Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with po...verty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
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WHO Technical Report Series, No. 961, 2011, Annex 8 - These guidelines are intended to provide a description of ways in which pharmacists can improve access to health care, health promotion and the use of medicines on behalf of the patients they serve. The role of FIP is to provide leadership for na...tional pharmacy professional organizations, which in turn provide the impetus for setting national standards. The vital element is the commitment of the pharmacy profession worldwide to promoting excellence in practice for the benefi t of those served. The public and other professions will judge the pharmacy profession on how its members translate that commitment into practice in all settings, especially community and hospital pharmacy settings.
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The Capacity Project used the Learning for Performance (LFP) approach to develop the family planning (FP), HIV/AIDS and gender components included in the competency-based A1 nursing and midwifery pre-service curricula. LFP was also used to adapt the Rwanda national FP curriculum to an on-the-job tra...ining approach. This study documents the implementation of the and the lessons learned from its application in preservice education and in-service training in Rwanda.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of... Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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These updates include shorter novel 6-month all-oral regimens for the treatment of multidrug- and rifampicin-resistant TB (MDR/RR-TB), with or without additional resistance to fluoroquinolones (pre-XDR-TB) as well as an alternative 9-month all-oral regimen for the treatment of MDR/RR-TB.
This Ra...pid Communication is released in advance of updated WHO consolidated guidelines expected later in 2022, to inform national TB programmes and other stakeholders of key changes in the treatment of DR-TB and to allow for rapid transition and planning at the country level.
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These guidelines provide updated evidence-based recommendations on the priority HCV-related topics from the 2018 WHO Guidelines for the care and treatment of persons diagnosed with chronic hepatitis C infection and the 2017 WHO Guidelines on hepatitis B and C testing. These priority areas are:
... direct-acting antiviral (DAA) treatment of adolescents and children ages ≥3 years of age
simplified HCV service delivery (decentralization, integration and task sharing)
HCV diagnostics – use of point-of-care (POC) HCV ribonucleic acid (RNA) assays and reflex HCV RNA testing.
These guidelines also update existing chapters without new recommendations, such as the inclusion of new manufacturers’ protocols on the use of dried blood spot (DBS) for HCV RNA testing and new data to inform the limit of detection for HCV RNA assays as a test of cure, in addition to their use for diagnosis.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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Injection practices worldwide and especially in low- and middle-income countries (LMICs) include multiple, avoidable unsafe practices that ultimately lead to the large-scale transmission of bloodborne viruses among patients, health care providers and the community at large.
Non-Motorized Transport (NMT) has immense benefits for individual users, as well as society at large, through improvements to physical health, air quality, the environment, climate change, personal finance, accessibility, mobility and the empowerment of vulnerable groups.
Tropical Medicine and International Health volume 21 no 1 pp 101-107 january 2016
DHS Further Analysis Reports No. 109 - This report documents trends in key child nutrition indicators in Rwanda. Data from the Demographic and Health Surveys (DHS) in 2005, 2010, and 2014-15 were analyzed, disaggregated by selected equity-related variables, and tested for trends. Over the survey per...iod, Rwanda had high rates of exclusive breastfeeding, with regional variation. Rates of continued breastfeeding were also high but generally decreased as mother’s education and household wealth increased in all survey years. Complementary feeding practices varied by region, mother’s education, household wealth, urban-rural residence, and sex of the child.
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The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i...n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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Johnson CC et al. Journal of the International AIDS Society 2017, 20:21594 http://www.jiasociety.org/index.php/jias/article/view/21594 | https://doi.org/10.7448/IAS.20.1.21594
Atherosclerotic lower-extremity peripheral artery disease (PAD) is increasingly recognized as an important cause of cardiovascular morbidity and mortality that affects more than 230 million people worldwide. Traditional cardiovascular risk factors, including advanced age, smoking, and diabetes, are ...strongly linked to an increase risk of PAD. Although PAD has been historically underappreciated compared to coronary artery disease and stroke, greater attention on PAD in recent years has led to important new epidemiologic insights in the areas of thrombosis, inflammation, dyslipidemia, and microvascular disease. In addition, the concept of polyvascular disease, or clinically-evident atherosclerosis in multiple arterial beds, is increasingly identified as a particularly malignant cardiovascular disease worthy of special clinical attention and further study. It is noteworthy that PAD may increase the risk of adverse outcomes in similar or even greater magnitude than coronary disease or stroke. In this review, we highlight important new advances in the epidemiology of PAD with a particular focus on polyvascular disease, emerging biomarkers, and differential risk pathways for PAD compared to other atherosclerotic diseases.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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STUDY REPORT | This study of the impact of the Nepal earthquake of 25 April, 2015, aims to understand the impact factors leading to the exclusion of older people and persons with disabilities from humanitarian action, barriers to their inclusion, and the extent to which their skills and knowledge we...re utilised to promote inclusive humanitarian action and, using this understanding, to formulate a set of recommendations for promoting inclusion. These recommendations will be used to sensitise the broader humanitarian community to the need for inclusive disaster risk management practices in future emergency responses which pay attention to factors such as gender, age, disability and ethnicity, and build upon the capacities of older people and persons with disabilities.
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How do local authorities and humanitarian agencies collaborate when refugees are in transit? An IIED-supported research project is looking at the transit refugee response in Croatia.