To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from inception until August 2020, to identify Indian CPGs for... the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures. Quality of the each included CPG was assessed using the AGREE II tool by four reviewers in duplicate, independently. Each AGREE II domain score and overall quality score was considered low (≤40%), moderate (40.1%-59.9%), and high (≥60%). Of the 23 CPGs included, six (26%) were reported to be adapted from other CPGs. Fourteen (61%) CPGs were produced by medical associations, six (26%) by individual authors and three (13%) by government agencies. Based on the AGREE II overall quality score, two (9%) CPGs were of high quality, four (17%) and seventeen (74%) CPGs were of moderate and low quality, respectively. Except for scope and purpose, and clarity of presentation all other domains were rated low. The quality of most Indian CPGs for managing CVD conditions assessed using the AGREE II tool was moderate-to-low. Combined efforts from different stakeholders are needed to develop, disseminate and implement high-quality CPGs while identifying and addressing barriers to their uptake to optimize patient care and improve outcomes.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Over one third of all deaths in Kenya in 2019 were attributed to NCDs (Vos et al., 2020). The four major NCDs – CVDs, cancer,
diabetes and chronic respiratory diseases – accounted for 57% of these deaths. Furthermore, the direct and indirect economic
impact of NCDs is significant- Kenya is sai...d to have lost Ksh 230 billion or 3.4% of its gross domestic product in 2016 from rising
NCD-related medical costs and indirect productivity losses. At the household level, an estimated decrease of 28.6% in income
due to NCDs was reported in 2007 (Mwai & Muriithi, 2016; Mensah et al., 2020). Therefore, preventing and managing NCDs are
significant public health and economic priorities.
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Cervical cancer is a disease of the female reproductive tract caused primarily by oncogenic types of human papillomavirus
(HPV). In 2020, it was the fourth most common cancer among women worldwide, with an estimated 604 000 new cases and 342 000 deaths
This document provides an updated list of “best buys” and other recommended interventions to address noncommunicable diseases (NCDs). It is based on Appendix 3 of the Global action plan for the prevention and control of noncommunicable diseases 2013–2020, which was first approved in 2013 and l...ast updated in 2017. The global action plan, which was extended to 2030 by a World Health Assembly decision in 2019 has 6 objectives, the implementation of which at country level supports the attainment of the 9 voluntary NCD targets, and facilitates the realization of Sustainable Development Goal (SDG) 3 on good health and well-being.
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WHO has a unique combination of technical public health and scientific expertise, and a global operational footprint, with field offices in more than 150 countries. In 2020, this global, technical, and operational reach meant WHO was able to support countries around the world in every aspect of COVI...D-19 public health response, from surveillance and laboratory testing to maintaining essential health services in the most vulnerable and fragile contexts.
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The Coronavirus disease (COVID-19) pandemic has revealed the fragility of pre-crisis African health systems, in which too little was invested over the past decades. Yet, development assistance for health (DAH) more than doubled between 2000 and 2020, raising questions about the role and effectivenes...s of DAH in triggering and sustaining health systems investments.
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Antimicrobial resistance (AMR) is impacting our health, economies and development. Up to 5.2 million people may die because of resistant bacterial infections across the Western Pacific Region from 2020-2030. Childbirth, surgery, cancer treatment and other interventions will become impossibly d...angerous if bacterial infections no longer respond to available antibiotics.
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Efforts driving universal coverage have recently been strengthened through implementation of the Global Vaccine Action Plan (GVAP) where cost estimates for immunization support were developed totaling US$40 billion of donor assistance by 2020. In addition to resource mobilization, there has been an ...increasing focus on improving both vaccine access and delivery systems. We track donor assistance for immunization by funding objective and channel from 1990 to 2016, and illustrate projections through 2020 to inform progress of the GVAP.
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Tracking global malaria spending provides insight into how far the world is from reaching the malaria funding target of $6·6 billion annually by 2020. Because most countries with a high burden of malaria are low income or lower-middle income, mobilising additional government resources for malaria m...ight be challenging.
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The WHO Disability-Inclusive Health Services Training Package is a companion to the “WHO Disability-Inclusive Health Services Toolkit: A resource for health facilities in the Western Pacific Region” published by WHO in 2020. This package offers a range of additional training materials including ...presentations, workbooks and videos that will allow users to develop the foundational skills and understanding of the Toolkit for its implementation. Together the Toolkit and Training Package will help ensure equitable access to health services, best-quality outcomes and improved quality of life for all people with disabilities to achieve universal health coverage.
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This publication articulates the WHO Botswana Country Office’s focus and investment needs for the biennium 2022–2023, building on achievements, networks, and partnerships fostered in 2020-2021.
As the leading health authority within the United Nations system in Botswana, the WHO Country Offi...ce has been at the forefront of supporting the government to improve health since 1996. The WHO Country Office supports the Ministry of Health in realizing the health goals the Government of Botswana defines. Acknowledging that as an upper middle-income country, Botswana provides the bulk of its resources for implementing health programmes, the WHO directly brings technical expertise to the table by collaborating with relevant partners. Where the country office has limitations in terms of human resources with the requisite expertise to answer the country’s needs, the regional level and headquarters of the WHO will be mobilized to provide the necessary support.
