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1
Este documento reúne um conjunto de recomendações formuladas pela OMS e pela OPAS para ajudar os profissionais responsáveis pelos programas de controle de vetores nas Américas em nível nacional, subnacional e local a se atualizarem e tomarem decisões baseadas em evidências sobre as medidas d
...
e controle mais apropriadas para cada situação. O MIV pode ser utilizado quando o objetivo é a vigilância e o controle ou a eliminação (dependendo da situação específica) das DTVs e pode ajudar a reduzir o desenvolvimento de resistência aos inseticidas pelo uso racional desses produtos. Este documento contém instruções para a execução do mandato de 2008 da OPAS sobre o manejo integrado de vetores (resolução CD48.R8, documento CD48/13) e, em particular, complementa uma série de diretrizes da OMS publicadas em 2012
more
Epidemiology
Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or
...
drink.1-4 The hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
Vector-borne transmission occurs only in the Americas, where an estimated 8 to 10 million people have Chagas disease.5 Historically, transmission occurred largely in rural areas in Latin America, where houses built of mud brick are vulnerable to colonization by the triatomine vectors.4 In such areas, Chagas disease usually is acquired in childhood. In the last several decades, successful vector control programs have substantially decreased transmission rates in much of Latin America, and large-scale migration has brought infected individuals to cities both within and outside of Latin America.
more
Chagas is a parasitic disease that affects over 6 million people in the
world. As the disease typically remains asymptomatic for years, new cases
often go unnoticed and unreported, and most people with the disease
are unaware of their condition. Less than 10% of people affected are
diagnosed and
...
the vast majority do not receive the treatment they need.
If not treated, Chagas may cause irreversible, life-threatening damage to
the heart and other vital organs.
more
Information for the General Public
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
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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.
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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
...
s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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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
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New Drugs for Human African Trypanosomiasis: A Twenty First Century Success Story
Dickie, E.A.; Giordani, F.; Gould, M.K.; Mäser, P.; Burri, C.; Mottram, J.C.; Rao, S.P.S.; Barrett, M.P.
MDPI Tropical Medicine and Infectious Disease
(2020)
CC2
The twentieth century ended with human African trypanosomiasis (HAT) epidemics raging across many parts of Africa. Resistance to existing drugs was emerging, and many programs aiming to contain the disease had ground to a halt, given previous success against HAT and the competing priorities associat
...
ed with other medical crises ravaging the continent. A series of dedicated interventions and the introduction of innovative routes to develop drugs, involving Product Development Partnerships, has led to a dramatic turnaround in the fight against HAT caused by Trypanosoma brucei gambiense. The World Health Organization have been able to optimize the use of existing tools to monitor and intervene in the disease. A promising new oral medication for stage 1 HAT, pafuramidine maleate, ultimately failed due to unforeseen toxicity issues. However, the clinical trials for this compound demonstrated the possibility of conducting such trials in the resource-poor settings of rural Africa.
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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
...
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.
more
Human African Trypanosomiasis (HAT, sleeping sickness) and Animal African Trypanosomiasis (AAT) are neglected tropical diseases generally caused by the same etiological agent, Trypanosoma brucei. Despite important advances in the reduction or disappearance of HAT cases, AAT represents a risky reserv
...
oir of the infections. There is a strong need to control AAT, as is claimed by the European Commission in a recent document on the reservation of antimicrobials for human use. Control of AAT is considered part of the One Health approach established by the FAO program against African Trypanosomiasis. Under the umbrella of the One Health concepts, in this work, by analyzing the pharmacological properties of the therapeutic options against Trypanosoma brucei spp., we underline the need for clearer and more defined guidelines in the employment of drugs designed for HAT and AAT. Essential requirements are addressed to meet the challenge of drug use and drug resistance development. This approach shall avoid inter-species cross-resistance phenomena and retain drugs therapeutic activity.
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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
...
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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PLoS Negl Trop Dis 15(8): e0009697. Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7 million people worldwide. Significant limitations still exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses t
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o address the many outstanding research questions. This systematic review aims to describe the characteristics and treatment practices of clinical studies in CD and assess the breadth and availability of research data for the potential establishment of a data-sharing platform.
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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
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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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Research and Reports in Tropical Medicine 2021:12 63–76 . This review focusses on the interactions between the etiologic agent of Chagas disease, Trypanosoma cruzi, and its triatomine vector.
Chagas disease affects approximately 6 million people, mainly in Latin America. Less than 1% of affected individuals receive proper antiparasitic treatment, and current drugs are inadequate to fight the entire spectrum of the disease. Against this background, Novartis is pursuing an end-to-end appro
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ach, with activity on three fronts: drug discovery, clinical research and health system strengthening.
more
Leishmaniasis is a vector-borne disease with a wide variety of parasite species, reservoirs, and vectors involved in transmission. It is caused by different species of the protozoa Leishmania and is transmitted to animals and humans through a bite of insects in the Psychodidae family. Its presence i
...
s directly linked to poverty, but social, environmental, and climatalogic factors directly influence the disease's epidemiology.
more
Leishmaniasis is a complex vector-borne disease involving in its transmission several species of protozoan parasites called Leishmania, a wide variety of animal reservoirs and phlebotomine sandflies vectors. Cutaneous Leishmaniasis (CL) is the most common form of the disease, and its clinical manife
...
stations vary from few papules to multiple ulcers affecting the skin but also the mucous membranes, leaving permanent scars and serious disability. It is a disfiguring and stigmatizing disease that often has a devastating psychosocial and economic impact on the affected resources limited communities.
more
Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan Africa. HAT transmission l
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ast soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
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This statistical overview has been prepared on the occasion of the European Institute for
Gender Equality (EIGE) study on FGM in the European Union and Croatia. Little is known
about FGM in the European Union in general, and this statement holds true about FGM
and asylum more specifically. In lig
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ht of the recognized need for country- and community-
tailored responses, this study provides some of the statistical evidence needed to
advance the discussion on the necessary policies and tools to address the specific
vulnerabilities of female asylum-seekers with FGM in the asylum system on the one hand,
and of refugee girls and women living with FGM and integrating in EU Member States on
the other hand
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