This report, published in conjunction with a summary overview of results of rounds 1–8, is the eighth and final report in a series of laboratory-based evaluations of rapid diagnostic tests (RDTs) for malaria. It provides a comparative measure of their performance in a standardized way to distingu...ish between well and poorly performing tests.
These results constitute the laboratory evaluation component of the WHO prequalification process for malaria RDTs and inform the current WHO procurement recommendations. In round 8, 35 RDTs from 17 manufacturers were assessed. For the first time the evaluation included an assessment of product performance against a panel of P. falciparum parasites with pfhrp2/3 gene deletions and therefore not expressing HRP2.
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This document provides interim recommendations for the surveillance of Zika virus infection, microcephaly and Guillain-Barré syndrome, in four different contexts and describes reporting requirements to WHO. Transmission refers to vector-borne transmission, unless specified differently. Autochthonou...s infection is considered to be an infection acquired in-country, i.e. among patients with no history of travel during the incubation period or who have travelled exclusively to non-affected areas during the incubation period. This document does not provide guidance on laboratory investigation or vector surveillance.
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This preliminary report summarizes the impact of the Ebola epidemic on the health workforce of Guinea, Liberia and Sierra Leone. It investigates the determinants of infection and describes safe practices put in place to protect health workers during the epidemic. The report covers the period from 1 ...January 2014 to 31 March 2015 and is presents findings from the 815 confirmed and probable cases for whom individual case reports were available.
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The major areas of focus for the plan will be:
- Social mobilization and community empowerment (health promotion & education for disease prevention);
- Promotion of access to safe water, good sanitation and hygiene;
- Surveillance and laboratory confirmation of outbreaks;
- Prom...pt case management and infection control;
- Complementary use of oral cholera vaccine (OCV) for cholera endemic communities; and
- Coordination and stewardship between and for all actors.
- Monitoring, supervision, evaluation and operation research to ensure continued improvement in service delivery.
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This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent ...class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
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On the 31st December 2019, the World Health Organization (WHO) China country office reported a cluster of pneumonia cases in Wuhan City, Hubei Province of China now known to be caused by a novel virus. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been confirmed as the causative v...irus of Coronavirus disease 2019 (COVID-19). Cases have now been identified in over 100 countries including South Africa.
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Kenya reported its first case of COVID-19 on 12 March 2020 and, as at 7 April 2020, 172 cases had been confirmed and 6 deaths reported. The Government of Kenya has taken a number of measures to curb the spread of the virus, including implementing a curfew, restricting movement out and into four coun...ties, including Nairobi Metropolitan, and closing most of the urban and rural markets to enforce social distancing. However, these measures, along with the global economic shock caused by the pandemic, are expected to generate new needs, requiring an immediate and urgent response.
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Coronavirus Disease-19 (COVID-19) was declared a global pandemic on 11 March 2020, and Malawi declared its first case on 2 April. As of 30 April, there were 36 confirmed positive cases of COVID-19 and 3 deaths. A State of Disaster was declared by President Arthur Peter Mutharika on 20 March and a 21...-day lockdown was implemented from 18 April to 9 May. The lockdown measures include: bans on public gatherings; closure of schools; and bans on international flights and cross-border passenger buses.
