PowerPoint Slides for the Geneva IAPAC meeting , 13 October 2016 by Sabin Nsanzimana, MD -Division Manager, HIV, STIs and Viral Hepatitis
Institute of HIV Disease Prevention and Control, Rwanda Biomedical Center AND Basel Clinical Epidemiology& Biostatistics and SwissTPH , University of Basel, Swit...zerland
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Ebola interventions: The intervention to combat Ebola aims to stop human-to-human transmission. The package is composed of five elements necessary to control the spread of the disease: care to patients, contact monitoring, safe burials, laboratory support and social mobilisation.
The document al...so describes key information on Ebola virus disease, patient care, contact tracing and monitoring, safe and dignified burial, laboratory diagnosis.
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The school and a community teaching modules are aimed at preventing vector-borne diseases through community participation. Meanwhile, the interactive toolkit is meant to be help raise awareness on health, sanitation and vector control. These materials will help volunteers and practitioners foster di...alogue with communities and ensure that prevention is seen as the primary way of combatting vector-borne diseases
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The report explores strategies for sustaining the country’s responses to the three diseases and eventually transitioning away from external funding and programmatic support. It takes stock of Kenya’s health financing landscape and identifies opportunities and challenges for sustaining effective ...coverage of HIV, TB, and malaria services in the long run, mindful of macro-fiscal and institutional constraints. The report informs ongoing dialogue within government, including among the Ministry of Health, National Treasury, Council of Governors, and National AIDS Control Council, as well as between government and development partners.
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Fact sheet on Zika virus containing recommendations for pregnant women and information for the treatment, prevention and control of the disease.
This factsheet is also available in Spanish, Portuguese and French!
The Directorate General of Epidemiology announces the virtual self-instruction course:
"Vigilance, Prevential and Control of Ebola Virus Disease"
The current SEARVAP (South-East Asia regional vaccine action plan) describes a set of regional goals and objectives for immunization and control of vaccine-preventable diseases for 2016 – 2020 and highlights priority actions, targets and indicators that address the specific needs and challenges of... countries in the Region.
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Progress in reducing tobacco use is a key indicator for measuring countries’ efforts to implement the WHO Framework Convention on Tobacco Control – target 3.a under the Sustainable Development Goals agenda. Countries have adopted this indicator to report progress also towards the tobacco reducti...on target under the Global Action Plan for the Prevention and Control of Noncommunicable Diseases 2013–2020 and the WHO’s Global Programme of Work triple billions target.
Fourth edition.
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Ethiopia GATS was implemented by Ethiopia Public Health Institute (EPHI) in collaboration with the Ethiopian Food, Medicine, Health Care Administration and Control Authority (FMHACA), CSA, FMOH and the World Health Organization (WHO)country office. Technical assistance ...for the implementation of the survey was provided by the WHO, the U.S. Centers for Disease Control and Prevention (CDC), and RTI International. Program support was provided by the CDC Foundation.Financial support for Ethiopia GATS was provided by the CDC Foundation with a grant from the Bill & Melinda Gates Foundation.GATS enhances countries’ capacity to design, implement and evaluate tobacco control programs. It also assistscountries to fulfill their obligations under the WHO FCTC to generate comparable data within and across countries. In addition,it allows countries to implement the WHO MPOWER policy package. WHO MPOWERisa technical packagedevelopedtoassist countries in implementing selected demand reduction measures contained in the WHO Framework Convention on Tobacco Control(FCTC)(5).The six MPOWER evidence-based measures contained in the FCTC;
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This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20...20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit...y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this condition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized ...as a disease by the American Medical Association and World Health Organization,
based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and
control of obesity would have a great impact in our society.
