This technical report summarizes the discussions on the status of programmatic transition to tenofovir, lamivudine and dolutegravir (TLD) in low– and middle- income countries, addressing the best practices and major challenges faced by HIV programmes.
The latest data on safety and efficacy of do...lutegravir (DTG) containing regimens were also reviewed. The document identified the remaining gaps in knowledge, research, monitoring, and surveillance on DTG and TLD transition and listed the future priorities.
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Ce guide donne un aperçu complet des informations essentielles relatives à la vaccination, notamment des informations techniques sur les vaccins, un examen des meilleures pratiques de gestion des programmes de vaccination, des conseils sur la prestation des services de vaccination, le suivi et l'...valuation, la surveillance des maladies et le rôle du changement de comportement.
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MEDBOX Issue Brief 26. Cholera is an acute diarrhoeal infection caused by eating or drinking food or water that is contaminated with the
bacterium Vibrio cholerae. Cholera remains a global threat to public health and is an indicator of inequity and lack of
social development. Researchers have esti...mated that every year, there are 1.3 to 4.0 million cases of cholera, and 21
000 to 143 000 deaths worldwide due to the infection.
However, cholera remains a neglected and underreported disease. Many cases are not recorded due to limitations in
surveillance systems and fears of potential impact on trade or tourism.
Today cholera affects 47 countries across the globe. Almost every developing country faces cholera outbreaks or
the threat of cholera. Major ongoing outbreaks are being reported from Afghanistan, Bangladesh, Democratic
Republic of Congo, Ethiopia and Nigeria. Major outbreaks are currently in Syria and Haiti.
Therefore, MEDBOX decided to produce issue briefs on cholera and available resources in Arabic, English and
French.
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The Pandemic Influenza Preparedness (PIP) Framework is a World Health Assembly resolution adopted unanimously by all Member States in 2011. It brings together Member States, industry, other stakeholders and WHO to implement a global approach to pandemic influenza preparedness and response. The Frame...work includes a benefit-sharing mechanism called the Partnership Contribution (PC). The PC is collected as an annual cash contribution from influenza vaccine, diagnostic, and pharmaceutical manufacturers that use the WHO Global Influenza Surveillance and Response System (GISRS). Funds are allocated for: (a) pandemic preparedness capacity building; (b) response activities during the time of an influenza pandemic; and (c) PIP Secretariat for the management and implementation of the Framework.
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MEDBOX Issue Brief 27: ces derniers temps, un nombre dramatique de cas de choléra a été enregistré dans le monde entier. Selon l'Organisation mondiale de la santé, 29 pays ont déjà signalé la présence de choléra cette année (2022).
La Syrie, le Malawi et Haïti sont actuellement aux pris...es avec des épidémies particulièrement importantes.
Le 2 octobre 2022, les autorités nationales haïtiennes ont signalé les deux premiers cas confirmés de Vibrio cholerae O1 dans l'agglomération de Port-au-Prince. Dans la prison de Port-au-Prince, il y a une épidémie de choléra qui a identifié 271 cas suspects à ce jour, dont 12 cas confirmés et 14 décès.
Il convient de noter que cette épidémie survient dans un contexte de crise humanitaire et sécuritaire complexe à Port-au-Prince et dans les villes voisines, où l'accès aux services de santé et, par conséquent, la surveillance épidémiologique pourraient être affectés.
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This manual is to assist health care providers and laboratory scientists to diagnose mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the clinical presentation and its diagnosis. The methods described are tailored to various levels of care and avail...able resources to improve the diagnosis and surveillance of the disease.
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In South and Central America, lymphatic filariasis (LF) is caused by Wuchereria bancrofti, which is transmitted by Culex quinquefasciatus, the only vector species in this region. Of the seven countries considered endemic for LF in the Americas in the last decade, Costa Rica, Suriname and Trinidad a...nd Tobago were removed from the World Health Organization list in 2011. The remaining countries, Brazil, Dominican Republic, Guyana and Haiti, have achieved important progress in recent years. Brazil was the first country in the Americas to stop mass drug administration (MDA) and to establish post-MDA surveillance. Dominican Republic stopped MDA in all LF-endemic foci: La Ciénaga and Southwest passed the third Transmission Assessment Survey (TAS) and the Eastern focus passed TAS-1 in 2018. Haiti passed the TAS and interrupted transmission in >80% of endemic communes, achieving effective drug coverage. Guyana implemented effective coverage in MDAs in 2017 and 2018 and in 2019 scaled up the treatment for 100% of the geographical region, introducing ivermectin in the MDA in order to achieve LF elimination by the year 2026. The Americas region is on its way to eliminating LF transmission. However, efforts should be made to improve morbidity management to prevent disability of the already affected populations.
