Le Bénin à l’instar des autres pays d’Afrique subsaharienne, fait face à une épidémie généralisée du VIH qui est actuellement au centre des préoccupations de santé publique et de développement. De 2002 à 2006, la prévalence nationale est stabilisée autour de 2% grâce à une améli...oration de la prise en charge des PVVIH, une augmentation du nombre de patients sous ARV, et un renforcement du partenariat avec la société civile y compris le secteur privé. En 2007, on a observé une légère inflexion à 1,7% de la prévalence.
Les conséquences multiples de l’infection par le VIH ont très vite imposé la nécessité d’une prise en charge globale des personnes infectées et affectées. Les interventions sont désormais multiples et intégrées allant de la prévention à la prise en charge en passant par le conseil - dépistage (CD).
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What at first glance appears to be simple causality – climate change leading to more and more migration – has triggered intense academic debate over the past ten years because the circumstances are complex. There is need for a thorough analysis in the ground between denying the problem and asser...ting immediate causality. In international relations, migration induced by climate change and environmental degradation is increasingly recognized as a problem, whether in the framework of international climate policy, international migration policy, development cooperation, or international crisis management. But considering the dimension of these major challenges, only small steps have been taken so far. The scope of the problem continues to be underestimated. Climate change is jeopardizing the livelihoods of more and more people. It is a risk multiplier. Although understanding of the connection between climate change and migration has increased, many questions have yet to be answered. We need more knowledge to better support the people affected.
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Results
Recommendations• NGOs should provide MHPSS services with a focus on empowerment and self-reliance
• Introduce interventions focusing on pain mechanisms, coping strategies and physical resilience
• Implement livelihood programmes
• Increase service accessibility and outreach activ...ities
• Provide support groups for people who have lost a close family member
• Highlight the importance of supervision and training
• Ensure high quality service provisions by applying relevant outcome measures and to further contribute to the evidence base for MHPSS
• Diversify MHPSS activities to different target groups, including men and women, and address the needs of elderly and individuals with disabilities
This study provides evidence of a large gap between the need of MHPSS among Syrian refugees and provided services. Of the 1082 respondents in this study, 62% expressed that they needed assistance to deal with physical pain and distress. Almost 80% reported being in pain, of which 27% were in severe or very severe pain. Additionally, 55% suffer from distress and 56% rate their own health as fair or poor. Even among the 18-25-yearolds, the prevalence of reporting their overall health as fair was 30.7%. For functionality levels, 28.5% felt severely or extremely emotionally affected by their health problems, and more than 20% had serious difficulties in doing day-to-day work. On the other hand, the majority (72-74%) had no problems in maintaining friendships and participating in community activities
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Ce manuel est destiné aux formations sanitaires de base afin qu’elles puissent faire face à la lutte contre la lèpre au Rwanda en s’alignant à la Stratégie mondiale renforcée telle que définie par l’OMS1. Cette stratégie de l’OMS et ses partenaires a pour but de réduire davantage la... charge de la lèpre, et fournir des services de qualité pour le traitement de la maladie dans toutes les communautés affectées, tout en garantissant le respect des principes d’équité et de justice sociale.
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On the evening of 25 April, Tropical Cyclone Kenneth made landfall between the districts of Macomia and Quissanga in the northern province of Cabo Delgado.
This report covers research conducted on HIV stigma and discrimination using the Stigma Index in the Papua New Guinea provinces of Western Highlands and Chimbu*. When Igat Hope began the project the aim was to conduct interviews in all regions of PNG. However, due to funding constraints and organis...ational capacities, the Stigma Index has only been applied in one region, that is, the Highlands Region. In future, the hope is to gather comparable data from other regions in PNG. Despite the fact that the overall project aims have not yet been achieved, the data contained in this report provides useful information that can be considered as work continues in PNG on HIV-related stigma and discrimination and human rights.
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Au cours des dix années à venir, la Fédération internationale œu
vrera, collectivement, à la réalisation des objectifs stratégiques
suivants:
1. Sauver des vies, protéger les moyens d’existence et renforcer
le relèvement après les catastrophes et les crises
2. Promouvoir des modes ...de vie sains et sûrs
3. Promouvoir l’intégration sociale et une culture de non-violenceet de paix.
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le Sénégal continue d’être confronté à une crise alimentaire et nutritionnelle qui touche particulièrement le nord et l’est du pays. Selon les estimations faites en novembre 20151, plus de 2,4 millions de personnes sont en insécurité alimentaire (soit 17% de la population), dont 220 461 ...seront en crise pendant la période de soudure 20162. le nombre d’enfants en situation de malnutrition aiguë pourrait être de plus de 407 500 en 2016, parmi lesquels plus de 86 000 en sévère3. les chocs climatiques tels que la sécheresse et le retard de démarrage de la saison pluvieuse ont affecté le nord du pays alors que dans d’autres zones les inondations ont affecté plus de 60 000 personnes4. l’épidémie de la maladie à virus Ebola (MVE) qui a sévi aux portes du pays a montré qu’un renforcement du système de surveillance épidémiologique ainsi que le renforcement des structures de santé sont requis.
