This document focuses on making recommendations for the diagnosis and treatment of Chagas disease, an infection caused by Trypanosoma cruzi, the protozoan agent of a systemic parasitic disease. Methodology: These clinical practice guidelines were prepared following the WHO handbook for guideline dev...elopment (5). A multidisciplinary development group was formed, comprised of thematic experts, epidemiologists, methodologists, and users. Since there were no existing guidelines that could be adapted, the guidelines were developed from scratch.
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The leishmaniases are a group of diseases caused by Leishmania spp., which occur in cutaneous, mucocutaneous and visceral forms. They are neglected tropical diseases (NTDs), which disproportionately affect marginalized populations who have limited access to health care. HIV co-infected patients with... Leishmania infection are highly infectious to sandflies, and an increase in the coinfection rate in an endemic area is likely to increase the effective infective reservoir.
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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...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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В дорожной карте по борьбе с забытыми тропическими болезнями на 2021–2030 гг. («дорожная карта») определены глобальные цели и основные этапы в отношении борьбы с 20 бол...знями и группами болезней, их элиминации или полной ликвидации. В ней также определены сквозные целевые показатели, согласованные с Тринадцатой общей программой работы ВОЗ и Целями в области устойчивого развития, а также стратегии по достижению этих целевых
показателей в течение ближайших десяти лет.
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The road map sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups as well as cross-cutting targets aligned with the Sustainable Development Goals. Three foundational pillars will support global efforts to achieve the targets: accelerate progra...mmatic action (pillar 1), intensify cross-cutting approaches (pillar 2) and change operating models and culture to facilitate country ownership (pillar 3).
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The Pharmaceutical Forum of the Americas (PFA) has previously published guidelines and organised campaigns for community pharmacists on the prevention, detection and control of arbovirus infections in 2018 with a grant from the FIP Foundation for Pharmacy Education and Research. Building on that exp...ertise, FIP joined efforts with the PFA and is now publishing its first-ever handbook to support pharmacists in the
area of vector-borne diseases. As the integration of the regional forums in FIP advances, such collaborative projects are tangible results of an increasingly regionally informed and regionally targeted work by FIP.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou...gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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It is Zika virus (ZIKV) that most often causes these neurological effects it appears to be the only arbovirus than can cause congenital malformations such as microcephaly. In any case, more scientific tests are needed to establish the causal relationship between the virus and this malformation (7-10...).
This document is a practical tool designed to help health workers improve clinical diagnosis and provide timely care for patients infected
with the dengue, chikungunya, or Zika virus. It is intended mainly for
health workers in primary care facilities where laboratory diagnosis of
arboviruses is not always available. However, this guide may also be
very useful in hospitals that provide second- and third-level care, as it
describes the clinical manifestations of each of the three most important
arboviral diseases currently found in the Region, the elements for
differential diagnosis, and their clinical behavior.
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Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capability for burns care from clinical, human resources a...nd operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
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Toolkit regarding Zika Virus
Uganda is Africa's largest refugee-hosting country and ranks fifth globally. Over the decades, Uganda has hosted refugees from nations including South Sudan, the Democratic Republic of Congo, Eritrea, Somalia, Sudan, Burundi, and Rwanda. As of early 2024, it hosts 1 600 000 refugees, primarily in re...fugee settlements in northern and southwestern Uganda, and in Kampala City. Thirteen districts accommodate 94% of these refugees.
The World Health Organization (WHO) and Uganda’s Ministry of Health conducted a joint review mission to provide a comprehensive overview of the health system's response. The aim was to understand service delivery challenges and identify opportunities to further support Uganda in strengthening health system capacity and ensuring continued access to health services for refugees, migrants and host communities.
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Japan has been implementing projects of global extension of medical technologies under an official development assistance policy to improve public health and medicine by promoting Japanese medical technologies worldwide. The current work examines the impact and goals of implementing this new scheme.... The scheme has involved dozens of projects that sent Japanese experts to partner countries and that invited their counterparts to Japan to showcase Japanese medical technologies. Approximately 50 projects have been implemented in 24 countries over 5 years, and 19,638 individuals have been trained. As a result, the introduced technology was adopted in national guidelines in 4 projects and the introduced equipment was procured in the partner country in 17 projects. In total, 912,334 individuals have benefitted from the introduction of these medical technologies. The concept of "creating shared value" (CSV) could help promote project success by both creating economic value and encouraging social progress. However, the sustainability of that business model remains in question in terms of the internationalization of CSV. Several successful projects improved medical care and led to new business opportunities.
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Prompt, effective antimalarial treatment, and supportive care can substantially reduce the rate of mortality from severe malaria. However, many children in malaria-endemic countries do not have access to health facilities or a qualified health care provider and do not receive the necessary care in a... timely fashion. Without rapid detection of danger signs and access to effective treatment, including pre-referral treatment that can be administered in the community level, many of these children with severe malaria die.
In situations where there is no immediate access to a health care facility, WHO recommends the administration of a standard dose of an effective antimalarial medicine as pre-referral treatment before referral to a facility at which complete treatment can be administered.
Rectal artesunate is the WHO-recommended pre-referral intervention in situations where artesunate injection are not feasible for children under the age of 6 years with suspected severe malaria. The intervention reduces the risk of death or permanent disability by up to 50% provided the child is referred to a health facility at which complete treatment can be administered.
This field guide is aimed at supporting the effective deployment of RAS as pre-referral treatment of suspected severe malaria in line with the WHO malaria guidelines.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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What countries need: Investments needed for 2010 targets
Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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This document is an output of a WHO cross-programme initiative aiming to improve the prevention, diagnosis and management of anaemia and thereby accelerate reduction in its prevalence. It comes at an important time, midway through the era of the Sustainable Development Goals, when progress in reduci...ng anaemia has stagnated. This framework is based on the core principles of primary health care: meeting people’s health needs through comprehensive promotive, protective, curative, and rehabilitative care along the life course; systematically addressing the broader determinants of health; and empowering individuals, families, and communities to optimize their health
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The KMC implementation strategy targets a broad audience. These include policy-makers and programme managers at national, regional and local levels, government and nongovernmental organizations working in the area of maternal and newborn care, global and national professional associations, public an...d private hospital management at all levels of care, and facility- and community-based maternal and infant care providers.
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This document puts forward the joint position and vision of an expert, global, multistakeholder working group on implementing Kangaroo Mother Care (KMC) for all preterm or low birth weight (LBW) infants as the foundation for small and/or sick newborn care within maternal, newborn, and child health p...rogrammes, and spur collaborative global action. The document summarizes the background information, evidence, and rationale for making KMC available to every preterm or LBW newborn and seeks to galvanize the international maternal, newborn, and child health community and families to come together to support the implementation of KMC for all preterm or LBW infants to improve their and their mothers and families health and well-being.
This position paper is intended to be used by policy-makers (i.e. those responsible for national policy, guideline development and budget allocation), development partners, programme managers, health workforce leadership, practising clinicians, civil society leadership (e.g. parent and professional organizations) and researchers/research organizations involved in KMC implementation research.
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