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En 1998, la Cinquante-et-Unième Assemblée mondiale de la Santé a adopté la résolution
WHA51.11 qui vise l’élimination mondiale du trachome en tant que problème de santé publique
à l’horizon 2020 (1). La stratégie recommandée pour atteindre cet objectif est récapitulée dans
le sig...le « CHANCE » qui signifie CHirurgie pour les personnes atteintes de trichiasis
trachomateux (TT – le dernier stade cécitant du trachome) ; Antibiothérapie, Nettoyage du
visage et Changements Environnementaux (2). Les interventions relatives aux volets A, N et CE
sont menées dans des districts entiers dans lesquels les cas de trachome évolutif
(inflammatoire) sont courants, dans le but de traiter les infections oculaires dues à Chlamydia
trachomatis, l’agent pathogène à l’origine du trachome, et de réduire durablement sa
transmission.
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La quincuagésima primera Asamblea de la Salud Mundial aprobó la resolución WHA51.11 en
1998, que busca la eliminación mundial del tracoma como problema de salud pública para el 2020
(1). La estrategia recomendada para lograr ese objetivo está encapsulada por las siglas "SAFE", que
represent...a: La cirugía para los individuos con triquiasis tracomatosa (TT; la última etapa que causa
ceguera por tracoma); y Antibióticos, Limpieza Facial y Mejoramiento ambiental (2). Las
intervenciones A, F y E se llevan a distritos enteros en los que el tracoma activo (inflamatorio) es
común para tratar la infección ocular causada por Chlamydia trachomatis, el agente causal del
tracoma y reduce de manera sustentable su transmisión.
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The Fifty-first World Health Assembly adopted resolution WHA51.11 in 1998, which targets the
global elimination of trachoma as a public health problem by 2020 (1). The strategy recommended
to achieve that goal is encapsulated by the acronym “SAFE”, which represents: Surgery for
individuals wi...th trachomatous trichiasis (TT; the late blinding stage of trachoma); and Antibiotics,
Facial cleanliness and Environmental improvement (2). The A, F and E interventions are delivered to
entire districts in which active (inflammatory) trachoma is common in order to treat ocular infection
with Chlamydia trachomatis, the causative organism of trachoma, and sustainably reduce its
transmission.
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Female Genital Mutilation (weibliche Genitalverstümmelung, FGM) ist ein globales Problem. Weltweit sind mehr als 200 Millionen Frauen und Mädchen betroffen. Davon lebten im Jahr 2020 ca. 75.000 in Deutschland. Viele der Betroffenen leiden unter FGM-bedingten Beschwerden
und benötigen medizinisch...e Hilfe. Leider gibt es in Deutschland bisher nur wenige medizinische Anlaufstellen, die qualitativ hochwertige und evidenzbasierte Versorgung für die Betroffenen gewährleisten. In Bayern leben schätzungsweise 13.000 Frauen mit Genitalverstümmelung. Im
Münchner Universitätsklinikum rechts der Isar gibt es bayernweit die erste medizinische Sprechstunde für von FGM betroffene Frauen und Mädchen.
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In 2012, the World Health Organisation (WHO) set out a roadmap for the control, elimination, or eradication of 17 neglected tropical diseases by 2020. Many were skeptical about the achievability of such goals. Now, still two years away from that end point, good news is emerging for gambiense human A...frican trypanosomiasis (HAT), or sleeping sickness, caused by the tsetse-fly−transmitted protozoan parasite Trypanosoma brucei gambiense in West and Central Africa. The Rhodesiense form of the disease is being pursued under a separate programme.
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Les pays progressent vers la réalisation de l’objectif mondial tendant à ce que, d’ici 2025, 95 pour cent des personnes qui vivent avec le VIH connaissent leur statut sérologique. Cependant, en 2020, on estimait encore à 6 millions le nombre de personnes séropositives non diagnostiquées da...ns le monde. Les hommes vivant dans des lieux où la prévalence du VIH est élevée et les hommes appartenant aux populations clés, tous lieux confondus, ont moins de chances de connaître leur séropositivité que les femmes. Ainsi, au niveau mondial, 78 pour cent des hommes de plus de 15 ans connaissent leur statut sérologique, contre 86 pour cent chez les femmes de cette même tranche d’âge.
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Les pays progressent vers la réalisation de l’objectif mondial tendant à ce que, d’ici 2025, 95 pour cent des personnes qui vivent avec le VIH connaissent leur statut sérologique. Cependant, en 2020, on estimait encore à 6 millions le nombre de personnes séropositives non diagnostiquées da...ns le monde. Les hommes vivant dans des lieux où la prévalence du VIH est élevée et les hommes appartenant aux populations clés, tous lieux confondus, ont moins de chances de connaître leur séropositivité que les femmes. Ainsi, au niveau mondial, 78 pour cent des hommes de plus de 15 ans connaissent leur statut sérologique, contre 86 pour cent chez les femmes de cette même tranche d’âge.
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Arsenical monotherapies were previously very successful for treating human African trypanosomiasis (HAT).
Melarsoprol resistance emerged as early as the 1970s and was widespread by the late 1990s.
Melarsoprol resistance represents the only example of widespread drug resistance in HAT patients wher...e the genetic mechanism has been established.
The current goal of elimination of HAT as a public health problem by 2020 may be undermined by the emergence and spread of resistance to current or new drugs.
Insights into potential resistance mechanisms for current and new drugs will facilitate predictions of the likelihood of resistance and will also facilitate rational approaches to minimizing, monitoring, and tackling the future emergence of resistance.
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