The key actions, activities, and approaches in this document are organized within each of the 5Cs (see Table 1 in the PDF) and those of the Strategic preparedness and response plan (SPRP) pillars as follows:
National action plan key activities, prioritized for the current context and the current ...understanding of the threat of SARS-CoV-2
A. Transition from emergency response to longer term COVID-19 disease management.
B. Integrate activities into routine systems.
C. Strengthen global health security.
Special considerations for fragile, conflict-affected and vulnerable (including humanitarian) settings
WHO global and regional support to Member States to implement their national action plans
Key guidance documents for reference
This is a living document that will be updated to incorporate new technical guidance in response to the evolving epidemiological situation. National plans should be implemented in accordance with the principles of inclusiveness, respect for human rights, and equity.
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Diabetes is one of the leading causes of chronic kidney disease (CKD). Up to 40% of people living with diabetes develop CKD, and the number of new cases of CKD in people with type 2 diabetes increased by 74% between 1990 and 2017. The prevalence of diabetes-related CKD varies widely between countrie...s. The majority of epidemiological data on CKD comes from high-income countries, but countries with lower socioeconomic status experience the largest increase in diabetes prevalence and their populations with diabetes are at higher risk of CKD.
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COVID-19 has altered health sector capacity in low-income and middle-income countries (LMICs). Cost data to inform evidence-based priority setting are urgently needed. Consequently, in this paper, we calculate the full economic health sector costs of COVID-19 clinical management in 79 LMICs under di...fferent epidemiological scenarios.
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El 23 de julio del 2022, el Director General de la OMS declaró el brote de viruela símica una emergencia de salud pública de importancia internacional. A raíz de esa declaración, se puso en marcha un dispositivo de respuesta coordinada con el objeto de interrumpir la transmisión y proteger a l...os grupos en situación de vulnerabilidad. En estas orientaciones se tratan diferentes aspectos relativos al uso de vacunas para respaldar las intervenciones primarias de salud púbica en la respuesta para detener la trasmisión de persona a persona. Tienen como propósito brindar información útil y accesible acerca de las vacunas contra la viruela símica a fin de facilitar el despliegue de estrategias de prevención adaptadas a la situación epidemiológica, con base en las recomendaciones de la VIII Reunión ad hoc del Grupo Técnico Asesor de la OPS sobre Enfermedades Prevenibles por Vacunación.
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A medida que las Américas experimentan un profundo cambio demográfico y hay más personas de 65 años que menores de 5 años, es crucial reconocer que los programas nacionales de inmunización deben rediseñarse para garantizar una protección integral a las personas a lo largo de toda su vida. Al... adoptar un enfoque de curso de vida para la inmunización, los programas de vacunación pueden adaptarse para cerrar las brechas de inmunidad en las distintas etapas de la vida. El enfoque del curso de vida prevé el establecimiento de múltiples estrategias para reducir las oportunidades perdidas de vacunación según el grupo de edad. El presente documento técnico explica los conceptos clave del enfoque de curso de vida en la inmunización mediante la vacunación, así como los mecanismos biológicos subyacentes que requieren la aplicación de diferentes vacunas en diversas etapas de la vida según los cambios en el sistema inmunitario y en la situación epidemiológica de la comunidad
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As the Americas undergo profound demographic change and there are more persons aged 65 years or older than children younger than 5 years, it is crucial to recognize that national immunization programs must be redesigned to ensure comprehensive protection for individuals across the lifespan. By adopt...ing a life course approach (LCA) to immunization, vaccination programs can be tailored to close immunity gaps at different stages of life. The life course approach foresees the establishment of multiple strategies to reduce missed opportunities for vaccination according to age group. This technical document explains the key concepts of the LCA with a focus on immunization by vaccination, as well as the underlying biological mechanisms that require the application different vaccines at different life stages according to changes to the immune system and in the epidemiological situation of a community.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant...imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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Website last accessed on 07.06.2023
Stopleishmania.org is an initiative of the VISAVET Health Surveillance Centre (UCM), the National Centre of Microbiology (ISCIII), the Animal Protection Centre (Madrid City Council) and the Directorate of Public Health (Regional Government of Madrid). This proj...ect launches the possibility of collaboration with other research centres, feeding the site with updated information on this disease.
Leishmaniosis prevention and control should include novel communication strategies that must be easily accesible and would include new advances in the knowledge of the disease. Recently, other animals different than dogs have been described as competent reservoirs of Leishmania, playing an important epidemiological role in recent outbreaks in Europe and Asia. At the moment, most of the information available is fundamentally devoted to humans and dogs, and there is no a global approach to the disease, taking into account all possible reservoirs.
