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This document compiles the recommendations made by the World Health Organization (WHO) and the Pan American Health Organization (PAHO) to help professionals in charge of vector control programs in Latin America and the Caribbean at the national, subnational, and local level update their knowledge in
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order to make evidence-based decisions on the most appropriate control measures for each specific situation. IVM can be used for surveillance and control or for elimination of VBDs and can help reduce the development of insecticide resistance through the rational use of these products. This document provides instructions for fulfillment of the 2008 PAHO mandate set forth in CD 48/13 (Integrated Vector Management).
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El presente documento reúne un conjunto de recomendaciones formuladas por la Organización Mundial de la Salud (OMS) y la Organización Panamericana de la Salud (OPS) para ayudar, a los profesionales encargados de los programas de control de vectores de Latinoamérica y el Caribe a nivel nacional,
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subnacional y local, a actualizar y tomar decisiones basadas en la evidencia sobre las medidas de control más apropiadas para cada situación específica. El MIV puede utilizarse cuando la meta es la vigilancia y el control o la eliminación (dependiendo de la situación específica) de las ETV y puede contribuir a reducir el desarrollo de la Resistencia a los insecticidas mediante el uso racional de estos productos. Este documento contiene las instrucciones para llevar a cabo el mandato de la OPS del 2008 sobre el control integrado de vectores (resolución CD48.R8, documento CD48/13) y, en particular, complementa una serie de guías de la OMS publicadas en el 2012
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This report provides a review and analysis of the research landscape for three diseases – Chagas disease, human African trypanosomiasis and leishmaniasis – that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease re
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ference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations.
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To support its R&D activities on Chagas disease, DNDi launched the Chagas Clinical Research Platform (CCRP). The platform brings together partners, experts, and stakeholders to provide support for evaluation and development of new treatments for Chagas disease. The patient-centred platform aims to f
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acilitate clinical research, provide a forum for technical discussions, develop a critical mass of expertise, and strengthen institutional research capacities. In addition, it identifies and reviews priority needs, works towards standardization of methodology to assess drug efficacy and reviews alternatives for using current approved drugs (new schemes, doses, combination) and special scenarios (resistance).
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About six to seven million people worldwide, mostly in Latin America, are estimated to be infected with
Trypanosoma cruzi, the parasite that causes Chagas disease (WHO data from 2021). Chagas disease is
found mainly in endemic areas of 21 Latin American countries. Chagas disease was once entirely
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confined to rural areas but in the last decades, due to population movements, most infected people live
in urban settings and the disease has spread to other continents. The burden of disease is due to its
chronic progression with people still suffering years later after initial infection.
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This guideline for the prevention and control of chikungunya fever
(CF) is intended for use by all peripheral health workers in the Region and
is based on the strategy outlined above. This document will focus mainly
on preventing, predicting and detecting outbreaks, and after detection,
investig
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ating and containing them.
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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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Theodor Bilharz, a German professor of anatomy and chief of surgery at the Kasr El Ani Hospital of Cairo from 1850, first identified an infective organism, Distomum hematobium in 1851, which was renamed Schistosoma haematobium in 1858. It arose from a cestode worm, Hymenoleptis nana, lying in the sm
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all colon of an Egyptian patient. He also discovered a trematode worm at the same time from an autopsy, thought to be the cause of urinary Schistosomiasis. Bilharz died from typhoid fever in 1862 at the age of 37. The Theodor Bilharz Research Institute in Giza, Egypt, stands as a tribute to him today. F. Milton published the first recorded peer-reviewed article report on Schistosomiasis in 1914.
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The sub-Saharan African region, carries 90% of the over 250 million cases of schistosomiasis occurring worldwide. In this region, after Nigeria, Tanzania is second country having the highest cases of schistosomiasis and approximately 51.5%0 of the Tanzanian population is either exposed or live in ar
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eas with high risk of exposure. The country is endemic to both Schistosoma mansoni and Schistosoma haematobium, these infections are common in communities characterised with limited access to water, sanitation, hygienic practices and health services. Schistosoma mansoni infection is associated with hepatosplenic disease characterised with hepatomegaly, splenomegaly, progressive periportal fibrosis (PPF) which can lead to portal hypertension and its related sequelae, mainly ascites, liver surface irregularities, oesophageal varices and haematemesis. The main consequences of S. haematobium infection are haematuria, dysuria, nutritional deficiencies, urinary bladder lesions, hydronephrosis, urinary bladder squamous cell carcinoma and in children, growth retardation. Preventive chemotherapy using mass drug administration (MDA) of praziquantel targeting primary school aged children is the main strategy for controlling schistosomiasis in Tanzania.
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Epidemiological Update
Dengue
7 February 2020
Situation summary
In the Region of the Americas, between epidemiological week (EW) 1 and EW 521 of 2019, a total of 3,139,335 cases of dengue have been reported (321.58 cases per 100,000 population), including 1,538 deaths. Of the total cases, 1,367,
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353 (43.6%) were laboratory-confirmed and 28,169 (0.9%) were classified as severe dengue. The case-fatality rate was 0.049%.
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The aim of this toolkit is to guide countries on how to best estimate their current burden of dengue by combining existing data from dengue surveillance systems with on-going research efforts to measure the community burden
of dengue.
