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Obesity is a global health problem. Its worldwide prevalence has tripled between 1975 and 2016, reaching a prevalence in Chile of 34.4%, according to the National Health Survey 2016-2017. If this co
...
ndition corresponds to a risk factor or primary disease is a widely discussed issue. It is recognized as a disease by the American Medical Association and World Health Organization,
based on its metabolic and hormonal features, such as dysregulation of appetite, abnormal energy balance and endocrine dysfunction, among others. Its main environmental risk factors are the consumption of ultra-processed foods and sedentariness. Preventive measures at the population level are fundamental, emphasizing promotion and prevention using a transdisciplinary approach. The individual approach in the management of obesity should improve the quality of life, avoid early mortality, reduce cardiovascular risk, and reduce the progression to type 2 diabetes and incidence of cancer. Thus, an adequate management and
control of obesity would have a great impact in our society.
more
Food environments are usually defined as the settings with all the different types of
food made available and accessible to people as they go about their daily lives.
That is, the range of food in supermarkets, small retail outlets, wet markets, street
food stalls, coffee shops, tea houses, s
...
chool canteens, restaurants, and all the other
venues where people buy and eat food. These environments differ enormously depending on the context. They can be extensive and diverse, with a seemingly endless array of options and price ranges, or they can be sparse, with very few options on offer. Because they determine what food consumers can access at a given moment in time, at what price, and with what degree of convenience, food environments both constrain and prompt the consumer’s choice.Food environments are influenced by the food systems which supply them, and vice versa. Food systems encompass the entire range of activities, people and institutions involved in the production, processing,
marketing, consumption and disposal of food (FAO, 2013). They include but are not limited to food supply chains. Making food systems nutrition-sensitive can contribute to addressing all forms of malnutrition, as food systems determine whether the food needed for good nutrition are available, affordable, acceptable and of adequate
quantity and quality. How closely food systems and food environments are interrelated and interdependent, and the degree to which external factors affect nutrition outcomes, varies from setting to setting.Many of today’s food systems
and food environments are challenged in supporting consumer choices that are
consistent with healthy diets and good nutrition. Consumers are not making choices based on nutrition and health, and poor diet is now the number one risk factor for death and disability worldwide (GBD, 2015). Food systems that do not enable healthy diets are increasingly recognized as an underlying cause of malnutrition (GLOPAN, 2016), and malnutrition, irrespective of form, has a huge cost. Economic costs associated with undernutrition are estimated at $1-2 trillion per year, about 2-3% of global GDP (FAO, 2013); the global economic cost of obesity and associated diet-related non-communicable diseases is estimated at $2 trillion per year, about 2.8% of global GDP (McKinsey, 2014). Influencing food environments for promoting healthy diets is an emerging strategy to address today’s nutrition challenges.
more
Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, par
...
tly as the result of the impact of climate change. Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
more
The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countrie
...
s, the causes of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel smoke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa.
more
Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burd
...
en in this already highly affected and resource-limited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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This situation analysis has gathered information about the current state of AMR, contributing factors and antimicrobial use in Zimbabwe from the human, animal, agricultural and environmental sectors. Data has been gathered from different sectors suc
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h as the general public, academia, the Ministry of Health and Child Care, the Ministry of Agriculture Mechanization and Irrigation Development and the Ministry of Environment, Water and Climate. It shows that AMR is a real concern in Zimbabwe and a threat to the health outcomes of humans, to the economic productivity of the livestock industry and a risk to the environment.
more
The Global Burden of Disease Study (GBD) is the most comprehensive worldwide observational epidemiological study to date. It describes mortality and morbidity from major diseases, injuries and risk factors
...
to health at global, national and regional levels. Examining trends from 1990 to the present and making comparisons across populations enables understanding of the changing health challenges facing people across the world in the 21st century.
