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1
Management of Type 2 Diabetes in Developing Countries: Balancing Optimal Glycaemic Control and Outcomes with Affordability and Accessibility to Treatment
Mohan, V.; Khunti, K.; Chan,S.P.; et al.
National Library of Medicine, National Center for Biotechnology Information
(2020)
CC3
With the growing prevalence of type 2 diabetes, particularly in emerging countries, its management in the context of available resources should be considered. International guidelines, while comprehensive and scientifically valid, may not be appropriate for regions such as Asia, Latin America or Afr
...
ica, where epidemiology, patient phenotypes, cultural conditions and socioeconomic status are different from America and Europe. Although glycaemic control and reduction of micro- and macrovascular outcomes remain essential aspects of treatment, access and cost are major limiting factors; therefore, a pragmatic approach is required in restricted-resource settings. Newer agents, such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in particular, are relatively expensive, with limited availability despite potentially being valuable for patients with insulin resistance and cardiovascular complications. This review makes a case for the role of more accessible second-line treatments with long-established efficacy and affordability, such as sulfonylureas, in the management of type 2 diabetes, particularly in developing or restricted-resource countries.
more
The study analyzes the global burden of cancer in 2020 attributable to alcohol consumption. Using data from the GLOBOCAN 2020 database and alcohol consumption patterns, it estimates that 4.1% of all new cancer cases globally (approximately 741,300 cases) were caused by alcohol. The most affected can
...
cers include esophageal, liver, and breast cancer, with heavy drinking contributing the most cases, followed by risky and moderate drinking. The study highlights regional differences, with the highest attributable fractions in Eastern Asia and Central and Eastern Europe. It underscores the need for policies to raise awareness about alcohol-related cancer risks and reduce alcohol consumption globally.
more
This publication provides an overview of the rehabilitation landscape in Armenia as of 1 November 2022. It summarizes notable accomplishments, identifies requirements and highlights opportunities for improvement within the rehabilitation sector in Armenia. The assessment was carried out under the gu
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idance of the Ministry of Health of Armenia, along with its Health Care Policy Department. Technical assistance was provided by the WHO Regional Office for Europe and the WHO Country Office in Armenia.
more
Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review
Iheanacho, I.; Zhang, S.; King, D.; et al.
International Journal of Chronic Obstructive Pulmonary Disease
(2022)
CC2
The article "Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review" examines the financial impact associated with moderate-to-very severe COPD. The review analyzes studies published between 2006 and 2016 that discuss healthcare resource utilization (HRU), di
...
rect costs, and indirect costs related to COPD, with a focus on Europe and North America. It highlights that direct costs, including hospitalizations and medical treatments, increase with the severity of COPD and the frequency of exacerbations. Multivariate analyses identify key factors driving these costs, such as comorbidities and prior treatment history. The findings underscore the significant economic burden of COPD on healthcare systems and emphasize the need for improved management strategies to reduce costs and optimize patient care.
more
Le 14 août, l’Organisation mondiale de la Santé (OMS) déclarait que l’épidémie de variole simienne, dite Mpox, était une « urgence sanitaire internationale », après une flambée des cas en Afrique. Le lendemain, un cas était déclaré en Suède. La branche européenne de l’OMS estime
...
que d’autres cas importés de Mpox sont susceptibles d’être détectés prochainement en Europe. Ce qu’il faut savoir sur cette épidémie.
more
Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa
...
ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
more
The prevalence of asthma and allergic rhinoconjunctivitis is high in western countries, and has been rising throughout the late 20th century. However, relatively little is known about the prevalence of allergic disorders in children in North Africa and the Middle East, and even less is known about t
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he relative importance of socioeconomic factors in its aetiology in these countries, when compared to Europe, the USA and Australia.
more
The active participation and engagement of health and care workers (HCWs) in health emergency preparedness, readiness and response is crucial to support risk communication, community engagement and infodemic management (RCCE-IM) interventions during emergencies. HCWs hold unique position
...
s in society – repeatedly being identified among the main influencers of people’s behaviours: they are one of the most trusted sources of health information and advice in communities and role models for the acceptance and uptake of protective measures during health emergencies. On the frontline, HCWs have valuable insights and knowledge that can be harnessed to support health emergencies across the entire emergency cycle. Between October and December 2023, the WHO Regional Office for Europe interviewed key informants on strategies and experiences to meaningfully engage HCWs during emergencies
more
The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika. Globalization in trade and travel can lead to the importation of these vi
...
ruses, but climatic conditions strongly affect the efficiency of transmission in local settings. In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission. Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission. Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe. The models presented here can be used to inform public health preparedness planning in a highly interconnected world.
more
Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin
...