The contents are available in Spanish and English, and come from the knowledge and experience in the disease of the above mentioned organisms, including research and information outreach.
The result is a website mainly focused on dissemination of the fundamental aspects for the control and prevention of the disease, taking into account that leishmaniosis due to its zoonotic condition, requires a multidisciplinary vision in accordance with the "One Health" principles. The web is complemented by a collaborative tool where the registered research groups can present themselves and disseminate their research results, therefore providing updated information on the scientific advances in the disease control.
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The Leprosy Programme and Transmission Assessment (LPTA) is an activity that is carried out by internal teams towards the end of Phase 1 (see Leprosy Elimination Framework in the Annex) when a subnational jurisdiction (typically second-tier) reaches the milestone for interruption of transmission, i....e., zero autochthonous child cases for a consecutive period of five years. It also needs to be done at the end of Phase 2, when the second milestone of elimination of leprosy disease has been reached. An LPTA will be carried out to document that all relevant programme criteria have been met and examine trends of epidemiological indicators in such jurisdiction to confirm that the milestone has been achieved. The LPTA includes assessment of health facilities that provide leprosy services. LPTA comprises of review of epidemiological data, health facility assessment and data validation and verification of the programme criteria through observation during a field visit. The evidence collected in this way in subnational health administrative units is compiled in a Leprosy Elimination Dossier to be submitted to WHO when the country reaches the milestone for elimination of disease in the country as whole. Countries that have not detected any new leprosy cases in the past three years or more can use the LPTA at national level prior to or as part of the verification process. Countries likely to be among the first to apply for verification may have had no new cases detected for more than 10 years.
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La fiebre amarilla es una enfermedad endémica en varios países de América Latina. Con vistas a brindar apoyo a los responsables de la toma de decisiones para priorizar las acciones preventivas frente a esta afección, la Organización Panamericana de la Salud presenta estos perfiles nacionales co...n una selección de datos concisa y exhaustiva de los países con endemicidad. En cada perfil se brinda un análisis de la situación actual del país, los factores ecológicos y climáticos asociados a la enfermedad, la distribución e incidencia de los vectores, y las claves de la actividad arboviral. Asimismo, se incluye una perspectiva histórica de la epidemiología y un resumen del estado de la vacunación contra la enfermedad en el país.
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The Leprosy Programme and Transmission Assessment (LPTA) is an activity that is carried out by internal teams towards the end of Phase 1 (see Leprosy Elimination Framework in the Annex) when a subnational jurisdiction (typically second-tier) reaches the milestone for interruption of transmission, i....e., zero autochthonous child cases for a consecutive period of five years. It also needs to be done at the end of Phase 2, when the second milestone of elimination of leprosy disease has been reached. An LPTA will be carried out to document that all relevant programme criteria have been met and examine trends of epidemiological indicators in such jurisdiction to confirm that the milestone has been achieved. The LPTA includes assessment of health facilities that provide leprosy services. LPTA comprises of review of epidemiological data, health facility assessment and data validation and verification of the programme criteria through observation during a field visit. The evidence collected in this way in subnational health administrative units is compiled in a Leprosy Elimination Dossier to be submitted to WHO when the country reaches the milestone for elimination of disease in the country as whole. Countries that have not detected any new leprosy cases in the past three years or more can use the LPTA at national level prior to or as part of the verification process. Countries likely to be among the first to apply for verification may have had no new cases detected for more than 10 years.
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Website last accessed on 10.04.2023
The Chagas disease is frequently referred to as the effects that the parasite Trypanosoma cruzi (T. cruzi) has on people’s health. However, from our perspective, Chagas is much more than that: it is a complex socioenvironmental health problem in which elemen...ts of different nature converge and interact. The biomedical and epidemiological aspects, which are most frequently addressed, are only a piece of the puzzle that needs to be complete in order to understand Chagas in all its complexity. Social, environmental, economic, political, cultural, and educational elements turn out to be essential in comprehending the magnitude of the problem without prejudice or stigmatizations.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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The new WHO recommendations for rabies immunization supersede the 2010 WHO position
on pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) for rabies. These updated
recommendations are based on new evidence and directed by public health needs that are cost-,
dose- and time-sparing..., while assuring safety and clinical effectiveness. In addition, new guidance on
prudent use of rabies immunoglobulins (RIG) is provided.
The following sections summarize the main points of the updated WHO position as endorsed by the
Strategic Advisory Group of Experts on immunization (SAGE) at its meeting in October 20171. The full
version of the WHO position on rabies vaccines and immunoglobulins will be published in the Weekly
Epidemiological Record2 in April 2018.