Accessed July 4, 2019
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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-communicable diseases (NCDs) worldwide. There is currently
an epide
...
miological 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.
more
PNAS | March 4, 2014 | vol. 111 | no. 9
Malaria is an important disease that has a global distribution and significant health burden. The spatial limits of its distribution and seasonal activity are sensitive to climate
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factors, as well as the local capacity to control the disease. Malaria is also one of the few health outcomes that has been modeled by more than one research group and can therefore facilitate the first model intercomparison for health impacts under a future with climate change. We used bias-corrected temperature and rainfall simulations from the Coupled Model Intercomparison Project Phase 5 climate models to compare the metrics of five statistical and dynamical malaria impact models for three future time periods (2030s, 2050s, and 2080s). We evaluated three malaria outcome metrics at global and regional levels: climate suitability, additional population at risk and additional person-months at risk across the model outputs. The malaria projections were based on five different global climate models, each run under four emission scenarios (Representative Concentration Pathways, RCPs) and a single population projection. We also investigated the modeling uncertainty associated with future projections of populations at risk for malaria owing to climate change. Our findings show an overall global net increase in climate suitability and a net increase in the population at risk, but with large uncertainties. The model outputs indicate a net increase in the annual person-months at risk when comparing from RCP2.6 to RCP8.5 from the 2050s to the 2080s. The malaria outcome metrics were highly sensitive to the choice of malaria impact model, especially over the epidemic fringes of the malaria distribution.
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The article examines the epidemiology of chronic obstructive pulmonary disease (COPD) in the Middle East, North Africa, and Turkey. It provides an overview of COPD prevalence, associated risk factors
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, and challenges in diagnosis and treatment across these regions. The study highlights smoking and environmental exposures, such as dust and pollution, as significant contributors to COPD. It also points out the gaps in awareness, healthcare infrastructure, and the availability of diagnostic tools, which hinder effective management of the disease. The authors emphasize the need for comprehensive public health strategies, education, and improved access to healthcare to address the COPD burden in these areas.
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The Our World in Data webpage on air pollution provides an extensive overview of the global impact of air pollution on health and the environment. It presents data on sources of pollution, such as industry, vehicles, and domestic energy use, and hig
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hlights the associated health risks, including respiratory and cardiovascular diseases. The site emphasizes that air pollution is one of the leading environmental risk factors for premature deaths worldwide, particularly affecting low- and middle-income countries. It also discusses trends in air pollution levels over time and the effectiveness of policy interventions in reducing pollution and improving public health.
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The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highligh
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ts the significant global impact of CRDs, including asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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Issue Brief 31: Antimicrobial resistance (AMR) can occur when viruses, bacteria, parasites and fungi change over time. There is no longer a response to medicines, and the infection treatment gets really difficult which increases the risk of a disesa
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se spread, which can lead to severe health problems. AMR is an increasing threat to global public health worldwide that requires cross-sectional and cross-disciplinary action. It is present in every country and is spurred by several human-made factors, including over- and/or inadequate use of antibiotics, poor hygiene and infection prevention control, and excessive usage of antibiotics outside the health care sector e.g. in life stock production.
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Many features of the environment have been found to exert an important influence on cardiovascular disease (CVD) risk, progression, and severity. Changes in the environment due to migration to different geographic locations, modifications in lifesty
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le choices, and shifts in social policies and cultural practices alter CVD risk, even in the absence of genetic changes. Nevertheless, the cumulative impact of the environment on CVD risk has been difficult to assess
and the mechanisms by which some environment factors influence CVD remain obscure. Human environments are complex; and their natural, social and personal domains are highly variable due to diversity in human ecosystems, evolutionary histories, social structures, and individual choices. Accumulating evidence supports the notion that ecological features such as the diurnal cycles of
light and day, sunlight exposure, seasons, and geographic characteristics of the natural environment such altitude, latitude and greenspaces are important determinants of cardiovascular health and CVD risk. In highly developed societies, the influence of the natural environment is moderated by the physical characteristics of the social environments such as the built environment
and pollution, as well as by socioeconomic status and social networks. These attributes of the
social environment shape lifestyle choices that significantly modify CVD risk. An understanding
of how different domains of the environment, individually and collectively, affect CVD risk could
lead to a better appraisal of CVD, and aid in the development of new preventive and therapeutic
strategies to limit the increasingly high global burden of heart disease and stroke.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
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patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Chronic Obstructive Pulmonary Disease (COPD) is now one of the top three causes of death worldwide and 90% of these deaths occur in low- and middle-income countries (LMICs).
