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 the 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.
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The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this paper explores the impact of this current macro-fisc...al outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
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This report explores the reasons why global health is critical to medicine and what this means for medical education. It argues that an understanding of global health is important for all students and practicing doctors, rather than being an ‘add-on’ or ‘option’ for specialization.
BMJ,Dodd PJ, et al. Thorax 2017;72:559–575. doi:10.1136/thoraxjnl-2016-209421
Leishmaniases are a group of diseases of zoonotic importance caused by over 20 species of protozoa of the genus Leishmania, in which domestic dogs are considered to be the main reservoir for the disease. However, the involvement of other vertebrates as reservoirs for these parasites has also been in...vestigated. Therefore, the objective of the present study was to carry out a systematic review with meta-analysis on occurrences of leishmaniasis in equids. The case reports described animals with cutaneous symptoms of leishmaniasis (papules, nodules, ulcers or crusts) that regressed spontaneously, located mainly on the head and limbs, from which three species of protozoa were identified in the lesions: Leishmania braziliensis, Leishmania infantum and Leishmania siamensis. In turn, the meta-analysis showed a combined prevalence of 25%, although with high heterogeneity among the studies, which was attributed to the use of different methods for diagnosing the disease. Leishmaniasis in equids is a benign disease but it should be included in the differential diagnosis of cutaneous diseases among these species. Seroepidemiological studies are important in investigating and monitoring suspected exposure of these hosts to the parasite, especially in endemic areas. However, there is also a need to standardize diagnostic methods.
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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.
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Chagas disease (CD) is caused by Trypanosoma cruzi. When acquired, the
disease develops in stages. For diagnosis, laboratory confirmation is required, and an extensive assessment of the patient’s health should be performed. Treatment consists of the administration of trypanocidal drugs, which may... cause severe adverse effects. The objective of our systematic review was to analyze data contained in the CD published case reports to understand the challenges that patients and clinicians face worldwide.
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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.
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Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination.
Schizophr Bull. 2014 Jan;40(1):192-213. doi: 10.1093/schbul/sbs150. Epub 2012 Dec 17.
Aligned to the Lancet Migration Global Statement to include migrants and refugees incountries’response to COVID-19, this update focuses on Mexico’s challenges and opportunities to build an inclusive response that is based on a contextualized adaptation of there commendations published by th...e Lancet Migration. A critical component for this analysis is the recognition of migration as a social determinant of health, which acts as a major risk factor for populations subjected to violence, trauma and forced exile while in the face of a global pandemic.
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The major neglected tropical diseases, Taenia solium taeniosis/cysticercosis and schistosomiasis caused by Schistosoma mansoni or S. haematobium are presumed to be widely distributed in Africa. Taenia solium taeniosis/ cysticercosis has been reported as an emerging disease in different regions of Af...rica [1, 2], but currently the exact distribution remains unclear. Reported prevalences of T. solium taeniosis and cysticercosis in African countries are not extensive and are further complicated by the lack of ‘gold standard’ tests for diagnosis.
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Lancet Planet Health 2021; 5: e542–52
The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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J Bras Pneumol. 2022;48(2):e20220082
The spread of Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV-2) continues to progress, causing damage in several countries of the world due to its rapid transmissibility and significant mortality rates, despite government measures to contain its tra...nsmission, such as movement control, the closing of schools, bans on travel and public gatherings, the mandatory use
of masks, and hand hygiene. The coronavirus disease (COVID-19) has clinical manifestations that are similar to those found in other infections also transmitted through the airways, such as pulmonary tuberculosis (TB) Although TB is a global health problem, it is a curable disease, with affordable treatment and prevention. Nonetheless, it remains one of the leading
causes of death from a single infectious agent worldwide, a situation threatened by COVID-19.
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COVID-19 vaccine hesitancy is currently one of the main obstacles to worldwide herd immunity and socioeconomic recovery. Because vaccine coverage can vary between and within countries, it is important
to identify sources of variation so that policies can be tailored to different population groups. ...In this paper, we analyze the results from a survey designed and implemented in order to identify early adopters and
laggers in six big cities of Latin America. We find that trust in government and science, accurate knowledge about the value of vaccination and vaccine effects, perceived risk of getting sick, and being a student
increase the odds to get vaccinated. We also identify potential laggers as women and populations between 20 and 35 years old who are not students. We discuss specific strategies to promote vaccination among
these populations groups as well as more general strategies designed to gain trust. These findings are specific to the context of Latin America insofar as the underlying factors associated with the choice to be
vaccinated vary significantly by location and in relation to individual-level factors.
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World's largest Science, Technology & Medicine Open Access book publisher
Chapter 7 from the book People's Movements in the 21st Century - Risks, Challenges and Benefits
Guidelines
UNAIDS/WHO working group on global HIV/AIDS and STI surveillance
August 2015
HIV strategic information for impact