Natural disasters often increase morbidity and mortality rates. Taking appropriate measures to maintain environmental health helps to reduce or eliminate the risks of preventable disease and death. Such measures contribute not only to the health of individuals in and near disaster-stricken areas, bu...t they also contribute to decreasing the high costs of providing emergency health services in the aftermath of disaster.
This document is divided into several parts. The first section primarily addresses the effects of natural disasters on environmental health conditions and services. In the second section, environmental health measures are described that should be undertaken in each of three time frames: the predisaster, disaster, and postdisaster periods.
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The threat posed by Zika virus infection highlights the need to reinforce preparedness arrangements for mosquito-borne diseases in EU/EEA countries, especially for pathogens transmitted by Aedes aegypti and Aedes albopictus.
The aim of this document is to highlight measures that can effectively red...uce the risk of importation and local transmission of pathogens transmitted by Ae. aegypti and Ae. albopictus. The main diseases of concern in this context are Zika, dengue, chikungunya and yellow fever.
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Background: Atherosclerotic cardiovascular diseases (ASCVD) including myocardial infarction, stroke and peripheral arterial disease continue to be major causes of premature death, disability and healthcare expenditure globally. Preventing the accumulation of cholesterol-containing atherogenic lipopr...oteins in the vessel wall is central to any healthcare strategy to prevent ASCVD. Advances in current concepts about reducing cumulative exposure to apolipoprotein B (apo B) cholesterol-containing lipoproteins and the emergence of novel therapies provide new opportunities to better prevent ASCVD. The present update of the World Heart Federation Cholesterol Roadmap provides a conceptual framework for the development of national policies and health systems approaches, so that potential roadblocks to cholesterol management and thus ASCVD prevention can be overcome.
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Pandemics and outbreaks have differential impacts on women and men. From risk of exposure and biological susceptibility to infection to the social and economic implications, individuals’ experiences are likely to vary according to their biological and gender characteristics and... their interaction with other social determinants. Because of this, global and national strategic plans for COVID-19 preparedness and response must be grounded in strong gender analysis and must ensure meaningful participation of affected groups, including women and girls, in decision-making and implementation.
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For COVID-19, as for many infectious diseases, the true level of transmission is frequently underestimated because a substantial proportion of people with the infection are undetected either because they are asymptomatic or have only mild symptoms and thus typically fail to present at healthcare fac...ilities. There may also be neglected or under-served segments of the population who are less likely to access healthcare or testing. Under-detection of cases may be exacerbated during an epidemic, when testing capacity may be limited and restricted to people with severe cases and priority risk groups (such as frontline healthcare workers, elderly people and people with comorbidities). Cases may also be misdiagnosed and attributed to other diseases with similar clinical presentation, such as influenza.
Differences in mortality between groups of people and countries are important proxy indicators of relative risk of death that guide policy decisions regarding scarce medical resource allocation during the ongoing COVID-19 pandemic. This document is intended to help countries estimate CFR and, if possible, IFR, as appropriately and accurately as possible, while accounting for possible biases in their estimation
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Background book on Management of the Child with a Serious Infection or Severe Malnutrition
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i...n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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Neonatal mortality is a major challenge in reducing child mortality rates in Nepal. Despite efforts by the Government of Nepal, data from the last three demographic and health surveys show a rise in the contribution of neonatal deaths to infant and child mortality. The Government of Nepal has implem...ented community-based programs that were piloted and then scaled up based on lessons learned. These programs include, but are not limited to ensuring safe motherhood, birth preparedness package, community-based newborn care package, and integrated management of childhood illnesses. Despite the implementation of such programs on a larger scale, their effective coverage is yet to be achieved. Health system challenges included an inadequate policy environment, funding gaps, inadequate procurement, and insufficient supplies of commodities, while human resource management has been found to be impeding service delivery. Such bottlenecks at policy, institutional and service delivery level need to be addressed incorporating health information in decision-making as well as working in partnership with communities to facilitate the utilization of available services.
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Prevention, early diagnosis, and effective treatment are essential for the control and elimination of Neisseria gonorrhoeae as a public health problem. Currently, in Latin America and the Caribbean, treatment for gonorrhea infection is largely empiric and based on clinical diagnosis. In the Americas..., the high burden of new N. gonorrhoeae infections (estimated at 11 million new cases a year), the complexity of the disease epidemiology, and in many countries the limited resources, make it difficult to fully understand the burden of disease and the burden of antimicrobial resistance (AMR) in N. gonorrhoeae.
