SARS-CoV-2 infections among children and adolescents cause less severe illness and fewer deaths compared to adults. While a less severe course of infection is a positive outcome, there are concerns that mild symptoms may have led to less testing, resulting in fewer identified cases of COVID-19 in ch...ildren. If children with mild or no symptoms transmit the disease, they may act as drivers of transmission within their communities. Understanding symptoms, infectivity and patterns of SARS-CoV-2 transmission in children and adolescents is essential for developing, adapting and improving control measures for COVID-19 across all ages. This is a summary of the current knowledge around SARS-CoV-2 infection acquisition and transmission and COVID-19 disease symptoms in children and adolescents. It aims to inform decisions, based on local contexts, on how to best keep schools, kindergarten and day-care facilities open and what advice to apply to intergenerational mixing.
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The global increase of healthcare-associated infections (HAI) presents a growing concern in healthcare worldwide. According to the European Centre for Disease Prevention and Control (ECDC), the annual number of HAI exceeds 2.6million and produces the highest estimated amou...nt of disability-adjust-ed-life-years, surpassing all other reported communicable diseases in the European Union and European Economic Area. Multi-drug-resistant Gram-negative (MDR-GN) bacteria have become increasingly common as a cause for HAI, such as central line-as-sociated bloodstream infections, wound or surgical site infections and catheter-associated urinary tract infections
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Buruli ulcer is caused by infection with Mycobacterium ulcerans. The disease is reported in more than 33 countries worldwide, but only about half of these countries regularly report data to WHO; most cases are reported from subregions of West and Central Africa. The mode of transmission is not known....
About half of those affected are children aged under 15 years; there is no gender difference. Diagnosis is based mainly on clinical and epidemiological characteristics. Of the four methods used for laboratory confirmation (microscopy, polymerase chain reaction (PCR), histopathology and culture), PCR is the most rapid and widely used. Other rapid methods for detection of mycolactone in lesions from suspected cases, such as fluorescent thin-layer chromatography, are under evaluation in four countries in Africa.
Research to develop point-of-care tests is in progress. Treatment of Buruli ulcer comprises 8 weeks of combined antibiotics (rifampicin and clarithromycin). Complementary therapies such as wound care, skin graft and prevention of disability are needed in some cases to ensure full recovery.
The target set by the World Health Organization (WHO) for control of Buruli ulcer is for countries to achieve a rate of case confirmation by PCR of at least 70%. All endemic countries have at least one PCR facility to support confirmation of cases. However, most countries in the WHO African Region have not been able to reach the target, and the rate of case confirmation has been declining
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Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatment for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas..., the high burden of new N. gonorrhoeae infections (estimated at 11 million new cases a year), the complexity of the disease epidemiology, and in many countries the limited resources, make it difficult to fully understand the burden of disease and the burden of antimicrobial resistance (AMR) in N. gonorrhoeae.
PAHO has developed this document to facilitate the navigation of available guidance and recommendations for N. gonorrhoeae AMR surveillance by public health and health care professionals, at the national and subnational levels, involved in designing, implementing, and/or strengthening AMR surveillance of N. gonorrhoeae and overall surveillance of sexually transmitted infections.
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Antimicrobial resistance represents a big threat to public health. The Centers for Disease Control and Prevention (CDC) estimate that every year two million Americans are infected with a (multi-)drug resistant bacterium, resulting in 23,000 deaths. The WHO has repeatedly drawn attention to this majo...r health issue. In the worst-case scenario, we will shortly run out of effective antibiotics. Surgery and cancer therapy will then become very dangerous due to the risk of infection associated with such treatments. (Organ) transplantation will become close to impossible as the immunosuppression necessary for transplant patients makes them highly vulnerable to infections. Some infections we can easily treat today could turn deadly. It is therefore conceivable that infectious diseases once again become the leading cause of death as in early 20th century.
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The health care environment contains a diverse population of microorganisms and can be a reservoir for potential pathogens. If environmental cleaning is not performed correctly, then environmental contamination can contribute to the spread of multidrug-resistant organisms and health care-associated ...infections. Collaboration between infection prevention and control (IPC) and environmental services (EVS) staff limits the role of the health care environment in disease transmission.
This course is also available in the following languages:
Tetun - Bahasa Indonesia
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The International Rescue Committee (IRC) is a leading humanitarian agency dedicated to helping people whose lives have been shattered by conflict and disaster to survive, recover, and gain control of their future. Health comprises nearly half of IRC’s program portfolio globally and encompasses thr...ee sectors: 1) Primary Health (including child health, sexual and reproductive health and rights, and mental health); 2) Nutrition; and 3) Environmental Health. IRC health programming across its portfolio, in terms of the size and breadth, responds to significant needs in crisis affected settings, improving health and wellbeing while reducing causes of ill-health.
This five-year Health Strategy sharpens our focus on where we can have the most impact. It guides our efforts in planning, technical assistance, business development, advocacy, and internal and external collaboration. Through this strategy, we will invest and grow in areas that will help us achieve high impact at scale for our clients. For the next five years these priorities will include: Nutrition; Immunization: Infectious Disease Prevention and Control; Last Mile Delivery of Primary Health Care: Clean Water.
