Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Overview
Epilepsy is one of the most common neurological disorders globally. The WHO epilepsy technical brief aims to strengthen action for epilepsy and complements the Intersectoral global action plan on epilepsy and other neurological disorders 2022–2031.
The technical bri...ef presents the key information on epilepsy and recommends actions to policy makers and other stakeholders. Using the concept of levers for change introduced by the Operational Framework for Primary Health Care, it identifies actions on the policy and operational levels that stakeholders should take to strengthen services for people with epilepsy using a person-centered approach based on human rights and universal health coverage.
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Recency assays use one or more biomarkers to identify whether HIV infection in a person is recent (usually within a year or less) or longstanding. Recency assays have been used to estimate incidence in representative cross-sectional surveys and in epidemiological studies to better understand the pat...terns and distributions of new and longstanding HIV infections.
This technical guidance outlines best practices regarding the appropriate use of HIV recency assays for surveillance purposes and updates 2011 technical guidance from the World Health Organization (WHO) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) on the use of HIV recency assays.
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Trachoma is the leading infectious cause of blindness (2). It is characterized by repeated
conjunctival infection with particular strains of Chlamydia trachomatis. This scars the conjunctivae and,
in some cases, leads to trichiasis with or without entropion. The abrasive action of eyelashes can
d...amage the cornea. In 2018, trachoma affected the poorest residents of the poorest communities of 43
countries
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The HHFA Comprehensive guide serves as the main reference document for planning and implementing a country HHFA. This guide will promote understanding of:
What the HHFA is and the information it can and cannot provide.
The HHFA modules, questionnaires and CSPro electronic data collection tool.
Th...e HHFA indicators, indices and their organization within the HHFA indicator inventory platform.
The HHFA data analysis platform.
The HHFA sampling and data collection methodologies.
The detailed steps involved in planning and implementing an HHFA.
Key concepts in review, interpretation and communication of HHFA findings.
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The Indigenous tribe called the Wiwa lives retracted in the Sierra Nevada de Santa Marta, Colombia. Little is known about their health status and whether the health care system in place covers their needs.
La santé est un droit humain universel et un facteur essentiel de bien-être, de développement économique, de croissance,
de richesse et de prospérité pour tous. Les systèmes de santé jouent un rôle essentiel, car ils protègent, rétablissent et
préservent la santé des patients et des p...opulations. Un personnel de santé bien formé, motivé et soutenu est la clé de
voûte de tout système de santé et, sans lui, il n’y aurait pas de soins de santé
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Un an après le début de la pandémie, la COVID-19 a changé le monde et continue de peser sur notre quotidien. La pandémie a mis en évidence les lacunes des systèmes de santé tandis que le personnel de santé a été exposé au virus de façon
disproportionnée. Tout au long de l’année pas...sée, les infirmières ont affiché leur volonté et leur souplesse
en s’adaptant à de nouvelles méthodes de travail. Des millions d’infections à la COVID-19 ont été signalées parmi les agents de santé dans le monde et, hélas, le Conseil International des Infirmières (CII) a enregistré près de 3 000 décès qui lui sont
imputables parmi les infirmières dans 60 pays. Il est probable que le chiffre réel soit beaucoup plus élevé, le nombre d’infections et de décès parmi les agents de santé restant impossible à évaluer avec précision dans la mesure où de nombreux systèmes et pays n’ont pas assuré le suivi de cette question capitale.
Sur le long terme, les effets de la COVID-19, dont la « COVID longue » et le syndrome de stress posttraumatique différé, pourraient avoir d’importants effets délétères, en particulier sur le personnel infirmie
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Conformément aux dispositions de l’article 19 de la Constitution de l’Organisation internationale du Travail (OIT), le Conseil d’administration, à sa 334e session (octobre-novembre 2018), a décidé que l’Étude d’ensemble qui devait être préparée par la Commission d’experts pour l...application des conventions et recommandations (CEACR) en 2020 et présentée à la
Conférence internationale du Travail (la conférence) en 2021 porterait sur quatre instruments relatifs au travail décent pour les travailleurs du soin et des services à la personne dans une économie en évolution: la convention (no 149) et la recommandation (no 157) sur le personnel infirmier, 1977, la convention (no 189) et la recommandation (no 201) sur les travailleuses et
travailleurs domestiques, 20111 . L’Étude d’ensemble examinerait en profondeur la situation en droit et en pratique des travailleurs du soin et des services à la personne au regard des conventions nos 149 et 189.
