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2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10–19 years, adolescents are both at
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risk of TB and represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
more
This global guidance provided the framework for over 100 countries to develop their NDVPs. This updated (second) version supersedes the previous version published in 16 November 2020. New information has been added on the following areas:
the COVID-19 Partners Platform;
the use of COVID
...
-19 simulation exercises to test deployment strategies;
the indemnity agreement and no-fault compensation programme for vaccines secured through the COVAX Facility in the Advance Market Commitment (AMC) eligible economies;
the availability and use of the WHO-UNICEF COVID-19 Vaccine Introduction and deployment Costing (CVIC) tool;
the COVAX Facility’s humanitarian buffer that enables allocation of vaccine to cover high-risk populations in humanitarian settings;
recommendations for vaccination of pregnant and lactating women;
supplementary information on infection prevention and control (IPC) measures to be used to deliver COVID-19 vaccines safely;
the WHO licensed COVID-19 vaccines product-specific information;
use of geospatial data and digital micro plans for equitable access and delivery of COVID-19 vaccines;
lessons learned from the development of NDVPs and early experiences in COVID-19 vaccine deployment in countries; and
updated additional resources at the end of each chapter.
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In this video we take a look at Public Health – the science and art of preventing disease, prolonging life, and promoting health through the organized efforts of society. Public health focuses on improving the health of a population and preventing health problems before they happen. It is a broad
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field and covers a range of topics such as air pollution, epidemiology, communicable disease control, risk assessment and health promotion. We’ll take a look at what public health is, how it is different to clinical medicine, who is responsible for doing it and how it’s done!
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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 factors, as well as the local capacity to
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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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This regional report on the situation of tuberculosis (TB) in the Americas contains information from 2019, provided by the countries of the Region through the World Health Organization TB data collection system. These data have been consolidated and analyzed at the regional level. In addition to pre
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senting the epidemiological and programmatic situation of TB in the Americas, the report aims to raise awareness and to motivate and encourage all stakeholders in the prevention and control of this disease, to accelerate efforts towards TB elimination in the Region, and to achieve the targets of the End TB Strategy. The report records the Region's achievements, but also the gaps in the work being carried out in diagnosis, treatment, comorbidities, vulnerable populations, risk factors, and funding, among other issues. Based on the information presented, specific recommendations are provided for further progress.
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Onchocerca volvulus transmitted by repeated bites of infected blackflies (Simulium spp.). These blackflies breed along fast-flowing rivers and streams, close to remote villages located near fertile land where people rely on agriculture.
There is a need to reinforce skills of national and district
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health workers to know and identify the disease, understand the risk factors according to the context and living conditions of the affected communities, and promote the implementation of public health interventions. With the shift from control to elimination, large areas in Africa require mapping to assess whether transmission is active, and treatment required. A sampling strategy named Onchocerciasis elimination mapping has been developed to help countries conduct those assessments and start treatment where needed.
This course examines the epidemiology of Onchocerciasis, clinical aspects, impact, diagnosis, treatment and control, elimination, public health interventions and role of community health workers
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Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin
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America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
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Soil-Transmitted Helminthiasis in Children from a Rural Community Taking Part in a Periodic Deworming Program in the Peruvian Amazon
Errea, R.; Vasquez-Rios, G.; Calderon, M.; et al.
The American Jornal of Tropical Medicine and Hygiene
(2019)
CC
Infections by the soil-transmitted helminths (STH), including Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale/Necator americanus (hookworms), and Strongyloides stercoralis, disproportionately affect children around the world. Because of their transmission associated with poor sanita
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ry conditions and inadequate hygiene practices, higher burden of disease is seen in children from developing countries from sub-Saharan Africa, Southeast Asia, and Latin America. Approximately 267 million preschool-age children (PSAC) and 568 million school-age children (SAC) worldwide are at risk of STH infection as well as impaired child growth and cognitive development from A. lumbricoides, T. trichiura, and hookworm infections, and death due to severe S. stercoralis infection. Thus, their control is a global health priority.