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Évaluation du programme burkinabé dans les districts de Kaya et de Zorgho
Objectif. L’objectif central de cette thèse est d’évaluer, dans des conditions réelles d’implantation, les effets du programme burkinabé de prise en charge communautaire du paludisme sur le recours aux soins de...s enfants fébriles. Les objectifs spécifiques sont : (1) de sonder les perceptions des ASC à l’égard du programme et explorer les facteurs contextuels susceptibles d’affecter leur performance ; (2) d’estimer le recours aux ASC par les enfants fébriles et identifier ses déterminants ; (3) de mesurer, auprès des enfants fébriles, le changement des pratiques de recours aux soins induit par l’introduction d’une intervention concomitante – la gratuité des soins dans les centres de santé.
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Cette mission menée conjointement par la représentante du Ministère de la Santé en charge du projet, la
responsable EVIPNet de l’OMS à Genève et le directeur de la fondation Winds of Hope visait à établir le lien entre
le Ministère de la Santé et les différentes parties prenantes du B...urkina Faso en charge de la prévention et de
prise en charge du noma, notamment les ONG : Sentinelles, Persis et Hymne aux Enfants. En effet, le Ministère
de la Santé du Burkina Faso a décidé d’écrire une note de politique (policy brief) sur cette maladie négligée non
transmissible qu’est le noma pour provoquer un dialogue politique (forum délibératif) devant déboucher sur des
actions politiques concrètes. Cette maladie, symbole des ravages de l’extrême pauvreté, affecte les zones les
plus isolées et pauvres du Burkina Faso. Cette initiative du Ministère de la Santé du Burkina Faso qui a acquis
maintenant une grande expérience dans l’écriture de notes de politique et dans l’organisation de dialogues
politiques est une démarche concrète et significative pour adresser les inégalités sociales et l’extrême pauvreté.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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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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The development of this Operational Roadmap has been driven by a growing consensus in Ukraine on the need to prioritize activities that are urgently required to address the mental health and psychosocial needs of the country’s population and also the importance of basing the response on existing s...tructures, resources and innovations introduced in reforms in past years.
According to this consensus, new resources mobilized by and for Ukraine should complement existing ones, in line with the national vision and with best international standards, and should be planned in a way that further strengthens the country’s mental health system.
The Government of Ukraine is committed to urgently addressing the mental health and psychosocial needs of the population, under the auspices of the First Lady of Ukraine and the leadership of the recently established Intersectoral Coordination Council for Mental Health and Psychological Assistance to Victims of the Armed Aggression of the Russian Federation against Ukraine (referred to in this document as the Intersectoral Coordination Council).
This Roadmap has been developed following a series of consultations with Ukrainian authorities and national and international agencies working in the area of mental health and psychosocial support (MHPSS) and engaged in emergency response in Ukraine. The consultation process was organized by the Ministry of Health of Ukraine (MOH) and supported by WHO Ukraine, under the auspices of the First Lady of Ukraine and in collaboration with the MHPSS Technical Working Group of Ukraine (MHPSS TWG Ukraine) and the IASC MHPSS Reference Group (IASC MHPSS RG), and building on substantial advances in the mental health sector under existing programmes in the country.
The Roadmap is informed by international technical guidance and national policies and plans, including the IASC Guidelines on MHPSS in Emergency Settings, the Minimum Services Package for MHPSS in Emergencies (MHPSS MSP), the IASC Common Monitoring and Evaluation Framework, the World Health Organization (WHO)’s Comprehensive Mental Health Action Plan 2013– 2030, the WHO European Framework for Action on Mental Health, the Concept for Development of Mental Health Care in Ukraine until 2030, the National Mental Health Action Plan for 2021–2023 and the National Recovery and Development Plan.
Informed by the overall goal of MHPSS assistance in Ukraine – to reduce suffering and improve the mental health and psychosocial well-being of the affected population – the Roadmap aims to provide a consolidated overview of envisioned MHPSS priorities, informed by the local context and the vision of the Government of Ukraine together with national and international partners, and with the best available evidence and resources, to all MHPSS stakeholders already engaged in or joining emergency response and recovery efforts in Ukraine.
As well as information on the context in Ukraine, the Roadmap includes:
• a list of evidence-based MHPSS interventions and services contextualized and introduced in Ukraine in recent years (described in Table 1) and
• a set of multisectoral actions to scale up MHPSS services in both the short and longer terms, informed by available evidence, international technical guidance and expert consensus (described in Table 2).
