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This manual is to assist health care providers and laboratory scientists to diagnose mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the clinical presentation and its diagnosis. The methods described are tailored to various levels of care and avail
...
able resources to improve the diagnosis and surveillance of the disease.
more
Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim
...
ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
more
Government of Nepal has an obligation to ensure availability of affordable and high quality basic health care services to its population
Sector Environmental Guidelines, Full technical Update
It is Zika virus (ZIKV) that most often causes these neurological effects it appears to be the only arbovirus than can cause congenital malformations such as microcephaly. In any case, more scientific tests are needed to establish the causal relationship between the virus and this malformation (7-10
...
).
This document is a practical tool designed to help health workers improve clinical diagnosis and provide timely care for patients infected
with the dengue, chikungunya, or Zika virus. It is intended mainly for
health workers in primary care facilities where laboratory diagnosis of
arboviruses is not always available. However, this guide may also be
very useful in hospitals that provide second- and third-level care, as it
describes the clinical manifestations of each of the three most important
arboviral diseases currently found in the Region, the elements for
differential diagnosis, and their clinical behavior.
more
The World Health Organization's fourth Country Cooperation Strategy 2022-2026 is an outcome of a consultative process with inputs from the Ministry of Health, various agencies in the health sector, and other relevant stakeholders. It has been developed to provide strategic direction and support towa
...
rd achieving the priorities of the Government of the Kingdom of Eswatini.
It is designed to support the strengthening of health systems and services toward the attainment of Universal Health
Coverage (UHC) and the Sustainable Development Goals targets. The CCS 2022-2026 also presents the collaborative
agenda between the Kingdom of Eswatini and the three levels of WHO, aligns with the strategic priorities of WHO’s
13th General Programme of Work (2019 – 2025), as well as Eswatini’s United Nations Sustainable Development Cooperation Framework (UNSDCF) 2021-2025
more
Travailler avec les dirigeants communautaires pour lutter contre la VBG est une très bonne et prometteuse approche, car les dirigeants communautaires sont les gardiens de toutes nos croyances et coutumes. Étant donné que la VBG est enracinée dans les croyances et les coutumes, essayer de s
...
attaquer à la VBG sans impliquer les dirigeants communautaires peut mener à un grand conflit, et vous n’aurez aucun résultat. Les dirigeants communautaires ont également des rôles à jouer dans la réponse aux survivantes de la VBG. Les survivantes s’adressent aux chefs de villages pour faire part de leurs préoccupations et de leurs expériences, et les dirigeants ont des pratiques pour traiter les préoccupations et une approche de la justice qui se base d’abord sur le maintien de la cohésion sociale, mais la VBG ne peut pas être résolue comme n’importe quel autre conflit. D’après mon expérience des programmes de VBG dans mon propre pays et ailleurs, j’ai appris qu’il est plus difficile d’impliquer les dirigeants communautaires dans certains endroits que dans d’autres. Parfois, les aspects religieux rendent les choses plus difficiles. Mais si vous demandez à n’importe quel dirigeant de décrire ce qu’est un dirigeant, ce qu’un dirigeant fait, il parlera de la protection de la communauté. Et c’est aussi ce que nous voulons — protéger les femmes et les filles dans la communauté.
more
The Strategic Advisory Group of Experts (SAGE) on Immunization held a meeting on 3-6 October 2022. This report summarizes the discussions, conclusions and recommendations.
It covers the following items:
Global Reports
Immunization Agenda 2030 and Regional reports
Monkeypox
RSV
COVID-19 vacci
...
nes
Polio vaccination
Ebola (Sudan ebolavirus outbreak update)
more
Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph
...
of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
more
Despite the significant role of vector control in national leishmaniasis control programmes, the programmatic community perceives vector control as the weakest component of leishmaniasis control strategies in terms of resources, scientific evidence of the usefulness of interventions and capacity for
...
quality-assured implementation. Therefore, the main objective of this manual is to provide practical tools, techniques and procedures to strengthen sand fly control and surveillance in order to improve implementation of leishmaniasis control programmes. The manual provides a rationale for programme managers in different geographical regions on the types of vector control interventions to be used in different epidemiological and environmental settings and also how to measure their impact.
more
Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi
...
nes.
more
April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t
...
he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
more
This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita
...
ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
more
Leishmaniasis is a climate-sensitive disease. Changes in temperature, rainfall, and humidity can have strong impacts on
the sandfly vector, altering their distribution and influencing their survival and population sizes. Increased temperatures shorten vector development time, reduce Leishmania para
...
site incubation time, and increase vector biting rates, allowing transmission
in areas not previously endemic for the disease. Poor and
marginalized communities will be hit disproportionately harder by
the effects of climate change, and droughts, famines, and floods
can also lead to displacement and migration of immunologically
naive people to areas where leishmaniasis is endemic, posing a
threat of leishmaniasis outbreaks.
more
This project aimed to reduce the risk of vector-borne infection with Chagas disease by
controlling triatomine bugs, the vectors transmitting the parasite of Chagas disease, and
establishing an epidemiological surveillance system with community participation.
The conditionality of this recommendation is largely driven by the current higher unit cost of pyrethroid-PBO ITNs compared
to pyrethroid-only LLINs and therefore the uncertainty of their cost-effectiveness. Furthermore, as PBO is less wash-resistant
than pyrethroids, its bioavailability declines
...
faster over the three-year estimated life of an ITN; therefore, the added impact of
pyrethroid-PBO ITNs over that of pyrethroid-only LLINs may decline over time. The evidence comes from two sites in
eastern Africa with pyrethroid resistance and not from other geographies where transmission levels and vector characteristics
may vary. PBO acts by inhibiting certain metabolic enzymes, primarily oxidases, and so are likely to provide greater protection
than pyrethroid-only LLINs where mosquitoes display mono-oxygenase-based insecticide resistance mechanisms.
more
This document aims to assist countries to take the first step towards better considering gender and equity issues in their efforts to tackle antimicrobial resistance (AMR), to inform the implementation of strategies in national action plans and contribute to improved reach and effectiveness of AMR e
...
fforts in the longer term. It is part of a series of papers being developed y WHO, FAO and OIE to build a better global evidence base for implementing AMR national action plans. This version is illustrated by examples from the health sector predominantly but
will be updated with advice from the food and animal sectors in due course.
more
The PS Centre has released three publications addressing the need for MHPSS tools and guidance in Ukraine and surrounding countries.
The Introduction to Psychological First Aid, presents a training module on basic psychological first aid skills for people affected by the international armed confl
...
ict in Ukraine which can be delivered in four hours. It is an adaption of another PS Centre publication, Training in Psychological First Aid for Red Cross and Red Crescent Societies. Module 1. An introduction to PFA.
more
During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc
...
e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
more
Africa is off track to reach the Sustainable Development Goals by 2030 and lags behind in building resilient health systems
and health security, against a backdrop of limited resources. The world envisaged a significant role for governments
in funding the Sustainable Development Agenda, but inadeq
...
uate funding for health in African countries is
persistent, despite additional continental commitments to address the problem. When commitments to global health
targets and available fiscal space do not align, innovation is warranted.
more
