Chronic Non Communicable Diseases. Case Management Desk Guide
Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of ...box">communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests that SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-...ibute-to-highlight medbox">communicable diseases (NCDs) worldwide. There is currently
an epidemiological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Infectious disease outbreaks and epidemics are increasing in frequency, scale and impact. Health care facilities can amplify the transmission of emerging infectious diseases or multidrug-resistant o...rganisms (MDRO) within their settings and communities. Therefore, evidence-based infection prevention and control (IPC) measures in health care facilities are critical for preventing and containing outbreaks, while still delivering safe, effective and quality health care. This toolkit is intended to support IPC improvements for outbreak management in all such facilities, both public and private throughout the health system. Specifically, this document systematically describes a framework of overarching principles to approach the preparedness, readiness and response outbreak management phases. The document also provides a toolkit of resource links to guide specific actions for each infectious disease and/or MDRO outbreak management phase at any health facility. This document is specifically tailored to an audience of stakeholders who establish and monitor health care facility-level IPC programs including: IPC focal points, epidemiologists, public health experts, outbreak response incident managers, facility-level IPC committee(s), safety and quality leads and managers, and other facility level IPC stakeholders.
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Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already d...eprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
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Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary ...e-to-highlight medbox">disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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2nd edition. This toolkit provides step-by-step guidance to NTD programme managers and partners on how to engage and work collaboratively with the WASH community to improve delivery of water, sanitation and hygiene services to underserved population affected by many neglected tropical ...ttribute-to-highlight medbox">diseases. The toolkit draws on tools and practices used in the delivery of coordinated and integrated programmes for control, elimination and eradication of NTDs. This second edition include revisions and new tools based on experiences of using the toolkit in more than 20 countries.
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Kenya in undergoing an epidemiological transition marked by a decline in morbidity and mortality due to communicable conditions, and an increase in the burden of non-communicable ...ute-to-highlight medbox">diseases (NCDs), which include diseases such as diabetes, cancers, cardiovascular diseases and chronic respiratory infections. The second strategic objective of KHSSP 2014-2018 targets to halt and reverse the rising burden of non-communicable conditions, while the fifth strategic objective is focused on putting into place health promotion interventions that will address risk factors to health.
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The Kenya Health Policy 2014-2030 aims at attaining the highest possible standard of health in a manner responsive to the health needs of our population. One of the major policy directions towards realizing the intentions of this policy is to halt and reverse the
rising burden of non-...ttribute-to-highlight medbox">communicable diseases.
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Apart from implementation of TB infection Prevention and Control measures, treatment of those with active TB of the lungs is key in preventing the spread of the TB bacilli. The Public Health Act CAP 242, section 17 classify TB as notifiable infectio...us disease and under section 26 as part of prevention and control of infectious diseases, those exposed or suffer from the notifiable infectious diseases should be isolated in designated place and detained while taking medication until in the assessment of the Medical officer of health confirm that the person is free from infection or able to be discharged without danger to public health.
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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and ...hlight medbox">control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be added the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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Schistosomiasis is widely recognized as a disease that is socially determined. An
understanding of the social and behavioural factors linked to disease transmission and
...ighlight medbox">control should play a vital role in designing policies and strategies for schistosomiasis
prevention and control. To this must be added the awareness that schistosomiasis is
also a disease of poverty. It still survives in poverty-stricken, remote areas where there
is little or no safe water or sanitation, and health care is scarce or non-existent. For
a variety of complex reasons, many of which are addressed in this book, the disease
is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural
China. This concern for human behaviour in an environment of poverty echoes the
concerns of the new research priority for “diseases of poverty” identified by the
Special Programme for Research & Training in Tropical Diseases.
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This report is primarily intended for the community of policymakers and researchers concerned about the rising risks of domestic, regional, and global infectious disease epidemics, and the collective failure to take the coordinated actions required ...to reduce such risks. These risks include the expected health, economic, and societal costs that are borne by countries, regions, and even all nations in the case of pandemics (which are worldwide epidemics). These risks also include the consequences of increasing antimicrobial resistance (AMR) and its spread within regions and globally. A necessary first step is to monitor whether a broad range of stakeholders are acting to prevent outbreaks from becoming epidemics, whether their capacities to respond to epidemics are robust, and whether preparedness to respond to pandemics and limit the resulting economic and health damage is improving. Analyzing the adequacy of these efforts is vitally important for the decisions of policymakers to invest in the public health and disaster-risk management capacities. Early and effective control of disease outbreaks prevents substantial health and economic costs whether or not the disease can spread globally and become a pandemic.
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The Global vector control response 2017–2030 (GVCR) provides a new strategy to strengthen vector control worldwide through increased capacity, improved surveillance, better coordination and integr...ated action across sectors and diseases.
In May 2017, the World Health Assembly adopted resolution WHA 70.16, which calls on Member States to develop or adapt national vector control strategies and operational plans to align with this strategy.
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The Lancet Planetary Health Volume 5, ISSUE 7, e466-e478, July 01, 2021
Transmission of many infectious diseases depends on interactions between humans, animals, and the environment. Incorporating these complex processes in transmission dynamic mo...dels can help inform policy and disease control interventions. We identified 20 diseases involving environmentally persistent pathogens (ie, pathogens that survive for more than 48 h in the environment and can cause subsequent human infections), of which indirect transmission can occur from animals to humans via the environment.
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BMJ Open 2021;11:e042279. doi:10.1136/bmjopen-2020-042279. Neglected tropical diseases tend to cluster in the same poor populations, and to make progress with their control, they will have to be dea...lt with in an integrated manner. Peptide microarrays may be a solution to tese problems, where diagnosis for co-infection can be detected simultaneously using the one tool.
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Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the... provision of safe water, sanitation and hygiene. In 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
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Interim rapid response guidance, 10 June 2022.
It includes considerations for certain populations such as patients with mild disease with considerations for community care, patients with moderate to severe ...">disease, sexually active persons, pregnant or breastfeeding women, children and young persons. The guidance also addresses considerations for clinical management such as the use of therapeutics, nutritional support, mental health services, and post-infection follow-up.
The document provides guidance for clinicians, health facility managers, health workers and infection prevention and control practitioners including but not limited to those working in primary care clinics, sexual health clinics, emergency departments, infectious diseases clinics, genitourinary clinics, dermatology clinics, maternity services, paediatrics, obstetrics and gynaecology and acute care facilities that provide care for patients with suspected or confirmed monkeypox
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Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-to-human transmission of the ...pan class="attribute-to-highlight medbox">disease, and reducing spillover of the virus from animals to humans.
Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks.
There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks.
A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world.
Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years.
The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission.
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Updated guidance. The guidance provides useful information to staff working in prisons, as well as to health and prison authorities, explaining how to prevent and address a potential outbreak of COVID-19. In addition, it aims to protect the health and well-being of all those who live and work in, an...d visit, these settings and the general population at large. People deprived of their liberty, and living or working in enclosed environments in close proximity, are likely to be more vulnerable to the COVID-19 disease than the general population. Moreover, correctional facilities may amplify and enhance COVID-19 transmission beyond their walls.
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