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In 2016, PAHO's Directing Council, through Resolution CD55.R9, approved the “Plan of Action for Elimination of Neglected Infectious Diseases (NID) and Post-Elimination Actions, 2016-2022.” This Resolution urges Member States to implement a set of interventions to reduce the burden of disease by ...NID in the Americas by 2022, including “…support promotion of treatment, rehabilitation, and related support services through an approach focused on integrated morbidity management and disability prevention for individuals and families afflicted by those neglected infectious diseases that cause disability and generate stigma.” NIDs can have devastating chronic sequelae for patients, such as disability, visible change or loss in body structure, loss of tissue, and impairment of proper tissue and organ function, among others. All of these can in turn lead to unjustified discrimination, stigmatization, mental health problems, and partial or total incapacity to work, perpetuating the vicious cycle of neglected diseases as both a consequence and a cause of poverty. Patients with chronic conditions caused by NIDs require proper health care in order to prevent further damage and improve their living and social conditions. This should be provided at the primary health care level, as patients suffering from NIDs are often unable to travel to or afford to pay for specialized care services. Care for patients suffering from chronic morbidity caused by NID should be integrated into care for other chronic conditions caused by non-communicable diseases. This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be used mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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Le Burkina connait depuis les 5 dernières années, une dégradation continue de la situation sécuritaire. Cette situation a connu une détérioration accélérée depuis 2029 principalement dans les régions du Nord, du Centre-Nord, du Sahel, de la Boucle du Mouhoun ,de l’Est et du Centre Est. C...ette dégradation a entraîné un accroissement substantiel des déplacements internes et réduit l'accès déjà très limité aux services sociaux de base, y compris les services de santé, dans un contexte d'extrême pauvreté dans ces localités.
On estime un total de 2,2 millions de burkinabè qui sont dans un besoin humanitaire de plus en plus croissant dans tous les secteurs. Parmi ces populations vulnérables, on compte 1 902 150 déplacés internes à la date du 30 avril 2022 et plus de 1,2 millions étaient directement privées d’un accès aux soins de santé à cause principalement de la fermeture et ou du fonctionnement au minima des formations sanitaires dans les zones à défis sécuritaire. Au total, 290 communes sont concernées par le phénomène des PDIs dont la majorité se retrouvent à Djibo (285 654),
Kaya (123 610), Barsalogho (93 378), Gorgadji (43 651), Fada N’Gourma (85 574), Dori (66 798) et Gorom-Gorom (65 106).
La situation actuelle est rendue complexe par une annonce d’un niveau alarmant d'insécurité alimentaire et nutritionnelle selon les analyses faites par le Cadre intégré de Classification (IPC) de la malnutrition aiguë de novembre 2021 (IPC AMN) et du cadre harmonisé (CH) de l’insécurité alimentaire de mars 2022. Tous ces facteurs concourent à la dégradation de la situation alimentaire et nutritionnelle des populations affectées surtout les couches les plus vulnérables que sont les femmes et les enfants. C’est ainsi que le Ministère de la santé en collaboration avec l’UNICEF et le PAM a entrepris de réaliser une nouvelle enquête SMART rapide après celles 2019 et de 2020 auprès de certain nombre de localités abritant un grand nombre de déplacés internes afin d’évaluer la situation nutritionnelle et sanitaire des enfants de 6 à 59 mois et des femmes enceintes et des femmes allaitantes ayant des enfants de moins de 2 ans. Cette enquête a couvert 12 communes et localités qui sont reparties par région et par district sanitaire de la manière suivante: Tougan, Nouna, Kaya, Kongoussi, Tougouri, Pissila, Gayéri, Thiou, Séguénéga, Gorom-Gorom,
Gorgadji et Bani.
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Snake bite is a neglected public health issue in many tropical and subtropical countries. About 5.4 million snake bites occur each year, resulting in 1.8 to 2.7 million cases of envenomings (poisoning from snake bites). There are between 81 410 and 137 880 deaths and around three times as many amput...ations and other permanent disabilities each year.
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Snakebite envenoming affects millions of people worldwide annually and is a significant source of mortality. Preventing and treating the problem is complex and requires collaboration among the fields of public health, medicine, ecology, and laboratory science. After being removed from the category A... neglected tropical disease (NTD) list in 2013, snakebite envenoming was reinstated in 2017 in response to antivenom shortages and advocacy from researchers and international NGOs. In 2019, the World Health Organization (WHO) set a target to halve the number of deaths and cases of snakebite envenoming by 2030.
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The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel during mass drug administration (MDA). However, the disease context is complex wi...th an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach.
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti...ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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