More than 3 million people died of COPD in 2012 accounting for 6% of all deaths globally. COPD represents an important public
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health challenge that is both preventable and treatable. COPD is a major cause of chronic morbidity and mortality throughout the world; many people suffer from this disease for years and die prematurely from it or its complications. Globally, the COPD burden is projected to increase incoming decades because of continued exposure to COPD risk factors and aging of thepopulation.
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Cholera which disproportionally impacts poor countries and the most vulnerable continues to affect at least 47 countries across the globe, resulting in an estimated 1.3 – 4 million cases, and 21,000 - 143,000 deaths per year worldwide. In Ethiopia, despite major improvements seen in the increasing
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access to healthcare, clean water, and improvement in maternal and child health, the country continues to be significantly affected by cholera outbreaks. From 2015 – 2021 for example, several outbreaks of cholera have occurred in multiple parts of the country resulting in over 105,000 cases and thousands of deaths. Some of the risk factors associated with cholera in Ethiopia include inadequate access to clean water, practice of open defecation, poor household and environmental sanitation, unhygienic latrine and weak sanitation practise among communities.
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Epidemiology of type 2 diabetes in India
Pradeepa, R.; Mohan, V.
Indian Journal of Ophthalmology 69(11):p 2932-2938, November 2021.
(2021)
CC2
The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over
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134 million by 2045. Approximately 57% of these individuals remain undiagnosed. Type 2 diabetes, which accounts for majority of the cases, can lead to multiorgan complications, broadly divided into microvascular and macrovascular complications. These complications are a significant cause for increased premature morbidity and mortality among individuals with diabetes, leading to reduced life expectancy and financial and other costs of diabetes leading to profound economic burden on the Indian health care system. The risk for diabetes is largely influence by ethnicity, age, obesity and physical inactivity, unhealthy diet, and behavioral habits in addition to genetics and family history. Good control of blood sugar blood pressure and blood lipid levels can prevent and/or delay the onset of diabetes complications. The prevention and management of diabetes and associated complications is a huge challenge in India due to several issues and barriers, including lack of multisectoral approach, surveillance data, awareness regarding diabetes, its risk factors and complications, access to health care settings, access to affordable medicines, etc. Thus, effective health promotion and primary prevention, at both, individual and population levels are the need of the hour to curb the diabetes epidemic and reduce diabetes-related complications in India
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Social and behavior change (SBC) professionals have often been tasked to find ways to influence knowledge, attitudes, and practices, about vaccines. Now that the COVID-19 vaccines are becoming available worldwide, renewed emphasis and urgency for SBC efforts arise.
To that end, WHO has offered thre
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e factors that play a role in vaccine hesitancy, the first two of which can be addressed by SBC: Complacency: Low perceived risk of vaccine-preventable diseases, and vaccination not deemed necessary. Other life/health issues are a greater priority.
Confidence: Low levels of trust in vaccines, in the delivery system, and in health authorities
Convenience: Barriers related to geographic accessibility, availability, affordability, and acceptability of services
This resource page provide a selection of SBC research, tools, and examples that aid in understanding this issue, especially in light of the recent availability of COVID-19 vaccines and the urgency for immunization worldwide.
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Diabetic foot ulcers are a complication affecting approximately 15% of the total population with diabetes mellitus. There are three and half million diabetic patients in Saudi Arabia alone. Aim: to determine capacity building for nurses’ knowledge and practice regarding prevention of diabetic foot
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complications. Research Questions: 1. Does the nurse’s knowledge prevent diabetic foot ulcer and other foot complications? 2. Does the high practice of the nurses during foot screening can prevent diabetic foot ulcer in primary health care centers in Saudi Arabia? Design: Descriptive, research designs have been utilized. Setting: Chronic disease clinic in primary health care centers in Jeddah city. Subjects: a purposive sample of 30 nurses and convenience sample of 30 patients. Tools: A. Diabetic foot ulcer Structured interview questionnaire to assess nurse’s knowledge regarding diabetes mellitus and diabetic foot. B. Health status assessment questionnaire to assess health history status of diabetic client. C. An observational checklist to assess the nurse practice once during diabetic foot screening. Results: Significant increase in nurse's knowledge had been observed, while the majority of them had poor practice in relation to foot screening. Whereas complicated diabetic patients represent 35.7% of diabetic patients have neuropathy. Moreover, only 7.1% have neuropathy and diabetic ketoacidosis. Also there was a significant moderate positive correlation between the overall score of nurse’s knowledge and the overall score of the practice regarding diabetic foot complications. Conclusions: Proper foot care, early recognition and management of risk factors prevent foot ulcer. Recommendations: Developing a structured training educational program for nurses dealing patients with diabetic foot disorders.
