Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to pharmacopeia unopened insulin vials must be stored in a... refrigerator (2–8°C), while storage at ambient temperature (25–30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2–8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four–week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
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Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should h...ave some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
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A healthcare worker manual. 2nd edition
The development of this National Manual for the Management of HIV-related Opportunistic Infections and Conditions for use by health care workers at the frontline of our fight against HIV/AIDS is intended to improve their understanding of the causes, preventio...n and appropriate management of opportunistic infections and conditions in adults and adolescents (OIs in children is covered effectively in the Integrated Management of Childhood Illnesses – IMCI – materials). It is also intended to be a practical guide at the clinic level, so as to improve quality of life, treatment outcomes and survival of PLHA. Crucially, this manual uses a “symptom-based” approach to support health care workers at the most basic primary level to be able to effectively initiate the care of PLHA with OIs and refer patients as appropriate (effective triage of patients at the primary care level). The result of this will be to move the management of OIs closer to the patient while ensuring that referral links with higher-level facilities and care is cultivated.
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Asthma is a chronic inflammatory condition characterized by airway hyper-responsiveness to a variety of stimuli largely of allergic origin with reversible airflow limitation. The major clinical features of asthma are wheezing, shortness of breath, and cough. It is a major cause of impaired quality o...f life with impact on work and recreational as well as physical activities and emotions. The goal of treatment is to achieve overall clinical control, which entails the achievement of symptom-free control and to minimize future risks. The goal is the same for all severity of the disease.
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The "National Guideline for Cholera Surveillance and Outbreak Response" by the Ethiopian Public Health Institute (EPHI) provides a comprehensive approach to combating cholera outbreaks in Ethiopia. It emphasizes the importance of a multisectoral approach, including case management, WASH measures, an...d the use of cholera vaccines. A key component is the establishment of Cholera Treatment Centers (CTCs) that provide 24/7 care. Additionally, the guideline stresses water quality monitoring and hygiene practices to prevent the spread of cholera and protect public health.
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The CDC's "About Cholera" webpage provides essential information on cholera, an intestinal infection caused by the bacterium Vibrio cholerae. It highlights that cholera is primarily spread through contaminated water and food, leading to severe diarrhea, dehydration, and potentially death if untreate...d. Individuals in areas with unsafe drinking water, poor sanitation, and inadequate hygiene are at the highest risk. The page emphasizes the importance of early and proper treatment, such as rehydration therapy, to improve survival rates. Preventative measures include using treated water, practicing good hygiene, and vaccination, especially for travelers to regions where cholera is prevalent.
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The World Health Organization's malaria fact sheet provides an overview of malaria, a life-threatening disease caused by Plasmodium parasites transmitted through the bites of infected female Anopheles mosquitoes. It highlights that malaria is preventable and curable, yet remains a significant glo...bal health challenge. Key statistics from 2023 indicate an estimated 263 million malaria cases and 597,000 deaths worldwide, with the WHO African Region bearing the majority of this burden. The fact sheet details transmission methods, symptoms, at-risk populations, diagnostic approaches, treatment options—including the use of artemisinin-based combination therapies (ACTs)—and preventive measures such as insecticide-treated nets (ITNs) and indoor residual spraying (IRS). It also discusses the impact of malaria on vulnerable groups like children under five and pregnant women, and outlines WHO's global response strategies aimed at reducing malaria incidence and mortality rates.
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The article "Malaria – MSD Manual Professional Edition" provides a comprehensive overview of malaria, an infection caused by Plasmodium species. It describes symptoms such as fever, chills, and anemia, explains diagnostic methods like parasite detection in blood smears, and discusses treatment opt...ions including artemisinin-based combination therapies. In addition, it outlines prevention strategies such as medical prophylaxis and mosquito control measures. The article is intended for medical professionals and offers detailed information on the pathophysiology, clinical presentation, and management of malaria.
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The AHO Malaria Fact Sheet gives a brief overview of malaria as a preventable and curable disease caused by Plasmodium parasites, mainly affecting sub-Saharan Africa. It highlights symptoms like fever and chills, notes vulnerable groups such as young children and pregnant women, and emphasizes the n...eed for targeted prevention and treatment.
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The WHO website titled "Malaria" provides a comprehensive overview of malaria, a potentially fatal disease caused by Plasmodium parasites and primarily transmitted through mosquito bites in tropical countries. It offers information on symptoms, at-risk groups, preventive measures, and treatment opti...ons. The site also presents recent statistics: in 2023, an estimated 263 million malaria cases and 597,000 deaths occurred in 83 countries, with the African region being the most affected—accounting for 94% of cases and 95% of deaths. Children under the age of five made up approximately 76% of the deaths in this region.
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The WHO website titled "Malaria" provides a comprehensive overview of malaria, a potentially fatal disease caused by Plasmodium parasites and primarily transmitted through mosquito bites in tropical countries. It offers information on symptoms, at-risk groups, preventive measures, and treatment opti...ons. The site also presents recent statistics: in 2023, an estimated 263 million malaria cases and 597,000 deaths occurred in 83 countries, with the African region being the most affected—accounting for 94% of cases and 95% of deaths. Children under the age of five made up approximately 76% of the deaths in this region.
