Parasites & Vectors volume 11, Article number: 264 (2018)
Dengue creates a staggering epidemiological and economic burden for endemic countries. Without a specific therapy and with a commercial vaccine that presents some problems relative to its full effectiveness, initiatives to improve vector... control strategies, early disease diagnostics and the development of vaccines and antiviral drugs are priorities. In this study, we present the probable origins of dengue in America and the trajectories of its spread. Overall, dengue diagnostics are costly, making the monitoring of dengue epidemiology more difficult and affecting physicians’ therapeutic decisions regarding dengue patients, especially in developing countries. This review also highlights some recent and important findings regarding dengue in Brazil and the Americas. We also summarize the existing DENV polymerase chain reaction (PCR) diagnostic tests to provide an improved reference since these tests are useful and accurate at discriminating DENV from other flaviviruses that co-circulate in the Americas. Additionally, these DENV PCR assays ensure virus serotyping, enabling epidemiologic monitoring.
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Nat Commun 9, 5370 (2018). https://doi.org/10.1038/s41467-018-07804-8. Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical skin disease that is most commonly found in children from West and Central Africa. Despite the severity of the infection, therapeutic options are... limited to antibiotics with severe side effects. Here, we show that M. ulcerans is susceptible to the anti-tubercular drug Q203 and related compounds targeting the respiratory cytochrome bc1:aa3. While the cytochrome bc1:aa3 is the primary terminal oxidase in Mycobacterium tuberculosis, the presence of an alternate bd-type terminal oxidase limits the bactericidal and sterilizing potency of Q203 against this bacterium. M. ulcerans strains found in Buruli ulcer patients from Africa and Australia lost all alternate terminal electron acceptors and rely exclusively on the cytochrome bc1:aa3 to respire. As a result, Q203 is bactericidal at low dose against M. ulcerans replicating in vitro and in mice, making the drug a promising candidate for Buruli ulcer treatment.
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n response to the outbreak, the Africa Centres for Disease Control and Prevention (Africa CDC) has been supporting African Union Member States in responding to the COVID-19 pandemic through a variety of interventions such as non-pharmaceutical interventions, quarantine, testing, isolation, contact t...racing, and clinical management. The Test to Treat guideline aims to increase continental testing efforts and reduce COVID-19 transmission in Africa and put-up response measures to control the impact of the virus, both to limit spread and to reduce substantially the risks of severe health outcomes related to COVID-19 infection. These countermeasures include highly effective vaccines and boosters, rapid testing options for monitoring exposure, and effective therapeutic options for both pre-exposure prevention and treatment of mild-to-moderate disease, oxygen therapy for moderate-severe disease, all of which can potentially be updated efficiently as new variants emerge that may affect the effectiveness of the available tools.
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This comprehensive intermediate level course is for clinicians caring for patients with suspected or confirmed Ebola virus disease (EVD). Modules provide information on screening and triage, infection prevention and control, laboratory diagnostics, organization of the Ebola Treatment Centre (ETC), c...linical care of patients in the ETC, and investigational therapeutic agents.
This training course provides clinicians with access to downloadable presentations and posters to facilitate their management of Ebola virus disease (EVD). Under this section, please find a Congolese Swahili translation of all modules with their presentation.
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There is strong demand for alternatives to pharmaceuticals for a variety of common illnesses due to concerns of safety, efficacy, and a desire for more “natural” products. Despite this growing interest, “conventional” healthcare providers may have little to no knowledge about herbal medicine...s, which is further compounded by the sometimes misleading information in the media and on the internet. This course provides the necessary background for providers to begin to incorporate herbal medicines into their practice, particularly in regards to their therapeutic properties, efficacy (or lack thereof), and safety concerns, including quality control and potential adverse effects
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AMCC, a Non-Governmental Organization (NGO) association governed by the law of 1901, the French branch of the INCTR (International Network for Treatment and Research on Cancer) mainly oriented towards women's and children's cancers, aims to strengthen the fight against cancer in low- and middle-inco...me countries through training, education, teaching, research with support for therapeutic care.
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The roadmap describes the actions needed to
achieve the three development goals for TB
vaccines set by the WHO:
1. A safe, effective and affordable TB vaccine
for adolescents and adults.
2. An affordable TB vaccine for neonates and
infants with improved safety and efficacy.
3. A therapeutic v...accine to improve TB
treatment outcomes
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Ivermectin is an antiparasitic drug approved for the treatment of parasitic infections, including strongyloidiasis and onchocerciasis in humans. There is a reported increase in the use of ivermectin for the prevention and treatment of COVID-19 by the public in African Union Member States.