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
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SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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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
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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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Factors Associated with Stunting in Children under Age 2 in the Cambodia and Kenya 2014 Demographic and Health Surveys
Grace A. K. Ettyang & Caroline J. Sawe
United States Agency for International Development (USAID)
(2016)
C2
DHS WORKING PAPERS 2016 No. 126 | DEMOGRAPHIC AND HEALTH SURVEYS
This revision covers the main non-communicable diseases in Mozambique as well as the National Strategic Plan's aim to create a positive environment to minimize or eliminate the exposure to risk factors
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and guarantee access to care.
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Overlapping Risk Factors But No Association Between HIV and Drug Resistance Among TB Patients in Kazakhstan
Tursynbayeva A.; Pak S.; Ismailov Sh.; van den Hof S.
USAID; TB CARE 1; KNCV (To eliminate TB); et al.
(2019)
C2
Accessed: 26.09.2019
To better adapt current case management practices and address excess mortality in otherwise treatable
cases will require better knowledge of the demographic characteristics of the patients and comorbidities
which can make severe dehydration harder to tolerate physiologically. With this in mind, a
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scoping review
was undertaken, to explore the literature and summarise the existing evidence on cholera mortality and
reported risk factors.
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Climate risks have significant effects on public health including: injury, death, communicable diseases such as vector-borne and water-borne diseases, and non-communicable impacts such as malnutrition, heat stress and
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health effects of air pollution.
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Annals of Global Health, 87(1), p.43. DOI: http://doi.org/10.5334/aogh.3269;
The aim of this study was to examine the prevalence of mental health symptoms (anxiety, depression, and stress) in Bang
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ladesh and the factors associated with these symptoms during the COVID-19 pandemic.
They found that about 64%, 87%, and 61% of the respondents in Bangladesh reported high levels of depression, anxiety, and stress, respectively and this varied between divisions (regions), more in women, those who self-quarantined, and those that experienced classical symptoms of COVID-19. We think there is a need for mental health support in this population to minimise the long term effects.
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This manual has been developed to guide rapid risk assessment of acute public health risks from any type of hazard in response to requests from Member States of the World
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Health Organization (WHO). The manual is aimed primarily at national departments with health-protection responsibilities, National Focal Points (NFPs) for the International Heath Regulations (IHR) and WHO staff. It should also be useful to others who join multidisciplinary risk assessment teams, such as clinicians, field epidemiologists, veterinarians, chemists, food-safety specialists.
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Technical Note
Recently, the approach to hazardous events has undergone a considerable shift, away from reactive activities focused on managing and responding to events and towards a more proactive process of emergency and disaster risk management
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(DRM). The ultimate goal of this shift in focus is to prevent new and reduce existing disaster risks, a process known as disaster risk reduction (DRR), while strengthening individual, community, societal and global resilience.
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DHS Working Papers No. 110 | Zimbabwe Working Papers No. 11
2nd edition. The purpose of the WHO human health risk assessment toolkit: chemical hazards is to provide its users with guidance to identify, acquire and use the information needed to assess chemica
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l hazards, exposures and the corresponding health risks in their given health risk assessment contexts at local and/or national levels.
The Toolkit provides road maps for conducting a human health risk assessment, identifies information that must be gathered to complete an assessment and provides electronic links to international resources from which the user can obtain information and methods essential for conducting the human health risk assessment
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Desta et al. Int J Ment Health Syst (2018) 12:38 https://doi.org/10.1186/s13033-018-0217-z
Survival rate and mortality risk factors among TB–HIV co-infected patients at an HIV-specialist hospital in Myanmar: A 12-year retrospective follow-up study
Z. Z. Aunga; Y. M. Saw; T. N. Saw; et al.
International Journal of Infectious Diseases; Elsevier; International Society for infectious diseases
(2019)
C2
International Journal of Infectious Diseases 80 (2019) 10–15
journal homepage: www.elsevier.com/locate/ijid
Interim guidance 19 March 2020
Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asth
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ma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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The Strategic Tool for Assessing Risks (STAR) offers a comprehensive, easy-to-use toolkit and approach to enable national and subnational governments to rapidly conduct a strategic and evidence-based assessment of public health risks for planning an
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d prioritization of health emergency preparedness and disaster risk management activities. This guidance describes the principles and methodology of STAR to enhance its adaptation and use at the national or subnational levels.
