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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The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs), as they have a higher risk of severe illness... and death from COVID-19. COVID-19 has been associated with an
excess in all-cause and cardiovascular disease (CVD) mortality beyond that related to the infection itself and its immediate consequences. Studies in the
United Kingdom (UK) and United States of America (USA) have clearly shown increasing deaths from ischemic heart disease, stroke and hypertensive disease due to COVID-19. Overall, the impact has been greater in individuals with lower socioeconomic status, even in high income nations.
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This paper explores the angles and opportunities of digital health, with a look
at digital innovation and its potential to support patients with circulatory diseases.
In reviewing developments in the field, current applications as well as gaps, the paper aims to support policymakers in leveraging ...technology for better circulatory health and to capture the roles that various sectors have in making
digital health a tool for everyone.
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This technical report has been developed within the framework of the WHO Global Initiative for
Childhood Cancer. Its goal is to improve the situation of children and adolescents with cancer worldwide,
giving them the best chances of survival, living a full life and, above all, enjoying quality of ...life and dying
without suffering
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ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability and affordability of CVD medicine, and service del...ivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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Sexual abuse perpetrated against children is one of the most significant crises of our time. Child sexual abuse is a significant risk factor for children, in common with other forms of child maltreatment. Sexual abuse can have severe short- and long-term consequences on the physical, mental, social,... emotional and economic well-being of children, families and communities. In emergencies, the threat of all forms of child abuse and gender-based violence (GBV), including child sexual abuse, is acute and widespread.
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The incidence and mortality of cardiovascular diseases (CVDs) in low and middle income countries (LMICs) have been increasing, while access to CVDs medicines is suboptimal. We assessed selection of essential medicines for the prevention and treatment of CVDs on national essential medicines lists (NE...MLs) of LMICs and potential determinants for selection.
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Through technical consultations with countries and partners, WHO has led the development of Preparedness and Resilience for Emerging Threats Module 1: Planning for respiratory pathogen pandemics. Version 1.0. The Module, currently available as an advanced draft, builds on previous pandemic lessons a...nd guidance, and has the following new elements:
It presents an integrated and efficient respiratory pathogen pandemic planning approach covering both novel pathogens and those known to have pandemic potential;
It enables coherence in addressing pathogen-agnostic and pathogen-specific elements for better preparedness;
It gives an organizing framework including operational stages and triggers for escalation and de-escalation between pandemic preparedness and response periods;
It contextualizes 12 IHR (2005) core capacities within the five components of health emergency preparedness, response and resilience (HEPR), from the respiratory threats perspective; and
It describes the critical sectors for respiratory pathogen pandemic preparedness to trigger multisectoral collaboration.
WHO will finalize and publish this Module after a global technical meeting that will be held on 24-26 April 2023.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202...1 to 784 million by 2045.1 As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030.2 Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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Produced by UNICEF and IRC, with the support of the German Corporation for International Cooperation GmbH (GIZ) and the generous funding from the German Federal Ministry of Economic Cooperation and Development (BMZ), the Caring for Child Survivors of Sexual Abuse (CCS) Resource Package (Second Editi...on, 2023) is a revision of the original CCS Guidelines and associated Training (First Edition, 2012). The Second Edition offers an up-to-date global technical guidance on providing a model of quality care for children and families affected by sexual abuse in humanitarian settings. The new resources include both revised and content additions based on practitioner feedback, the most recent evidence and learning. In particular, the Guidelines aim to bring a stronger focus on gender inequality, intersectionality, as well as the connections between the best interests of the child and a survivor-centered approach.
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Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven ...percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
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The document provides quality standards for managing Type 1 diabetes in adults, emphasizing areas like structured education, continuous glucose monitoring (CGM), cardiovascular risk management, and diabetic foot assessment. It aims to improve care processes, reduce complications, and enhance patient... outcomes through evidence-based and patient-centered approaches. The guidelines also focus on supporting inpatient self-management and ensuring equality and accessibility in diabetes care.
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Diabetes is a significant public health issue that affects approximately one in 10 adults globally, with type 2 diabetes accounting for 90–95% of cases. This chronic condition causes considerable morbidity and mortality and is growing in impact, with cases projected to rise from 537 million in 202...1 to 784 million by 2045. As cases rise, it is imperative to ensure the healthcare workforce is prepared to care for affected individuals. However, there is a growing global shortage of healthcare workers, which was estimated, pre pandemic, to reach 15 million by 2030. Therefore, all of the healthcare workforce will need to be utilised to their fullest potential in order to address the growing global burden of diabetes. Pharmacists will continue to be essential in this endeavour.
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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 article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including... asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu...s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se...verely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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