America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
more
April 2022 Volume 35 Issue 2 e00152-21
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 t
...
he 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
Long-term exposure of humans to air pollution enhances the risk of cardiovascular and respiratory diseases. A novel Global Exposure Mortality Model (GEMM) has been derived from many cohort studies, providing much-improved coverage of the exposure to fine particulate matter (PM2.5). We applied the GE
...
MM to assess excess mortality attributable to ambient air pollution on a global scale and compare to other risk factors.
Methods and results
We used a data-informed atmospheric model to calculate worldwide exposure to PM2.5 and ozone pollution, which was combined with the GEMM to estimate disease-specific excess mortality and loss of life expectancy (LLE) in 2015. Using this model, we investigated the effects of different pollution sources, distinguishing between natural (wildfires, aeolian dust) and anthropogenic emissions, including fossil fuel use. Global excess mortality from all ambient air pollution is estimated at 8.8 (7.11–10.41) million/year, with an LLE of 2.9 (2.3–3.5) years, being a factor of two higher than earlier estimates, and exceeding that of tobacco smoking. The global mean mortality rate of about 120 per 100 000 people/year is much exceeded in East Asia (196 per 100 000/year) and Europe (133 per 100 000/year). Without fossil fuel emissions, the global mean life expectancy would increase by 1.1 (0.9–1.2) years and 1.7 (1.4–2.0) years by removing all potentially controllable anthropogenic emissions. Because aeolian dust and wildfire emission control is impracticable, significant LLE is unavoidable.
Conclusion
Ambient air pollution is one of the main global health risks, causing significant excess mortality and LLE, especially through cardiovascular diseases. It causes an LLE that rivals that of tobacco smoking. The global mean LLE from air pollution strongly exceeds that by violence (all forms together), i.e. by an order of magnitude (LLE being 2.9 and 0.3 years, respectively).
more
This is one of seven Medical Peace Work cases.
Handbuch zu den europarechtlichen Grundlagen im Bereich Asyl, Grenzen und Migration - Ausgabe 2014
Agentur der Europäischen Union für Grundrechte; Europäischer Gerichtshof für Menschenrechte
(2014)
C1
Dieses Handbuch bietet einen Überblick über das geltende Recht im Zusammenhang mit Asyl, Grenzmanagement und Einwanderung und umfasst sowohl das Recht der Europäischen Union als auch die Europäische Menschenrechtskonvention (EMRK). Im Handbuch wird die Situation derjenigen Ausländer untersucht,
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die in der EU in der Regel als Drittstaatsangehörige bezeichnet werden. Mit diesem Handbuch sollen unter anderem Nichtregierungsorganisationen (NRO) und andere Einrichtungen unterstützt werden, die nicht auf den Bereich Asyl, Grenzen und Einwanderungsrecht spezialisiert sind und die sich möglicherweise mit rechtlichen Fragen in diesem Bereich auseinandersetzen müssen.
Für andere Sprachversionen siehe auch unter http://fra.europa.eu/de/publication/2013/handbuch-zu-den-europarechtlichen-grundlagen-im-bereich-asyl-grenzen-und-migration
more
Elaborat în cadrul proiectului „Fortificarea controlului tuberculozei în Moldova”, finanţat de către
Fondul Global de combatere a SIDA, Tuberculozei şi Malariei.
Руководство ВОЗ по политике и практике информирования о рисках при чрезвычайных ситуациях (ИРЧС)
ECDC MISSION REPORT 19–21 September 2016 ; 14–15 November 2016