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The guidance aspires
• To emphasize the 'need' to mainstream disaster risk reduction (DRR) in the health sector initiatives.
• To identify key approaches for mainstreaming DRR in the ... health sector in Myanmar, particularly in rural areas, based on the good practices, innovative approaches and lessons learned of Government, UN agencies, NGOs and others involved in the Cyclone Nargis recovery.
• Identify key ‘vulnerabilities and opportunities’ for creating a ‘safer health system’ in Myanmar.
No publication year indicated. more
• To emphasize the 'need' to mainstream disaster risk reduction (DRR) in the health sector initiatives.
• To identify key approaches for mainstreaming DRR in the ... health sector in Myanmar, particularly in rural areas, based on the good practices, innovative approaches and lessons learned of Government, UN agencies, NGOs and others involved in the Cyclone Nargis recovery.
• Identify key ‘vulnerabilities and opportunities’ for creating a ‘safer health system’ in Myanmar.
No publication year indicated. more
Perceived Susceptibility of Persons with Physical Disability to Factors Contributing to the Risk of Contracting HIV in Cameroon: A Qualitative Study
Elvis E. Tarkang, Prosper M. Lutala
International Journal of HIVAIDS Prevention, Educa tion and Behavioural Science
(2015)
CC
This guidance note is intended primarily for health actors working in emergency and disaster risk management (hereafter 'emergency risk
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management') at the local, national or international level, and in governmental or nongovernmental agencies. People with disabilities, those working in the disability sector and those working in other sectors that contribute to improved health outcomes related to emergency risk management, may also find this guidance note useful.
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The guide aims to provide health and DRM practitioners, planners and policymakers across sectors with targeted information to help them strengthen national health systems and integrate the risks of
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disease outbreaks in national DRR strategies
The following are some of the principles and approaches that have been based on lessons learned to date and may be considered to ensure effective all-hazards health EDRM, including prevention and preparedness for disease outbreaks, are addressed as part of the multihazard, multisectoral approach to developing or updating DRR strategies
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Urogenital schistosomiasis is a common neglected tropical disease in many rural communities in African countries, with patches of infection in the Eastern Mediterranean Region. Globally, an estimated 239 million people are currently infected, with burden estimated at more than 3.5 million disability
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-adjusted life years (DALYs). In many endemic areas, severely infected individuals may suffer fibrosis of the bladder, kidney damage, bladder cancer, and death if untreated. This, however, depends on several factors such as host-parasite genetics, degree and length of exposure, intensity of infection, host immune response to the parasites, and coinfections with other tropical diseases such as malaria and HIV-1.
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Non-communicable diseases (NCDs) are of increasing concern for society and national governments, as well as globally due to their high mortality rate. The main risk factors of NCDs can be classified
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into the categories of self-management, genetic factors, environmental factors, factors of medical conditions, and socio-demographic factors.
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Helping Adolescents Thrive (HAT) is a joint WHO-UNICEF initiative to strengthen programming and policy responses for adolescents, to promote positive mental health, prevent mental health conditions,
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and prevent self-harm and other risk behaviours. The vision of HAT is a world in which all adolescents, their caregivers, civil society and communities unite with governments to protect and promote adolescent mental health. This means taking action routinely to implement and monitor evidence-informed and human rights-based strategies for improving mental health, and to prevent and reduce mental health and substance use conditions in adolescents in order to improve lifelong well-being
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This guideline provides advice in regards to applications for Marketing Authorisations for antimicrobial veterinary medicinal products (VMPs) on the data required and the methodology to be used for performing an assessment of the risk to public
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health from antimicrobial resistance (AMR) due to use of the product. The scope of the guidance extends to VMPs intended for food producing species and to the transmission of AMR by the foodborne route or through direct contact with treated animals.