Rabies prevention involves two main strategies: (i) dog vaccination to interrupt virus transmission to
humans; and (ii) human vaccination as a series of vaccine administrations before or after an exposure.
Currently, rabies vaccines made from inactivated cell cultures are extremely well tolerated and have no
contraindications.
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El objetivo de esta nota conceptual y del marco que describe es la eliminación de un grupo de enfermedades transmisibles y los efectos negativos sobre la salud que generan que juntos crean una carga tangible en las personas afectadas, sus familias y comunidades, y en los sistemas de atención de sa...lud en toda la Región. Aunque no hay consenso sobre las mejores medidas que se deben usar para la salud de las personas y de acuerdo con la situación epidemiológica de un país, es habitual medir la carga de enfermedad mediante las tasas de enfermedad (incidencia, prevalencia, etc.), las tasas de mortalidad por enfermedad específica, las tasas de morbilidad y mortalidad comparativas, la distribución geográfica y los años de vida ajustados en función de la discapacidad (AVAD)…. Se analiza la situación epidemiológica actual, incluidos los datos sobre tasas de enfermedad o distribución geográfica para las enfermedades del cuadro 1. Hotez et al. (2008) fueron los primeros en examinar y comparar la carga de los AVAD en América Latina y el Caribe para las ETD, la infección por el VIH/sida, la malaria y la tuberculosis como era hace unos diez años atrás. Aunque la carga regional de tuberculosis, malaria y enfermedades infecciosas desatendidas (EID) es algo menor a la de hace diez años, se sigue perdiendo la posibilidad de trabajar (y de asistir a la escuela) debido a la enfermedad y muerte prematura o discapacidad, y la necesidad de acelerar los esfuerzos para eliminar las enfermedades es evidente en todas las comunidades en situación de vulnerabilidad.
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Chagas disease (American trypanosomiasis) is endemic in 21 countries of the Americas, where control is largely focused on elimination of the domestic insect vectors (Triatominae) coupled with measures to extend and improve the screening of blood donors in order to avoid tranfusional transmission. Th...rough national programmes and multinational initiatives coordinated by WHO-PAHO, much has been accomplished in these domains in terms of reducing transmission. Attention now turns to consolidating the successes in interrupting transmission, and improved treatment for those already infected and those who may become affected in the future. This article, based on technical discussions at the "Epidemiological and Sociological Determinants of Chagas Disease, Basic Information to Establish a Surveillance and Control Policy " meeting in Rio de Janeiro, is designed to open the debate on appropriate strategies for continuation of the successful initiatives against Chagas disease.
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El proyecto “Abordar las Enfermedades Infecciosas Desatendidas (EID) y las arbovirosis en el Chaco Paraguayo” ejecutado en el period 2017-2018 en el Chaco paraguayo por el Ministerio de Salud Pública y Bienestar Social de Paraguay (MSPyBS) con la cooperación técnica de la Representación en e...l Paraguay de la Organización Panamericana de la Salud/ Organización Mundial de la Salud (OPS/OMS) tiene como propósito generar evidencias sobre la capacidad de respuesta del país en esta zona geográfica, a fin de que permita establecer estrategias e intervenciones para fortalecer las capacidades existentes y facilite la toma de acciones oportunas para la prevención, el control y/o eliminación de este conjunto de enfermedades a la luz de los compromisos enmarcados en los Objetivos de Desarrollo Sostenible 2030, la Política Nacional de Salud 2030 y el Plan Estratégico de la OPS/OMS 2014-2019. El proyecto pretende lograr la implementación de un ambicioso sistema de vigilancia integrada (vigilancia epidemiológica, vigilancia de laboratorio y vigilancia entomológica) que proporcione datos de manera oportuna y eficaz para hacer frente a las arbovirosis y a las EID endémicas, como son en Paraguay la enfermedad de Chagas, leishmaniosis, helmintiasis transmitidas por el suelo, teniasis/cisticercosis, la lepra y de forma estratégica se ha incluido al dengue.
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Since 2000, concerted efforts by national programmes, supported by public–private partnerships, nongovernmental organizations, donors and academia under the auspices and coordination of the World Health Organization (WHO), have produced important achievements in the control of human African trypan...osomiasis (HAT). As a consequence, the disease was targeted for elimination as a public health problem by 2020. The Sixty-sixth World Health Assembly endorsed this goal in resolution WHA66.12 on neglected tropical diseases, adopted in 2013.
National sleeping sickness control programmes (NSSCPs) are core to progressing control of the disease and in adapting to the different epidemiological situations. The involvement of different partners, as well as the support and trust of long-term donors, has been crucial for the achievements.
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