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2
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
...
Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
more
Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasises the role of preexposure prophylaxis (PrEP) in
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reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
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What You Can Do About a Lung Disease Called COPD
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
Global Initiative for Chronic Obstructive Lung Disease (GOLD)
(2019)
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The "GOLD Patient Guide 2019" explains Chronic Obstructive Pulmonary Disease (COPD), its causes, symptoms, and stages. It provides practical advice for managing COPD, including the importance of quitting smoking, following medical treatment plans, exercising, maintaining a healthy diet, and creating
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a supportive living environment. The guide emphasizes early diagnosis, regular medical checkups, and strategies for managing severe COPD to improve quality of life.
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The document by the American Thoracic Society provides an overview of Chronic Obstructive Pulmonary Disease (COPD), explaining its causes, such as smoking and environmental factors, symptoms like breathlessness and chronic cough, and diagnostic methods including spirometry. It discusses treatment st
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rategies, emphasizing smoking cessation, medication use, oxygen therapy, and pulmonary rehabilitation. The document also highlights that while COPD is a lifelong condition, effective management can improve symptoms and quality of life.
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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
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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.
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This chapter of the AMP LLIN Mass Campaign Toolkit outlines the strategic communication approaches that are essential before, during and after long-lasting insecticide-treated net (LLIN) distribution campaigns. It emphasises the importance of setting up a national communications sub-committee under
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the leadership of the National Malaria Control Programme (NMCP) and the Ministry of Health (MoH) to coordinate advocacy, social mobilisation and behaviour change communication (BCC). The aim of these three components is to secure political and financial support, mobilise communities, and promote sustained net use through tailored, multi-channel messaging. Effective coordination and planning are critical for successful malaria prevention efforts.
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This UNHCR guidance note provides comprehensive recommendations for the prevention and control of malaria in refugee settings worldwide. Aligned with the WHO Global Technical Strategy for Malaria, it outlines strategies to ensure access to effective prevention, diagnosis and treatment, implement sus
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tainable transmission reduction measures and strengthen surveillance systems. The document is intended as a practical resource for humanitarian actors, public health officials and partners involved in planning and implementing malaria programmes in refugee operations, with the aim of reducing malaria-related morbidity and mortality among vulnerable populations.
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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.
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he United Nations Development Programme’s (UNDP) Gender Equality Strategy 2022-2025 has
been created during turbulent times. Multiple crises and risks are threatening the world and
we are witnessing an alarming backlash against women’s rights and gender equality. Since the
COVID-19 pandemic h
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it, women have been nearly twice as likely to lose their jobs compared to
men. Yet less than 20 percent of policy measures implemented by countries across the world have
addressed women’s economic insecurity. Gender inequality also takes a toll on men and other
affected groups. For men, rigid gender norms can fuel risky behaviours resulting in violence, poor
health, and lower life expectancy.
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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.
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The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp
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ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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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.
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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
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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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The Call to Action calls on the G20 member countries to ensure continuity of high-quality treatment, care and support services and programming that address the needs of the most affected and vulnerable populations, for a more efficient and effective
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TB response.
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The One UN Climate Change Learning Partnership, also known as UN CC:Learn, is a collaborative initiative of 36 multilateral organizations working together to help countries build the knowledge and skills they need to take action on climate change. These include better climate literacy and other cruc
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ial skills to tackle this challenge.
UN CC:Learn provides guidance and quality learning resources to support people, governments and businesses to understand, adapt, and build resilience to climate change.
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Globally, some 72 million children are out of school due to emergencies and
protracted crises. Of these, at least 17% are children with disabilities.1 Yet, education in a crisis context can be a
lifeline for children, providing psychosocial support, access to school feeding and
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health programmes, and a much-needed safe space where they can interact with peers and maintain the routine of learning
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Position statement on endoscopic lung volume reduction in South Africa: 2022 update
Koegelenberg, C.F.; Van Zyl-Smit, R.N.; Dheda, K. et al.
African Journal of Thoracic and Critical Care Medicine
(2022)
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The article from the African Journal of Thoracic and Critical Care Medicine provides updated guidelines on endoscopic lung volume reduction (ELVR) for treating advanced emphysema, a severe form of chronic obstructive pulmonary disease (COPD), which is prevalent in South Africa and other low- and mid
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dle-income countries. The guidelines focus on identifying suitable patients based on specific criteria, such as age, lung function, and the presence of hyperinflation, while ruling out contraindications like pulmonary hypertension and recent smoking.
ELVR aims to reduce lung volume in the most damaged areas, improving breathing mechanics and quality of life. Various devices, including endobronchial valves, intrabronchial valves, and coils, are reviewed with evidence from clinical trials supporting their use. The guidelines emphasize careful patient selection and recommend only performing ELVR in specialized centers due to its high cost and risk of complications, such as pneumothorax.
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Focusing on preventing and mitigating COVID-19 related risks, the standards aim to protect the health and safety of personnel, while ensuring that organizations continue to deliver on their mandates. Attention is paid to non-discrimination and ensur
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ing that all personnel, regardless of nationality or contractual type is equally covered and protected by the minimum standards in the COVID-19 context. It is acknowledged that the implementation of such standards may entail additional costs for organizations, for which a dialogue with donors may be warranted.
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Written by international experts in the fields of infection control and hospital epidemiology, the ISID’s Guide to Infection Control in the Healthcare Setting brings together the most up-to-date principles and interventions that can reduce the rate of infection and the impact of associated consequ
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ences for patients, their families, and healthcare systems including: lengthier hospital stays; long-term disability; increased anti-microbial resistance; higher financial costs; and unnecessary deaths.
As the field of infection prevention grows in importance and the science supporting it continues to evolve, the Guide’s objectives are to facilitate the implementation of effective prevention and control measures across different resource levels to improve quality of care; minimize risk; save lives; reduce costs; and limit the use of antibiotics to fight these often preventable infections around the world.
The chapters herein are intended to facilitate the implementation of effective infection prevention and control measures across different resource levels, improve quality of care, minimize risk, save lives, and reduce costs.
To explore the Guide click on the sections below to view the chapters. Chapters have been divided into four parts
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