A Guide For Multicentre Trials in High-Burden Countries
HIV infection, due to the immunosuppressant that leads, nowadays constitutes an aggravating factor of endemic tuberculosis. Tuberculosis remains a huge burden to human health, even in the early 21st century. The situation is deteriorating in many countries, particularly because of the synergy with t...he HIV epidemic and the emergence of multidrug-resistant (MDR) and extensively drug resistant (XDR) tuberculosis. The urgent development of new tools that can improve the diagnosis, prevention and/or treatment of tuberculosis and other major mycobacterium diseases depends largely on the progress of basic and applied research. Faced with this situation, there is an urgent need for effective strategies and actions to permanently solve the problem of this endemic disease whose impact is too negative on people’s lives.
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Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approximately twice as high as high-resource settings (15 o...ut of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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South Africa has faced many challenges over the past two decades, accomplishing profound positive changes in the social structure and government of the nation. This has not yet fully translated into better health for the population, however, particularly the poorest segment. In fact, the p...opulation has lost ground since the 1990s in virtually all important health indicators, leaving South Africa with a high burden of infectious disease.
August 2011, Vol. 101, No. 8 SAMJ
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The purpose of this work is to estimate potential COVID-19 case burdens in each African nation considering various social distancing interventions. Given current trends in case burden, the model estimates the potential resource needs that would be needed under different scenarios. The model is for p...lanning purposes and is based on current understanding and the most up-to-date assumptions. Results reported here are not forecasts but scenarios that may unfold given the assumptions about social-distancing and population health.
You can download scenarios for North Africa; Middle Africa; West Africa, East Africa and South Africa
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According to the World Health Organization (WHO), sub-Saharan Africa has only 3% of the world’s health workers to cater for 11% of the world population, bearing over 25% of the global disease burden (WHO, 2014). With a steady increase in reported cases on the African Continent, the current COVID-1...9 pandemic threatens to overwhelm our already taxed health infrastructure. It is, therefore, imperative to take serious and urgent measures towards disease management and monitoring especially as the need for self-quarantine and contact surveillance rises.
In view of the infrastructural and resource gaps, technology should be considered for remote management of healthcare deliver to patients during this period. As it is abundantly clear, even countries with more advanced healthcare infrastructure and resources have struggled to treat COVID-19 and non-COVID-19 patients during this pandemic.
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A Global Analysis of Antimicrobial Resistance and Its Drivers.
Since the first State of the World’s Antibiotics report in 2015, antimicrobial resistance has leveled off in some high-income countries but continues to rise in many low- and middle-income countries (LMICs), where access to antibiotic...s has risen with increases in gross domestic product per capita. Per capita antibiotic consumption in LMICs is lower than in high-income countries, despite a higher infectious disease burden; however, consumption rates are rapidly converging. These trends reflect both better access to antibiotics for those who need them and increases in inappropriate antibiotic use.
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The African Centers for Disease Control and Prevention and the African Union together have called for a New Public Health Order which will safeguard the health and economic security of the continent as it strives to meet the aspirations of the Agenda 2063. A key pillar of this mandate seeks to expan...d the local manufacture of vaccines, diagnostics, and therapeutics. Presently, less than one percent of vaccines administered on the continent are manufactured locally. This places a great burden on the health systems of African countries and reduces their ability to respond to pandemics and other health crises.
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Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 25, No. 12, December 2019 2183
Buruli ulcer is a neglected tropical disease caused by Myocobacterium ulcerans; it manifests as a skin lesion, nodule, or ulcer that can be extensive and disabling. To assess the global burden and the progress ...on disease control, we analyzed epidemiologic data reported by countries to the World Health Organization during 2010–2017.
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In January 2021, the World Health Organization (WHO) published a new road map to address the burden of disease and death imposed by neglected tropical diseases (NTDs). The end of the first year of the 2021-2030 NTD road map is an opportunity to take stock of where we stand and how we plan to move fo...rward.