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Original Article
SAGE Open Medicine Volume 5: 1–7 © The Author(s) 2017 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav httpDs:O//dIo: i1.o0r.g1/107.171/2770/52035013212171773311977 journals.sagepub.com/home/smo
Post-traumatic stress disorder (PTSD) and anxiety are both prevalent in trauma-related populations. However, comorbidity of these 2 psychiatric disorders has not been investigated in flood survivors. This study aimed to estimate the extent to which PTSD and anxiety co-occur in flood survivors, and i
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dentify shared risk factors for PTSD only and comorbidity of PTSD and anxiety. Individuals who experienced Dongting Lake flood in 1998 were enrolled in this study using stratified and systematic random sampling method. Information on social support, personality traits, PTSD, and anxiety was collected using self-report questionnaires. The intensity of exposure to the flood was measured by some questions. Logistic regression analyses were used to identify factors associated with PTSD only and comorbidity of PTSD and anxiety
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Research Article
Karo et al. BMC Infectious Diseases 2014, 14:148 http://www.biomedcentral.com/1471-2334/14/148
Stroke happens either when the blood supply to part of your brain is cut off because of a blood clot, or when a brain
artery ruptures and leads to a haemorrhage. Stroke is a leading cause of death and disability worldwide, but most strokes can
be prevented by addressing a small number of key
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risk factors.
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This document provides a generic model that can be used for risk assessment of exposure to insecticide products applied as indoor residual sprays. It aims to harmonize the risk assessment of such in
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secticides for public health use in order to generate comparable data for their registering and labelling by national regulatory authorities. The assessment considers both adults and children (all age groups) as well as people in the following specific categories:
- those preparing the spray;
- those applying the spray;
- residents living in the treated houses;
- residents who participate in preparing and applying insecticides. more
- those preparing the spray;
- those applying the spray;
- residents living in the treated houses;
- residents who participate in preparing and applying insecticides. more
Eur Respir J. 2014 April ; 43(4): 1132–1141. doi:10.1183/09031936.00203613.
Mohamed et al. BMC Public Health 2018, 18(Suppl 3):1215
https://doi.org/10.1186/s12889-018-6053-xpre-
The risk communication and community engagement (RCCE) competency framework is a resource that details the essential behaviours and activities necessary for effective communication and engagement with communities before, during and after public
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health emergencies. The purpose of this framework is to establish and promote a common understanding of behavioural competencies and how they should be applied for high-performing and community-centred health emergency programmes. It is intended to support the development of standardized training programmes, professional development and talent acquisition and to enhance the capabilities of public health professionals involved in RCCE. Its goal is to inform the establishment of a skilled, well-trained RCCE workforce that consistently understands and executes the necessary behaviours and activities required to conduct RCCE activities with competence and professionalism.
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The article explores the underlying factors influencing unhealthy diets and sedentary lifestyles among adolescents in Kilifi County, Kenya. Using a qualitative approach, the study involved interviews and focus group discussions with adolescents, sta
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keholders, and young adults. Key findings include a preference for unhealthy, carbohydrate-rich, and sugary foods over traditional and nutritious options, exacerbated by factors like low socioeconomic status, urbanization, and poor farming practices.
Sedentary behavior, such as gambling and extensive technology use, was prevalent, often replacing physical activity. Protective factors like school attendance, community-based services, and parental engagement were identified as mitigating risks. The study highlights the importance of ecological intervention strategies targeting intrapersonal, interpersonal, and community factors to address unhealthy behaviors and promote better health outcomes in adolescents.
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Working document from an informal consultation of experts. A Protocol for risk assessment at the field level. The purpose of document is to provide guidance on the methodology to be used for assessing, at field level, the yellow fever virus circula
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tion in areas at risk, and is primarily intended for public health specialists
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The WHO Guidelines on risk reduction of cognitive decline and dementia provide evidence-based recommendations on lifestyle behaviours and interventions to delay or prevent cognitive decline and dementia. These WHO Guidelines are an important tool fo
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r health care providers as well as governments, policy-makers and other stakeholders to strengthen their response to the dementia challenge.
Executive Summary available in Arabic, Chinese, French, Russian and Spanish at: https://www.who.int/mental_health/neurology/dementia/guidelines_risk_reduction/en/
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Overview: Risk communication and community engagement are essential for any disease outbreak response. This is particularly critical during outbreaks of Ebola which may create fear in the public and frontline responders alike due to severe presentat
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ion of symptoms, misunderstanding of the causes of illness and high fatality rates. This document outlines some of the key considerations for risk communication and community engagement response to Ebola outbreak in Democratic Republic of the Congo.
