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WHO policy brief: COVID-19 testing, 14 September 2022

World Health Organization WHO (2022) C_WHO

The World Health Organization (WHO) recognizes the challenges countries face for maintaining their COVID-19 response while addressing competing public health challenges, conflicts, climate change and economic crises. It remains critical for national programmes to continue to offer testing for COVI... more

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Government policy interventions to reduce human antimicrobial use: A systematic review and evidence map

Van Katwyk, S. R.; Grimshaw, J. M.; et al (2019) C2

BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans. METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review. CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published. more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable diseases (NCDs) worldwide. There is currently an epide...miological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Yuyun, M.F.; Sliwa, K.; Kengne, A.P. et al. Global Heart (2020) CC

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t... more

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The Burden of Pediatric Asthma

Ferrante, G.; La Grutta, S. Frontiers in Pediatrics (2018) CC

Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa... more

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How to support survivors of gender-based violence when a GBV actor is not available in your area

Inter-Agency Standing Committee (2023) CC

KEY MESSAGES Always talk to a GBV specialist first to understand what GBV services are available in your area. Some services may take the form of hotlines, a mobile app or other remote support. Be aware of any other available services in your area. Identify services provided by humanitarian pa...rtners such as health, psychosocial support, shelter and non-food items. Consider services provided by communities such as mosques/ churches, women’s groups and Disability Service Organizations. Remember your role. Provide a listening ear, free of judgment. Provide accurate, up-to-date information on available services. Let the survivor make their own choices. Know what you can and cannot manage. Even without a GBV actor in your area, there may be other partners, such as a child protection or mental health specialist, who can support survivors that require additional attention and support. Ask the survivor for permission before connecting them to anyone else. Do not force the survivor if s/he says no. Do not proactively identify or seek out GBV survivors. Be available in case someone asks for support. Remember your mandate. All humanitarian practitioners are mandated to provide non-judgmental and non-discriminatory support to people in need regardless of: gender, sexual orientation, gender identity, marital status, disability status, age, ethnicity/tribe/race/religion, who perpetrated/committed violence, and the situation in which violence was committed. Use a survivor-centered approach by practicing: Respect: all actions you take are guided by respect for the survivor’s choices, wishes, rights and dignity. Safety: the safety of the survivor is the number one priority. Confidentiality: people have the right to choose to whom they will or will not tell their story. Maintaining confidentiality means not sharing any information to anyone. Non-discrimination: providing equal and fair treatment to anyone in need of support. If health services exist, always provide information on what is available. Share what you know, and most importantly explain what you do not. Let the survivor decide if s/he wants to access them. Receiving quality medical care within 72 hours can prevent transmission of sexually transmitted infections (STIs), and within 120 hours can prevent unwanted pregnancy. Provide the opportunity for people with disabilities to communicate to you without the presence of their caregiver, if wished and does not endanger or create tension in that relationship. If a man or boy is raped it does not mean he is gay or bisexual. Gender-based violence is based on power, not someone’s sexuality. Sexual and gender minorities are often at increased risk of harm and violence due to their sexual orientation and/or gender identity. Actively listen and seek to support all survivors. Anyone can commit an act of gender-based violence including a spouse, intimate partner, family member, caregiver, in-law, stranger, parent or someone who is exchanging money or goods for a sexual act. Anyone can be a survivor of gender-based violence – this includes, but isn’t limited to, people who are married, elderly individuals or people who engage in sex work. Protect the identity and safety of a survivor. Do not write down, take pictures or verbally share any personal/identifying information about a survivor or their experience, including with your supervisor. Put phones and computers away to avoid concern that a survivor’s voice is being recorded. Personal/identifying information includes the survivor’s name, perpetrator(s) name, date of birth, registration number, home address, work address, location where their children go to school, the exact time and place the incident took place etc. Share general, non-identifying information To your team or sector partners in an effort to make your program safer. To your support network when seeking self-care and encouragement. more

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Control measures for Shiga toxin-producing Escherichia coli (‎STEC)‎ associated with meat and dairy products: meeting report

World Health Organisation (WHO) (2022) C_WHO

Although Shiga toxin-producing Escherichia coli (STEC) have been isolated from a variety of food production animals, they are most commonly associated with ruminants from which we derive meat and milk. Because of the widespread and diverse nature of ruminant-derived food production, coupled with the... more

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Ukrainian Prioritized Multisectoral Mental Health and Psychosocial Support Actions During and After the War: Operational Roadmap

World Health Organisation (WHO) (2022) C_WHO

The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years. According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system. The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council). This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country. The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan. Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine. As well as information on the context in Ukraine, the Roadmap includes: • a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and • a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2). more

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Guidelines for the prevention, management and care of diabetes mellitus - World Health Organization

World Health Organization (WHO) World Health Organization (WHO) (2006) C_WHO

Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of ... more

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Prioritization of treatments for lower extremity peripheral artery disease in low- and middle-income countries

Fowkes, G.F.; Forster, R.B.; Levin, C.E. et al. International Angiology (2017) CC3

INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require substantial resources but little consideration has been given to which treatments are appropriate for les... more

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Prevention and control of noncommunicable diseases: guidelines for primary health care in low resource settings 2012

World Health Organization (WHO) World Health Organization (WHO) (2012) C_WHO

The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate management of diabetes into primary health care. It will serve as basis for development of simple algor... more

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Fig. 1: GINA treatment recommendations for patients aged ≤5 years, 6–11 years and ≥12 years

npj Primary Care Respiratory Medicine (2020) CC2

Adults and adolescents 12+ years. Asthma medication options: Adjust treatment up and down for individual patient needs

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European Respiratory Society clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years

Gaillard, E.A.; Kuehni, C.E.; Turner, S.; et al. European Respiratory Journal (2021) CC

Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence... more

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European Respiratory Society guidelines for the diagnosis of asthma in adults

Renaud, L.; Imran, S.; Inigo, O., et al. European Respiratory Journal (2022) CC

Although asthma is very common, affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world, which results in both over- and under-diagnosis. A taskforce was set up by the European Respiratory Society to systematically review the literature on the dia... more

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Use of non-sugar sweeteners: WHO guideline 2023

World Health Organization (WHO) World Health Organization (WHO) (2023) C_WHO

The document titled "Use of Non-Sugar Sweeteners: WHO Guideline" provides recommendations from the World Health Organization on the use of non-sugar sweeteners (NSS) to reduce sugar intake, manage weight, and prevent diet-related noncommunicable diseases (NCDs). It discusses the potential effects of... more

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ERS/EAACI statement on adherence to international adult asthma guidelines

Mathioudakis, A.G.; Tsilochristou, O.; Adcock, I. M.; et al. (2021) CC2

In the European Union, over 20 million people suffer from asthma. During the 1990s there was a rapid decrease in asthma mortality, probably related to the increased use of inhaled corticosteroids (ICS). However, during the last decade, asthma mortality rates have plateaued, and a consistently high p... more