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The WHO website titled "Malaria" provides a comprehensive overview of malaria, a potentially fatal disease caused by Plasmodium parasites and primarily transmitted through mosquito bites in tropical countries. It offers information on symptoms, at-risk groups, preventive measures, and treatment opti...ons. The site also presents recent statistics: in 2023, an estimated 263 million malaria cases and 597,000 deaths occurred in 83 countries, with the African region being the most affected—accounting for 94% of cases and 95% of deaths. Children under the age of five made up approximately 76% of the deaths in this region.
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The "Regional Action Plan 2017–2030: Towards a Malaria-Free South-East Asia Region" by the World Health Organization (WHO) outlines a strategic framework to eliminate malaria in the 11 countries of the WHO South-East Asia Region by 2030. It focuses on reducing transmission, particularly of Plasmod...ium falciparum and P. vivax, addressing multidrug resistance, improving surveillance, and ensuring universal access to diagnosis, treatment, and prevention. The plan sets clear objectives and milestones and emphasizes strong governance, cross-border collaboration, community involvement, and sustainable financing to achieve and maintain a malaria-free status across the region.
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All malaria-endemic countries in the Region of the Americas have taken on the challenge to eliminate the disease and to put in place measures to orient their health programs and strategies in that direction. This manual explains how to implement measures to achieve malaria elimination and prevent it...s reestablishment by increasing the intensity and quality of interventions, reorienting initiatives, reducing delays that favor transmission, and ensuring adequate monitoring to adjust interventions. In this regard, the first suggested step is to stratify the territory - so that interventions and population groups can be planned and prioritized - and then implement diagnosis, treatment, investigation and response (DTI-R) actions as a key strategy aimed at effectively eliminating the disease and preventing its reestablishment in all strata. In addition, the document seeks to operationalize the concept of "surveillance as an intervention" promoted by the World Health Organization through the Global Technical Strategy for Malaria 2016-2030 and highlights the importance of communities having access to early diagnosis and treatment. Finally, the manual also includes management and monitoring aspects that must be taken into account to eliminate the foci with transmission.
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The National Strategic Plan for Malaria Elimination in India (2023-2027) focuses on achieving malaria elimination by 2030, in alignment with the Global Technical Strategy. The document outlines the strategies, targets, and goals for malaria elimination, aiming for zero indigenous malaria cases by 20...27. It emphasizes district-based planning, robust surveillance systems, and enhancing case management and vector control. The plan stresses the importance of universal access to treatment, prevention, and data-driven decision-making. Furthermore, it encourages innovation and research in malaria elimination efforts, fostering multisectoral coordination and community engagement.
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The document titled "Classification and Referral Algorithm – iCCM South Sudan", published by Malaria Consortium in 2012, provides a practical tool for community health workers to assess, classify, and manage common childhood illnesses in South Sudan. It outlines step-by-step procedures for identif...ying danger signs and symptoms related to malaria, pneumonia, diarrhoea, and severe acute malnutrition. Based on clinical findings, the algorithm guides health workers in making decisions about immediate treatment, referral to higher-level health facilities, and caregiver counseling. The aim is to support timely and appropriate care at the community level through the Integrated Community Case Management (iCCM) strategy.
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emale genital mutilation (FGM) comprises all procedures that involve the partial or total removal of external genitalia or other injury to the female genital organs for non-medical reasons; the procedure has no health benefits . Moreover, the removal of or damage to healthy genital tissue interferes... with the natural functioning of the body and may cause several immediate and long-term health consequences. In addition, FGM violates a series of well established human rights principles, including the principles of equality and nondiscrimination based on sex, the right to life (when the procedure results in death), and the
right to freedom from torture or cruel, inhuman or degrading treatment or punishment, as well as the rights of the child to physical and mental integrity.
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Malaria in pregnancy is a significant health problem in malaria-endemic areas. It not only causes substantial childhood morbidity and mortality but also increases the risks of adverse events for pregnant women and their developing fetuses. Most of the burden in these areas is due to infection with P...lasmodium falciparum. Artemisinin-based combination therapy (ACT) has been recommended as first-line treatment for uncomplicated P. falciparum malaria in all populations, including pregnant women in their second and third trimesters, since 2006. However, for women in their first trimester of pregnancy, WHO recommended as first-line treatment a combination of quinine and clindamycin.
Based on a review of the evidence conducted in 2022, WHO now recommends artemether–lumefantrine, the ACT with the most human safety data available, as the preferred treatment for uncomplicated P. falciparum malaria in the first trimester of pregnancy. This document presents all relevant evidence on the effects and safety in early pregnancy of artemisinins and partner medicines used in ACTs from both studies in experimental animals and observational studies in humans.
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