Ebola outbreaks have been associated with misinformation and false rumours. In the context of RCCE, rumours refer to unsubstantiated information, claims or beliefs about what is causing the disease or how it can be treated/cured. If not proactively addressed in culturally appropriate ways, misinformation and rumours can lead to the further rapid spread of the disease and unnecessary deaths, severe disease, suffering, and societal and economic loss.
The publication includes a 'Rumour Tracking Tool' (Annex II).
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The publication conveys the most recent quantitative surveillance results focusing on noncommunicable disease (NCDs)-related risk behaviours among adults from the WHO STEPwise approach to NCD risk f
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actor surveillance (STEPS) and tobacco use among adults from the Global Adult Tobacco Survey (GATS) in Member States of the WHO South-East Asia Region. This publication contains selected indicators relating to tobacco use and other related risk behaviours of adults in Member States of the WHO South-East Asia Region. The tobacco indicators are taken from GATS or STEPS and other indicators relating to risk behaviours (history– dietary behaviours, physical activity, alcohol use, cervical cancer screening; physical measurements – body mass index, blood pressure, waist circumference; biochemical measurements – fasting blood glucose level, blood glucose level 2 hours after glucose load, total blood cholesterol, urine sodium and urine creatinine) are taken from STEPS. The latest findings from surveys conducted in Member States are presented in the publication.
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Long-lasting insecticidal nets (LNs) constitute a core vector control intervention against malaria. A number of new LN products are under development and will require assessment of risks to humans. This document provides an updated generic model that can be used for the
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risk assessment of exposure to insecticides of individuals sleeping under LNs and during the washing of nets.
In an Annex, exposures and health risks are described for the conventional treatment or retreatment of nets (ITNs) with an insecticide considering that such practices may still be used in evaluation of ITNs and their use. The generic model does not include the risks associated with the manufacturing of LNs in a factory environment. more
In an Annex, exposures and health risks are described for the conventional treatment or retreatment of nets (ITNs) with an insecticide considering that such practices may still be used in evaluation of ITNs and their use. The generic model does not include the risks associated with the manufacturing of LNs in a factory environment. more
Pandemic Influenza Risk Management
recommended
A WHO guide to inform & harmonize national & international pandemic preparedness and response
The main updates from the 2013 interim guidance are:
Alignment with other relevant United Nations policies for crisis and emergency management, and
Inclusion of the significant development in re
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cent years of the strategies for pandemic vaccine response during the start of a pandemic.
The guide is available in English, Arabic, Chinese, French, Spanish and Russian
more
Toolkit regarding Zika Virus
Prevention Of Cardiovascular Disease: Guidelines For Assessment And Management Or Cardiocascular Risk
recommended
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event.
Accessed November 2017
Zhou et al. Int J Ment Health Syst (2019) 13:10 https://doi.org/10.1186/s13033-019-0263-1
Factors associated with hepatitis C seropositivity in people living with HIV
V. M. Kuehlkamp; I. J. C. Schneider; M. F. Biudes; et al.
PAHO (Pan American Health Organization; World Health Organization); Iris (Institutional Repository); Rev Panam Salud Publica
(2014)
C2
Investigación original / Original research
Rev Panam Salud Publica 35(1), 2014
The content of the tool has been updated to reflect new WHO technical guidance and new evidence on both COVID-19 pandemic and mass gatherings, as well as feedback from end-users. This revision of the risk assessment tool was developed and reviewed b
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y the WHO Mass Gathering Technical Expert Group with input from WHO area-specific technical teams. The expanded tool includes eight tabs: 1. Instructions; 2. Assessment Overview; 3. Decision Tree; 4. Risk Evaluation; 5. Risk Mitigation; 6. Decision Matrix; 7. Risk Communication; and 8. Reviewer Sign Off. There as an additional tab with a glossary and list of abbreviations.
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WHO six-year strategy for the health sector and community capacity development.
Contact tracing is a key element of WHO’s recommended approach to control the spread of COVID-19 by breaking the chains of human-to-human transmission.
