Cotonou Declaration oBuruli Ulcer
Cotonou, Benin, 30 March 2009
Neglected tropical diseases kill, weaken or incapacitate millions of people every year, causing permanent physical suffering, social stigmatization and reduced productive capacity. Bu
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ruli ulcer, one such disease, causes immense suffering and disabilities, especially among children. Delayed schooling and loss of productivity are considerable among the affected populations. These adverse consequences tend to aggravate poverty in affected communities. Globally, the disease has been reported in 30 countries. In WHO’s African Region, Buruli ulcer has been confirmed in 12 countries and is suspected in 10 others.
Significant progress has been made in the past 10 years in knowledge of Buruli
ulcer, investments in related research, control of the disease, and improvement
of tools for case diagnosis and development of treatment protocols. Substantial achievements have been made in diagnosis, treatment, immunology and epidemiology. Despite these achievements, little is known about the exact mode of transmission of the disease, and there is no simple diagnostic test usable in the field.
The use of antibiotics has revolutionized treatment and contributed to reducing the need for surgery by half. However, efforts are still needed to develop simple diagnostic tools usable in the field as well as disability prevention methods. The Global Buruli Ulcer Initiative has adopted the strategy recommended by WHO. The strategy is based on early diagnosis of the disease and the use of antibiotics for treatment upon the onset of the first signs by improving access to screening and case management at the most peripheral level of the health system.
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The WHO standard: Universal access to rapid tuberculosis diagnostics sets benchmarks to achieve universal access to WHO-recommended rapid diagnostics (WRDs), increase bacteriologically confirmed tuberculosis and drug resistance detection,
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and reduce the time to diagnosis. WHO-recommended rapid diagnostics are highly accurate, cost-effective, reduce the time to treatment initiation, and impact patient-important outcomes.
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The OpenWHO course titled "Interventions for Noncommunicable Diseases in Primary Health Care" provides guidance on screening, detection, diagnosis, and management of major noncommunicable diseases (
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NCDs) such as cardiovascular diseases, type 2 diabetes, chronic respiratory diseases (asthma and chronic obstructive pulmonary disease), and early cancer detection within primary health care settings. It emphasizes delivering high-impact essential NCD interventions through a primary healthcare approach to enhance early detection and timely treatment. This course is part of the SEARO NCD PEN-HEARTS series, which includes four courses aimed at enabling learners to plan and deliver NCD services effectively.
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The "GOLD Patient Guide 2019" explains Chronic Obstructive Pulmonary Disease (COPD), its causes, symptoms, and stages. It provides practical advice for managing COPD, including the importance of quitting smoking, following medical
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treatment plans, exercising, maintaining a healthy diet, and creating a supportive living environment. The guide emphasizes early diagnosis, regular medical checkups, and strategies for managing severe COPD to improve quality of life.
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Policy brief.
Globally, one in five people with HIV are unaware of their status, despite considerable scale up of HIV testing, treatment and prevention services. Many of those unreached by HIV test
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ing services (HTS) are from key populations, partners of people with HIV and, in Eastern and southern Africa, men and young people. Improving the availability, accessibility, friendliness and quality of services is important to address these testing gaps.
At the same time, tools and interventions that increase the demand for HTS are needed to reach people who are uninformed about HTS options and advances in treatment and prevention, people who are not motivated to seek HTS and those who are hesitant to test because of fear of an HIV diagnosis or other reasons.
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The document outlines the 2019 update to the South African guideline for managing chronic obstructive pulmonary disease (COPD). It emphasizes the importance of early diagnosis, prevention through smoking cessation, use of bronchodilators as primary
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pharmacotherapy, and a comprehensive approach to patient care including pulmonary rehabilitation and the management of comorbidities. The guideline also covers recommendations for handling acute exacerbations, surgical interventions, and long-term treatment options.
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TNew data from the World Health Organization reveal that the COVID-19 pandemic has disrupted malaria services, leading to a marked increase in cases and deaths.
According to WHO’s latest World malaria report, there were an estimated 241 million m
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alaria cases and 627 000 malaria deaths worldwide in 2020. This represents about 14 million more cases in 2020 compared to 2019, and 69 000 more deaths. Approximately two-thirds of these additional deaths (47 000) were linked to disruptions in the provision of malaria prevention, diagnosis and treatment during the pandemic.
As in past years, the report provides an up-to-date assessment of the burden of malaria at global, regional and country levels. It tracks investments in malaria programmes and research as well as progress across all intervention areas. This latest report draws on data from 87 countries and territories with ongoing malaria transmission.