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Antimicrobial resistance (AMR) is a threat to global health and development and it contributes to millions of deaths worldwide each year. Inappropriate use and overuse of antibiotics are driving an increase in AMR and have a detrimental impact on the effectiveness of these critical medicines. Throug...h the Global Action Plan on AMR, WHO is working to improve the surveillance of antimicrobial resistance and reduce inappropriate antibiotic consumption.
There is a recognized need for high-quality resources to improve antibiotic prescribing globally. To address this need, a pragmatic approach was taken by WHO to develop actionable guidance for empiric antibiotic use.
The WHO AWaRe (Access, Watch, Reserve) antibiotic book provides concise, evidence-based guidance on the choice of antibiotic, dose, route of administration, and duration of treatment for more than 30 of the most common clinical infections in children and adults in both primary health care and hospital settings. The information included in the book supports the recommendations for antibiotics listed on the WHO Model Lists of Essential Medicines and Essential Medicines Children and the WHO AWaRe classification of antibiotics.
The WHO AWaRe antibiotic book is accompanied by summary infographics for each infection for both adults and children that provide a quick-reference guide for health care workers at the point of care.
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The COVID-19 pandemic has raised profound ethical challenges on an unprecedented global scale. These challenges include how to allocate scarce resources (especially vaccines and therapeutics), both within and between countries, whether and when to mandate vaccines and/or masks, whether and how to co...nduct public health surveillance, whether to issue vaccine passports, and how to address stark international and intranational inequities. In addition, there have been ethical concerns about the conduct of COVID-19 research, such as the appropriateness of challenge studies.
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This document compiles the recommendations made by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) to help professionals in charge of vector control programs in Latin America and the Caribbean at the national, subnational, and local level update their knowledge in... order to make evidence-based decisions on the most appropriate control measures for each specific situation. IVM can be used for surveillance and control or for elimination of VBDs and can help reduce the development of insecticide resistance through the rational use of these products. This document provides instructions for fulfillment of the 2008 PAHO mandate set forth in CD 48/13 (Integrated Vector Management).
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Le présent document rassemble une série de recommandations émises par l’Organisation mondiale de la Santé (OMS) et l’Organisation panaméricaine de la Santé (OPS) pour aider les professionnels chargés des programmes de lutte antivectorielle en Amérique latine et dans les Caraïbes aux niv...eaux national, infranational et local à mettre à jour et prendre des decisions à base factuelle qui touchent les mesures de lutte antivectorielle les mieux adaptées à chaque situation particulière. La GIV peut être utilisée lorsque la cible est la surveillance et la lutte ou l’élimination (en function de chaque situation) des MTV et peut contribuer à réduire le développement de la résistance aux insecticides au moyen de l’utilisation rationnelle de ces produits. Le présent document contient les instructions nécessaires pour mener à bien le mandat établi par l’OPS en 2008 (résolution CD48.R8, document CD48/13), en particulier, il complémente une série de guides de l’OMS publiés en 2012
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Dengue is the fastest spreading, mosquito-borne viral infectious disease worldwide, with remarkable morbidity and mortality. In the past decades, profound contributions have been made towards understanding its epidemiology, including disease burden and distributions, risk factors, and control and pr...evention practices. Dengue continues to disseminate to new areas, including high latitude regions, and a new serotype (dengue virus serotype 5) has been identified. Vaccine research has made new progress, in which the licensed yellow fever and dengue virus quadrivalent chimeric vaccine is now under further safety assessment. In disease surveillance, because of its operational simplicity, rapidity, capability, and utility as an indicator of disease severity, dengue virus NS1 antigen detection has great promotion and application value among primary health care institutions. Vector control progress has driven new breakthroughs in biotechnology, including Wolbachia-infected Aedes and genetically modified Aedes. Both Aedes variants have been used to block transmission of the dengue virus through population replacement and suppression. In the future, vector control should still be pursued as a key measure to prevent transmission, along with anti-viral drug and vaccine research.