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Lymphatic filariasis (LF), a neglected tropical disease, is targeted for global elimination as a public health problem. This article reviews the history of LF control and elimination activities in the countries of the World Health Organization's (WHO) Eastern Mediterranean Region (EMR) over the last... 2 decades. In 2000, the estimated at-risk population in EMR countries was 12.6 million people, accounting for approximately 1% of the global disease burden. Of the 22 EMR countries, 3 countries (Egypt, Sudan and Yemen) were LF endemic and the disease was suspected in 4 other countries (Djibouti, Oman, Somalia and Saudi Arabia). After almost 2 decades of implementing sustained control and prevention measures, Egypt and Yemen were successfully validated by the WHO as having achieved the elimination criteria in 2017 and 2019, respectively. In 2018, Sudan completed mapping of LF, reaching 26.2% geographical coverage where mass drug administration (MDA) is required and is scaling-up MDA. Extensive epidemiological assessment indicated the absence of LF transmission in the four suspected countries and no MDA required. Challenges faced during the elimination and post-elimination phases are described and discussed
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Dengue is the fastest spreading, mosquito-borne viral infectious disease worldwide, with remarkable morbidity and mortality. In the past decades, profound contributions have been made towards understanding its epidemiology, including disease burden and distributions, risk factors, and control and pr...evention practices. Dengue continues to disseminate to new areas, including high latitude regions, and a new serotype (dengue virus serotype 5) has been identified. Vaccine research has made new progress, in which the licensed yellow fever and dengue virus quadrivalent chimeric vaccine is now under further safety assessment. In disease surveillance, because of its operational simplicity, rapidity, capability, and utility as an indicator of disease severity, dengue virus NS1 antigen detection has great promotion and application value among primary health care institutions. Vector control progress has driven new breakthroughs in biotechnology, including Wolbachia-infected Aedes and genetically modified Aedes. Both Aedes variants have been used to block transmission of the dengue virus through population replacement and suppression. In the future, vector control should still be pursued as a key measure to prevent transmission, along with anti-viral drug and vaccine research.
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Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT ...control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
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American cutaneous leishmaniasis (CL) is a severely understudied and neglected“disease of poverty” widespread throughout Peru. Transmission dynamics of CL are complex, requiring sandfly vectors and mammalian reservoir hosts to maintain the pathogen in a local environment whereby incidental hosts... (people) can become infected. We employed a One-Health approach to understand CL transmission in rapidly changing region of northern Peru. We describe the characteristics of 529 CL positive patients from four participating clinics. Using conditional logistic regression, we assessed risk factors of CL for residents of small urban areas through a matched case-control study with 63 patients who had visited one of the same clinics for CL (cases) or other medical reasons (controls). We later enrolled 343 households as part of a community based study occurring in 15 urban and rural areas of Soritor. We
found 256 positive humans (n= 914) as tested via the Montenegro Skin Test; we found 11 positive dogs (n = 236) via an immunofluorescence antibody test. Our results suggest that most- if not all- of CL transmission is occurring in rural areas and that urban women and urban children engage in many high risk activities typically attributed to men. We find evidence that prevalence of past infection is highest among rural residents and men. We believe dogs are unlikely Leishmania reservoirs in either rural or urban settings. It remains unknown if the high number of MST positive children in rural areas is a result of peridomestic or intradomestic transmission.
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Leishmaniasis is a major vector-borne disease caused by obligate intramacrophage protozoa of the genus Leishmania, and transmitted by the bite of phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia, in the old and new worlds, respectively. Among 20 well-recognized Leishmania speci...es known to infect humans, 18 have zoonotic nature, which include agents of visceral, cutaneous, and mucocutaneous forms of the disease, in both the old and new worlds. Currently, leishmaniasis show a wider geographic distribution and increased global incidence. Environmental, demographic and human behaviors contribute to the changing landscape for zoonotic cutaneous and visceral leishmaniasis. The primary reservoir hosts of Leishmania are sylvatic mammals such as forest rodents, hyraxes and wild canids, and dogs are the most important species among domesticated animals in the epidemiology of this disease. These parasites have two basic life cycle stages: one extracellular stage within the invertebrate host (phlebotomine sand fly), and one intracellular stage within a vertebrate host. Co-infection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms and more difficult to manage. The disease is endemic to Ethiopia, and the clinical signs are not pathognomic. The visceral form (Kala-azar) may be confused with other similar conditions such as malaria, tropical splenomegaly, schistosomiasis, milliary tuberculosis, and brucellosis. Similarly, cutaneous leishmaniasis should be differentiated from disease like tropical ulcers, impetigo and leprosy. There are several methods of laboratory diagnosis of leishmaniasis, including parasitological, immunological and molecular. Different forms of treatments are available including oral, parenteral, and topical medications such as pentavalent antimonials, liposomal amphotericin B, miltefosine and paromomycin. Methods of control are largely limited to destruction of animal reservoirs, treatment of infected humans, and management of sand fly populations. Development of an effective vaccine against leishmaniasis has been largely unsuccessful and hinders its prevention.
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In 2012, the World Health Organisation (WHO) set out a roadmap for the control, elimination, or eradication of 17 neglected tropical diseases by 2020. Many were skeptical about the achievability of such goals. Now, still two years away from that end point, good news is emerging for gambiense human A...frican trypanosomiasis (HAT), or sleeping sickness, caused by the tsetse-fly−transmitted protozoan parasite Trypanosoma brucei gambiense in West and Central Africa. The Rhodesiense form of the disease is being pursued under a separate programme.
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Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan Africa. HAT transmission l...ast soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
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To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric...a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
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