This document provides guidance to health authorities at all levels to improve the success rat
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e of contact tracing by informing efforts with RCCE principles, evidence and activities, and provides ready-to-use tools for professionals involved in contact-tracing efforts to inform their practices with RCCE principles and likewise improve their success rate.
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Traditional food markets play important economic, cultural, and social role and are sources of livelihood for millions of people in urban and rural areas. The manual Five keys for safer traditional food markets: risk mitigation in traditional food m
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arkets in the Asia-Pacific Region aims to support and guide local authorities, market community, and consumers to transform these markets into safer and healthier places through practical risk mitigation measures and community engagement strategies. The manual provides guidance on the implementation of five keys to promote public health and safety, particularly, in the context of food safety, zoonoses diseases, and infectious respiratory diseases.
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Bulletin of the World Health Organization, http://dx.doi.org/10.2471/BLT.16.178608
Risk Communication and Community Engagement (RCCE) is an essential part of any disease outbreak response. Risk communication in the context of an Ebola outbreak refers to real time exchange of infor
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mation, opinion and advice between frontline responders and people who are faced with the threat of Ebola to their survival, health, economic or social wellbeing. Community engagement refers to mutual partnership between Ebola response teams and individuals or communities in affected areas, whereby community stakeholders have ownership in controlling the spread of the outbreak.
It is intended to be used to guide RCCE work which is central to stopping the outbreak and preventing its further amplification. Unlike other areas of response, RCCE draws heavily on volunteers, frontline personnel and on people without prior training in this area. As such, the document provides basic background information, scopes the socio-economic and cultural aspects (that are known at the time of publication), and provides the latest evidence-based advice and approaches
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Introduction to HIV, AIDS and Sexually Transmitted Infection Surveillance - Surveillance of Most-At-Risk Populations (MARPS)
United States Department of Health and Human Services; Centers for Disease Control and Prevention (HHS-CDC); Global AIDS Program (GAP); et al.
United States Department of Health and Human Services; Centers for Disease Control and Prevention (HHS-CDC); Global AIDS Program (GAP); et al.
(2012)
C2
Participant Manual September 2012
Surveillance of Populations at High Risk for HIV Transmission
Interim guidance v2, 19 March 2020
This document provides WHO checklists for risk communication and community engagement (RCCE) readiness and initial response for novel coronaviruses (nCoV) recently identified in Wuhan, China (2019-nCoV). The objec
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tive of this document is to provide actionable guidance for countries to implement effective RCCE strategies which will help protect the public’s health in the early response to nCoV. This document includes recommended RCCE goals and actions for countries preparing for nCoV cases and for countries that have confirmed -nCoV cases.
Available in English, French and Chinese
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This document facilitate the preparation of a risk communication and community engagement strategy for vaccination against COVID-19. Its goal is to help to strengthen the communication and planning capacities of the ministries or secretariats of
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health and other agencies in charge of communicating about new COVID-19 vaccines in the Americas.
Available in English, Spanish and Portuguese
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People-centered approaches that help communities maintain protective behaviours and follow guidelines set out by public health and government agencies are more important than ever. The evidence is clear, communities play a role in preventing and con
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trolling epidemics and they are best able to take action and slow or stop the spread of disease when properly engaged and empowered. This toolbox in 2 parts offers best practice approaches to community engagement with families. Promoting individual and joint responsibilities for the safety of the family, this toolbox aims to bring families and households together to manage shared risks and agree to safe behaviours critical for their safety and the safety of their community.
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Interim guidanceAnnex to: Policy considerations for implementing a risk-based approach to international travel in the context of COVID-19, 2 July 2021
Countries across the world are facing diverse epidemiological situations with varying response
capacities and access to life saving tools. The World Health Organization (WHO) recommends that national authorities continue to apply a
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risk-based approach when implementing measures related to COVID-19 and international travel while respecting the dignity, human rights and fundamental freedoms of travellers. This approach should consider the risk posed by travel for the importation and exportation of cases in the context of the evolving epidemiology, including the emergence and circulation of virus variants of concern; the expansion of the COVID-19 vaccination roll-out; and lessons learned while responding to the pandemic, including on the early detection and management of cases and the application of public health and social measures.
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Guidance statement
Recommendations on contraceptive methods used by
women at high risk of HIV