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Lymphatic filariasis (LF) infection if untreated results in fluid accumulation in the limbs or breasts (lymphedema) or genitalia (hydrocele) that is painful and causes great discomfort. Morbidity management and disability prevention (MMDP) strategies such as surgery for hydrocele, treatment of acute... attacks and management of lymphedema are necessary for the management of the advanced stages of LF. However, very few countries including Zambia, have adequate information on the health beliefs and health seeking behavior of communities living in endemic areas towards MMDP services for LF. This study sought to explore community and health provider perspectives towards MMDP services for LF in a highly endemic region, Luangwa District, Zambia, between February and April 2019.
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The aim of this toolkit is to guide countries on how to best estimate their current burden of dengue by combining existing data from dengue surveillance systems with on-going research efforts to measure the community burden
of dengue.
Female Genital Schistosomiasis (FGS) is a gynaecological disease caused by Schistosoma haematobium, a parasitic worm that is acquired by skin contact with freshwater contaminated by schistosome cerceriae. Communities in which the infection is most endemic have limited access to clean water and healt...hcare services. Up to 150 million adolescent girls and women are estimated to be at risk of FGS and about 16–56 milion womens are living with FGS, with the majority of these in sub-Saharan Africa. The variability of these estimates points to the fact that this neglected tropical disease is not well studied and frequently not prioritized by local, regional, and global health policy makers.
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Human schistosomiasis, a parasitic and often chronic illness, is one of the major neglected tropical diseases worldwide. It is estimated that 240 million people suffer from schistosomiasis, with more than 200000 fatalities recorded each year. Schistosomiasis is caused by an infection of the blood fl...uke Schistosoma and is transmitted to humans through direct contact with infected water.
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Background: The World Health Organization (WHO) published a clinical case definition of post COVID-19
condition, by a Delphi consensus, on 6 October 2021. That process concluded that a separate definition
may be applicable for children. It is important to understand the frequency, characteristics ...and risk factors
that lead to post COVID-19 condition, along with its impact on everyday functioning and development of
children and adolescents. Long-term outcomes of the condition are currently unknown and need to be
studied. For these reasons, a globally standardized clinical case definition is needed.
Aim: To develop a globally relevant standardized clinical case definition for children and adolescents by
building on the WHO clinical case definition for post COVID-19 condition in adults.
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This policy brief aims to provide a review of the current progress on implementing the Mali national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing act...ions to combat antimicrobial resistance in Mali.
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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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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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Snakebite envenoming constitutes a serious medical condition that primarily affects residents of rural communities in Africa, Asia, Latin America, and New Guinea. It is an occupational, environmental, and domestic health hazard that exacerbates the already impoverished state of these communities. Co...nservative estimates indicate that, worldwide, more than 5 million people suffer snakebite every year, leading to 25,000–125,000 deaths, while an estimated 400,000 people are left with permanent disabilities.
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The objectives of the meeting were:
1. To update the current status of the disease transmission, country capacities and plans for tackling the disease.
2. To understand the epidemiology including disease distribution and risk, the models
for estimating under-detection, the geographical variati...ons of in clinical presentation,
the roles of domestic and wild animal reservoirs and the subsequent different
transmission patterns and control approaches, including vector control.
3. To update current research and development efforts for improving diagnostic and
treatment tools.
4. To define the goals for achieving the control of r-HAT, the need for a multisectoral
approach and to discuss the strategy for controlling r-HAT and the coordination
mechanisms.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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