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The epidemiology of the disease is mediated by the interaction of the parasite (trypanosome) with the vectors (tsetse flies), as well as with the human and animal hosts within a particular environment. Related to these interactions, the disease is confined in spatially limited areas called “foci
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, which are located
in Sub-Saharan Africa, mainly in remote rural areas. The risk of contracting HAT is, therefore, determined by the possibility of contact of a human being with an infected tsetse fly. Epidemics of HAT were described at the beginning of the 20th century; intensive activities have been set up to confront the disease, and it was under control in the 1960s, with fewer than 5,000 cases reported in the whole continent.
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Soil-transmitted helminths (STH) affect 1.45 billion people worldwide, and high intensity infections are associated with anemia, undernutrition and impaired cognition, particularly among children. Mathematical models suggest it may be possible to interrupt the transmission of STH in a community by e
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xpanding mass drug administration (MDA) from targeted high-risk groups (primarily school-aged children and women of child-bearing age) to all community members with high coverage. The DeWorm3 Project will test the feasibility of this approach to interrupting the transmission of STH using a series of cluster randomized trials in Benin, India and Malawi. Each study area (population 80,000) will be divided into 40 clusters and randomized to community-wide or standard-of-care targeted MDA for three years. Two years following the final round of MDA, prevalence of STH will be compared between arms and transmission interruption assessed in each cluster. The DeWorm3 trials will provide stakeholders with information regarding the potential to switch from STH control to a more ambitious and sustainable strategy.
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WASH in schools during a cholera response is important due to the strong correlation between WASH and IPC. Not only can it impact the health and well-being of students and staff but also facilitate the potential spread of the disease via the congregation of children and adults from multiple househol
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ds. Hygiene can often be more difficult to control with young children and therefore efforts to put in place systems to encourage good practices are essential.
To prevent the spread of cholera in schools, it is important to have clean and safe water sources, proper sanitation facilities, and good hygiene practices in place. This includes providing clean drinking water, hand-washing stations with soap, and education on hygiene and sanitation practices and implement Risk Communication and Community Engagement (RCCE) including dissemination of Information, Education and Communication materials (IEC).
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report
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ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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The cholera outbreak has affected 14 countries in the WHO African Region. The climate-induced natural disasters such as cyclone and flooding in the southern African region and drought in the Horn of Africa led to increase in cases of cholera in many of the affected countries. With the rainy season c
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ommencement in the west African region there is risk of more cholera outbreaks on the horizon. The trend across the region is being closely monitored and this highlights the need for Member States to enhance readiness, heighten surveillance and institute preventive and control measures in communities and around border crossings to prevent and mitigate cross border infection. Since 1 January 2022, a cumulative number of 213 443 cholera cases has been reported to the WHO Regional Office for Africa (AFRO), including 3 951 deaths with a case fatality ratio (CFR) of 1.9% as of 16 July 2023 (Table 1). Malawi accounts for 28% (58 941) of the total cases and 45% (1 766) of all deaths reported, and together with Cameroon, Democratic Republic of the Congo, Mozambique, and Nigeria contribute to 85% (181 300) of the overall caseload and 88% (3 464) of cumulative deaths. In Epidemiologic week 28, six countries Burundi, Cameroon, Ethiopia, Kenya, Malawi and Mozambique reported a total of 667 new cases.
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Fully functioning water, sanitation, hygiene (WASH) and health care waste management services are a critical aspect of infection prevention and control (IPC) practices, and ensuring patient safety and quality of care. Such services are also essentia
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l for creating an environment that supports the dignity and human rights of all care seekers, especially mothers, newborns, children and care providers.
WASH and waste services are also critical for preventing and effectively responding to disease outbreaks. The COVID-19 pandemic has exposed gaps in these basic services (Box 1). These gaps threaten the safety of patients and caregivers, and have environmental consequences, especially as a result of large increases in plastic health care waste. In short, WASH is a critical foundation for improving quality across the health system (1).
Many facilities lack plans and budgets for WASH, which has impacts on IPC. This lack of services, and of systems to improve them, compromises the ability to provide safe and quality care, and places health care providers and those seeking care at substantial risk of infection and loss of dignity. Unhygienic health care facilities without drinking water or functional toilets are also a disincentive to seeking care and undermine staff morale – these factors can have a critical impact on controlling infectious disease outbreaks.
Climate change and its impacts on WASH and health services, gender-specific needs, and equity in service provision and management all require rigorous attention, adaptable tools and regular monitoring.
