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April 2022 Volume 35 Issue 2 e00152-21
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 t
...
he 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.
more
The World Health Organization (WHO) and the global community of countries, partners, donors, technical experts, scientists and field implementation teams continue to work towards the ultimate goal of a world free of the burden of neglected tropical diseases (NTDs).
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d
...
evelopment needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
more
Climate change presents the single biggest threat to human development, and its widespread impacts disproportionately burden the poorest and most vulnerable households in fragile and rural developing contexts – particularly women and children.
According to the Intergovernmental Panel on Climate C
...
hange’s (IPCC) latest report, ‘between 2010 and 2020, droughts, floods and storms killed 15 times as many people in highly vulnerable countries, particularly in Africa — which is responsible for less than 3 percent of global emissions – than in the wealthiest countries’.
Recognising environmental degradation and climate change are key accelerators of extreme child vulnerability, World Vision (WV) approved the Environmental Stewardship Management Policy (‘the Policy’) and Guidelines (‘the Guidelines’) in 2021.
To support the implementation of the Policy and Guidelines, WV has developed this Environmental Stewardship and Climate Action Handbook (‘the Handbook’) to help offices across the WV Partnership implement best practice environmental management strategies both in the field and in our operations and facilities.
Integrating environmental stewardship and climate action into all our work – whether that be in our Area Programmes, grant projects, responses to disasters or advocacy – is critical to achieving WV’s strategy.
As a Christian organisation we are compelled to follow the ways of Jesus Christ, calling us to care for the ‘least of these’ (Matthew 25:40) – the vulnerable children who are disproportionately impacted by climate change. Our response to the degradation of the environment is not motivated by political expediency or funding – but because we are called to steward God’s creation (Genesis 1:28).
more
After five consecutive below-average rains, the humanitarian crisis in the Horn of Africa is expanding and deepening.
Combined with insecurity and macroeconomic volatility, the impact of the drought on food and nutrition security has been devastating. Across Ethiopia, Kenya and Somalia, an estima
...
ted 22 million people are now acutely food insecure because of the drought. The malnutrition situation is also critical. Some 5.1 million children across drought-affected areas of the three countries are acutely malnourished in 2023, with dire implications for their health, growth and survival. Concerningly, the upcoming March-May 2023 rains are also forecast to be below-average. Should these rains fail, and humanitarian assistance not be delivered at scale, food insecurity will continue to deteriorate.
Regardless of how the 2023 rains perform, extremely high humanitarian needs will persist through 2023 while a full recovery from a drought of this magnitude will take years. To address the devastating drought-induced hunger and malnutrition across the region, WFP is pursuing an integrated dual track approach; meeting immediate life-saving food and nutritional needs while simultaneously building resilience to extreme climate variability.
more
Prevalence of Schistosoma Haematobium Measured by a Mobile Health System in an Unexplored Endemic Region in the Subprefecture of Torrock, Chad
Layaye, D.; E de Bruijn, M.; de Jong, T.;
JMIR Publication Advancing Digital Health and Open Science
(2019)
CC
Schistosoma haematobium is a parasitic digenetic trematode responsible for schistosomiasis (also known as bilharzia). The disease is caused by penetration of the skin by the parasite, spread by intermediate host molluscs in stagnant waters, and can be treated by administration of praziquantel. Schis
...
tosomiasis is considered to be an important but neglected tropical disease.
more
The aim of this toolkit is to guide countries on how to best estimate their current burden of dengue by combining existing data from dengue surveillance systems with on-going research efforts to measure the community burden
of dengue.
The Return Counselling Toolkit is a capacity-building instrument aimed at providing a harmonized and coherent approach to return counselling, based on key migrant-centred principles while protecting migrants’ rights. Mindful of the specific needs and rights pertaining to children, this additional
...
module on counselling children and families further complements the first five modules of the Return Counselling Toolkit. It provides specialized guidance on how to prepare and deliver return counselling to accompanied, unaccompanied and separated children while upholding child rights and safeguards.
more
This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita
...
ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
more
The Food and Agriculture Organization of the United Nations (FAO) launched a new Framework for Environmental and Social Management (FESM) to ensure that both people and the environment are protected from any potential impacts of FAO programmes and projects.
“This Framework ensures that our proj
...
ects do both “no harm” and support the transformation to more efficient, more inclusive, more resilient and more sustainable agrifood systems by upholding the highest international standards for risk management,” FAO Director-General QU Dongyu explained during a virtual event.
