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Therapeutics and COVID-19 (Living Guideline, 10 November 2023)

World Health Organization WHO (2023) C_WHO

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-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. more

WHO guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition) in infants and children under 5 years

World Health Organization WHO (2023) C_WHO

Today, the World Health Organization (WHO) is advancing the global fight against acute malnutrition in children under 5 with the launch of its new guideline on the prevention and management of wasting and nutritional oedema (acute malnutrition). This milestone is a crucial response to the persistent... more

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Lao People’s Democratic Republic-WHO Country Cooperation Strategy 2024–2028

World Health Organization WHO (2023) C_WHO

This country cooperation strategy (CCS) outlines how the World Health Organization (WHO) will work with the Lao People’s Democratic Republic over the next five years (2024–2028), supporting the implementation of the five-year health sector development plans and the Health Sector Reform Strategy ...2021–2030 to attain the Sustainable Development Goals (SDGs) by 2030. The Lao People’s Democratic Republic experienced substantial economic growth in the 30 years prior to the coronavirus disease (COVID-19) pandemic, contributing to reduced poverty and significant progress toward the SDGs. However, the COVID-19 pandemic brought this development to a halt. It was anticipated that the COVID-19 recovery and the tremendous population growth in recent years would provide opportunities for a shift toward more sustainable and inclusive development in the years ahead. In 2023, however, the contrary was the case. Rural residents, including many ethnic minorities, continued to face marginalization because of limited access to education, health care and economic opportunities. Despite the challenges of COVID-19 and other disease outbreaks, the country has made significant improvements in health. Nonetheless, progress has been uneven and not everyone has benefited from these achievements. In the mountainous region, many people lack access to quality health care because of the unequal distribution of well-trained health-care workers. Preventable deaths due to poor-quality health care for children and newborns, infants and mothers remain a concern, as do communicable diseases such as sexually transmitted infections and tuberculosis. The increasing burden of noncommunicable diseases and the health impact of worsening climate change further heighten the need for strengthened and resilient health systems, which are at risk due to an underfunded health sector and weak economy. This CCS aims to address remaining and future challenges as well as health needs while creating an impact that is sustainable. It identifies three strategic priorities and nine deliverables (Table 1) to support the attainment of the national vision of Health for all by all, as articulated in the 9th Health Sector Development Plan 2021–2025. It contributes to the country’s goals to achieve universal health coverage, graduate from least developed country status by 2026 and attain SDGs by 2030. more

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Empowering Frontline Primary Healthcare Workers in a Global Health Partnership Training of Trainers Intervention to Strengthen the Prevention and Control of Cardiovascular Disease in Mozambique

Harris. P.; Juga, E.; Bay, N. et al. Global Heart (2022) CC

Unpreparedness of health professionals to address non-communicable diseases (NCD) at peripheral health facilities is a critical health system challenge in Mozambique. To address this weakness and decentralize NCD care, training of the primary care workforce is needed. We describe our experience in t... more

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Resource Effective Strategies to Prevent and Treat Cardiovascular Disease

Schwalm, J.; McKee, M.; Huffman, M. et al. Circulation (2016) CC

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... more

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Focus Area Strategic Plan for Climate Action 2024-2030 Advance copy, December 2023
recommended

UN High Commissioner for Refugees UNHCR (2023) CC

As a central component of the UNHCR Strategic Directions 2022-2026, UNHCR has identified eight focus areas for renewed attention and accelerated action, including Climate Action. This Focus Area Strategic Plan for Climate Action sets out a global roadmap for prioritized action, providing further cla... more

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Challenges in management and prevention of ischemic heart disease in low socioeconomic status people in LLMICs

Gupta, R.; Yusuf, S. BMC Medicine (2019) CC

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 (... more

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Screening for cardiovascular disease risk and subsequent management in low and middle income countries: challenges and opportunities

Bovet, P.; Chiolero, A.; Paccaud, F. et al. Public Health Reviews (2015) CC

Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the leading cause of premature mortality in low and middle income countries (LMICs). Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector... more

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Donor Government Funding for HIV in Low- and Middle-Income Countries in 2022

Wexler A.; Kates J,; UNAIDS (2023) C2

This report provides an analysis of donor government funding to address the HIV response in low- and middle-income countries in 2022, the latest year available, as well as trends over time. It includes both bilateral funding from donors and their contributions to the Global Fund to Fight AIDS, Tub... more

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Environmental Determinants of Cardiovascular Disease

Bhatnagar, A. Circulation Research (2018) CC

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 lifestyle choices, and shifts in social policies and cultu... more

Pediatric Oncology nursing practice in Latin America and the Carribbean

World Health Organization WHO (2023) C_WHO

This technical report has been developed within the framework of the WHO Global Initiative for Childhood Cancer. Its goal is to improve the situation of children and adolescents with cancer worldwide, giving them the best chances of survival, living a full life and, above all, enjoying quality of ... more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

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

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Operational guidance on the use of yellow fever assays in the context of surveillance

World Health Organization WHO (2023) C_WHO

This publication aims to provide updated guidance on the specific use of yellow fever laboratory assays in the context of surveillance to be used across the Global Yellow Fever Laboratory Network for disease surveillance. In the recent years, new commercial assays became available and are now recomm... more

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The Somali strategy for Cholera prevention and control 2020-2024
recommended

Government of SomaliaWorld Health Organization WHO (2023) C_WHO

Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already d... more

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Recent Advances in the Management Strategies for Buruli Ulcers

Popa G.; Muntean Al., Popa M. (2023) CC

Buruli ulcer (BU) is a bacterial skin infection that is caused by Mycobacterium ulcerans and mainly affects people who reside in the rural areas of Africa and in suburban and beach resort communities in Australia.

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Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

Peiris, D.; Ghosh, A.; Manne-Goehler, J. et al. PLoS Medicine (2021) CC

Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char... more

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Cardiovascular Diseases in Sub-Saharan Africa Compared to High-Income Countries: An Epidemiological Perspective

Yuyun, M.F.; Sliwa, K.; Kengne, A.P. et al. Global Heart (2020) CC

Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t... more

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Laboratory manual for yellow fever
recommended

World Health Organization WHO (2024) C_WHO

This WHO laboratory manual provides the most up to date methods and procedures for the laboratory identification of yellow fever virus infection in humans. It provides guidance on the establishment and maintenance of an effective laboratory providing routine surveillance testing for yellow fever, wh... more

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Guidelines for Management of ST-Elevated Myocardial Infarction

Directorate General of Health Services Ministry of Health & Family Welfare Government of India (2022) CC

Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi... more

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Clinical management of diphtheria: guideline

World Health Organization WHO (2024) C_WHO

WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO. It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen... more

Focus Area Strategic Plan for Climate Action 2024-2030 Advance copy, December 2023 recommended

The Somali strategy for Cholera prevention and control 2020-2024 recommended

Laboratory manual for yellow fever recommended

Focus Area Strategic Plan for Climate Action 2024-2030 Advance copy, December 2023
recommended

The Somali strategy for Cholera prevention and control 2020-2024
recommended

Laboratory manual for yellow fever
recommended