There is strong evidence of the impact CHWs can have on health outcomes for their communities. Justification for investment in in CHWs has been well established, but there remain questions about how to find the resources to do this sustainably. Real and practical challenges to building and supportin...g a strong community health workforce persist- challenges that existed before Ebola, but in many cases have become even worse
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Reducing the humanitarian impact of the use of explosive weapons in populated areas is a key priority for the United
Nations, the International Committee of the Red Cross (ICRC), civil society and an increasing number of Member States.
The United Nations Secretary-General has expressly called on... parties to conflict to avoid the use in populated areas of
explosive weapons with wide-area effects.
While the use of explosive weapons in populated areas may in some circumstances be lawful under international
humanitarian law (IHL), empirical evidence reveals a foreseeable and often widespread pattern of harm to civilians,
particularly from explosive weapons with wide-area effects.
Many types of explosive weapons exist and are currently in use. These include air-delivered bombs, artillery projectiles,
missiles and rockets, mortar bombs, and improvised explosive devices (IEDs). Some are launched from the air and
others are surface launched. Whilst different technical features dictate their accuracy of delivery and explosive effect,
these weapons generally create a zone of blast and fragmentation with the potential to kill, injure or damage anyone
or anything within that zone. This makes their use in populated areas – such as towns, cities, markets and camps for
refugees and displaced persons or other concentrations of civilians – particularly problematic. The problems increase
further if the effects of the weapon extend across a wide-area either because of the scale of blast that they produce; their
inaccuracy; the use of multiple munitions across an area; or a combination thereof.
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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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Documento de trabajo
Considerando, las Alertas Epidemiológicas sobre el nuevo coronavirus (COVID-19) publicadas en enero y la más reciente 5 de febrero del 2020 (disponibles en: https://www.paho.org/hq/index.php?option=com_docman&view=download&category_slug=coronavir us-alertas-epidemiologicas&...alias=51567-5-de-febrero-de-2020-nuevo-coronavirus-ncov-actualizacionepidemiologica-1&Itemid=270&lang=es que refieren la circulación de este virus en al menos 23 países, según lo reportado a la Organización Mundial de la Salud (OMS).
Así mismo, que a esta fecha, continua la incertidumbre sobre el nuevo patógeno y el espectro de manifestaciones que pueda causar, la fuente de infección, el modo de transmisión, el periodo de incubación, la gravedad de la enfermedad y las medidas específicas de control: y que, existe un riesgo teórico de transmisión del virus a través de la transfusión de productos sanguíneos lábiles como: sangre completa, preparaciones de glóbulos rojos, preparaciones de plaquetas, preparaciones de granulocitos, plasma fresco congelado y crioprecipitado.
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A WFP analysis of the economic and food security implications of the pandemic
In this paper they make estimates of the potential short-term economic impact of COVID-19 on global monetary poverty through contractions in per capita household income or consumption.
The estimates are based on three scenarios: low, medium, and high global contractions of 5, 10, and 20 per cent;... we calculate the impact of each of these scenarios on the poverty headcount using the international poverty lines of US$1.90, US$3.20 and US$5.50 per day.
The estimates show that COVID poses a real challenge to the UN Sustainable Development Goal of ending poverty by 2030 because global poverty could increase for the first time since 1990 and, depending on the poverty line, such increase could represent a reversal of approximately a decade in the world’s progress in reducing poverty.
In some regions the adverse impacts could result in poverty levels similar to those recorded 30 years ago. Under the most extreme scenario of a 20 per cent income or consumption contraction, the number of people living in poverty could increase by 420–580 million, relative to the latest official recorded figures for 2018.
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19 April 2020
To contain the spread of COVID-19 and to keep infections at a manageable level, many countries have instituted lockdowns and social distancing. In India, a nationwide 21-day lockdown was announced with effect from 25 March 2020. This lockdown is expected to avert a sudden and large in...crease in the number of infections in the short term. Additionally, interventions such as social distancing and isolation of infected individuals over several months could reduce peak infections. Interventions such as frequent handwashing, reduced mass gatherings, contact tracing, and quarantines could slow transmission and reduce overall infections.
