This manual describes some of the strategic, managerial, financial, technical and scientific aspects to be considered in establishing a national EQA programme for clinical laboratories and other testing services at all health care levels
The survey aimed at evaluating the quality of selected antimalarials in six countries of sub-Saharan Africa (Cameroon, Ethiopia, Ghana, Kenya, Nigeria and the United Republic of Tanzania). These countries have been supported by WHO to strengthen their regulatory controls o...ver antimalarial products. The survey was organized independently of manufacturers of antimalarial medicines.
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La fourniture de sang et de produits sanguins sûrs et efficaces pour la transfusion ou la fabrication d’autres produits sanguins fait intervenir un certain nombre de processus, allant de la sélection des donneurs de sang et de la collecte, au traitement et au dépistage des dons de sang ainsi qu...’à l’analyse des échantillons des malades, à la délivrance de sang compatible et à son administration au patient. Il existe un risque d’erreur à chaque étape de la « chaîne de transfusion », et une défaillance à une quelconque de ces étapes peut avoir des conséquences graves pour les receveurs du sang ou des produits sanguins. Si la transfusion sanguine peut sauver des vies, elle comporte aussi des risques, en particulier la transmission des infections par le sang.
Le dépistage des infections transmissibles par transfusion (ITT) en vue d’exclure les dons de sang présentant un risque de transmettre une infection du donneur aux receveurs est une étape critique du processus visant à garantir au mieux la sécurité des transfusions. Un dépistage efficace des agents transmissibles par le sang les plus courants et les plus dangereux peut réduire le risque de transmission à des niveaux très faibles.
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External quality assessment (EQA) is an important component of quality systems for blood transfusion services. Establishing external quality assessment programmes for screening of donated blood for transfusion-transmissible infections (TTI): implementation guide aims to support WHO member States in ...establishing and operating EQA programmes for screening donated blood for TTI. The guides has been designed for use by national health authorities and EQA organizing institutions in the development of EQA programme. It will also give participating laboratories an insight into the organization of EQA programmes for TTI screening and an understanding of the benefits of participation.
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The provision of safe and efficacious blood and blood components for transfusion or manufacturing use involves a number of processes, from the selection of blood donors and the collection, processing and testing of blood donations to the testing of patient samples, the issue of compatible blood and ...its administration to the patient. There is a risk of error in each process in this “transfusion chain” and a failure at any of these stages can have serious implications for the recipients of blood and blood products. Thus, while blood transfusion can be life-saving, there are associated risks, particularly the transmission of bloodborne infections.
Screening for transfusion-transmissible infections (TTIs) to exclude blood donations at risk of transmitting infection from donors to recipients is a critical part of the process of ensuring that transfusion is as safe as possible. Effective screening for evidence of the presence of the most common and dangerous TTIs can reduce the risk of transmission to very low levels.
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L’évaluation externe de la qualité (EEQ) est une composante importante des systèmes qualité des services de transfusion sanguine. L’EEQ est l’évaluation externe de la qualité générale des résultats obtenus par un laboratoire dans l’analyse d’échantillons de contrôle dont le cont...enu est connu, mais n’a pas été dévoilé, et la comparaison de ces résultats avec ceux qu’ont obtenus d’autres laboratoires qui ont analysé les mêmes échantillons. Dans les laboratoires qui pratiquent le dépistage des infections transmissibles par transfusion (ITT) dans les dons de sang, la participation à l’EEQ aide à surveiller et améliorer la qualité des résultats. Les informations issues de l’EEQ permettent d’améliorer continuellement la qualité en mettant en évidence les erreurs d’un laboratoire et d’appliquer des mesures pour éviter qu’elles se reproduisent. L’EEQ joue ainsi un rôle essentiel dans l’amélioration de la sécurité transfusionnelle.
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Reporting system for the general public - This document aims to provide practical guidelines on how to set up national systems for consumers to report adverse reactions to medicines. The purpose is to help countries set up a well-organized and effective consumer reporting system within their pharmac...ovigilance centre. Throughout this document, the phrase “consumer reporting” is used to refer to reporting of adverse drug reactions (ADRs) by the general public.
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Thefirst report on Latin America and the Carribean presents key indicators on health and health systems in 33 Latin America and the Caribbean countries. . Analysis is based on the latest comparable data across almost 100 indicators including equity, health status, determinants of health, health car...e resources and utilisation, health expenditure and financing, and quality of care. The editorial discusses the main challenges for the region brought by the COVID-19 pandemic, such as managing the outbreak as well as mobilising adequate resources and using them efficiently to ensure an effective response to the epidemic.
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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.
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Neonatal tetanus (NT), a severe newborn illness from the toxigenic strains of Clostridium tetani, persists in middle- and low-income countries due to non-sterile childbirth practices. Unlike smallpox and polio, tetanus cannot be eradicated: Clostridium tetani spores exist in the environment, and ani...mal reservoirs. However, elimination as a public health issue is achievable through widespread tetanus vaccination, clean deliveries, and proper umbilical cord care. The goal of eliminating maternal and neonatal tetanus (MNT) as a public health problem is considered met when all municipalities in a country have an annual incidence rate of NT of less than 1 case per 1000 live births. The Region of the Americas achieved the maternal and neonatal tetanus elimination (MNTE) target in 2017 when elimination was validated in the Republic of Haiti. Yet maintaining this progress requires continued efforts. High vaccination coverage, booster doses in countries lacking them, hygienic practices, and strong maternal and child health services are key. The Pan American Health Organization’s (PAHO) integrated maternal and neonatal immunization platform further strengthens this fight against early childhood diseases.