These guidelines have been compiled for education ministries or other educational leaders (including development partners, non-governmental or private organizations working with schools or directly with caregivers) who want to adapt and adopt resources to support the marginalized caregivers of child
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ren with disabilities.
The guidance presented in this document was developed by a team of international and national experts following a proof-of-concept pilot4 of the resources in two countries. The work was carried out between February 2021 and January 2022. The pilots demonstrated that principles and activities described in the resources could be carried out, in practical terms, in line with existing government programmes supporting the implementation of disability-inclusive education.
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This document focuses on the management of patients affected by gambiense HAT and
constitutes an update to the WHO therapeutic guidance issued in 2013. The main changes in recommendations concern the criteria and methods for deciding the treatment among the new set of therapeutic options and the pa
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rticular conditions that apply to treatment with fexinidazole, as outlined below. Because HAT is a serious, life-threatening disease and because the efficacy of fexinidazole depends on swallowing the medicine after an appropriate intake of food as well as on completing the full 10-day
treatment schedule, the recommendations regarding fexinidazole administration are considered key elements that must be carefully followed. When the conditions listed in these guidelines are not met for any individual patient, the alternative available treatments should be prescribed.
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Female Genital Schistosomiasis (FGS) is a gynaecological disease caused by Schistosoma haematobium, a parasitic worm that is acquired by skin contact with freshwater contaminated by schistosome cerceriae. Communities in which the infection is most endemic have limited access to clean water and healt
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hcare services. Up to 150 million adolescent girls and women are estimated to be at risk of FGS and about 16–56 milion womens are living with FGS, with the majority of these in sub-Saharan Africa. The variability of these estimates points to the fact that this neglected tropical disease is not well studied and frequently not prioritized by local, regional, and global health policy makers.
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Human schistosomiasis, a parasitic and often chronic illness, is one of the major neglected tropical diseases worldwide. It is estimated that 240 million people suffer from schistosomiasis, with more than 200000 fatalities recorded each year. Schistosomiasis is caused by an infection of the blood fl
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uke Schistosoma and is transmitted to humans through direct contact with infected water.
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Clinical Spectrum of Schistosomiasis
Carbonell, C.; Rodríguz-Alonso, B.; López-Bernús, A.; et al.
MDPI Journal of Clinical Medicine
(2021)
CC
Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated th
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at at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
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The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of
recommended preventive measures (wearing a mask in public, keeping a distance from other people and regular handwashing). The roll-out of the vaccines, however, raised concerns that vac
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cination may lead to lower adherence to the existing
preventive measures. The advice from the World Health Organization (WHO) was to continue these public health and
social measures after being vaccinated.1 However, evidence from other epidemics suggests that there is lower adherence to
preventive measures when some level of protection exists (for example, individuals who use human immunodeficiency virus
pre-exposure prophylaxis
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Clinical Presentation of T.b. rhodesiense Sleeping Sickness in Second Stage Patients from Tanzania and Uganda
Kuepfer, I.; Hhary, EP.; Mpairwe, A.; Edielu, A.; Burri, C.; Blum, JA.
PLOS Neglected Tropical Diseases
(2011)
CC
A wide spectrum of disease severity has been described for Human African Trypanosomiasis (HAT) due to
Trypanosoma brucei rhodesiense (T.b. rhodesiense), ranging from chronic disease patterns in southern countries of East Africa to an increase in virulence towards the north. However, only limited d
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ata on the clinical presentation of T.b. rhodesiense HAT is available. From 2006-2009 we conducted the first clinical trial program (I MPAMEL III) in T.b. rhodesiense endemic areas of
Tanzania and Uganda in accordance with international standards (ICH-GCP). The primary and secondary outcome measures were safety and efficacy of an abridged melarsoprol schedule for treatment of second stage disease. Based on diagnostic findings and clinical examinations at baseline we describe the clinical presentation of T.b. rhodesiense HAT in second stage patients from two distinct geographical settings in East Africa.
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Full Perscribing information on Fexinidazole Tablet for oral use
INDICATIONS AND USAGE
Fexinidazole Tablets are indicated for the treatment of both the first-stage (hemolymphatic) and second-stage (meningoencephalitic) human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense in pati
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ents 6 years of age and older and weighing at least 20 kg.
Limitations of Use
Due to the decreased efficacy observed in patients with severe second stage HAT (cerebrospinal fluid white blood cell count (CSF-WBC) >100 cells/μL) due to T. brucei gambiense disease, Fexinidazole Tablets should only be used in these patients if there are no other available treatment options [see Warnings and Precautions (5.1)]
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Knowledge, attitudes and practices about human African trypanosomiasis and their implications in designing intervention strategies for Yei county, South Sudan
Bukachi, SA.; Mumbo, AA.; Alak, ACD.; Sebit, W.; Rumunu, J. et al.
PLOS Neclected Tropical Diseases
(2018)
CC
A clear understanding of the knowledge, attitudes and practices (KAP) of a particular community is necessary in order to improve control of human African trypanosomiasis (HAT).New screening and diagnostic tools and strategies were introduced into South Sudan, as part of integrated delivery of primar
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y healthcare. Knowledge and awareness on HAT, its new/improved screening and diagnostic tools, the places and processes of getting a confirmatory diagnosis and treatment are crucial to the success of this strategy.
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