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SARS-CoV-2 infections among children and adolescents cause less severe illness and fewer deaths compared to adults. While a less severe course of infection is a positive outcome, there are concerns that mild symptoms may have led to less testing, resulting in fewer identified cases of COVID-19 in ch
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ildren. If children with mild or no symptoms transmit the disease, they may act as drivers of transmission within their communities. Understanding symptoms, infectivity and patterns of SARS-CoV-2 transmission in children and adolescents is essential for developing, adapting and improving control measures for COVID-19 across all ages. This is a summary of the current knowledge around SARS-CoV-2 infection acquisition and transmission and COVID-19 disease symptoms in children and adolescents. It aims to inform decisions, based on local contexts, on how to best keep schools, kindergarten and day-care facilities open and what advice to apply to intergenerational mixing.
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The Infant and young child feeding counselling: an integrated course includes this Director’s guide, a Trainer’s guide and Participant’s manual. Additional tools include: Course handouts; Guidelines for follow-up after training; Supportive supervision/mentoring and monitoring and an accompanyi
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ng toolkit; a slide set for the trainer; a set of 24 Counselling cards and Guidance on the use of counselling cards. The course includes 79 sessions arranged within 8 modules, covering a range of topics, including breastfeeding, complementary feeding, growth assessment and monitoring, HIV and infant feeding, and infant and young child feeding counselling. Course facilitators can decide which sessions to cover, depending on the specific learning needs of the health workers in your community.
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The Participant’s manual contains summaries of information presented by the trainers, copies of worksheets and checklists for the clinical practice and practical sessions, and exercises that participants will do during the course. One manual should be provided for each participant, using the modul
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es selected, for use during the course and can be used as a reference after the course. child feeding counselling. Course facilitators can decide which sessions to cover, depending on the specific learning needs of the health workers in your community.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
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e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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Against the backdrop of the COVID-19 pandemic, health is receiving unprecedented public and political attention. Yet the fact that climate change also presents us with a health crisis deserves further recognition. From more deaths due to heat stress to increased transmission of infectious diseases,
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climate change affects the social and environmental determinants of health in ways that are profound and far-reaching. The fundamental interdependency of human health and the health of the environment is encapsulated in the concept of planetary health, a scientific field and social movement that has been gaining force since the 2015 publication of the Rockefeller Foundation-Lancet Commission report “Safeguarding human health in the Anthropocene epoch”.
We see an urgent need for strategic communication to raise awareness of climate-health synergies in order to overcome the misperception that climate and health are two independent agendas. The fragmented and sector-focused nature of thinking and action remains a significant barrier to integrating health considerations into climate planning and project development. Inevitably, collaboration across sectors requires a community of practice. Despite recent efforts focused on the climate-health nexus, much work remains to be done to translate scientific findings for policymakers, mobilise climate financing resources in support of health co-benefits, and promote genderjust solutions within climate change projects.
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1.1 Why this course is needed
The first few hours and days of a newborn baby’s life are a critical window for establishing breastfeeding and for providing mothers with the support they need to breastfeed successfully. Since 1991, the Baby-friendly Hospital Initiative (BFHI) has helped to motivate
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facilities providing maternity and newborn baby services worldwide to better support breastfeeding. It has been adopted by many countries and organizations. The BFHI aims to provide a health-care environment that supports mothers to acquire the skills necessary to exclusively breastfeed for six months, and to continue breastfeeding for two years or beyond.
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Cancer centres are a major resource in ensuring a comprehensive approach to cancer treatment and its planning. As part of a new roadmap developed by WHO and IAEA to help countries design national cancer control programmes, this publication proposes a framework to develop a cancer centre and/or to st
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rengthen the provision of services in an existing cancer centre. The publication provides the features of multidisciplinary cancer care and details the infrastructure, human resources and equipment for different services. This framework is expected to be used as a guide to implementation, taking into consideration the local context and resources.
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Understanding and building resilience to early life trauma in Belarus and Ukraine
Marais, J.F.; Ol. Kazakova, D. Krupchanka, et al.
World Health Organization WHO, Regional Office of Europe
(2019)
C_WHO
In 2018 and early 2019, the WHO Regional Office for Europe’s cultural contexts of health and well-being project worked alongside the University of Exeter’s WHO Collaborating Centre on Culture and Health, the Minsk Regional Centre for Psychiatry and Addiction, and the Institute of Mental Health o
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f the Ukrainian Catholic University to engage researchers, practitioners, health-care workers and other relevant stakeholders in a series of workshops on the cultural contexts of early life trauma in Belarus and Ukraine.
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WHO issued an updated appeal (May 2022) detailing its resource needs for Ukraine and refugee-receiving and hosting countries for March-August for Ukraine and March-December 2022 for other countries.
The needs are an estimated US$ 147.5 million: US$ 80 million for health response in Ukraine and ano
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ther US$ 67.5 million is needed to address the health needs of Ukrainian people affected by the conflict in refugee-receiving and hosting countries.
