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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal
...
ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
more
Curr Opin Pharmacol . 2022 Apr;63:102203.doi: 10.1016/j.coph.2022.102203. Epub 2022 Feb 11.
The COVID-19 pandemic has widespread economic and social effects on Latin America (LA) and the Caribbean (CA). This region, which has a high prevalence of chronic diseases, has been one of the most affected
...
during the pandemic. Multiple symptoms and comorbidities are related to distinct COVID-19 outcomes. However, there has been no explanation as to why different patients present with different arrays of clinical presentations. Studies report that similar to comorbidities, each country in LA and the CA has its own particular health issues.
more
The marathon to eradicate polio is on its final lap: the world is more than 99% of the way to success. After millennia of living with poliovirus and suffering the paralysis it causes, today nearly all the world’s people live in polio-free countries; two of the three strains of wild poliovirus (WPV
...
) have been eradicated. Some 20 million people are walking who would have been paralysed had it not been for the efforts of national governments and health workers. If eradicating polio has been a marathon, the finishing line is in sight.
more
A qualitative assessment of knowledge gaps about female genital schistosomiasis among communities living in Schistosoma haematobium endemic districts of Zanzibar and Northwestern Tanzania.
PloS Neglected Tropical Diseases September 30, 2021 https://doi.org/10.1371/journal.pntd.0009789
Schistosoma
...
haematobium causes urogenital schistosomiasis and is widely distributed in Tanzania. In girls and women, the parasite can cause Female Genital Schistosomiasis (FGS), a gynecological manifestation of schistosomiasis that is highly neglected and overlooked by public health professionals and policy makers. This study explored community members’ knowledge, attitudes and perceptions (KAP) on and health seeking behavior for FGS.
more
In one of his final essays, statesman and former United Nations secretary general Kofi Annan said, ‘Snakebite is the most important tropical disease you’ve never heard of’. Mr. Annan firmly believed that victims of snakebite envenoming should be recognised and afforded greater efforts at impro
...
ved prevention, treatment, and rehabilitation. During the last years of his life, he advocated strongly for the World Health Organisation (WHO) and the global community to give greater priority to this disease of poverty and its victims.
more
The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
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 number 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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Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr
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oteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.
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In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South
American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention
and rehabilitation (CVDPR). In the context of the imple
...
mentation of a regional and national health policy in Latin American
countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on
Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation
of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline
and adapt it to the national reality.
The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine
clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World
Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025.
more
Infection 2023 Oct;51(5):1399-1406. doi: 10.1007/s15010-023-01999-9. Epub 2023 Feb 20.
The results indicate a significantly higher rate of infections with S. mansoni in street children compared with orphans. This might be explained by the lack of access to adequate sanitation for street children
...
as well as regular contact with the water of Lake Victoria. However, we did not find similar results concerning infection rates with protozoa. The study results show overall inadequate living conditions in this study population, which could be addressed by public health interventions.
more
These guidelines have been developed in simple, user-friendly language and they explain the procedures for patients’ access to and the safe management of Schedule I and II drugs that are necessary for the treatment and relief of moderate to severe pain. They provide both procedures for acquisition
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and information on records or documents that are necessary to ensure that these medicines are made available and accessible to patients across the entire health care delivery system (i.e. from tertiary institutions to primary level) and ensuring prevention of illicit non-medical use.
more
For education to be competency-based and effective, appropriate training methodologies have to be used to support the learner to have the appropriate knowledge and to translate this knowledge into skills and competencies. Such education and training should lead to a change in attitudes, beliefs a
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nd values, thus making the palliative care graduate able to do their job very effectively. To that end, APCA has developed this new resource, which is a guide to effective teaching methodologies in palliative care, targeting educators and trainers across Africa. This guide has been developed to enable educators and trainers to acquire knowledge and skills for using effective, practical, participatory and experiential teaching methods, and to use these in extending learning to all health care providers in Africa. The methods presented in this guide are based on existing practical and documented evidence of effective palliative care education.
