Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP)..., which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes.
more
Guidelines for the Management of common childhood Illness. 2nd edition
These guidelines focus on the management of the major causes of childhood mortality in most developing countries, such as newborn problems, pneumonia, diarrhoea, malaria, meningitis, septicaemia, measles and related conditions, ...severe acute malnutrition and paediatric HIV/AIDS. It also covers common procedures, patient monitoring and supportive care on the wards and some common surgical conditions that can be managed in small hospitals.
A smart phone and tablet application is available from the Apple or Google Play Store.
Special attention is drawn to the following sections, which are particulary relevant within the COVID-19 context:
Chapter 4: information on cough and difficulty in breathing, pneumonia and bronchiolitis;
Chapter 10: information on essential supportive care including feeding, fluid and oxygen provision;
Annex 1: information on related practical procedures.
more
Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the propagation and dissemination of MDR TB.
The term "Programmatic Management of Drug Resistant TB" (PMD...T) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases.
more
Background
Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death.
Methods
This review is based on articles retrieved by a selective search in PubMed, as well as on r...elevant guidelines.
Results
Evidence-based treatment options are available only for congestive heart failure with a low ejection fraction. Pharmacotherapy is based on neurohumoral inhibition of the renin-angiotensin-aldosterone system and the adrenergic system. The prognosis of patients with this condition has been further improved recently through the introduction of combined angiotensin receptor antagonists and neprilysin inhibitors. Modern implantable devices are a further component of treatment. Implantable defibrillators and special pacemakers for cardiac resynchronization are well established; the utility of alternative devices (baroreflex modulation or cardiac contractility modulation) needs to be investigated in further studies. It was recently shown that the catheter-based treatment of secondary mitral regurgitation with a MitraClip improves the outcome of selected patients.
Conclusion
The treatment of chronic systolic heart failure as recommended in the relevant guidelines, with drugs and implanted devices if indicated, can significantly improve the clinical outcome.
more
The 2014-2015 outbreak of Ebola virus disease (EVD) in Liberia resulted in over 10,000 cases and 5,000 deaths. Recognizing the importance of addressing children’s trauma, the Ebola recovery and restoration trust fund (EERTF) funded the implementation of a Comfort for kids (C4K) program which encou...rages psychological healing, and promotes resilience in children who have experienced a crisis or disaster. The C4K program in Liberia was implemented between January 2015 and December 2016 in fifteen townships in Montserrado County through a collaboration between Mercy Corps Liberia, the World Bank’s Liberian health task team, and the government of Liberia. C4K primarily centers on the My Story workbook and associated classroom activities, which provide children with the opportunity to express their emotions about their experiences through drawing, writing, and facilitated discussion. C4K also provides capacity building for parents, teachers, and other caretakers on how to identify and more effectively respond to children’s trauma responses and to support their recovery
more
Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog.... Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
more
Breast cancer is the most common cancer worldwide and the leading cause of cancer deaths among women, disproportionately affecting low- and middle-income countries. The Global Breast Cancer Initiative strives to reduce breast cancer mortality by 2.5 percent per year, which over a 20-year period can ...save 2.5 million lives. The purpose of this core technical package is to outline a pathway for incremental, sustainable improvements tailored to country-specific needs based on three key strategies and objectives: health promotion for early detection; timely diagnosis; and comprehensive breast cancer management. This document provides a common framework linking policy makers, stakeholders, the clinical community, program managers and civil society to evidence-based systematic approaches that can facilitate health systems strengthening and reduce inequities in women’s health throughout their life cycles
more
The Greater Horn of Africa is experiencing one of the worst food insecurity situations in decades. It is estimated
that more than 37 million people are in Integrated Food Security Phase Classification (IPC)1 phase 3 or above and approximately 7 million children under the age of five are acutely mal...nourished in the region. While finding food and safe water is the absolute priority, the health response is essential to avert preventable disease and death.
more
The purpose of this interim guidance is to provide information and insight to assist public policy and
health system leaders in preparing for and responding to an MCE caused by terrorist use of explosives
(TUE). This document provides practical information to promote comprehensive mass casualty ca...re
in the event of a TUE event and focuses on two areas:
1. leadership in preparing for and responding to a TUE event, and
2. effective care of patients in the prehospital and hospital environments during a TUE event.
more
Integrated Management of Childhood Illness (IMCI) is an integrated approach to child health that focuses on the holistic well-being of the child. IMCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMCI includes bo...th preventive and curative elements that are implemented by families and communities as well as by health facilities.