PAHO has developed this document to facilitate the navigation of available guidance and recommendations for N. gonorrhoeae AMR surveillance by public health and health care professionals, at the national and subnational levels, involved in designing, implementing, and/or strengthening AMR surveillance of N. gonorrhoeae and overall surveillance of sexually transmitted infections.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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The socioeconomic factors and public health inadequacies that facilitated the rapid spread of this infection continue to exist. As it is a new and emerging disease it has not received sufficient coverage yet in the medical curricula of Member States. Specific treatment is not available, and there is... no vaccine for the prevention of chikungunya fever. It has therefore become imperative to develop guidelines, based on the limited clinical experience gathered from managing patients so far, for appropriate management of patients in communities and in health facilities. Experts engaged in managing patients with chikungunya fever in the Region were brought together by the WHO Regional Office for South-East Asia to outline guidelines for managing various situations and stages of the disease.
The socioeconomic factors and public health inadequacies that facilitated the rapid spread of this infection continue to exist. As it is a new and emerging disease it has not received sufficient coverage yet in the medical curricula of Member States. Specific treatment is not available, and there is no vaccine for the prevention of chikungunya fever. It has therefore become imperative to develop guidelines, based on the limited clinical experience gathered from managing patients so far, for appropriate management of patients in communities and in health facilities. Experts engaged in managing patients with chikungunya fever in the Region were brought together by the WHO Regional Office for South-East Asia to outline guidelines for managing various situations and stages of the disease. This publication is the end result of that exercise and is intended to assist health-care providers in planning and implementing appropriate care to patients with chikungunya fever according to their actual clinical conditions
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Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains of these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph ...of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
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Yaws is a disfiguring non-venereal disease caused by infection with the spirochaete. Treponema pallidum subspecies pertenue which is closely related to the causative agent of syphilis and those of the other endemic treponematoses, bejel and pinta. The disease is endemic in certain areas of the World... Health Organization (WHO) African, South-East Asia and Western Pacific regions. Of the neglected tropical diseases identified for elimination and eradication, yaws is one of two diseases targeted for eradication. In 1949, the Second World Health Assembly adopted resolution WHA2.36, which addresses yaws, bejel and pinta as major public health problems that need attention.
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This project aimed to reduce the risk of vector-borne infection with Chagas disease by
controlling triatomine bugs, the vectors transmitting the parasite of Chagas disease, and
establishing an epidemiological surveillance system with community participation.
This document provides interim guidance for effective risk communication around Zika virus transmission and potential complications. A causal relationship between Zika virus infection and these potential complications has not yet been proven. In this uncertainty, effective communication strategies s...hould be implemented to enable people to take the best informed decisions about protecting themselves, their families and communities. This interim guidance is intended to be used by risk and health communication managers, staff and volunteers at global, regional or country level; communications professionals; anthropologists; sociologists; healthcare providers;hospital administrators; community leaders; programme managers;
and policymakers.
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The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/AIDS, and tuberculosis attributable to health system failures exceeded deaths from ...Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
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La enfermedad de Chagas es el resultado de la infección por elTrypanosoma cruzi. En Colombia, zona endémica para la enfermedad, existe al menos un millón de personas infectadas y tres millones en riesgo. Por lo anterior, el Ministerio de la Protección Social avaló la creación de una Guía de a...tención de la enfermedad de Chagas para el país.
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More than two years since the first SARS-CoV-2 infections were reported, the COVID-19 pandemic remains an acute global emergency. In this Strategic Preparedness, Readiness and Response plan for 2022, WHO sets out a number of key strategic adjustments that, if implemented rapidly and consistently at ...national, regional, and global levels, will enable the world to end the acute phase of the pandemic.
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A discussion paper on the scope of the problem, its drivers, and strategies for moving forward for policy, practice, and research
In many protracted emergencies, the prevalence rates of global acute malnutrition (GAM) regularly exceed the emergency threshold of > 15% of children with acute malnutri...tion (< -2 weight-for-height z-scores (WHZ) or with nutritional edema), despite ongoing humanitarian interventions. The widespread scale and long-lasting nature of “persistent GAM” means that it is a policy and programming priority.
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