Otros trastornos
Capítulo H.2
Editores: Matías Irarrázaval, Daniel F. Martínez Uribe, Andres Martin
Traducción: Jaime J. Gómez Alamán, Begoña Arenas Tuzón, Beatriz Ortega
BMJ Glob Health 2017;2:e000345. doi:10.1136/bmjgh-2017-000345. WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical expo...sure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.
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J Glob Health Sci. 2020 Jun;2(1):e3. A group of enzootic and zoonotic protozoan infections, the leishmaniases constitute among the most severely neglected tropical diseases (NTDs) and are found in all continents except Oceania. Representing the most common infectious diseases, NTDs comprise an open-...ended list of some 20 parasitic, bacterial, viral, protozoan and helminthic infections. Called “diseases of the poor,” because of their characteristic prevalence in poor populations regardless of a country's income status, they infect over one billion people in over 140 countries, with about 90% of the global burden in Africa. While NTDs do not contribute significantly to global deaths, they are debilitating and remain the most common infections among the poor worldwide, preventing them from escaping poverty by impacting livelihoods such as agriculture and livestock, and affecting cognitive, developmental and education outcomes.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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With 71 million people forcibly displaced around the world and aid budgets woefully underfunded, how do humanitarian agencies decide whom to help and for how long?
Harm reduction: evidence, impacts and challenges
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Globalization and Health (2021) 17:74 https://doi.org/10.1186/s12992-021-00722-3
Guía para el Equpo de Salud
Background: Healthcare workers’ mental health was affected by SARS-CoV-2 pandemic.
Aim: To evaluate healthcare workers’ mental health and its associated factors during the pandemic in Chile. Material and Methods: An online self-reported questionnaire was designed including the Goldberg Healt...h Questionnaire, the Patient Health
Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers.
Results: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one
percent reported the need for mental health support, and 38% of them received it.
Conclusions: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it.
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Despite the stated centrality of protection in humanitarian action and a growing attention to protection activities, the evaluation of protection has received relatively little attention. This pilot guide seeks to fill this gap, providing insights and guidance to those evaluating protection in the c...ontext of humanitarian action
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This companion to the ALNAP EHA Guide offers protection-specific insights for evaluators and evaluation commissioners across the humanitarian sector. It covers the planning, data management and analysis phases of evaluation and addresses a range of challenges that – whilst not all unique to protec...tion – are often exacerbated by the contexts in which protection activities typically take place. Challenges addressed include those arising from the multi-faceted nature of protection activities, the difficulty understanding cause-effect relationships underlying protection risks, and the challenges of accessing and managing very sensitive data, sometimes drawn from communities in conflict.
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The GHS Index is intended to be a key resource in the face of increasing risks of high-consequence and globally catastrophic biological events and in light of major gaps in international financing for preparedness. These risks are magnified by a rapidly changing and interconnected world; increasing ...political instability; urbanization; climate change; and rapid technology advances that make it easier, cheaper, and faster to create and engineer pathogens.
Key findings from the study of 195 countries:
• Out of a possible 100 points, the average GHS Index score across 195 countries was 40.2.
• The majority of high- and middle-income countries do not score above 50.
• Action is urgently needed to improve countries’ readiness for high-consequence infectious disease outbreaks.
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Strengthening competency based training of health care providers for Reproductive Maternal Newborn Child & Adolescenct Health (RMNCH + A) services
El objetivo fue determinar cuáles son las percepciones de distintos actores del sistema de salud
colombiano sobre los problemas del sistema que están detrás de la crisis. Se realizó un estudio
cualitativo a partir de entrevistas semiestructuradas y en profundidad con cuarenta agentes del
sect...or salud, en Bogotá, Cali, Ibagué, Espinal y Calima-Darién. Los resultados mostraron que la
corrupción, el incumplimiento de normas y los conflictos entre los intereses de diversos actores
del sistema debilitan la legitimidad de este último, atomizan la cooperación y cohesión de los
actores y fortalecen el interés particular.
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El Programa Nacional de Chagas ha definido la utilización de dos medicamentos para el tratamiento de la Enfermedad de Chagas Crónico Reciente Infantil (en niños de 9 meses a menor de 15 años); el benznidazol (BNZ) que será utilizado como medicamento de primera elección en todos los casos con d...iagnóstico serológico positivo confirmado y el nifurtimox (NFT) que será utilizado como segunda alternativa en aquellos casos que hubieran presentado reacciones adversas graves al benznidazol, e indiquen un cambio de conducta.
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