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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
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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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The World Health Organization's Global Health Observatory (GHO) provides comprehensive data on noncommunicable diseases (NCDs), including cardiovascular diseases, cancers, chronic respiratory diseases, and diabetes. The portal offers country-specific statistics on NCD mortality rates,
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risk factors, and national responses, facilitating analysis and comparison across regions. It also includes resources such as publications and tools to support global efforts in NCD prevention and control.
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The Noncommunicable Diseases (NCD) Data Portal provides comprehensive information on NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It offers country-specific data on mortality rates, risk factors, and n
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ational responses, enabling analysis and comparison across regions. The portal also includes resources such as publications and tools to support global efforts in NCD prevention and control.
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The Noncommunicable Diseases (NCD) Data Portal provides comprehensive information on NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It offers country-specific data on mortality rates, risk factors, and n
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ational responses, enabling analysis and comparison across regions. The portal also includes resources such as publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal provides comprehensive information on NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It offers country-specific data on mortality rates, risk factors, and n
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ational responses, enabling analysis and comparison across regions. The portal also includes resources such as publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and
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national responses, facilitating analysis and comparison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and
...
national responses, facilitating analysis and comparison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and
...
national responses, facilitating analysis and comparison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and
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national responses, facilitating analysis and comparison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
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WHO convened the fifth stakeholders meeting on the elimination of HAT due to infection with Trypanosoma brucei gambiense (g-HAT) and Trypanosoma brucei rhodesiense (r-HAT) in Geneva, Switzerland, on 7–9 June 2023. The meeting was held again in person after the coronavirus disease (COVID-19) pandem
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ic and jointly for both forms of the disease. The previous meetings on g-HAT held in 2014, 2016 and 2018, as well as on r-HAT in 2015, 2017 and 2019, and jointly for g-HAT and r-HAT in 2021 (8) reinforced the partnership and commitment for HAT elimination and structured the mechanisms of collaboration within the WHO network for HAT elimination. The network includes NSSCPs, groups developing new tools, international and nongovernmental organizations involved in disease control, and donors.
Fewer than 1000 cases of HAT annually have been reported over the past 5 years, which is a historic achievement. The area at risk has been substantially reduced. The elimination of HAT as a public health problem at the global level has been achieved.
The new road map for neglected tropical diseases (NTDs) 2021−2030 (“the road map”) with the target to interrupt the transmission of g-HAT requires the strengthened and sustained efforts of all stakeholders, national authorities and partners, under WHO coordination. It will take disproportionally high efforts and innovative strategies to find the last cases of g-HAT and neutralize its transmission. Given the limited resources and other competing public health priorities, this is a challenge that requires our joint commitment.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE
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CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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Small drinking-water supplies commonly experience operational, managerial, technical and resourcing challenges that impact their ability to deliver safe and reliable services. The needs and opportunities associated with these supplies therefore warrant explicit consideration in policies and regulati
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ons.
These Guidelines, specifically tailored to small water supplies, build on over 60 years of guidance by the World Health Organization (WHO) on drinking-water quality and safety. They focus on establishing drinking-water quality regulations and standards that are health based and context appropriate; on proactively managing risks through water safety planning and sanitary inspections; and on carrying out independent surveillance. The guidance is intended primarily for decision-makers at national and subnational levels with responsibility for developing regulatory frameworks and support programmes related to these activities. Other stakeholders involved in water service provision will also benefit from the guidance in this document.
Designed to be practical and accessible, these Guidelines offer clear guidance that is rooted in the principle of progressive improvement. State-of-the-art recommendations and implementation guidance are provided, drawn from a comprehensive evidence review and established good practices. Additionally, case examples are provided from countries and areas around the world to demonstrate how the guidance in this publication has been implemented in practice in a wide variety of contexts.
Together with WHO’s 2024 Sanitary inspection packages – a supporting tool for the Guidelines for drinking-water quality: small water supplies, these Guidelines update and supersede WHO’s 1997 Guidelines for drinking-water quality. Volume 3: surveillance and control of community supplies. Key changes to this updated publication include a greater focus on preventive risk management and a broader range of small water supplies covered, including those managed by households, communities and professional entities.
