This publication describes the history of malaria in Uzbekistan. It evaluates the policies and strategies applied after the re-establishment of local transmission to contain malaria outbreaks in the 1990s and early 2000s, and highlights the interventions subsequently used to eliminate malaria in the... country. Uzbekistan was officially certified by WHO as a malaria-free country in 2018. Lessons for countries embarking upon elimination are distilled. The publication is intended for health managers and personnel, researchers, teachers, students and post-graduates at medical schools.
more
The number of reported cases of Ebola virus disease (EVD) consistently declined in recent weeks, with 14 new confirmed cases reported in North Kivu and Ituri provinces during the epidemiological week of 30 September through 6 October. At peak transmission in April 2019, there were 126 cases in the w...eek. Although the decline in case incidence is encouraging, it must be interpreted with caution as the situation remains highly contingent upon the level of access and security.
more
The first chapter provides an overview of gender and domestic violence in the HIV and AIDS discourse and their interconnect-
edness. It analyses literature regarding gender and HIV transmission, domestic violence, and HIV and AIDS. It then discusses how gender roles impact the effects of AIDS.
The... second chapter outlines implications of these findings for policy and practice. This section provides a definition for mainstreaming and deals with various aspects of mainstreaming HIV, AIDS and gender.
more
Today is World Chagas Disease Day. This year’s theme is Finding and reporting every case to defeat Chagas disease.
Despite progress, the global case detection rate for Chagas disease is low (estimated to be around 10%), posing a substantial barrier to accessing treatment and care and in prevent...ing transmission.
Often termed as a “silent and silenced disease”, many people with Trypanosoma cruzi infection (the parasite that causes the disease) develop no symptoms or unspecific mild symptoms. Moreover, many countries with cases lack systems to track the number of affected people and active transmission routes.
more
The highly complex and largely neglected Chagas disease (CD) has become a global health problem due to population movements between Latin America and non-endemic countries, as well as non-vectorial transmission routes. Data on CD testing and treatment from routine patient care in Germany of almost t...wo decades was collected and analysed.
more
Leptospirosis is a zoonotic disease with epidemic potential, especially after a heavy rainfall,
caused by a bacterium called Leptospira. Leptospira interrogans is pathogenic to humans and
animals, with more than 200 serologic variants or serovars. Humans usually acquire
leptospirosis through dire...ct contact with the urine of infected animals or a urine-contaminated
environment. Human-to-human transmission occurs only very rarely. Leptospirosis may present
with a wide variety of clinical manifestations, from a mild illness that may progress to a serious
and sometimes fatal disease. Its symptoms may mimic many diseases, such as influenza,
dengue and other viral haemorrhagic diseases; making the correct diagnosis (clinical and
laboratory) at the onset of symptoms is important to prevent severe cases and save lives,
primarily in outbreak situations.
more
Leptospirosis is an infectious disease caused by pathogenic organisms belonging to the genus Leptospira, that are transmitted directly or indirectly from animals to humans. Leptospirosis is a major direct zoonosis. Humanto-human transmission occurs only very rarely.
Les présentes lignes directrices ont pour objet de préparer les pays d’endémie à arrêter l’AMM à l’issue du traitement, à passer à la surveillance post-thérapeutique ainsi qu’à confirmer l’interruption de la transmission à l’issue de la phase 2 et à débuter la surveillance p...ost-élimination.
Le but est de fournir un outil actualisé pour atteindre et vérifier l’élimination de la
transmission d’Ovolvulus à l’issue des programmes d’élimination de l’onchocercose qui utilisent principalement l’AMM.
