Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the onset of Diabetes Type 2, even in high-risk individu...als.
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Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa...nded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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To give you a better idea of when and how psychotherapy can help you, we have written this brochure titled Paths to Psychotherapy. While it is therefore primarily intended for people who have never been treated by a psychotherapist, the brochure can also enable those who have previously had psychoth...erapy to find out about the range of psychotherapeutic care and assistance that is currently available. Regardless of your previous experience with psychotherapy, this brochure offers you clear information about what a mental illness is, whether scheduling an initial appointment is advisable, and the circumstances in which psychotherapeutic treatment is necessary.
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Die Broschüre wendet sich deshalb in erster Linie an Menschen, die noch
nicht bei einer Psychotherapeut*in waren. Aber auch Menschen, die bereits bei einer Psychotherapeut*in gewesen sind, können sich hier noch einmal über die aktuellen psychotherapeutischen Angebote und Hilfen informieren. Die ...Broschüre bietet verständliche Informationen darüber, was eine psychische Erkrankung ist, wann ein erster Termin bei einer Psychotherapeut*in ratsam ist und wann eine Behandlung notwendig ist.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T...he Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obliga...tion to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
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Medical devices are used for the prevention, diagnosis and treatment of illness and diseases and for rehabilitation. WHO developed guidance on medical device donation in 2011, which has been now reviewed, with new evidence, new references on considerations for medical device solicitation and provisi...on, risks associated with inappropriate donations, the responsibilities of donors and recipient, and the steps they should follow before, during and after a donation. It includes three sections: description of major problems that may be faced during the donation process, listing of best practices for donors and recipients and addressing situations requiring special attention. It also has three annexes for further reading: the criteria for the acceptability of a donation, literature review on donations of medical devices between 2010 and 2023 and a flyer. This document is intended to improve the quality of medical devices donations, including medical equipment, single-use medical devices and in-vitro diagnostics, to provide maximum benefit to all stakeholders. The considerations can be used to develop institutional or national policies and regulations for medical devices donations. This document is intended for use by any organization, expert or practitioner involved in the donation, procurement, management of medical devices, including health workers, biomedical engineers, health managers, policymakers, donors, nongovernmental organizations and academic institutions.
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Over the 20 years that followed, this unique partnership has invested more than US$53 billion, saving 44 million lives and reducing the combined death rate from the three diseases by more than half in the countries in which the Global Fund invests.
The global burden of disease associated with air pollution exposure exacts a massive toll on human health worldwide: exposure to air pollution is estimated to cause millions of deaths and lost years of healthy life annually. The burden of disease attributable to air pollution is now estimated to be ...on a par with other major global health risks such as unhealthy diet and tobacco smoking, and air pollution is now recognized as the single biggest environmental threat to human health.
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This document contains guidance for strengthening the disability inclusiveness of MHPSS responses and programmes in emergency settings. It is intended to supplement the IASC Guidelines on Mental Health and Psychosocial Support in Emergency Settings (2007).
Overall Objective
To consider and add...ress the mental health and psychosocial support (MHPSS) requirements of persons living in emergency settings with all types of disabilities on an equal basis to the MHPSS requirements of all persons, using a human rights-based approach and implementing social-ecological frameworks.
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The Commission on Macroeconomics and Health (CMH) was established by World Health Organization Director-General Gro Harlem Brundtland in January 2000 to assess the place of health in global economic development. Although health is widely understood to be both a central goal and an important outcome ...of development, the importance of investing in health to promote economic development and poverty reduction has been much less appreciated. We have found that extending the coverage of crucial health services, including a relatively small number of specific interventions, to the world’s poor could save millions of lives each year, reduce poverty, spur economic development, and promote global security.
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Im Hinblick auf die Finanzierung von Gesundheit im Allgemeinen und von Kindergesundheit im Speziellen ist zunächst zu berücksichtigen, ob die Gelder aus öffentlichen oder privaten Quellen stammen. Denn daraus ergeben sich grundsätzliche Unterschiede. Da private Krankenversicherungen gewinnorient...iert handeln, sind sie daran interessiert, in ihren Versicherungssystemen vor allem von gesunden Menschen mit ausreichend finanziellen Mitteln zu profitieren. Dies führt oft dazu, dass ausgerechnet die Menschen, die eine Gesundheitsversorgung am nötigsten brauchen – nämlich arme und gesundheitlich beeinträchtigte Menschen – außen vor gelassen werden.
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Ukraine: Russian invasion has forced older people with disabilities to endure isolation and neglect – new report
Many temporary shelters inaccessible to people with physical disabilities
Overburdened care system often provides few alternatives to institutions for older people
Authorities ...and humanitarian actors must ensure an inclusive response
Displaced older people with disabilities in Ukraine are physically and financially unable to access adequate housing and care amid Russia’s ongoing invasion, sometimes leaving few alternatives to being placed in residential institutions, Amnesty International said in a new report.
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Analyse und Vorausschau der Official Development Assistance (ODA) für die 20. Legislaturperiode des Deutschen Bundestages
African countries, like many regions of the world, are affected by the legacy of atrocity crimes. Genocide, the transatlantic slave trade and slavery, colonialism and post-independence violence committed during dictatorships, not to mention civil war and violent extremism, have severely violated hum...an rights and left devastating marks on societies across the continent. The way in which societies deal with violent pasts has profound implications for the present and the future, as well as their chances of building sustainable peace.
Strengthening education about atrocity crimes, including genocide, crimes against humanity and war crimes, is an essential part of addressing violent pasts and preventing future atrocity crimes. Echoing a series of United Nations resolutions on the importance of educational measures for genocide prevention,1 in 2013, the Secretary-General’s annual report Responsibility to protect: State responsibility and prevention included the recommendation: “Education curriculums should include instruction on past violations and on the causes, dynamics and consequences of atrocity crimes” as an important means to promote societal resilience to atrocity crimes.
This recognition is in line with the Education 2030 Agenda and, more specifically, target 4.7 of Sustainable Development Goal (SDG) 4 on Education. This target calls on countries to promote education that fosters sustainable development, human rights, gender equality, a culture of peace, global citizenship and an appreciation of cultural diversity.
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In In recent years, China has increased its international engagement in health. Nonetheless, the lack
of data on contributions has limited efforts to examine contributions from China. Existing estimates that track
development assistance for health (DAH) from China have relied primarily on one data...set. Furthermore, little is known
about the disbursing agencies especially the multilaterals through which contributions are disbursed and how these
are changing across time. In this study, we generated estimates of DAH from China from 2007 through 2017 and
disaggregated those estimates by disbursing agency and health focus area.
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