Our strategy aligns with Strategy 100 (S100) and Strategy Action Plans (SAPs). It lays out how IRC, through health, nutrition, and Environmental Health (EH) programming, will advance the IRC’s S100 ambitions, respond to global trends, and capitalize on our value add. The strategy will be complemented by delivery plans that detail investments, actions, and roles and responsibilities to advance our priorities. At the end of FY24, we will take stock of the implementation of the strategy, measure progress towards achieving our goals, and review if it continues to be fit for purpose.
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Rabies has an enormous impact on both agriculture and conservation biology, but its greatest burden is undeniably on public health. As such, routine methods for rapid risk assessment after human exposures to rabies as well as applications for laboratory-based surveillance, production of biologicals ...and management of this infectious disease are critical. Given its mandate to improve human health and control disease among its Member States, WHO has led the production of this fifth edition of Laboratory techniques in rabies.
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Rabies has an enormous impact on both agriculture and conservation biology, but its greatest burden is undeniably on public health. As such, routine methods for rapid risk assessment after human exposures to rabies as well as applications for laboratory-based surveillance, production of biologicals ...and management of this infectious disease are critical. Given its mandate to improve human health and control disease among its Member States, WHO has led the production of this fifth edition of Laboratory techniques in rabies.
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WHO convened the fifth stakeholders meeting on the elimination of HAT due to infection with Trypanosoma brucei gambiense (g-HAT) and Trypanosoma brucei rhodesiense (r-HAT) in Geneva, Switzerland, on 7–9 June 2023. The meeting was held again in person after the coronavirus disease (COVID-19) pandem...ic and jointly for both forms of the disease. The previous meetings on g-HAT held in 2014, 2016 and 2018, as well as on r-HAT in 2015, 2017 and 2019, and jointly for g-HAT and r-HAT in 2021 (8) reinforced the partnership and commitment for HAT elimination and structured the mechanisms of collaboration within the WHO network for HAT elimination. The network includes NSSCPs, groups developing new tools, international and nongovernmental organizations involved in disease control, and donors.
Fewer than 1000 cases of HAT annually have been reported over the past 5 years, which is a historic achievement. The area at risk has been substantially reduced. The elimination of HAT as a public health problem at the global level has been achieved.
The new road map for neglected tropical diseases (NTDs) 2021−2030 (“the road map”) with the target to interrupt the transmission of g-HAT requires the strengthened and sustained efforts of all stakeholders, national authorities and partners, under WHO coordination. It will take disproportionally high efforts and innovative strategies to find the last cases of g-HAT and neutralize its transmission. Given the limited resources and other competing public health priorities, this is a challenge that requires our joint commitment.
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American cutaneous leishmaniasis (CL) is a severely understudied and neglected“disease of poverty” widespread throughout Peru. Transmission dynamics of CL are complex, requiring sandfly vectors and mammalian reservoir hosts to maintain the pathogen in a local environment whereby incidental hosts... (people) can become infected. We employed a One-Health approach to understand CL transmission in rapidly changing region of northern Peru. We describe the characteristics of 529 CL positive patients from four participating clinics. Using conditional logistic regression, we assessed risk factors of CL for residents of small urban areas through a matched case-control study with 63 patients who had visited one of the same clinics for CL (cases) or other medical reasons (controls). We later enrolled 343 households as part of a community based study occurring in 15 urban and rural areas of Soritor. We
found 256 positive humans (n= 914) as tested via the Montenegro Skin Test; we found 11 positive dogs (n = 236) via an immunofluorescence antibody test. Our results suggest that most- if not all- of CL transmission is occurring in rural areas and that urban women and urban children engage in many high risk activities typically attributed to men. We find evidence that prevalence of past infection is highest among rural residents and men. We believe dogs are unlikely Leishmania reservoirs in either rural or urban settings. It remains unknown if the high number of MST positive children in rural areas is a result of peridomestic or intradomestic transmission.
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Leishmaniasis is a major vector-borne disease caused by obligate intramacrophage protozoa of the genus Leishmania, and transmitted by the bite of phlebotomine female sand flies of the genera Phlebotomus and Lutzomyia, in the old and new worlds, respectively. Among 20 well-recognized Leishmania speci...es known to infect humans, 18 have zoonotic nature, which include agents of visceral, cutaneous, and mucocutaneous forms of the disease, in both the old and new worlds. Currently, leishmaniasis show a wider geographic distribution and increased global incidence. Environmental, demographic and human behaviors contribute to the changing landscape for zoonotic cutaneous and visceral leishmaniasis. The primary reservoir hosts of Leishmania are sylvatic mammals such as forest rodents, hyraxes and wild canids, and dogs are the most important species among domesticated animals in the epidemiology of this disease. These parasites have two basic life cycle stages: one extracellular stage within the invertebrate host (phlebotomine sand fly), and one intracellular stage within a vertebrate host. Co-infection with HIV intensifies the burden of visceral and cutaneous leishmaniasis by causing severe forms and more difficult to manage. The disease is endemic to Ethiopia, and the clinical signs are not pathognomic. The visceral form (Kala-azar) may be confused with other similar conditions such as malaria, tropical splenomegaly, schistosomiasis, milliary tuberculosis, and brucellosis. Similarly, cutaneous leishmaniasis should be differentiated from disease like tropical ulcers, impetigo and leprosy. There are several methods of laboratory diagnosis of leishmaniasis, including parasitological, immunological and molecular. Different forms of treatments are available including oral, parenteral, and topical medications such as pentavalent antimonials, liposomal amphotericin B, miltefosine and paromomycin. Methods of control are largely limited to destruction of animal reservoirs, treatment of infected humans, and management of sand fly populations. Development of an effective vaccine against leishmaniasis has been largely unsuccessful and hinders its prevention.