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The objective of this report is to assess the situational landscape during mid-May 2020 surrounding the value chain of the production and distribution of generic antiretroviral medicines in low- and-middle-income countries and to provide recommendations on mitigating the risks of potential disruptio...ns.
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The COVID-19 pandemic has exacerbated and added yet another layer of vulnerability to an already dire web of vulnerabilities of girls in the African continent, which constitute about 49% of the total child population. Critically, gender equality and girls’ multidimensional vulnerability have been ...accentuated to an unprecedented level. The pandemic has triggered major concerns about the potential reversal of the strides achieved over the years towards gender equality and human development in Africa.
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This report provides the context, underlying evidence, content and process related to the
development of the draft global strategic directions for nursing and midwifery 2021–2025.
Environment International Volume 86, January 2016, Pages 14-23
Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing health problems. This review examines the scientific e...vidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects — the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial–temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change.
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Este informe se conforma del resumen ejecutivo, metodología, contextualización de la población migrante venezolana en República Dominicana, contextualización de la inversión y empresariado; un informe descriptivo de los resultados de campo; el impacto económico real e impacto económico poten...cial y barreras de inserción de la población migrante venezolana en República Dominicana; y por último, consideraciones finales que incluyen recomendaciones y lecciones aprendidas, conclusiones y anexos.
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Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose... potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.
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It is estimated that, in Latin America alone, between 6 and 8 million people are infected with the parasite, and 99% of these are not receiving treatment, either because they are unaware of their infection or because they do not know that treatment exists. The potential spread of the disease is also... a cause for considerable concern: 65 million people live in areas of exposure and are at risk of contracting Chagas disease, and 28,000 new cases occur every year.
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It is estimated that, in Latin America alone, between 6 and 8 million people are infected with the parasite, and 99% of these are not receiving treatment, either because they are unaware of their infection or because they do not know that treatment exists. The potential spread of the disease is also... a cause for considerable concern: 65 million people live in areas of exposure and are at risk of contracting Chagas disease, and 28,000 new cases occur every year.
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Chikungunya fever (CHIKF) is an emerging infectious disease caused by an alphavirus transmitted by Aedes spp. mosquitoes. Because mosquito control programs are not highly efficient for outbreak containment, vaccines are essential to reduce the burden of disease. Although no licensed vaccine against ...CHIKF is yet available, many highly promising candidates are undergoing preclinical studies, and a few of them have been tested in human trials of phase 1 or 2. Here, we review recent findings regarding the need for a CHIKF vaccine and provide an update on vaccines nearing or having entered clinical trials. We also address needs to tackle bottlenecks to vaccine development—including scientific and financial barriers—and to accelerate the development of vaccines; several actions should be taken:
(i) design efficacy trials to be conducted during the course of outbreaks;
(ii) evaluate the opportunity for adopting the “animal rule”for demonstration of efficacy for regulatory purposes;
(iii) strengthen the collective commitment of nations, international organizations, potential donors and industry;
(iv) stimulate public and/or private partnerships to invest in vaccine development and licensure; and
(v) identify potential markets for an effective and safe CHIKF vaccine.
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The risk of emergence and re-emergence of arboviruses with pandemic potential has increased as a global public health threat and will continue to do so in the years to come. The Global Arbovirus Initiative outlines an integrated approach across these viruses and disciplines that will enable optimal ...use of limited resources to achieve the greatest impact, particularly in areas with the heaviest arboviral burden and in areas that are at risk of emergence of arboviruses. Following a series of global consultations and review by the Technical Advisory Group on Arbovirus (TAG-Arbovirus), the Global Arbovirus Initiative and its 6 constituent pillars, each with strategic objectives and priority activities, are consolidated in this reference document.
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The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct ...definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
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