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Leishmaniasis is a vector-borne tropical/subtropical disease caused by an intracellular parasite transmitted to humans by sand fly bite. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide reports include 1.5–2 million new cases each year, more than 300 million at
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risk of acquiring the disease, and 70,000 deaths per year. Clinical features depend on the Leishmania species and immune response of the host, varying from localized cutaneous disease to visceral form with potentially fatal outcome; however, the common presentation is either cutaneous, mucocutaneous, or visceral leishmaniasis. Many therapeutic agents are being used in Leishmania treatment, but the only effective treatment is achieved with current pentavalent antimonials. WHO considers Leishmaniasis as one of the “Neglected Tropical Diseases” that continues to be prevalent despite international, national, and local efforts towards its control and elimination over the last decade. This chapter reviews the global perspective of Leishmaniasis with increasing recognition of emerging “Atypical forms” and new surge of disease across the world mainly due to increasing conflicts in endemic areas leading to forced migration among other causes. All these challenges related to environment, disease, and vector pose major implications on WHO’s leishmaniasis control and elimination plan.
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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
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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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This study was aimed to ascertain the clinical profile and management of patients with ischemic heart disease (IHD) and/or peripheral artery disease (PAD). In this observational and cross-sectional study developed in 80 hospitals throughout Spain, consecutive adults with stable IHD and/or PAD were i
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ncluded. A total of 1089 patients were analyzed, of whom 65.3% had only IHD, 17.8% PAD and 16.9% both. A total of 80.6% were taking only one antiplatelet agent, and 18.2% were on dual antiplatelet therapy (mainly aspirin/clopidogrel). Almost all patients were taking ≥1 lipid lowering drug, mainly moderate-to-high intensity statins. IHD patients took ezetimibe more commonly than PAD (43.9% vs. 12.9%; p < 0.001). There were more patients with IHD that achieved blood pressure targets compared to PAD (<140/90 mmHg: 67.9% vs. 43.0%; p < 0.001; <130/80 mmHg: 34.1% vs. 15.7%; p < 0.001), LDL-cholesterol (<70 mg/dL: 53.1% vs. 41.5%; p = 0.033; <55 mg/dL: 26.5% vs. 16.0%; p = 0.025), and diabetes (HbA1c < 7%, with SGLT2i/GLP1-RA: 21.7% vs. 8.8%; p = 0.032). Modifications of antihypertensive agents and lipid-lowering therapy were performed in 69.0% and 82.3% of patients, respectively, without significant differences between groups. The use of SGLT2i/GLP1-RA was low. In conclusion, cardiovascular risk factors control remains poor among patients with IHD, PAD, or both. A higher use of combined therapy is warranted.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera
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lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
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. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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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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Zika Virus Infection: Step by Step Guide on Risk Communication and Community Engagement
recommended
Pan American Health Organization
(2016)
C_WHO
This document offers suggested risk communication actions in relation to Zika virus infection and other health issues linked to this disease. It is directed toward ministers of health and other health sector actors who, with their national (multidis
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ciplinary) teams for communication and social mobilization, will be able to adapt the provided information to the needs of their countries and audiences.
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Cholera is a diarrhoeal disease that is usually contracted when drinking water contaminated with Vibrio cholerae bacteria. The fight against this disease requires a multidisciplinary approach that combines a water, hygiene and sanitation (WaSH) response with a monitoring system, improved water suppl
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y and quality, sanitation and hygiene, and a health response with the treatment of the disease itself.
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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 heal
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th 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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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 Health Organization (WHO). The manual is aimed primarily at national departmen
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ts 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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The World Health Organization (WHO) Global Status Report on Noncommunicable Diseases 2010 projects that noncommunicable diseases (NCDs) will be responsible for over 44 million deaths during the next decade, representing an increase of about 15% since 2010. Most of these deaths will occur in the WHO
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regions of Africa, South-East Asia and the Eastern Mediterranean. In the African Region alone, NCDs will cause around 3.9 million deaths by 2020.
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Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis a
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nd management of silent cerebrovascular disease to prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds. The writing committee found strong evidence that silent cerebrovascular disease is a common problem of aging and that silent brain infarcts and white matter hyperintensities are associated with future symptomatic stroke risk independently of other vascular risk factors. In patients with cerebral microbleeds, there was evidence of a modestly increased risk of symptomatic intracranial hemorrhage in patients treated with thrombolysis for acute ischemic stroke but little prospective evidence on the risk of symptomatic hemorrhage in patients on anticoagulation. There were no randomized controlled trials targeted specifically to participants with silent cerebrovascular disease to prevent stroke. Primary stroke prevention is indicated in patients with silent brain infarcts, white matter hyperintensities, or microbleeds. Adoption of standard terms and definitions for silent cerebrovascular disease, as provided by prior American Heart Association/American Stroke Association statements and by a consensus group, may facilitate diagnosis and communication of findings from radiologists to clinicians.