more
The NIAID Pandemic Preparedness Plan describes the strategy of the National Institute of Allergy and Infectious Diseases (NIAID) to strengthen research and development for future pandemic threats. The plan focuses on identifying and studying viruses with the potential to cause epidemics or pandemics
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and developing medical countermeasures such as vaccines, therapeutics and diagnostics. A key concept is the research on “prototype pathogens,” which represent virus families that may cause future outbreaks, allowing scientists to prepare tools and knowledge in advance. The document also outlines the importance of surveillance, epidemiological research, technological innovation, clinical trials and international collaboration to enable a faster and more effective response to emerging infectious diseases. Overall, the plan aims to improve scientific preparedness so that new health threats can be detected earlier and controlled more rapidly.
more
The International Federation of Red Cross and Red Crescent Societies (IFRC) is the world’s largest volunteer-based humanitarian network. With our 190 member National Red Cross and Red Crescent Societies worldwide, we are in every community reaching 160.7 million people annually through long-term s
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ervices and development programmes, as well as 110 million people through disaster response and early recovery programmes. We act before, during and after disasters and health emergencies to meet the needs and improve the lives of vulnerable people. We do so with impartiality as to nationality, race, gender, religious beliefs, class and political opinions.
more
Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu
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ral practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
more
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
...
hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
more
Sexual abuse perpetrated against children is one of the most significant crises of our time. Child sexual abuse is a significant risk factor for children, in common with other forms of child maltreatment. Sexual abuse can have severe short- and long-term consequences on the physical, mental, social,
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emotional and economic well-being of children, families and communities. In emergencies, the threat of all forms of child abuse and gender-based violence (GBV), including child sexual abuse, is acute and widespread.
more
Nutrición de menores de 2 de edad
Considerando los desafíos de la implementación de la Política Pública para el Desarrollo Integral de la Primera Infancia 2010-2020 (PPDIPI), el Gobierno de Guatemala tomó la decisión de realizar su actualización a través de un proceso que se encuentra liderado por la Mesa Temática de la Pri
...
mera Infancia (MTPI), que forma parte de la estructura de gobernanza del Gabinete Específico de Desarrollo Social (GEDS), y siguiendo los lineamientos establecidos en la Guía para Formulación de Políticas Públicas de la Secretaría de Planificación y Programación de la Presidencia (SEGEPLAN). Este proceso tiene como fin definir las acciones estratégicas que permitan potenciar el impacto de los programas nacionales integrados e incidir para mejorar la implementación de intervenciones que permitan alcanzar la amplia realización de los derechos y el potencial de todas las niñas y los niños del país.
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Namibia has, for many years, had a strong legislative and policy framework for the protection of children. These policies and laws have been developed through the combined expertise of those working in the field of child protection who have ensured Namibia has a robust legal framework that is in li
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ne with international best practices.
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La thèse de Yobouet Inès Kouakou, soutenue à l’Université Claude Bernard Lyon 1, porte sur le traitement d’urgence du paludisme sévère chez l’enfant à l’aide d’une administration intranasale d’artésunate. L’objectif principal de ce travail est d’explorer, in vitro, la voie na
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sale comme alternative à la voie intra-rectale recommandée actuellement en pré-hospitalier. L’étude démontre la non-toxicité de formulations d’artésunate sur un modèle de muqueuse nasale humaine, bien que la perméation observée reste faible. Des pistes sont proposées pour améliorer cette perméation, notamment par l’optimisation galénique. La thèse inclut également une revue de la pharmacocinétique de l’artésunate et le développement de méthodes de dosage simples et peu coûteuses, adaptées aux laboratoires à ressources limitées. Ce travail s’inscrit dans une démarche de lutte contre le paludisme, notamment en zones rurales où l’accès aux soins reste difficile.
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