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Временные рекомендации
17 марта 2020 г.
Данный документ представляет собой адаптированную версию временных рекомендаций, разработанных для ближневосточного респ...ираторного синдрома, вызванного коронавирусом (БВРС-КоВ), которые были опубликованы в июне 2018 г.1, и был составлен на основе опубликованных ВОЗ научно обоснованных рекомендаций, включая руководство «Infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care» (Профилактика инфекций и борьба с острыми респираторными инфекциями, способными вызывать эпидемии и пандемии, при оказании медико-санитарной помощи)2, а также имеющейся на сегодняшний день информации о COVID-19.
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Spirometry is required as part of the comprehensive evaluation of both adult and paediatric individuals with suspected or confirmed respiratory diseases and occupational assessments. It is used in the categorisation of impairment, grading of severity, assessment of potential progression and response... to interventions. Guidelines for spirometry in South Africa are required to improve the quality, standardisation and usefulness in local respiratory practice. The broad principles of spirometry have remained largely unchanged from previous versions of the South African Spirometry Guidelines; however, minor adjustments have been incorporated from more comprehensive international guidelines, including adoption of the Global Lung Function Initiative 2012 (GLI 2012) spirometry reference equations for the South African population.
All equipment should have proof of validation regarding resolution and consistency of the system. Daily calibration must be performed, and equipment quality control processes adhered to. It is important to have standard operating procedures to ensure consistency and quality and, additionally, strict infection control as highlighted during the COVID-19 pandemic.
Adequate spirometry relies on a competent, trained operator, accurate equipment, standardised operating procedures, quality control and patient co-operation. All manoeuvres must be performed strictly according to guidelines, and strict quality assurance methods should be in place, including acceptability criteria (for any given effort) and repeatability (between efforts).
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essential for creating an environment that supports the dig...nity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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Version 1.1. The WHO protocol has been adapted to resource-limited settings and builds on existing methodologies from the European Centre for Disease Prevention and Control (ECDC), the Global PPS project from University of Antwerp, the US Centers for Disease Control and Prevention (CDC), and the Med...icines Utilisation Research in Africa (MURIA).
Point Prevalence Surveys collects information on prescribing practices of antibiotics and other information relevant to treatment and management of infectious diseases in hospitalized patients, and complements surveillance of antimicrobial consumption.
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Since the World Health Organization (WHO) launched the Global Antimicrobial Resistance Surveillance System (GLASS) in 2015, there has been rapidly growing awareness among many African countries that they need to be doing more to combat antimicrobial resistance (AMR). The Africa Centres fo...r Disease Control and Prevention (CDC) was officially inaugurated in January 2017 and will support countries commencing surveillance for serious infectious disease threats in Africa, including resistance. Review of the recent WHO GLASS report suggests that, while certain nations do have some surveillance systems in place, very few countries in Africa currently conduct effective routine surveillance.
African Journal of Laboratory MedicineISSN: (Online) 2225-2010, (Print) 2225-2002
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21 January 2022
The overall threat posed by Omicron largely depends on four key questions: (i) how transmissible the variant is; (ii) how well vaccines and prior infection protect against infection, transmission, clinical disease and death; (iii) how virulent the variant is compared to other varian...ts; and (iv) how populations understand these dynamics, perceive risk and follow control measures, including public health and social measures (PHSM).
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Over the past twenty years, huge efforts made by a broad coalition of stakeholders curbed the last epidemic and brought the disease to the brink of elimination. In this paper, the latest figures on disease occurrence, geographical distribution and control activities are presented. Strong evidence in...dicates that the elimination of sleeping sickness ‘as a public health problem’ by 2020 is well within reach. In particular, fewer than one thousand new cases were reported in 2018, and the area where the risk of infection is estimated as moderate, high or very high has shrunk to less than 200,000 km2. More than half of this area is in the Democratic Republic of the Congo. The interruption of transmission of the gambiense form, targeted by the World Health Organization (WHO) for 2030, will require renewed efforts to tackle a range of expected and unexpected challenges. The rhodesiense form of the disease represents a small part of the overall HAT burden. For this form, the problem of under detection is on the rise and, because of an important animal reservoir, the elimination of disease transmission is not envisioned at this stage.
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Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to sustained and coordinated efforts during the past 15 years the nu...mber of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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