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In December 2019 a novel coronavirus (2019-nCoV) was identified as the causative agent of a severe acute respiratory illness among people exposed in a seafood market in Wuhan, China; • Human-to-human transmission has been documented, including in healthcare workers, and aerosol-generating procedur...es (AGP)† may play a role in the spread of the disease; • There are uncertainties in the natural history of the 2019-nCoV, including source(s), transmissibility mechanisms, viral shedding, and persistence of the virus in the environment and on fomites; • As of 6 February 2020, the following precautions are recommended for the care of patients with suspected or confirmed cases of 2019-nCoV: o For any suspected or confirmed cases of 2019-nCoV: standard + contact + droplet precautions o For any suspected or confirmed cases of 2019-nCoV and AGP: standard + contact + airborne precautions • The use of personal protective equipment (PPE) by healthcare workers requires an evaluation of the risk related to healthcare-related activities;
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A new publication - Waste Management during the COVID-19 Pandemic: from response to recovery - reviews current practices for managing waste from healthcare facilities, households and quarantine locations accommodating people with confirmed or suspected cases of COVID-19. Jointly produced by UNEP, th...e Institute for Global Environmental Strategies and the International Environmental Technology Centre, the report considers various approaches, identifies best practices and technologies, and provides recommendations for policy-makers and practitioners to improve waste management, over the long term.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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These guidelines are based on the 3rd Edition of the WHO Guidelines (Published 2015) World Health Organization’s Guidelines for the treatment of malaria. Additional literature surveys have been undertaken. Factors that were considered in the choice of therapeutic options included effectiveness, sa...fety, and impact on malaria transmission and on the emergence and spread of antimalarial drug resistance. On-going surveillance is critical given the spread of artemisinin resistance in Southeast Asia, although not yet confirmed anywhere in Africa. The guidelines on the treatment of malaria in South Africa aim to facilitate effective, appropriate and timeous treatment of malaria, thereby reducing the burden of this disease in our communities. This is essential to further reduce the malaria case fatality rates currently recorded in South Africa, to decrease malaria transmission and to limit resistance to antimalarial drugs.
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WHO invites Member States, health facilities and other entities to participate in the global effort to collect anonymized clinical data relating to suspected or confirmed cases of monkeypox and contribute data to the WHO Global Clinical Platform.
WHO has developed a clinical characterization case ...report forms (CRF) to standardize data collection of clinical features of monkeypox among outpatient and hospitalized cases.
For onboarding to the WHO Global Clinical Platform for monkeypox, please contact: monkeypox_clinicaldataplatform@who.int
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The Ministry of Health (MoH) of Syria officially declared a cholera outbreak on 10 September 2022, with the majority of cases reported from Aleppo, Deir-ez-Zor and Al-Hasakeh governorates. Since the situation report issued on 26 September 2022, the number of confirmed and suspected cases continues t...o rise. A total of 13 of 14 governorates are now affected, compared with 10 during the last reporting period.
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Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the
disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may... cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide.
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Most neglected tropical diseases (NTDs) occur in remote areas of low- and middle-income countries, where health systems are often poorly developed. Therefore, these neglected patients generally lack access to quality preventive, diagnostic, and therapeutic care [1]. The difficulty to access NTD-ende...mic areas, challenging logistics, and the lack of skilled human resources in these areas are also major obstacles to conduct clinical research. We had to face these when conducting a good clinical practice/good clinical laboratory practice (GCP/GCLP)-compliant clinical study in eastern Sudan, a well-known endemic area for visceral leishmaniasis and other NTDs. We share here the challenges related to study preparation and implementation of this GCP/GCLP study that investigated the causes of persistent fever in a rural hospital located in Gedaref State in eastern Sudan. We think this type of paper may be of interest for researchers planning to conduct a clinical trial in a resource-limited setting as well as for funders of such research.
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The epidemiology of the disease is mediated by the interaction of the parasite (trypanosome) with the vectors (tsetse flies), as well as with the human and animal hosts within a particular environment. Related to these interactions, the disease is confined in spatially limited areas called “foci..., which are located
in Sub-Saharan Africa, mainly in remote rural areas. The risk of contracting HAT is, therefore, determined by the possibility of contact of a human being with an infected tsetse fly. Epidemics of HAT were described at the beginning of the 20th century; intensive activities have been set up to confront the disease, and it was under control in the 1960s, with fewer than 5,000 cases reported in the whole continent.
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The WHO standard: Universal access to rapid tuberculosis diagnostics sets benchmarks to achieve universal access to WHO-recommended rapid diagnostics (WRDs), increase bacteriologically confirmed tuberculosis and drug resistance detection, and reduce the time to diagnosis. WHO-recommended rapid diagn...ostics are highly accurate, cost-effective, reduce the time to treatment initiation, and impact patient-important outcomes.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen...t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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