Este documento resume la actual posición del
Departamento de Salud Mental y Toxicomanías para
asistir a las poblaciones expuestas a factores estresantes
extremos, como los refugiados, los desplazados
internos, los sobrevivientes de desastres y poblaciones
expuestas al terrorismo, a la guerra ...o al genocidio.
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The Sphere Handbook is the oldest initiative in the field of humanitarian standards. It has been field-tested over twenty years and regularly updated to ensure it remains fit for purpose in a changing world. What does not change is its rights-based foundations: people have the right to assistance, ...the right to life with dignity, the right to protection and security, and the right to fully participate in decisions related to their own recovery
A New Version in English and French was published in 2018
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An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions... to future response to health emergencies. The final report of EPRC culminates with eight evidence-based recommendations of actions to strengthen future pandemic responses, while building a resilient recovery in the Region. The recommendations by the external team focus on PAHO’s governance and management, on specialized regional mechanisms, diversified funding models, and use of new technologies, among others.
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The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countries, the causes of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel sm...oke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa.
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Un adecuado crecimiento y desarrollo durante los primeros años de vida no solo sienta las bases para que un individuo sea saludable, sino también para que una sociedad sea más equitativa y próspera
Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women ...and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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A erradicação da varíola humana (mpox em inglês) foi certificada em 1980. A varíola símia (mpox em inglês) é endêmica nos países da África Central e Ocidental desde a sua primeira detecção, em 1958. Trata-se de uma zoonose cujos casos geralmente ocorrem perto de florestas tropicais, ond...e diversos animais são portadores do ortopoxvírus causador da doença. A maioria das infecções em seres humanos pelo vírus da varíola símia em países onde a doença é endêmica é resultado de transmissão primária de animais para humanos. A transmissão de pessoa a pessoa pode ocorrer por meio de contato próximo com secreções respiratórias ou lesões cutâneas de uma pessoa infectada ou com objetos recém-contaminados. A transmissão também pode ocorrer através da placenta da mãe para o feto ou por contato direto durante ou após o parto. Até 21 de maio de 2022, 12 países onde não há varíola símia endêmica, em 2 regiões da Organização Mundial da Saúde (OMS), haviam notificado 92 casos confirmados da doença. Até 26 de agosto de 2022, 96 países sem endemicidade, de todas as 6 regiões da OMS, haviam notificado 45.198 casos confirmados de varíola símia, incluindo 6 óbitos. No mesmo período, os países onde a doença é endêmica notificaram 350 casos confirmados e 6 óbitos. Na Região das Américas, 29 países e territórios notificaram 23.479 (48%) casos confirmados e 3 óbitos. Diversos estudos observacionais sobre as vacinas de primeira geração demonstraram que a eficácia da vacinação contra a varíola humana na prevenção da varíola símia é de aproximadamente 85%. Atualmente, as vacinas originais (de primeira geração) contra a varíola humana não estão mais disponíveis.
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Desde el 2016, la Organización Panamericana de la Salud (OPS) ha promovido la implementación de la Iniciativa HEARTS en las Américas, una adaptación regional de la estrategia Global HEARTS de la Organización Mundial de la Salud (OMS). Durante este tiempo, 33 países de la Región de las Améric...as se han comprometido a implementar HEARTS y la OPS ha desarrollado una amplia variedad de herramientas clínicas para asistir a los equipos de salud en su trabajo cotidiano e impulsarlos a buscar la mejora continua de la calidad. Este compendio pretende presentar en un solo documento, y de manera simple y didáctica, todos los recursos técnicos desarrollados por la Iniciativa HEARTS en las Américas para facilitar su implementación en la práctica diaria del ámbito clínico. El lector notará que cada herramienta se detalla en una sola página y se presenta en un formato modular. Por lo tanto, cada herramienta se puede utilizar en conjunto o por separado según sea necesario. Además, en la parte inferior de cada herramienta, el lector encontrará las referencias y los enlaces para acceder a los textos completos en caso de que los usuarios deseen profundizar más su conocimiento respecto a cada tema.
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Las necesidades de salud mental insatisfechas en la Región de las Américas son una de las principales causas de morbimortalidad, y tienen enormes consecuencias sociales, económicas y para la salud. La pandemia de COVID-19 ha exacerbado la crisis de la salud mental en la Región, por lo que se nec...esita una acción urgente en los niveles más altos del gobierno y en todos los sectores con el propósito de reconstruir para mejorar los sistemas y servicios de salud mental ahora y en el futuro. En este histórico informe, elaborado por la Comisión de Alto Nivel de la OPS sobre Salud Mental y COVID-19, se presenta un análisis de la situación de la salud mental en las Américas, seguido de una serie de recomendaciones y sus puntos de acción correspondientes, a fin de ayudar a los países a priorizar y promover la salud mental con enfoques basados en los derechos humanos y la equidad.