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HIV infection, due to the immunosuppressant that leads, nowadays constitutes an aggravating factor of endemic tuberculosis. Tuberculosis remains a huge burden to human health, even in the early 21st century. The situation is deteriorating in many countries, particularly because of the synergy with t
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he HIV epidemic and the emergence of multidrug-resistant (MDR) and extensively drug resistant (XDR) tuberculosis. The urgent development of new tools that can improve the diagnosis, prevention and/or treatment of tuberculosis and other major mycobacterium diseases depends largely on the progress of basic and applied research. Faced with this situation, there is an urgent need for effective strategies and actions to permanently solve the problem of this endemic disease whose impact is too negative on people’s lives.
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The Global Health Network is an open source platform that provides trusted knowledge, guidance, tools and resources to support the generation of more and better health research data. During emerging
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outbreaks it is vital to learn as much as possible to generate evidence on best practice for prevention, diagnosis and treatment and to facilitate effective preparedness and response for future outbreaks.
This pop-up space for 2019 Novel Coronavirus COVID-19 (formerly 2019-nCoV) supports evidence generation by pooling protocols, tools, guidance, templates, and research standards generated by researchers and networks working on the response to this outbreak. Findings from previous outbreaks, largely obtained during MERS and SARS, are also available. This all aims to make research faster and easier and to enable standardised, quality data to be collected and prepared for sharing.
Latest updates will be provided on transmission as well as recommendations for healthcare professionals on transmission, disease management, and care.
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It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi-sectoral technical working groups on testing, case management, risk communication
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and community engagement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbid
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ity and mortality. However, the burden of disease is likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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Chagas disease or American trypanosomiasis is, together with geohelminths, the neglected disease that causes more loss of years of healthy life due to disability in Latin America. Chagas disease, as determined by the factors and determinants, shows
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that different contexts require different actions, preventing new cases or reducing the burden of disease. Control strategies must combine two general courses of action including prevention of transmission to prevent the occurrence of new cases (these measures are cost effective), as well as opportune diagnosis and treatment of infected individuals in order to prevent the clinical evolution of the disease and to allow them to recuperate their health. All actions should be implemented as fully as possible and with an integrated way, to maximise the impact. Chagas disease cannot be eradicated due because of the demonstrated existence of infected wild triatomines
in permanent contact with domestic cycles and it contributes to the occurrence of at least few new cases. However, it is possible to interrupt the transmission of Trypanosoma cruzi in a large territory and to eliminate Chagas disease
as a public health problem with a dramatic reduction of burden of the disease.
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The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, chronic respiratory diseases,
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and cancers. Designed for implementation in primary healthcare settings, especially in low-resource environments, the package includes protocols for screening, diagnosis, treatment, and management of these diseases. The document emphasizes an integrated approach, supporting universal health coverage by empowering healthcare workers with practical tools to improve NCD care. It aims to reduce premature mortality from NCDs and enhance global health equity.
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The document "COPD 101: Understanding the Basics" from the COPD Foundation provides foundational knowledge about chronic obstructive pulmonary disease (COPD). It explains what COPD is, common symptoms, risk factors, diagnosis methods,
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and treatment options, including medications and lifestyle changes. The guide emphasizes early diagnosis and management to help patients live healthier lives and prevent disease progression.
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The document "COPD 101: Understanding the Basics" from the COPD Foundation provides foundational knowledge about chronic obstructive pulmonary disease (COPD). It explains what COPD is, common symptoms, risk factors, diagnosis methods,
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and treatment options, including medications and lifestyle changes. The guide emphasizes early diagnosis and management to help patients live healthier lives and prevent disease progression.
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Expert international faculty present weekly, concise MedicalMinute updates, host biweekly Question and Answer Webinars, and author a continually updated downloadable slideset including the latest da
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ta on COVID-19 epidemiology and clinical management; specific topics include best practices and ongoing research in screening, prevention, diagnosis, disease management, and treatment for diverse patient populations.
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Sleeping sickness is a neglected tropical disease affecting rural communities in sub-Saharan Africa. The reduction in the number of reported cases in recent years indicates that disease transmission is under control. However, many aspects of patient management still need to be improved. Undiagnosed
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patients or inappropriate treatment due to an incorrect determination of the disease stage could in fact lead to its re-emergence. There is thus a strong need for new diagnostic and staging tools to keep the disease under control and to improve the clinical care of patients. This review describes the most promising biomarkers proposed so far for the diagnosis and stage determination of patients suffering from sleeping sickness, with a particular emphasis on their translation into diagnostic tools for field applications.
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Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to sustained
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and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low-
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and middle-income countries and remains under-recognised and poorly managed.
OBJECTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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As we approach World Asthma Day on the May 2, 2023, we reflect on the theme “ Asthma Care for All”. Prevalence of Asthma is increasing amongst children, adolescents and adults. Under-diagnosis,
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underutilization of inhaled corticosteroids, inaccessibility of treatment, and unaffordability of medicines are amongst the challenges that low-middle income countries are faced with. This commentary seeks to highlight the challenges, the resources available and to suggest recommendations that can be implemented to improve asthma care for all and reduce burden of asthma in Africa.
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