Considerable progress has been made since 2012 when the first road map was adopted. As of 6 June 2022, forty-six countries have eliminated at least one NTD, while 600 million people no longer require treatment because they are no longer exposed to risks associated with the pathogens that previously harmed them. In some cases, diseases that have plagued humanity for centuries, such as sleeping sickness and Guinea worm disease, are at an all-time low. Less tangible, but also important, there has been significant progress in the way NTDs are viewed. Additionally, the disruptive impact of the COVID-19 pandemic on NTD programmes is evident.
This brochure is the first in a series of advocacy briefs for the new NTD road map presenting highlights of success and challenges towards attaining the 2030 goals.
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Leptospirosis is a bacterial zoonotic disease of worldwide importance, though relatively neglected in many African countries including sub Saharan Africa that is among areas with high burden of this disease. The disease is often mistaken for other febrile illnesses such as dengue, malaria, rickettsi...oses and enteric fever. Leptospirosis is an occupational disease likely to affect people working in environments prone to infestation with rodents which are the primary reservoir hosts of this disease. Some of the populations at risk include: sugarcane plantation workers, wetland farmers, fishermen and abattoir workers. In this study we investigated the prevalence of antibodies against Leptospira among sugarcane plantation and factory workers, fishing communities as well as among rodents and shrews in domestic and peridomestic environments within the study areas.
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Human rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria–the most populous country in Africa–rabies causes a significant public health burden partly due to perennial obstacles to implementing a national prevention and control progra...m.
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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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As a high-burden neglected tropical disease, soil-transmitted helminth (STH) infections remain a major problem in the world, especially among children under five years of age. Since young children are at high risk of being infected, STH infection can have a long-term negative impact on their life, i...ncluding impaired growth and development. Stunting, a form of malnutrition in young children, has been long assumed as one of the risk factors in acquiring the STH infections. However, the studies on STH infection in children under five with stunting have been lacking, resulting in poor identification of the risk. Accordingly, we collected and reviewed existing related research articles to provide an overview of STH infection in a susceptible population of stunted children under five years of age in terms of prevalence and risk factors. There were 17 studies included in this review related to infection with Ascaris lumbricoides, Trichuris trichiura, hookworm, and Strongyloides stercoralis from various countries. The prevalence of STH infection in stunted children ranged from 12.5% to 56.5%. Increased inflammatory markers and intestinal microbiota dysbiosis might have increased the intensity of STH infection in stunted children that caused impairment in the immune system. While the age from 2 to 5 years along with poor hygiene and sanitation has shown to be the most common risk factors of STH infections in stunted children; currently there are no studies that show direct results of stunting as a risk factor for STH infection. While stunting itself may affect the pathogenesis of STH infection, further research on stunting as a risk factor for STH infection is encouraged.
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Comprehensive and comparable estimates of health spending in each country are a key input for health
policy and planning, and are necessary to support the achievement of national and international health goals. Previous
studies have tracked past and projected future health spending until 2040 and ...shown that, with economic development,
countries tend to spend more on health per capita, with a decreasing share of spending from development assistance
and out-of-pocket sources. We aimed to characterise the past, p
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The Creditor Reporting System was analysed for official development assistance funding disbursements towards TB control in 11 conflict-affectedstates, 17 non-conflict-affected fragile states and 38 comparable non-fragile states. The amounts of funding, funding relative to burden, funding relative to... malaria and human immunodeficiency virus (HIV) control, disbursements relative to commitments, sources of funding as well as funding activities were extracted and analysed.
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An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we furth...er explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends.
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The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed,
especially during public health emergencies. Development assistance is an important source of health financing in
many low-income countries, yet little is known about how much of this funding was di...sbursed for COVID-19. We
aimed to put development assistance for health for COVID-19 in the context of broader trends in global health
financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.
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The COVID-19 pandemic highlighted gaps in health surveillance systems, disease prevention, and treatment globally. Among the many factors that might have led to these gaps is the issue of the financing of national health systems, especially in low-income and middle-income countries (LMICs), as well ...as a robust global system for pandemic preparedness.
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