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Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr...ies, most mpox infections in humans result from a primary animal-to-human transmission. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or through close contact during and after birth.
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A erradicação da varíola humana (mpox em inglês) foi certificada em 1980. A varíola símia (mpox em inglês) é endêmica nos países da África Central e Ocidental desde a sua primeira detecção, em 1958. Trata-se de uma zoonose cujos casos geralmente ocorrem perto de florestas tropicais, ond...e diversos animais são portadores do ortopoxvírus causador da doença. A maioria das infecções em seres humanos pelo vírus da varíola símia em países onde a doença é endêmica é resultado de transmissão primária de animais para humanos. A transmissão de pessoa a pessoa pode ocorrer por meio de contato próximo com secreções respiratórias ou lesões cutâneas de uma pessoa infectada ou com objetos recém-contaminados. A transmissão também pode ocorrer através da placenta da mãe para o feto ou por contato direto durante ou após o parto. Até 21 de maio de 2022, 12 países onde não há varíola símia endêmica, em 2 regiões da Organização Mundial da Saúde (OMS), haviam notificado 92 casos confirmados da doença. Até 26 de agosto de 2022, 96 países sem endemicidade, de todas as 6 regiões da OMS, haviam notificado 45.198 casos confirmados de varíola símia, incluindo 6 óbitos. No mesmo período, os países onde a doença é endêmica notificaram 350 casos confirmados e 6 óbitos. Na Região das Américas, 29 países e territórios notificaram 23.479 (48%) casos confirmados e 3 óbitos. Diversos estudos observacionais sobre as vacinas de primeira geração demonstraram que a eficácia da vacinação contra a varíola humana na prevenção da varíola símia é de aproximadamente 85%. Atualmente, as vacinas originais (de primeira geração) contra a varíola humana não estão mais disponíveis.
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El 23 de julio del 2022, el Director General de la OMS declaró el brote de viruela símica una emergencia de salud pública de importancia internacional. A raíz de esa declaración, se puso en marcha un dispositivo de respuesta coordinada con el objeto de interrumpir la transmisión y proteger a l...os grupos en situación de vulnerabilidad. En estas orientaciones se tratan diferentes aspectos relativos al uso de vacunas para respaldar las intervenciones primarias de salud púbica en la respuesta para detener la trasmisión de persona a persona. Tienen como propósito brindar información útil y accesible acerca de las vacunas contra la viruela símica a fin de facilitar el despliegue de estrategias de prevención adaptadas a la situación epidemiológica, con base en las recomendaciones de la VIII Reunión ad hoc del Grupo Técnico Asesor de la OPS sobre Enfermedades Prevenibles por Vacunación.
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Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th...e implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
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An external team evaluated PAHO’s response to COVID-19 to provide an independent assessment of the Pan American Sanitary Bureau’s (PASB) performance regarding preparedness for and response to the COVID-19 pandemic. The evaluations’ final report culminates with eight recommendations for actions... to future response to health emergencies. The final report of EPRC culminates with eight evidence-based recommendations of actions to strengthen future pandemic responses, while building a resilient recovery in the Region. The recommendations by the external team focus on PAHO’s governance and management, on specialized regional mechanisms, diversified funding models, and use of new technologies, among others.
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The purpose of this manual is to provide guidance on how to implement Pan American Health Organization (PAHO) recommendations for malaria elimination at the local level. It is a streamlined, more operational version of the Manual for Stratifying Malaria Risk and Elimination of Foci, aimed primarily ...at operational teams working in the field. The content has been prioritized and the steps of the process organized to facilitate greater understanding by local teams. Adjustments have also been made to underscore its versatility for all malaria transmission scenarios in the Region of the Americas.
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Todos los países de la Región de las Américas en los que la malaria es endémica han asumido el reto de eliminar la enfermedad y de poner en marcha intervenciones para orientar sus programas y estrategias de salud en esa dirección. Esta versión simplificada y más operativa del Manual para la e...stratificación según el riesgo de malaria y la eliminación de focos de transmisión, dirigida al personal de campo, orienta sobre cómo implementar las acciones básicas de eliminación de la malaria. Se propone orientar un cambio en la operación de malaria con la atención centrada en abordar los focos y la organización de la operación en el nivel más local. El documento parte de la necesidad de identificar y definir un ámbito operativo (el foco o microárea) en donde se pone en práctica una intervención programática concreta (DTI-R) que, si bien es estandarizada a nivel nacional, debe ser ante todo guiada por la comprensión de la dinámica de la transmisión a nivel local
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The article investigates the diagnostic capabilities and prevalence of chronic obstructive pulmonary disease (COPD) in primary care settings in northern Brazil. It highlights that COPD is often underdiagnosed and undertreated in resource-limited regions. The study involved 34 general practitioners a...nd used spirometry to evaluate their diagnostic accuracy compared to clinical assessments. Findings revealed significant discrepancies between GP diagnoses and spirometry results, with many false positives and negatives. The study underscores the need for better training and the use of spirometry to improve COPD diagnosis and case-finding in primary care, emphasizing the importance of targeted strategies to enhance healthcare outcomes in developing countries.
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Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the prevalence of asthma is among the highest in the world. Asthma admissions are very common in children, l...eading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.
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Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r...egion in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
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