Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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Community health workers (CHWs) play a vital role in facilitating social connectedness, building trust, decrease stigma, and link communities to essential healthcare and social support services. More studies are needed to understand the factors facilitating these interactions among CHWs, clients, an...d community members.
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The Malawian government recently introduced cost-covering consultation fees for self-referral patients in tertiary public hospitals. Previously, patients received medicines free of charge in government-owned health facilities, but must pay elsewhere. Before the government implements a payment policy... in other areas of health care, it is important to investigate the prices, affordability and availability of essential medicines in Malawi.
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The article "Cardiovascular Diseases" on Our World in Data provides an in-depth analysis of cardiovascular diseases (CVD), the leading cause of death globally. It examines CVD trends, such as the decline in mortality rates in high-income countries due to improved healthcare and lifestyle changes, wh...ile low- and middle-income countries experience rising CVD burdens. The article highlights major risk factors, including high blood pressure, obesity, smoking, and poor diet. It emphasizes the importance of preventive measures and access to treatment to reduce global disparities in CVD outcomes. The data-driven approach uses visualizations to illustrate the global impact and distribution of CVD.
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People with diabetes mellitus are at an increased risk for foot ulcerations as a result of poorly controlled blood glucose which may lead to gangrene. These patients are at a high risk for lower limb amputations, higher healthcare costs, and lower quality of life. This course aims to cover the preve...ntion of foot ulcers in persons with diabetes, classification of diabetic foot ulcers, diagnosis and treatment of foot infection in people with diabetes and interventions to enhance healing of foot ulcers.
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For over 23 years, CDC has collaborated in Malawi with local and international partners to strengthen health systems. The office works to prevent, detect and respond to diseases. Efforts include building healthcare workforce capacity, strengthening laboratory systems, and increasing the capacity of ...surveillance and health information systems. CDC also implements high-impact HIV and tuberculosis programs through the President's Emergency Plan for AIDS Relief and supports malaria control activities under the U.S. President's Malaria Initiative.
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The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of ...the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
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The article "Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review" examines the financial impact associated with moderate-to-very severe COPD. The review analyzes studies published between 2006 and 2016 that discuss healthcare resource utilization (HRU), di...rect costs, and indirect costs related to COPD, with a focus on Europe and North America. It highlights that direct costs, including hospitalizations and medical treatments, increase with the severity of COPD and the frequency of exacerbations. Multivariate analyses identify key factors driving these costs, such as comorbidities and prior treatment history. The findings underscore the significant economic burden of COPD on healthcare systems and emphasize the need for improved management strategies to reduce costs and optimize patient care.
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The GOLD website is dedicated to providing comprehensive information on Chronic Obstructive Pulmonary Disease (COPD). It offers resources and guidelines for healthcare professionals and public health authorities to improve the diagnosis, management, and prevention of COPD worldwide. The site include...s the latest reports, strategies, and updates on COPD research, emphasizing evidence-based practices for better patient outcomes. GOLD also provides educational materials, workshops, and support for implementing COPD care programs, aiming to raise global awareness and promote effective treatments for COPD.
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The document provides information on managing chronic obstructive pulmonary disease (COPD). It emphasizes the importance of recognizing early symptoms such as persistent coughing, shortness of breath, and wheezing. The guide offers practical advice, including quitting smoking, avoiding lung irritant...s, regular consultations with healthcare providers, and seeking support from friends and caregivers. It also highlights the value of preparing for medical visits, noting symptoms, understanding risk factors, and taking notes during appointments to maximize treatment effectiveness.
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This study investigated occupational risk factors and exposure–response relationships for airway disease among health workers (HWs) exposed to cleaning agents in two tertiary hospitals in South Africa and Tanzania.
Previous studies have demonstrated an association between asthma or respiratory... symptoms and exposure to broad categories of cleaning-related exposures in healthcare settings. However, few studies have identified the specific cleaning agents responsible for asthma and other health outcomes. Products used for medical instrument cleaning and disinfection such as glutaraldehyde, orthophthalaldehyde (OPA) and quaternary ammonium compounds (QACs) have been implicated in the causation and exacerbation of work-related asthma (WRA) and upper airway outcomes such as rhinitis.
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PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts of COVID-19 and sustain progress achieved over the l...ast two decades towards HIV epidemic control.
At the conclusion of the March 2020 Johannesburg Regional Planning Meeting, the PEPFAR Malawi team presented a COP20 surge strategy to improve client-centered care, mitigate treatment disruption, scale prevention programs to key and vulnerable populations, and strengthen national health systems.
Following this meeting, the first three COVID-19 cases were reported in Malawi and immediately thereafter, adaptations to the COP20 strategy became imperative to deliver safe, client-centered care.
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The article discusses the challenges and opportunities for lung health in Africa in the context of the COVID-19 pandemic. It highlights the strain on healthcare systems, the increase in chronic respiratory diseases like asthma and COPD, and the limited resources for managing these conditions. The pa...ndemic has exacerbated issues like delayed diagnosis and treatment, while also impacting child lung health and increasing risks for those with tuberculosis. It emphasizes the importance of leveraging global partnerships and strategies to improve healthcare infrastructure and response in Africa.
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The COPD Foundation's website provides a range of educational resources and downloadable materials aimed at helping patients, caregivers, and healthcare professionals learn more about COPD, including information on prevention, treatment, and disease management.
The International Primary Care Respiratory Group (IPCRG) is a clinically-led charitable company that works locally in primary care and collaborates globally to improve respiratory health. Our vision is that, through universal access to the right care, everyone can breathe and feel well.
A worldwide increase in the prevalence of asthma has been reported in recent years. With an increase in prevalence comes an increased burden of disease in terms of morbidity, mortality and compromised quality of life. The economic burden in terms of utilisation of healthcare resources and limitation... of the earning capacity of the individuals and families is an added problem. Various indicators such as disability-adjusted life years and healthy life years have been used to define the economic burden. The data from Asian countries regarding these parameters is scarce, underlining the need for systematic studies in these countries, especially those that are resource poor. The purpose of this review is to highlight the varying prevalence of asthma in Asia and to assess the likely economic burden for the future.
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It is estimated that as many as 300 million people of all ages, and all ethnic backgrounds, suffer from asthma and the burden of this disease to governments, health care systems, families, and patients is increasing worldwide. In 1989 the Global Initiative for Asthma (GINA) program was initiated in ...an effort to raise awareness among public health and government officials, health care workers, and the general public that asthma was on the increase. The GINA program recommends a management program based on the best available scientific evidence to provide effective medical care for asthma tailored to local health care systems and resources.
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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.
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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...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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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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