This booklet contains useful information on childhood sickness and offers practical guidance on diagnosis and treatment of said illnesses. it is divided into 2 parts, one for infants (new born until 2 months) and from 2 months to 5 years. It also includes:
Antiretroviral Therapy ART) treatment for children
Skin problems
Counselling the mother or caregiver on infant and you child feeding
more
This document aims to support public health preparedness planning and response activities on the safe handling of bodies of deceased persons with suspected or confirmed COVID-19: at the site of death, during transport, storage and preparation before burial/cremation, and during burial/cremation.
Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
more
This brief considers the rationale for shielding individuals at high risk of severe disease or death from COVID-19 in low- and middleincome countries. It provides an overview of proposed approaches to shielding, discusses the categories of individuals who may be identified for shielding, and outline...s the likely difficulties of these measures and ways to mitigate them.
more
Effective malaria case management requires quick access to diagnostics and antimalarial treatments to reduce illness and death. Artemisinin-based combination therapy (ACT) has been essential to malaria treatment since 2001, as it combines artemisinin for rapid parasite reduction with a partner drug ...to ensure complete cure. However, resistance to antimalarial drugs, where parasites survive standard doses, threatens malaria control.
more
Since the last situation report on the multi-country outbreak of cholera was published on 1 June 2023 (covering data reported until 15 of May), no new country reported a cholera outbreak. In total, 24 countries have reported cases since the beginning of 2023. The WHO African Region remains the most ...affected region with 14 countries reporting cholera cases since the beginning of the year. The overall capacity to respond to the multiple and simultaneous outbreaks continues to be strained due to the global lack of resources, including shortages of the Oral Cholera Vaccine (OCV) and cholera supplies, as well as overstretched public health and medical personnel, who are dealing with multiple parallel disease outbreaks and other health emergencies. Based on the large number of outbreaks and their geographic expansion, as well as a lack of vaccines and other resources, WHO continues to assess the risk at global level as very high.
more
The Lancet Global Health, published online 18 August 2017;
http://dx.doi.org/10.1016/S2214-109X(17)30332-7
The article "The Political Determinants of the Cholera Outbreak in Yemen" examines how the ongoing civil war has contributed to Yemen’s severe cholera outbreak. The 2017 epidemic was des...cribed as the worst in the world, with cholera spreading rapidly due to the collapse of health, water, and sanitation systems.
The analysis shows that Houthi-controlled areas were disproportionately affected, accounting for 77.7% of cases and 80.7% of deaths. The article highlights the role of the Saudi-led coalition in worsening conditions through airstrikes on infrastructure, blockades restricting medical and food supplies, and the overall humanitarian crisis. It criticizes UNICEF for accepting a $67 million donation from Saudi Arabia while the coalition contributed to the crisis.
The article underscores that political actions and conflict have been key factors in the outbreak’s severity, with both warring sides failing to protect civilians.
more
While virtually unheard of in developed countries, NTDs are a group of medically diverse parasitic and bacterial infectious diseases common in tropical and subtropical areas. NTDs affect more than 1.5 billion people annually, causing death, blindness, disfigurement, chronic pain, cognitive impairmen...t and other long-term disabilities that create obstacles to education, employment, economic growth and overall
development. When measured in disability-adjusted life years (DALYs), the NTD burden is greater than malaria or tuberculosis.
more
Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – along with mental health, cause nearly three quarters of deaths in the world. Their drivers are social, environmental, commercial and geneti...c, and their presence is global. Every year 17 million people under the age of 70 die of NCDs, and 86% of them live in low- and middle-income countries (LMICs).
more
Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrom...e, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status
more
Snakebites are well-known medical emergencies in many parts of the world, especially in rural areas. Agricultural workers and children are the most affected. The incidence of snakebite mortality is particularly high in South-East Asia. Rational use of snake anti-venom can substantially reduce mortal...ity and morbidity due to snakebites. These guidelines are a revised and updated version of Regional Guidelines for the Management of snakebites published by the WHO Regional Office in South-East Asia in 2011. These guidelines aim to promote the rational management of snakebite cases in various health facilities where trained health functionaries and quality snake antivenom are available.
more