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This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards
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have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
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The poster highlights the critical role of handwashing in preventing the spread of infections. It emphasizes the importance of washing hands multiple times a day, even if they do not appear dirty, as handwashing is the most effective way to reduce the risk
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of illness. Specific recommendations include washing hands after using the toilet, before preparing food or eating, and after cleaning or changing a baby's diaper. The message underlines the need for consistent hygiene practices to protect health and prevent infections.
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Diabetes mellitus (DM) is one of the commonest chronic diseases worldwide. Self-Management Education (SME) is regarded as a critical element of treatment for all people with diabetes, as well as those at risk of developing the condition. While a gre
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at variety of diabetes self-management education (DSME) interventions are available in high-income countries, limited information exists on educational programs for the prevention and management of diabetes complications in Africa. This study, therefore, aimed at synthesizing information in the literature to describe the state of the science of DSME interventions in the WHO African Region.
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The "Global NCD action plan" provides a road map and a menu of policy options for countries to take in order to attain the 9 voluntary global targets, including that of a 25% relative reduction in premature mortality from cardiovascular diseases, cancer, diabetes or chronic respiratory diseases by 2
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025. The main focus of this action plan is on 4 types of NCDs (cardiovascular diseases, cancer, chronic respiratory diseases, diabetes) which make the largest contribution to morbidity and mortality due to NCDs, and on 4 shared behavioural risk factors (tobacco use, unhealthy diet, physical inactivity, harmful use of alcohol).
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Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women
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and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
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The document "Proteksyon Maladi" focuses on preventing waterborne and hygiene-related diseases through practical measures. It emphasizes the importance of personal hygiene, including washing hands with soap and clean water before eating, after using the toilet, and during food preparation. Maintaini
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ng personal cleanliness is highlighted as a key step in preventing the spread of diseases.
Water safety is another critical focus, with recommendations to use treated or boiled water for drinking and cooking and to store water in clean, covered containers to prevent contamination. The document also addresses sanitation, encouraging the construction and maintenance of latrines to eliminate open defecation and promoting proper waste disposal to protect the environment and water sources.
Overall, the document serves as an educational resource, providing simple and effective strategies for communities to reduce the risk of diseases and improve public health through better hygiene, sanitation, and water safety practices.
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Interim guidance 19 March 2020
Health facilities in the Region of the Americas frequently suffer the effects of health emergencies and disasters, which jeopardize their ability to provide services to the population. The STAR-H methodology helps staff responsible for health emergency and disaster
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risk management to identify and assess risks as part of strategic planning to improve facility preparedness. It is intended to help them develop, with a multi-hazard approach, a response framework with operating procedures to deal with hazards of any type, scale, or frequency; determine roles and responsibilities; facilitate the effective use of resources; undertake strategic planning exercises, and improve the preparedness of facilities to effectively respond to and recover from impacts. This methodology is designed for use in health facilities of any size and capacity, and makes it possible to generate historical reports and national or subnational risk profiles. This information can be used to develop an effective health emergency and disaster risk management program.
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This guidance has been developed in line with the WHO corporate risk management framework, the WHO business continuity and contingency plans, as well as the Inter-Agency Emergency Response Preparedness Framework. It is based on a common organiza-tio
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nal approach and procedures for managing including emergency response across all hazards and at each level of the Organization. It relates WHO’s responsibilities (1) under the International Health Regulations (2005) and the Sendai Framework for Disaster Risk Reduction 2015-2030, and other international treaties; (2) as the United Nations’ lead agency for health and the health cluster; and (3) as a member of the United Nations or Humanitarian Country Teams
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Part 3: Use Safe Burial Practices
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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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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Noncommunicable diseases (NCDs) are the principal cause of morbidity, disability and premature mortality in Azerbaijan. The most effective way to reduce the NCD burden is to prevent NCD development, by addressing thebehavioural risk factors un
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derlying NCDs at the population and individual levels: smoking, alcohol use, excessive salt intake, low physical activity, overweight and obesity, and unhealthy diets. In Azerbaijan, a national survey of the prevalence of major NCD risk factors, aligned with the WHO-endorsed STEPwise approach to surveillance (STEPS) methodology, was conducted in 2017.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID
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-19
The guidance includes updated risk rates for hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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Although Shiga toxin-producing Escherichia coli (STEC) have been isolated from a variety of food production animals, they are most commonly associated with ruminants from which we derive meat and milk. Because of the widespread and diverse nature of ruminant-derived food production, coupled with the
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near ubiquity of STEC worldwide, there is no single definitive solution for controlling STEC that will work alone or in all situations. Instead, the introduction of multiple interventions applied in sequence, as a “multiple-hurdle scheme” at several points throughout the food chain (including processing, transport and handling) will be most effective.
