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The 2014-2015 outbreak of Ebola virus disease (EVD) in Liberia resulted in over 10,000 cases and 5,000 deaths. Recognizing the importance of addressing children’s trauma, the Ebola recovery
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and restoration trust fund (EERTF) funded the implementation of a Comfort for kids (C4K) program which encourages psychological healing, and promotes resilience in children who have experienced a crisis or disaster. The C4K program in Liberia was implemented between January 2015 and December 2016 in fifteen townships in Montserrado County through a collaboration between Mercy Corps Liberia, the World Bank’s Liberian health task team, and the government of Liberia. C4K primarily centers on the My Story workbook and associated classroom activities, which provide children with the opportunity to express their emotions about their experiences through drawing, writing, and facilitated discussion. C4K also provides capacity building for parents, teachers, and other caretakers on how to identify and more effectively respond to children’s trauma responses and to support their recovery
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Chronic kidney disease (CKD) is an important contributor to mortality from noncommunicable diseases. No decrease has been seen for CKD mortality contrary to many other important non-communicable dis
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eases (e.g., cardiovascular disease). The prevalence of CKD and kidney failure are increasing all over the world – and thereby also the need for dialysis. Unfortunately, the prevalence increases most rapidly in lowand middle-income countries. Globally, there are great inequities in access and quality of management of kidney failure. Many low- and middle-income countries cannot meet the increased need for dialysis. If the patients receive dialysis, it might only be for a limited period due to the out-of-pocket expenses. There are global disparities in CKD mortality reflecting the disparities in access to care. Lack of access to dialysis is an important cause of the increased CKD mortality in low- and middle-income countries.
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In 2019, the Task Force on Fiscal Policy for Health concluded that taxes on tobacco, alcohol, and sugar-sweetened beverages were a highly effective but greatly underused policy tool to reduce consum
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ption, save lives, and raise domestic resources. The Task Force estimated that if all countries increased their excise taxes to raise prices by 50 percent, over 50 million premature deaths could be averted worldwide over the next 50 years while
raising over USD 20 trillion of additional revenue. Since the Task Force first convened, the world has faced a “polycrisis,” including a global pandemic, an economic recession, and the outbreak of wars in Europe and the Middle East. Against this backdrop, the world has also experienced prolonged health and fiscal crises. Health systems, weakened by the COVID-19 pandemic, lack sufficient financing to rebuild and respond to the surging noncommunicable diseases epidemic caused by uncontrolled risk factors such as tobacco, alcohol, and sugar consumption. Opportunities to raise domestic resources are limited and debt burdens have squeezed budgets. The period from 2019 to 2027 risks becoming a “lost decade” for health and social policies, with 110 countries facing little prospect of any
ability to raise government revenues beyond current levels. In this paper, we describe the current health and fiscal crises and review the contribution that health taxes could make in turning around this dire situation. We conclude that taxes on tobacco, alcohol, and
sugar-sweetened beverages are an ideal policy solution—good for the budget and good for health. These taxes are relatively quick to implement, and, unlike other taxes, do not put economic growth at risk—a vital benefit in the current era.
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Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewa
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rdship activities focus on measuring and improving how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment
The 2020 recommendations for the programmatic management of TB preventive treatment are the first to be released under the rubric of WHO consolidated TB guidelines (Module 1 – Prevention). The WHO
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consolidated TB guidelines will gradually group all TB recommendations and will be complemented by matching modules of a consolidated operational handbook. [1] The handbook will provide practical advice on how to put in place the recommendations at the scale needed to achieve national and global impact. The first handbook module in the series will be on the programmatic management of TB preventive treatment and will accompany the 2020 guidelines.
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Contact tracing and quarantine in the context of COVID-19: interim guidance, 6 July 2022
recommended
Contact tracing for COVID-19 is the process of identifying, assessing, and managing people who have been exposed to someone who has been infected with the SARS-CoV-2 virus, while quarantine is the s
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eparation of contacts from other people after exposure to a probable or confirmed case of SARS-CoV-2 infection. In the context of growing global population immunity from COVID-19 vaccination and past SARS-CoV-2 infection, WHO recommends that identification, contact, quarantine and follow-up should be prioritized for individuals at high risk who have been in contact with a confirmed or probable case of SARS-CoV-2 infection, rather than targeting all contacts. This updated guidance also introduces shorter recommended quarantine periods, including the ability to further shorten quarantine through the use of testing. National and local health authorities should use risk-based approaches to contact tracing and quarantine that include reviewing and adjusting to their local circumstances and disease epidemiology, population immunity, their health system’s capacities, and risk tolerance.