Currently..., there is:
1. No scientific evidence from pre-clinical studies on the therapeutic effect of ivermectin for the management of COVID-19;
2. No evidence of its clinical efficacy for the management of patients with asymptomatic, mild, moderate or severe COVID-19; and
3. No safety data regarding the use of ivermectin for COVID-19 in the majority of the published studies.
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Healthcare 2020, 8(1), 26; https://doi.org/10.3390/healthcare8010026
The current article is an integrative and analytical literature review on the concept and meaning of empathy in health and social care professionals. Empathy, i.e., the ability to understand the perso...nal experience of the patient without bonding with them, constitutes an important communication skill for a health professional, one that includes three dimensions: the emotional, cognitive, and behavioral. It has been proven that health professionals with high levels of empathy operate more efficiently as to the fulfillment of their role in eliciting therapeutic change.The empathetic professional comprehends the needs of the health care users, as the latter feel safe to express the thoughts and problems that concern them. Although the importance of empathy is undeniable, a significantly high percentage of health professionals seem to find it difficult to adopt a model of empathetic communication in their everyday practice. Some of the factors that negatively influence the development of empathy are the high number of patients that professionals have to manage, the lack of adequate time, the focus on therapy within the existing academic culture, but also the lack of education in empathy. Developing empathetic skills should not only be the underlying objective in the teaching process of health and social care undergraduate students, but also the subject of the lifelong and continuous education of professionals
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The aim of the register is to support rapid evidence synthesis by all systematic review producers, including Cochrane's work on Rapid Reviews in response to COVID-19. The register helps systematic reviewers prioritize topics, identify available evidence, and produce urgently needed reviews for front...-line health professionals, public health policymakers, and research teams developing new therapeutic, diagnostic, and preventive interventions for COVID-19.
The new COVID-19 Study Register will be continually updated with human studies on COVID-19. More background information about the register can be found here: https://community.cochrane.org/about-covid-19-study-register
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Community-Based Management of Acute Malnutrition (CMAM) is a decentralised community-based approach to treating acute malnutrition. Treatment is matched to the nutritional and clinical needs of the child, with the majority children receiving treatment at home using ready-to-use foods. In-patient car...e is provided only for complicated cases of acute malnutrition. CMAM consists of four components: (1) stabilisation care for acute malnutrition with complications, (2) out-patient therapeutic care for severe acute malnutrition without complications, (3) supplementary feeding for moderate acute malnutrition and (4) community mobilisation.
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Antimicrobials are widely used in food animal production, and use is rapidly increasing.
In an era of growing demand for animal products, there is an increasing trend towards the industrial production of food animals, especially in lower- and middle-income countries (LMICs). One hallmark of this me...thod of animal production is the
use of antimicrobial drugs, which in the majority of cases are administered to healthy animals for purposes other than
treating or controlling disease (termed “therapeutic uses”)
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This manual guides trained health care providers through the LEEP procedure to remove precancerous cervical lesions that cannot be treated with cryotherapy in order to prevent cervical cancer. The Standard Operating Procedures describe the equipment, step-by-step procedure, safeguards in practice, a...nd infection prevention guidelines surrounding LEEP and recommended follow-up schedules and procedures. LEEP can be performed in an outpatient setting under local anesthesia. The procedure can be both diagnostic and therapeutic, and replaces traditional follow-up evaluations and treatments such as cold knife conization and hysterectomy
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WHO regional publications. Western Pacific series ; no.3
The book has three main parts. The first part describes research in Viet Nam conducted on medicinal plants in line with the national policy of developing a system of medicine and pharmacy that integrates the modern and traditional systems. Th...e second part, which constitutes the core of the book, describes and illustrates the 200 most valuable species of wild and cultivated medicinal plants in Viet Nam. Each plant species is first documented by a full colour drawing illustrating the plant's distinctive features and natural colours. Explanatory notes for each species provide a concise description of the plant and give local names, flowering period, geographical distribution, parts used, chemical composition, and therapeutic uses. Information on indications and dosage is also provided.
To facilitate retrieval of information, the third part indexes plant species according to botanical name, Vietnamese name, and English name.
Large File to download: 75 MB!
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f...or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
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Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Chi...ldhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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Élément culturel important, les plantes ont été utilisées pendant des siècles par les populations pour se soigner. Cependant, peu d’ethnies connaissent leur pharmacopée de par le manque d’études ethnobotaniques. La présente étude, réalisée en pays San, entité territoriale traditionn...elle (Nord-Ouest du Burkina Faso), répond à ce souci de documenter les plantes médicinales. À travers une série d’enquêtes ethnobotaniques, 75 tradithérapeutes Sananont été interviewés. Les informations recherchées ont porté sur la plante, son nom local, ses parties utilisées, les pratiques médicales et les vertus thérapeutiques afférentes. Les résultats ont montré que 94 espèces végétales sont utilisées pour combattre différentes pathologies. Les feuilles (31 %), les racines (25 %) et les écorces du tronc (23 %) sont les principales parties utilisées pour préparer les recettes. Seules ou en association, ces parties interviennent dans l’élaboration des recettes par des procédés utilisant principalement la décoction (58 %), la trituration (17 %) et la macération aqueuse (11 %). Soixante-cinq pour cent (65 %) des produits obtenus sont administrés par voie orale via la boisson et les applications externes représentent 35 %. Treize catégories d’utilisation ont été recensées. Cependant, les tradipraticiens de santé sont en désaccord sur les thérapies proposées pour traiter ces catégories. La diversité des thérapies recensées en pays San, est une richesse culturelle. Ces données de la pharmacopée san sont une base pour une étude approfondie des aptitudes sylvicoles des plantes victimes de déracinement et la création de pépinières communautaires, afin de disposer de réservoirs de plantes médicinales proches des villages.
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Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifestyle choices, and shifts in social policies and cultu...ral practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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