This report summarizes the review and evaluation of interventions applied for the control of STEC in cattle, raw beef and raw milk and raw milk cheese manufactured from cows’ milk, and also evaluates available evidence for other small ruminants, swine and other animals. The information is presented from primary production, to the end of processing, providing the reader with information on the currently available interventions based on the latest scientific evidence.
This work was undertaken to support the development of guidelines for the control of STEC in beef, raw milk and cheese produced from raw milk by the Codex Committee on Food Hygiene (CCFH).
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Over the past few decades and throughout the world, the landscape of adolescent health has been altered dramatically. Currently, the total population of adolescents between the ages of 10 and 19 years is 1.2 billion – the largest generation of young people in history. The vast majority of adolesce
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nts (85%) live in developing countries where, in many areas, they make up more than a third of the population. They face a variety of different experiences given the diverse political, economic, social and cultural realities within their communities. Although, for many, adolescence is a period of learning and building confidence in a nurturing environment, for others it is a period of heightened risk and complex challenges.
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This section deals with implementing and improving infection control practices in hospitals, health centres and other health services in the outbreak area. It explains the need for, and implementation of, effective triage procedures, and basic requi
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rements for infection control and supporting activities. Further guidance can be found in the MSF Infection Control Guideline
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GUIDELINES ON LEPROSY CONTROL IN SOUTH AFRICA | 2011
Draft version 2017
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
Mosquitoes, flies, bugs and other vectors transmit viruses, parasites and bacteria that infect millions of people globally. They cause many diseases, including malaria, dengue, leishmaniases, Chagas disease and Zika virus disease.
The World Health Organization (WHO) has developed a new strategy to
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strengthen vector control worldwide. Member States welcomed this integrated approach at the 2017 World Health Assembly and adopted a resolution to support the strategy.
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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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In Control. A Practical Handbook for Professionals Working in Health Emergencies Internationally
recommended
In Control imparts knowledge, provokes reflection and triggers curiosity. The first half of the book provides an overview of the organisations, principles, frameworks and themes that every professional deploying to health emergencies should be aware
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of. The second half of the book provides practical advice to help professionals survive and thrive during their mission – from staying healthy, protecting oneself from cyber-attacks and coping with stress to building trust among the host community or dealing with language barriers and the press.
This handbook is free of charge and can be made available in small quantities as long as supply lasts. To order, please send this form to: incontrol-handbook@rki.de
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The technical note calls for raising awareness among practitioners and policymakers about the importance of strong tobacco control measures for protecting the health and development of children, including banning tobacco advertising, implementing 10
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0% smoke-free environments and raising taxes on tobacco.
Exposure to tobacco smoke has devastating impacts throughout childhood and adolescence, starting from conception.
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This document summarizes the findings of the STEPS survey in Ukraine and compares them with the results of STEPS surveys carried out in other countries in the WHO European Region, as well as with selected other surveys in Ukraine. The survey is designed to be repeated approximately every five years
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in each country to allow assessment of trends.
The study revealed very high prevalence of NCDs and their behavioural and biological risk factors in Ukraine. Data on behavioural risk factors include tobacco and alcohol use, diet, and physical activity. Data on biological risk factors include overweight and obesity, blood pressure, blood glucose, and blood lipid levels.