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Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di...agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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La réanimation a pour objectifs de prévenir et de pallier les différentes défaillances
viscérales aiguës. Elle s’adresse aux malades graves et est actuellement considérée
comme un élément normal de l’arsenal thérapeutique. Les médecins et les soignants ont
démontré l’utilité ...de la présence permanente 24 heures/24 et 7 jours/7 auprès des
malades graves d’une équipe hautement spécialisée. Ensemble, ils ont fait progresser les
techniques nécessaires à la prise en charge de ces malades : ventilation mécanique,
épuration extrarénale, surveillance et exploration cardiovasculaires... La réanimation
médicale née sur le terrain hospitalier a obtenu sa reconnaissance universitaire en 1969.
Le champ d’application de la réanimation s’étend à toute la pathologie et en particulier aux malades chirurgicaux. La distinction entre réanimation médicale et réanimation chirurgicale a été nécessaire pour une répartition raisonnable des tâches, surtout en
CHU, et aucunement en raison de connaissances pratiques et théoriques différentes. Cette distinction est obsolète, car il n’y a pas plusieurs façons de faire de la réanimation.
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Lateral-flow rapid diagnostic tests (RDTs) continue to play a vital role in global health in the management and diagnosis of infectious diseases, including malaria, HIV and COVID-19. Visually interpreted RDTs, more than any other class of diagnostics, fulfil WHO’s ASSURED criteria,1 enabling their... use at the lowest levels of health care and in self-testing.2 Their utility is, however, compromised every time a test is incorrectly performed or interpreted or its result is not available in a timely manner for clinical decisionmaking and surveillance.
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Human African trypanosomiasis (HAT) is a lethal neglected tropical disease (NTD) transmitted by the bite of infected tsetse flies. The disease is also known as “sleeping sickness”. During the 20th century it caused enormous suffering in the endemic areas in sub-Saharan Africa. HAT transmission l...ast soared in the late 1990s, triggering a renewed, coordinated and very successful control effort. In this paper, we present achievements towards HAT elimination, with a focus on the WHO road map targets for 2020. In particular, reported cases continue to decline, from over 30,000 cases per year at the turn of the century to 663 cases in 2020. Despite the impact of the COVID-19 pandemic, HAT surveillance was largely sustained, and the network of health facilities able to diagnose and treat the disease further expanded. Looking to the future, the World Health Organization (WHO) set bold new targets for HAT in its 2021–2030 road map for NTDs, namely: the elimination of transmission of gambiense HAT, which occurs in western and central Africa, and the elimination as a public health problem of rhodesiense HAT, which is found in eastern and southern Africa. The strong commitment of national health authorities and the international community will be essential if these goals are to be achieved.
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To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric...a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
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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.
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Avec l’essor des traitements antirétroviraux (TAR) à base de dolutégravir (DTG) pour soigner les personnes vivant avec
le VIH dans le monde, il est important d’estimer la vitesse à laquelle la résistance acquise au DTG apparaît dans les
populations sous TAR. Bien que la résistance au DT...G ne soit pas apparue dans les populations naïves aux TAR incapables
de supprimer la charge virale dans les essais cliniques, certains éléments portent à croire que la résistance au
DTG peut émerger chez les personnes suivant des schémas thérapeutiques incluant le DTG. L’OMS recommande aux
pays qui étendent les TAR incluant le DTG d’accompagner ce déploiement d’une surveillance en routine de la pharmacorésistance
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Lymphatic filariasis (LF) is a parasitic disease that is a major cause of chronic disability in the developing world. According to the 2021–2030 road map for neglected tropical diseases (NTDs) published by the World Health Organization (WHO), the global goal for LF is elimination as a public healt...h problem by 2030 through repeated rounds of mass drug administration (MDA). Critical components of any elimination program are monitoring and surveillance. Appropriate assessment tools and methods are needed for each stage of an elimination program; mapping to identify which areas require intervention, monitoring to assess the impact of interventions, and post-intervention surveillance to validate elimination or detect recrudescence.
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