Diabetes is a serious, chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. Diabetes is an important public health problem, one of four priority noncom...municable diseases (NCDs) targeted for action by world leaders. Both the number of cases and the prevalence of diabetes have been steadily increasing over the past few decades
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Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy)
and more specific interventions, such as carotid revascularization or... anticoagulation for atrial fibrillation. The objective of this review is to discuss effective interventions for optimal primary and secondary stroke prevention.
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The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Nutrición de menores de 2 de edad
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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We combine data on Chinese development projects with data from Demographic and Health Surveys to study the impact of Chinese aid on household welfare in sub-Saharan Africa. We use a novel methodology to test the effect of Chinese aid on three important development outcomes: education, health, and nu...trition. For each outcome, we use difference-in-difference estimations to compare household areas near Chinese project sites to control areas located farther away, before and after receiving Chinese aid. This empirical strategy rules out many confounding factors that can bias measuring the impact of Chinese aid on our outcome variables. First, we find that Chinese projects significantly improve education and child mortality in treatment areas, but do not significantly affect nutrition. Second, social sector projects have a larger effect on outcomes than economic projects. Third, we do not find significant effects for projects that ended more than five years before the post-treatment survey wave. Our results are robust to a host of robustness checks.
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Buruli ulcer (BU) is a bacterial skin infection that is caused by Mycobacterium ulcerans and mainly affects people who reside in the rural areas of Africa and in suburban and beach resort communities in Australia.
To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of equity and evidence-based policies, strategies and interventions to accelerate equitable progress in ...the health of women, children and adolescents. Although progress has been made, great inequities persist. Women from the LAC region’s poorest countries are almost four times more likely to die due to complications during childbirth than those living in the wealthiest countries. Through the years, several tools, instruments and methods (TIMs) have been developed by global, regional and country partners that can be used to conduct systematic equity-based analyses and/or re-designs of health systems, programs, strategies and interventions. The main purpose of this document is to present an overview of existing TIMs that can be used by policymakers, program managers, development partners, nongovernmental organizations, academia and civil society partners to strengthen systematic identification, analysis and responding to social inequities in the health of women, children and adolescents in LAC. The TIMs included were identified through a systematic search process
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Cystic echinococcosis (CE) is a well-known neglected parasitic disease. However, evidence supporting the four current treatment modalities is inadequate, and treatment options remain controversial. The aim of this work is to analyse the available data to answer clinical questions regarding medical t...reatment of CE.
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This literature review summarizes the link between psychological well-being and entrepreneurial outcomes for small and medium-size enterprises in fragile, conflict, and violence–affected contexts. It identifies potentially promising, scalable psychosocial training interventions, based on cognitive...-behavioral therapy approaches, that can be adapted and implemented to improve psychological health at the individual level, that could lead to better business performance at the firm level.
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HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination...; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
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Dracunculiasis (Guinea worm disease), caused by the parasite Dracunculus medinensis, is traditionally acquired by drinking water containing copepods (water fleas) infected with D. medinensis larvae, but in recent years also appears increasingly to be transmitted by eating fish or other aquatic anima...ls. The worm typically emerges through the skin on a lower limb of the host 1 year after infection, causing pain and disability.
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Despite a historical association with poor tolerability, a comprehensive review on safety of antileishmanial chemotherapies is lacking. We carried out an update of a previous systematic review of all published clinical trials in visceral leishmaniasis (VL) from 1980 to 2019 to document any reported ...serious adverse events (SAEs).
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Antimicrobial resistance (AMR) as a serious public health threat was globally acknowledged by WHO in 2015, through the launch of the Global Action Plan (GAP). With a limited number of new antibiotics in the developmental pipeline, many countries are in the process of establishing strategies for anti...microbial stewardship (AMS). Within each country, different healthcare challenges have
contributed to AMR. This has also shaped individual AMS strategies and policies. In South Africa (SA), there is a high burden of infectious diseases, mainly of bacterial origin. In addition, SA also has the highest number of people living with
human immunodeficiency virus (HIV) globally. According to the 2019 statistics, there are approximately 7.97 million people living with HIV in SA. Together with this, SA has the fourth largest tuberculosis population globally.
Other important challenges include poverty, malnutrition, a high burden of non-communicable diseases, and a dire shortage of trained healthcare professionals (e.g. clinicians, pharmacists, and nurses).
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the health care settings. It aims to rationali...ze the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi...nes.
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Human schistosomiasis, a parasitic and often chronic illness, is one of the major neglected tropical diseases worldwide. It is estimated that 240 million people suffer from schistosomiasis, with more than 200000 fatalities recorded each year. Schistosomiasis is caused by an infection of the blood fl...uke Schistosoma and is transmitted to humans through direct contact with infected water.
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Contraceptive Dynamics Following HIV Testing