prevent COVID-19 contains the Organization’s most up-to-date recommendations for the use of drugs to prevent COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform.
Guidelines ...regarding the use of drugs to treat (rather than prevent) COVID-19 are included in a separate WHO document, Therapeutics and COVID-19: living guideline, that can via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform). Guidelines regarding the clinical management of COVID-19 patients are included in a further document, COVID-19 Clinical management: Living guideline, that can be accessed via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform).
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This package, developed jointly by The ACQUIRE Project and Promundo, a Brazilian nongovernmental organization, can be used by individuals, organizations, and donors to carry out needs assessments to identify gaps in male engagement programming related to HIV and AIDS prevention, care, treatment, and... support.
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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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Common Threads, Common Practice provides a concise, easy to use reference guide for best practice when working with immigrant and refugee women in sexual and reproductive health.