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This WHO laboratory manual provides the most up to date methods and procedures for the laboratory identification of yellow fever virus infection in humans. It provides guidance on the establishment and maintenance of an effective laboratory providing routine surveillance testing for yellow fever, wh...ich operates within the WHO coordinated Global Yellow Fever Laboratory Network (GYFLaN) capable of providing confirmation of yellow fever infection reliably and timely. This second edition supersedes the first edition of the 2004 WHO manual for the monitoring of yellow fever virus infection.
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En la reunión de alto nivel de las Naciones Unidas del 2018 se fijó el objetivo de tratar al menos a 40 millones de personas con tuberculosis (TB) entre el 2018 y el 2022; sin embargo, en el 2021 ese objetivo solo se había cumplido en un 66%. Las pruebas diagnósticas son fundamentales para logra...r el objetivo, pero constituyen un eslabón débil en la continuidad de la atención. Las pruebas de diagnóstico rápido recomendadas por la Organización Mundial de la Salud (PDRO) son sumamente precisas, acortan el tiempo hasta el inicio del tratamiento, influyen en resultados importantes para el paciente y son costo-eficaces. Aunque el objetivo para el año 2025 es que todos los pacientes notificados se hagan inicialmente una PDRO, en el 2021 tan solo el 38% se hizo una PDRO como prueba inicial, y se determinó que el acceso a las pruebas diagnósticas era un problema crítico. Una de las principales consecuencias del uso insuficiente de las PDRO es la gran brecha en la detección de la farmacorresistencia. La presente Norma de la OMS: Acceso universal a las pruebas de diagnóstico rápido de la tuberculosis se basa en las directrices de la OMS y en el manual operativo conexo
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Las olas de transmisión de la fiebre amarilla ocurridas en la Región de las Américas entre el 2016 y el 2018 causaron el mayor número de casos humanos y epizoóticos registrados en varios decenios. La fiebre amarilla es una enfermedad hemorrágica viral grave que representa un desafío para el p...rofesional de salud: exige el reconocimiento temprano de signos y síntomas muchas veces inespecíficos, que pueden parecerse a otros síndromes febriles agudos. La detección temprana de los casos sospechosos o confirmados, el monitoreo de los signos vitales y las medidas de soporte vital, y el tratamiento de la insuficiencia hepática aguda siguen siendo las estrategias recomendadas para el manejo de los casos. El presente informe es el resultado de las deliberaciones sobre la experiencia de expertos de la Región en cuanto al manejo clínico de pacientes con fiebre amarilla, especialmente en brotes y epidemias, mediante la contextualización de esa experiencia en el conjunto actual de la evidencia médico-científica y la consideración de las directrices técnicas ya disponibles en los países de la Región. Presenta flujogramas para la evaluación inicial del paciente con sospecha clínica de fiebre amarilla y sugiere un conjunto mínimo de pruebas de laboratorio que puede ser útil cuando hay pocos recursos; además, detalla aspectos de la organización de los sistemas de salud para enfrentar brotes y epidemias de fiebre amarilla.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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Este documento de consenso brinda herramientas a los equipos de salud para acompañar modificaciones corporales vinculadas a procesos de construcción identitaria de niñeces y adolescencias trans, travestis y no binarias desde una mirada integral, basadas en la evidencia científica disponible, con...sensos internacionales y la experiencia de equipos locales que vienen trabajando en la temática. Cuenta con la revisión de integrantes de sociedades científicas y equipos de salud de diversas jurisdicciones del país.
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Le présent document rassemble une série de recommandations émises par l’Organisation mondiale de la Santé (OMS) et l’Organisation panaméricaine de la Santé (OPS) pour aider les professionnels chargés des programmes de lutte antivectorielle en Amérique latine et dans les Caraïbes aux niv...eaux national, infranational et local à mettre à jour et prendre des decisions à base factuelle qui touchent les mesures de lutte antivectorielle les mieux adaptées à chaque situation particulière. La GIV peut être utilisée lorsque la cible est la surveillance et la lutte ou l’élimination (en function de chaque situation) des MTV et peut contribuer à réduire le développement de la résistance aux insecticides au moyen de l’utilisation rationnelle de ces produits. Le présent document contient les instructions nécessaires pour mener à bien le mandat établi par l’OPS en 2008 (résolution CD48.R8, document CD48/13), en particulier, il complémente une série de guides de l’OMS publiés en 2012
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