With the funds sought, WHO aims to ensure, until August, that up to 6 million people can access essential health services including trauma care in Ukraine.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of
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Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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Hendra virus (HeV) continues to pose a serious public health concern as spillover events occur sporadically. Terminally ill horses can exhibit a range of clinical signs including frothy nasal discharge, ataxia or forebrain signs. Early signs, if detected, can include depression, inappetence, colic o
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r mild respiratory signs. All unvaccinated ill horses in areas where flying foxes exist, may potentially be infected with HeV, posing a significant risk to the veterinary community. Equivac® HeV vaccine has been fully registered in Australia since 2015 (and under an Australian Pesticides and Veterinary Medicines Authority special permit since 2012) for immunization of horses against HeV and is the most effective and direct solution to prevent disease transmission to horses and protect humans. No HeV vaccinated horse has tested positive for HeV infection. There is no registered vaccine to prevent, or therapeutics to treat, HeV infection in humans. Previous equine HeV outbreaks tended to cluster in winter overlapping with the foaling season (August to December), when veterinarians and horse owners have frequent close contact with horses and their bodily fluids, increasing the chance of zoonotic disease transmission. The most southerly case was detected in 2019 in the Upper Hunter region in New South Wales, which is Australia's Thoroughbred horse breeding capital. Future spillover events are predicted to move further south and inland in Queensland and New South Wales, aligning with the moving distribution of the main reservoir hosts. Here we (1) review HeV epidemiology and climate change predicted infection dynamics, (2) present a biosecurity protocol for veterinary clinics and hospitals to adopt, and (3) describe diagnostic tests currently available and those under development. Major knowledge and research gaps have been identified, including evaluation of vaccine efficacy in foals to assess current vaccination protocol recommendations.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delama
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nid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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The Lancet Regional Health - Americas 2022;00: 100248 Published online xxx https://doi.org/10.1016/j.lana.2022.100248.
The Lancet Countdown report, discuss the overlapping social, climate and health challenges in Latin America and the Caribbean, and urge multisectoral and political action to trans
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form these challenges into opportunities through adaptation and mitigation measures that place peoples’ health and wellbeing at the centre of public policies. Latin American and Caribbean governments are called upon to promote climate-resilient health care systems with adaptation plans that are tailored to guarantee quality access to care for all in this viewpoint.
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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 morbidity and mortality. However, the burden of disease i
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s 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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WHY THIS GUIDE?
Because, in the face of crises and emergencies, it is vital to include a human rights perspective in responses. Vulnerable groups face major obstacles to accessing and benefiting from prevention, mitigation, and health care policies
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due to structural barriers of inequality. To offer guidelines to the countries of the Americas for crafting and implementing inclusive and accessible, human rights-based responses to a pandemic that is unprecedented in the region and in the world as a whole.
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The Committee discussed the implications for preparedness for smallpox-like events reflected by the ongoing COVID-19 pandemic. The Committee noted how quickly diagnostics and vaccines could be developed and deployed when resources and political will were abundant. This rapidity was also due to the f
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act that the genetic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been shared worldwide. It was noted that in one country SARS-CoV-2 had been reconstructed in a laboratory from the viral genome sequence before the first case of COVID-19 had been reported, highlighting the benefits of synthetic biology technologies for accelerated development of diagnostics as well as the oft-described potential risks. Lessons learned about clinical care during the COVID-19 pandemic were also discussed.
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Cancer in sub-Saharan Africa
recommended
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mo
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rtality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
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Severe bacterial infections are a leading cause of morbidity and mortality among people with advanced HIV disease, after tuberculosis and cryptococcal disease. For countries to reach the end-AIDS targets for 2030, there is a need to establish a roadmap for managing severe bacterial infections and re
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duce mortality. The purpose of the meeting was to
Review the current research and implementation data on the use of prophylactic antibiotics (specifically azithromycin/macrolides) as part of the AHD package of care; To review options for preventing SBIs that are in line with goals of reducing AMR; Present the current evidence on diagnostics for SBI; Discuss research gaps and implementation challenges.
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Despite its rich culture, great economic potential, high level of education and last but not least its sheer size – it is the largest state whose borders lie entirely within Europe and is 1.7 times the size of the Federal Republic of Germany – Ukraine seems far away in perception and awareness.
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Publications on recent dramatic events, such as the Ukraine conflict or the Crimea crisis, have done little to change this. In fact, the armed conflict in the eastern Ukrainian oblasts of Donetsk and Luhansk, which has been ongoing since February 2014, is still a burdening feature of many political and economic difficulties destabilizing the country. News coverage of health issues in Ukraine has recently been dominated by highly critical reports on the handling of the Covid 19 pandemic. This pandemic exacerbated existing weaknesses in the Ukrainian health care system, but at least it did not create any new ones.
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On September 10, 2022, the Ministry of Health (MOH) announced a cholera outbreak in Aleppo governorate with 15 laboratory confirmed cases reported between August 25 and September 9, 2022. Activities under this plan seek to address the immediate needs stemming from this outbreak and highlight respons
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e priorities across all areas of the response and key sectors involved. This plan initially focuses on the Health, Water Sanitation and Hygiene (WASH), and Risk Communication and Community Engagement (RCCE) responses for an initial period of 90 days. The activities detailed in this plan are also within the programmatic scope of the 2022-2023 Humanitarian Response Plan (HRP).
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