The aim of the present study was to predict which patients with severe or difficult-to-treat asthma are at highest risk for healthcare utilisation can be predicted so as to optimise clinical management. Data were derived from 2,821 adults with asthma enrolled in The Epidemiology and Natural History ...of Asthma: Outcomes and Treatment Regimens (TENOR) study. Multiple potential predictors were assessed at baseline using a systematic algorithm employing stepwise logistic regression. Outcomes were asthma-related hospitalisations or emergency department (ED) visits within 6 months following baseline.
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he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m...ethodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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I examine the effectiveness of donors in targeting the highest burden of malaria in the Democratic Republic of Congo when health information structure is fragmented. I exploit local variations in the burden of malaria induced by mining activities as well as financial and epidemiological data from he...alth facilities to estimate how local aid is matching local health needs. Using a regression discontinuity design, I find significant but quantitatively small variations in aid to health facilities located within mining areas. Comparing local aid with the additional cost of treatment and prevention associated with the increased risk of malaria transmission, I find suggestive evidence that local populations with the highest burden of the disease receive a proportionately lower share of aid compared to neighbouring areas with reduced exposure to malaria infection. The evidence of disparities in the allocation of aid for malaria supports the view that donors may have inaccurate information about local population needs.
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This report presents findings from research conducted by Economist Impact to assess the health, demographic, social and economic impacts associated with different scenarios for financing the HIV epidemic across 13 selected countries in Sub-Saharan Africa. The sponsorship of UNAIDS towards this repor...t is gratefully acknowledged. However, the findings and ideas expressed herein represent those of Economist Impact. They do not necessarily reflect the views and opinions of UNAIDS, nor do they engage the responsibility of UNAIDS.
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As the Group of Eight (G8) world leaders meet in Saint Petersburg, Russia for this year’s G8 Summit, it is important to take stock of international efforts to finance the response to the global HIV/AIDS epidemic. Financing a sufficient and sustained response to the epidemic has emerged as one of t...he world’s greatest challenges, and one that will be with us for the foreseeable future. Often, those countries most affected are also least able to respond, increasing their vulnerability to HIV/AIDS and in turn further complicating their ability to address the epidemic, as is the case for many nations in sub-Saharan Africa. In addition, concerns have been raised about “second wave” nations, particularly China, India, and Russia, which stand on the brink of generalized epidemics if more is not done now
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This publication describes the reasons for the resurgence of malaria in Kyrgyzstan and presents an analysis of evidence-based elimination strategies and policies that were applied to contain the epidemic and outbreaks of the disease, achieve its elimination, and maintain the country malaria-free. Th...e strong political commitment and the mobilization of human resources that were crucial in achieving elimination are emphasized. It is hoped that the experiences of Kyrgyzstan's national malaria control programme can assist other countries aiming to eliminate malaria. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
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This action plan is intended for senior-level decision-makers in ministries of health, malaria
programme managers, entomologists, and epidemiologists working on malaria and other vectorborne diseases programmes. It is also intended for decision-makers and technical and advocacy
staff at other orga...nizations and stakeholders involved in public health, malaria control and
elimination, and urban and rural development.
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Ethiopia faces unprecedented public health risks with over 17.4 million people in need of health assistance due to a compounded security, epidemiological, environmental and socio-economic hardships throughout the country. Specifically, the prolonged drought and localized conflicts have negatively im...pacted public health systems, whose access has become severely hindered because of physical constraints, infrastructure, equipment damages, lack of available healthcare workforce and negative coping mechanisms resulting from livelihoods deterioration. Whereas the World Health Organization (WHO) assistance has been critical to coordinate humanitarian efforts in affected areas, additional efforts are required in the coming months to address ongoing epidemic outbreaks and support the recovery process in conflict-affected areas (Afar, Amhara, Tigray and Gambelia) that are now accessible.
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Las olas de transmisión de la fiebre amarilla ocurridas en la Región de las Américas entre el 2016 y el 2018 causaron el mayor número de casos humanos y epizoóticos registrados en varios decenios. La fiebre amarilla es una enfermedad hemorrágica viral grave que representa un desafío para el p...rofesional de salud: exige el reconocimiento temprano de signos y síntomas muchas veces inespecíficos, que pueden parecerse a otros síndromes febriles agudos. La detección temprana de los casos sospechosos o confirmados, el monitoreo de los signos vitales y las medidas de soporte vital, y el tratamiento de la insuficiencia hepática aguda siguen siendo las estrategias recomendadas para el manejo de los casos. El presente informe es el resultado de las deliberaciones sobre la experiencia de expertos de la Región en cuanto al manejo clínico de pacientes con fiebre amarilla, especialmente en brotes y epidemias, mediante la contextualización de esa experiencia en el conjunto actual de la evidencia médico-científica y la consideración de las directrices técnicas ya disponibles en los países de la Región. Presenta flujogramas para la evaluación inicial del paciente con sospecha clínica de fiebre amarilla y sugiere un conjunto mínimo de pruebas de laboratorio que puede ser útil cuando hay pocos recursos; además, detalla aspectos de la organización de los sistemas de salud para enfrentar brotes y epidemias de fiebre amarilla.