Les objectifs sont de :
• formuler des recommandations basées sur des preuves à l’intention des prestataires de soins et des décideurs en matière de politique pour démontrer et confirmer l’interruption de la transmission d’O. volvulus avant, pendant et après la surveillance post-thérapeutique ;
• informer les utilisateurs finaux des procédures nécessaires pour vérifier l’élimination de l’onchocercose humaine.
more
Les progrès remarquables réalisés dans la lutte contre la forme à T. b. gambiense reposent sur le dépistage et le traitement curatif, une stratégie qui interrompt la transmission en réduisant le réservoir de parasites chez l’être humain. Parfois, cette
approche a été combinée avec des... activités de lutte antivectorielle. L’objet de ces lignes directrices est donc de la plus haute importance pour la poursuite des progrès en vue de l’élimination de la THA.
more
We developed an integrated vector surveillance (IVS) proposal for cutaneous leishmaniasis (CL) and visceral leishmaniasis (VL) in the Americas, based on eco-epidemiological studies conducted by researchers of the Leishmaniasis Research Network of Argentina. For CL, the transmission was explained in ...the framework of the edge effect, the increase of vectors and risk of exposure at ecotones and environmental interfaces, and typified as ephemeral, transient, or permanent edges, supporting a cost-effective IVS strategy for early warning of CL outbreaks through an environmental modification alert network, which includes multiple sources of information and actors. In relation to VL, the earliest colonization sites and spatial distribution were explained by modeling and forecasting the most likely hotspots, persistent in time and space, and modulated by environmental variables. Therefore, for VL, a scalar strategy of critical site selection is proposed from a “city” scale based on secondary sources such as remote sensing for the definition of possible areas to monitor and intervene, a scale of restriction from possible to most likely areas through local knowledge, and a “focal site” scale of trap placement through field observation; in this way, IVS activities are carried out at a few sites of the urban landscape and allow a sustainable program.
more
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD...) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
more
The incubation period (the time the virus spreads from the peripheral nerves near the site of the bite via the spinal cord to the brain – see transmission and pathogenesis) ranges in general between 2 and 3 month (2 weeks to 6 years are reported) depending on the site of infliction, the amount of ...virus and the virus strain. Due to its neurotropism all known lyssaviruses cause severe neurological symptoms as a result of an acute encephalitis. Therefore, clinical signs in humans and animals are very similar.
more
Chagas disease (American trypanosomiasis) is endemic in 21 countries of the Americas, where control is largely focused on elimination of the domestic insect vectors (Triatominae) coupled with measures to extend and improve the screening of blood donors in order to avoid tranfusional transmission. Th...rough national programmes and multinational initiatives coordinated by WHO-PAHO, much has been accomplished in these domains in terms of reducing transmission. Attention now turns to consolidating the successes in interrupting transmission, and improved treatment for those already infected and those who may become affected in the future. This article, based on technical discussions at the "Epidemiological and Sociological Determinants of Chagas Disease, Basic Information to Establish a Surveillance and Control Policy " meeting in Rio de Janeiro, is designed to open the debate on appropriate strategies for continuation of the successful initiatives against Chagas disease.
more
Leishmaniasis is a vector-borne disease with a wide variety of parasite species, reservoirs, and vectors involved in transmission. It is caused by different species of the protozoa Leishmania and is transmitted to animals and humans through a bite of insects in the Psychodidae family. Its presence i...s directly linked to poverty, but social, environmental, and climatalogic factors directly influence the disease's epidemiology.
more
Goal and objectives of the guideline
The goal of this guideline is to provide evidence-based recommendations to countries in their efforts to accomplish schistosomiasis morbidity control and elimination as a public health problem, and to move towards interruption of transmission.
The recommendatio...ns contained herein will help countries to implement national schistosomiasis control and elimination programmes and support efforts to verify the interruption of transmission.
The specific objectives are to provide guidance on:
prevalence thresholds, target age groups and frequency of preventive chemotherapy for schistosomiasis;
establishment of water, sanitation and hygiene (WASH) and snail control activities to support control and elimination of schistosomiasis;
use of diagnostic tests in humans in low transmission areas and for moving to, and evaluating the interruption of transmission of schistosomiasis;
tools for the assessment of Schistosoma spp. infection in snail hosts; and
diagnostic tests for the assessment of schistosomiasis infection in animal reservoirs of infection
more
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 ...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.
more
Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control tec...hnology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
more