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J Antimicrob Chemother https://doi.org/10.1093/jac/dkab423
Antibiotic stewardship is absolutely crucial in the fight to control antimicrobial resistance. Everyone has a part to
play. Grassroots action is essential; it is no good sitting back
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and waiting for world leaders to solve this problem.
In this article I outline some of the challenges and the steps that everyone can take to do their part in tackling
the slow-moving crisis of AMR.
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Current and expected problems such as ageing, increased prevalence of chronic conditions and multi-morbidity, increased emphasison healthy lifestyle and
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prevention, and substitution for care from hospitals by care provided in the community encourage countries worldwide to develop new models of primary care delivery. Owing to the fact that many tasks do not necessarily require the knowledge and skills of a doctor, interest in using nurses to expand the capacity of the primary care workforce is increasing. Substitution of nurses for doctors is one strategy used to improve access, efficiency, and quality of care. This is the first update of the Cochrane review published in 2005.
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The overall goal of the programme, to reduce the malaria morbidity and mortality by 75% (using 2012 as baseline) by the year 2020, continued to be pursued in 2014. The following areas were identified as some of the priorities
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for the year: Malaria Case Management under which we have Malaria in Pregnancy (MIP), Home Based Care and Diagnostics.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The
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disease is common in rural tropical communities in West and Central Africa, where access to proper health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
more
Rwanda first confirmed cases of coronavirus disease 2019 (COVID-19) in March 2020. Although the number of cases has been low, health system resources are being redirected to respond and an increasin
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g number of children are affected by the socio-economic impacts of the pandemic, including disruptions to schooling and heightened protection risks.
While Rwanda remained Ebola-free during the outbreak, it remains a priority country and continues to maintain its Ebola preparedness. Rwanda is also home to 147,000 refugees, half of whom are children, who require assistance in and outside of camps.1 In 2021, UNICEF will continue to deliver life-saving services to refugees and children and families affected by COVID-19 and its socio-economic impacts, and maintain its Ebola preparedness and contingency planning.
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Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contempor
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ary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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WHY THIS GUIDE?
Because, in the face of crises and emergencies, it is vital to include a human rights perspective in responses. Vulnerable groups face major obstacles to accessing and benefiting fr
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om prevention, mitigation, and health care policies due to structural barriers of inequality. To offer guidelines to the countries of the Americas for crafting and implementing inclusive and accessible, human rights-based responses to a pandemic that is unprecedented in the region and in the world as a whole.
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The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without health aid. It also presents a theoretical model
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of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and report
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ed hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and
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finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients with DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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This guideline provides global, evidence-informed recommendations on daily iron supplementation in infants and children, as a public-health intervention for the
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prevention of anaemia and iron deficiency. It includes recommendations for iron supplementation in countries where malaria is prevalent.
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The Republic of the Union of Myanmar’s National Strategic Plan on HIV/AIDS 2016–2020 is the strategic guide for the country’s response to HIV at national, state/regional and local levels. The
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framework describes the current dynamics of the HIV epidemic and articulates a strategy to optimize investments through a fast track approach with the vision of ending HIV as a public health threat by 2030. Myanmar’s third National Strategic Plan (HIV NSP III) issues a call to all partners to front-load investments to close the testing gap and reach the 90–90–90 prevention and treatment targets to protect health for all.
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This global guidance was developed to support malaria-free countries and those that are close to malaria elimination to prevent re-establishment. The document outlines key concepts and principles
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for preventing re-establishment and provides guidance on strategies, interventions, planning and management. Country examples are included to highlight good practices and illustrate practical applications.
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Practice paper in Brief 24
Containment strategies for Ebola rupture fundamental features of social, political and religious life. Control efforts
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that involve local people and appreciate their perspectives, social structures and institutions are therefore vital
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