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This country profile presents a summary and analysis of Argentina's status with yellow fever. It is part of a series of profiles on this topic, each focusing on a different country in the Region of the Americas. Argentina's geographical location presents a wide territorial extension throughout diffe...rent latitudes, which determines a wide climatic variety, maintaining the conditions for the enzootic transmission of the yellow fever virus in jungle areas of the northeast of the country bordering Brazil and Paraguay. After controlling the major urban epidemics that hit the port city of Buenos Aires in the 20th century, Argentina maintains foci of enzootic activity in the northeast and isolated human cases for jungle acquisition. The increases in viral activity usually occur in a regional context of epizootics that affect southern Brazil and eastern Paraguay. Argentina has not presented autochthonous cases since 2008. Outbreaks have been sporadic with long intervals without evidence of viral activity.
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La fiebre amarilla es una enfermedad endémica en varios países de América Latina. Con vistas a brindar apoyo a los responsables de la toma de decisiones para priorizar las acciones preventivas frente a esta afección, la Organización Panamericana de la Salud presenta estos perfiles nacionales co...n una selección de datos concisa y exhaustiva de los países con endemicidad. En cada perfil se brinda un análisis de la situación actual del país, los factores ecológicos y climáticos asociados a la enfermedad, la distribución e incidencia de los vectores, y las claves de la actividad arboviral. Asimismo, se incluye una perspectiva histórica de la epidemiología y un resumen del estado de la vacunación contra la enfermedad en el país.
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The Regional Action Framework for Noncommunicable Disease Prevention and Control provides a unified vision of objectives and recommended actions to combat the noncommunicable disease (NCD) epidemic in the Western Pacific Region. Implementation should be supported by cross-sectoral coordination..., sustainable financing, evidence-based policy, and community engagement, tailored to each Member State’s unique context. In doing so, Member States are encouraged to transform a disease treatment-centered “sick system” into a “health system” in which a population’s health and well-being enable socioeconomic development.
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The WHO Framework Convention on Tobacco Control (WHO FCTC) is an evidence-based treaty that reaffirms the right of all people to the highest standard of health and was developed in response to the globalization of the tobacco epidemic. Member States of the WHO South-East Asia Region have made... attempts to implement the demand and supply reduction strategies for tobacco control as recommended by the treaty. While recognizing the need to accelerate implementation of the WHO FCTC in the Region, this document has been developed to support the Member States in implementing the treaty using a ‘PRACTICAL’ Approach which pertains to identified demand and supply reduction strategies under the treaty.
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The number of reported cases of Ebola virus disease (EVD) consistently declined in recent weeks, with 14 new confirmed cases reported in North Kivu and Ituri provinces during the epidemiological week of 30 September through 6 October. At peak transmission in April 2019, there were 126 cases in the w...eek. Although the decline in case incidence is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security.
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Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to sustained and coordinated efforts during the past 15 years the nu...mber of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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The updates are based on evidence emerging from the: Ongoing monitoring of the disease. Protection that the population already developed against COVID-19 through previous infection or vaccination. Epidemiological situation, availability of diagnostic tests and access to therapeutic options.
Chikungunya virus (CHIKV) is a re-emerging mosquito borne alphavirus responsible
for the recent outbreak in the Americas. Immunologically naïve population in the Americas favors the spread of epidemics. Chikungunya fever is characterized by an abrupt febrile illness, polyarthralgia and maculopapul...ar rash. In chikungunya fever, shock or severe hemorrhage is very rarely observed; the onset is more acute and the duration of fever is shorter than dengue disease. The pain is much more pronounced and localized to the joints and tendons in chikungunya fever, in comparison to dengue fever. There is no specific and effective antiviral therapy and vaccines are still in trails. The only effective preventive measures consist of individual protection against mosquito bites and vector control. Disease prevention is important due to the
economic burden it entails. Clinicians need to distinguish chikungunya fever between dengue fever and other diseases to give a successful treatment and prevent disease spreading.
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Chagas disease caused by Trypanosoma cruzi is a public health issue in Latin America. This highly diverse parasite is divided into at least seven discrete typing units (DTUs) TcI-TcVI and Tcbat. Some DTUs have been associated with geographical distribution in epidemiological scenarios and clinical m...anifestations, but these aspects remain poorly understood. Many studies have focused on studying the parasite and its vectors/hosts, using a wide variety of genetic markers and methods. Here, we performed a systematic review of the literature for the last 20 years to present an update of DTUs distribution in the Americas, collecting ecoepidemiological information. We found that the DTUs are widespread across the continent and that there is a whole gamma of genetic markers used for the identification and genotyping of the parasite. The data obtained in this descriptor could improve the molecular epidemiology studies of Chagas disease in endemic regions.
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Onchocerciasis used to be an important public health problem in Africa, with over 37 million people infected and millions suffering from debilitating skin disease, terrible itching, impaired vision and
blindness. But the epidemiological situation has improved dramatically over the last two decades.... Community directed treatment with ivermectin has effectively brought the disease under control in most endemic areas where onchocerciasis is no longer a public health risk.
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