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22 April 2022, This document provides updated interim recommendations on the use of masks by health workers providing care to patients with suspected or confirmed COVID-19. This update is prompted by new evidence around mask use and COVID-19 transmission, as well as the emergence of variants of conc
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ern including Omicron. Masks continue to be a critical tool to prevent the spread of COVID-19. These interim guidelines supersede the recommendations provided in the WHO recommendations on mask use by health workers, in light of the Omicron variant of concern published on 22 December 2022.
WHO continually evaluates the emerging evidence and will review these interim recommendations within two months and issue new guidance as needed.
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The Interim Guidance for Risk Communication and Community Engagement (RCCE) outlines recommendations, considerations and methods to raise awareness, manage risk perception, maintain trust and proact
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ively support people at risk to make informed decisions to protect themselves and others from monkeypox. The guidance includes recommendations on identifying and communicating with affected populations and key audiences and avoiding stigma in communications outreach. It also includes key messages about symptoms of monkeypox, transmission, prevention measures, and communicating about uncertainty. This document also provides RCCE guidance for managers and planners of gatherings and events, where close physical contact may create an environment conducive for the transmission of monkeypox. Additionally, this document includes a compendium of recommendations for RCCE methods and resources to support the monkeypox response.
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Infection control is the forth edition from Clinical Pocket Reference for Nurses.
FAO and WHO jointly developed a comprehensive tool to assist Member states in assessing the effectiveness of national food control system. The FAO/WHO Food Control System Assessment Tool comprises 1
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62 assessment criteria under 25 system competencies over 4 Dimensions. This introductory booklet is developed to facilitate application of the assessment tool.
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This World Health Organization (WHO) and the International Labour Organization (ILO) joint guidelines production aims at harnessing the contribution of employers and workers towards the control of TB. It covers all the practical steps involved in es
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tablishing TB control activities, including (for large employers) starting and running a workplace TB control programme. They are intended for use in all countries in which TB incidence is high and the target audience for the guidelines includes employers, employee organizations, NTP managers, and agencies providing technical support for TB control.
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2nd edition. The interagency field handbook on malaria control was developed to set out effective malaria control responses in humanitarian emergencies, particularly during the acute phase when reli
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ance on international humanitarian assistance is greatest. This second edition represents a thorough updating and revision of the first edition. The structure remains similar, but includes an additional chapter on humanitarian coordination. All chapters have been revised to reflect changes in best practices, improvements in technologies, availability of new tools, and changes in WHO recommendations.
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Important Guideline for Ebola prevention and control
It is designed for the following uses:
- for prevention through preparedness--to help African health facilities make advance preparations for responding with appropriate precautions when a VH
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F (including Ebola) case is suspected.
- for planning and conducting in-service training to strengthen standard precautions and VHF isolation precautions.
- as a rapid reference when a VHF (i.e. Ebola) case appears at a health facility where no previous VHF preparations have been made.
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WHO practical guidelines. 2nd edition
Environmental Health in Emergencies and Disasters
Chapter 10
communicable Disease Toolkit
Trachoma Control a Guide for Programme Managers
Anthony W. Solomon, Marcia Zondervan, Hannah Kuper, et al.
WHO, London School of Hygiene & Tropical Medicine, and the International Trachoma Initiative
(2006)
In this guideline, natural ventilation is considered
among one the effective measures to control infections in health care. This guideline provides
a design and operation guide for hospital planners, engineers, architects and infection
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control
personnel. The recommendations in this guideline followed a systematic
review of the literature on the association of ventilation and disease transmission, as well
as effective natural ventilation solutions for infection control.
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The Ministry of Health of Saudi Arabia has developed the guidelines to meet the urgent need for up -to-date information and evidence-based recommendations
Guidance on temporary malaria control measures in Ebola-affected countries
World Health Organization
(2014)
Malaria is a prevalent cause of febrile illnesses in areas with high transmission, and its clinical presentation overlaps with initial signs of Ebola disease. For this reason, the effectiveness of the Ebola response in Guinea, Liberia and Sierra Leone can be optimized through the deployment of targe
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ted measures to reduce the number of fever cases due to malaria
WHO recommends specific adaptations in the diagnosis of malaria and in LLIN distribution in countries heavily affected by the Ebola outbreak and mass drug administration using artemisinin-based combination therapies (ACTs) in areas where transmission of both Ebola and malaria is high and access to malaria treatment is very low.
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at the national and acute health care facility level
Armed Forces Pest Management Board Technical Guide No. 47