The Framework, which includes key elements of a people-centered approach and establishes environmental and social performance requirements for FAO programming, is also intended to ensure that all stakeholders, including local and indigenous communities, have ample opportunities to actively participate in projects’ activities and to voice their concerns about them.
more
The domestic regulation of public health emergencies (PHEs) is inextricably linked to the regulation of other types of disaster. PHEs are usually governed at least partly by general disaster and emergency laws. Moreover, there is significant overlap in the legal mechanisms used to respond to PHEs an
...
d other types of disaster, including the declaration of a state of disaster or emergency and the use of emergency powers. Even where PHEs are regulated by separate instruments, those instruments must surmount many of the same policy and practical challenges as general disaster laws, such as finely balancing competing considerations (e.g. speedy response versus due process), facilitating the coordination of a multitude of actors, and protecting the most vulnerable within society. Finally, many contemporary developments in disaster risk management (DRM), such as a greater emphasis on risk reduction and preparedness, are just as pertinent to PHEs as to other types of disaster.
more
Female Genital Schistosomiasis (FGS) is a gynaecological disease caused by Schistosoma haematobium, a parasitic worm that is acquired by skin contact with freshwater contaminated by schistosome cerceriae. Communities in which the infection is most endemic have limited access to clean water and healt
...
hcare services. Up to 150 million adolescent girls and women are estimated to be at risk of FGS and about 16–56 milion womens are living with FGS, with the majority of these in sub-Saharan Africa. The variability of these estimates points to the fact that this neglected tropical disease is not well studied and frequently not prioritized by local, regional, and global health policy makers.
more
The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of
recommended preventive measures (wearing a mask in public, keeping a distance from other people and regular handwashing). The roll-out of the vaccines, however, raised concerns that vac
...
cination may lead to lower adherence to the existing
preventive measures. The advice from the World Health Organization (WHO) was to continue these public health and
social measures after being vaccinated.1 However, evidence from other epidemics suggests that there is lower adherence to
preventive measures when some level of protection exists (for example, individuals who use human immunodeficiency virus
pre-exposure prophylaxis
more
Knowledge, attitudes and practices about human African trypanosomiasis and their implications in designing intervention strategies for Yei county, South Sudan
Bukachi, SA.; Mumbo, AA.; Alak, ACD.; Sebit, W.; Rumunu, J.
PLOS Neclected Tropical Diseases
(2018)
CC
A clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into South Sudan, as part of integrated delivery of primar
...
y healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy.
more
Leishmaniasis is a climate-sensitive disease. Changes in temperature, rainfall, and humidity can have strong impacts on
the sandfly vector, altering their distribution and influencing their survival and population sizes. Increased temperatures shorten vector development time, reduce Leishmania para
...
site incubation time, and increase vector biting rates, allowing transmission
in areas not previously endemic for the disease. Poor and
marginalized communities will be hit disproportionately harder by
the effects of climate change, and droughts, famines, and floods
can also lead to displacement and migration of immunologically
naive people to areas where leishmaniasis is endemic, posing a
threat of leishmaniasis outbreaks.
more
Since 2000, concerted efforts by national programmes, supported by public–private partnerships, nongovernmental organizations, donors and academia under the auspices and coordination of the World Health Organization (WHO), have produced important achievements in the control of human African trypan
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osomiasis (HAT). As a consequence, the disease was targeted for elimination as a public health problem by 2020. The Sixty-sixth World Health Assembly endorsed this goal in resolution WHA66.12 on neglected tropical diseases, adopted in 2013.
National sleeping sickness control programmes (NSSCPs) are core to progressing control of the disease and in adapting to the different epidemiological situations. The involvement of different partners, as well as the support and trust of long-term donors, has been crucial for the achievements.
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Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy
Tirados, I.; Esterhuizen, J.; Kovacic, V.; Mangwiro, TNC.; Vale, GA
PLOS Neglected Tropical Diseases
(2015)
CC
Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control tec
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hnology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
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Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT
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control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
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Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di
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agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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This brochure presents a summary of the situation of health systems and services in the Americas as they progress toward the achievement of universal access to health and universal health coverage (universal health). The information provided presents an overview of the situation before the COVID-19
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pandemic, how the pandemic has impacted health systems, and recommendations to address current and future challenges for building resilient health systems to advance toward universal health in the Americas.
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