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8
WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
...
Hypoxaemic respiratory failure in ARDS commonly results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.
more
Nat Commun 9, 5370 (2018). https://doi.org/10.1038/s41467-018-07804-8. Mycobacterium ulcerans is the causative agent of Buruli ulcer, a neglected tropical skin disease that is most commonly found in children from West and Central Africa. Despite the
...
severity of the infection, therapeutic options are limited to antibiotics with severe side effects. Here, we show that M. ulcerans is susceptible to the anti-tubercular drug Q203 and related compounds targeting the respiratory cytochrome bc1:aa3. While the cytochrome bc1:aa3 is the primary terminal oxidase in Mycobacterium tuberculosis, the presence of an alternate bd-type terminal oxidase limits the bactericidal and sterilizing potency of Q203 against this bacterium. M. ulcerans strains found in Buruli ulcer patients from Africa and Australia lost all alternate terminal electron acceptors and rely exclusively on the cytochrome bc1:aa3 to respire. As a result, Q203 is bactericidal at low dose against M. ulcerans replicating in vitro and in mice, making the drug a promising candidate for Buruli ulcer treatment.
more
This publication represents a key step forward in translating Control of the leishmaniases (WHO Technical Report Series, No. 949) into a more practical tool for health personnel directly involved in the case management of cutaneous leishmaniasis. With this manual, countries will have, for the first
...
time, standardized diagnosis and treatment protocols, case definitions and indicators to enable them to easily track progress on cutaneous leishmaniasis case management across the Region. It will provide support to professionals in charge of cutaneous leishmaniasis, in order to alleviate the suffering of affected populations from this appalling disfiguring and stigmatizing neglected tropical disease.
more
Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and
...
transmitted by tsetse flies. Progress made in HAT control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
more
Le syndrome respiratoire aigu provoqué par le coronavirus-2 (SARS-CoV-2), initialement décrit en Chine, est responsable
de la pandémie que nous connaissons actuellement sous le nom de coronavirus disease 2019 ou COVID-19. L'épidémie de
corona
...
virus a été déclarée « urgence de santé publique mondiale » par l'Organisation mondiale de la santé (OMS) le 30 janvier 2020 . L'Afrique a été atteinte plus tard que les autres continents, mais à la date du 3 mai, tous les pays africains
avaient notifié au moins un cas. À la date du 09 juin 2020, l'Afrique comptait près de 200 000 cas confirmés, plus de
5000 décès, avec 25 pays ayant plus de 1000 cas actifs. Les patients atteints par ce virus peuvent développer des symptômes allant jusqu'à l'insuffisance respiratoire aiguë sévère
more
Mycetoma: epidemiology, treatment challenges, and progress
Taha, H.; Fahal, A.; Van de Sande, W.
Dovepress open access to scientific and medical research
(2015)
CC
Mycetoma is a specific chronic, granulomatous, inflammatory disease. It usually involves the subcutaneous tissue, most probably after traumatic inoculation of the causative organism. It has a prolonged, progressive, and indolent course, and, if untr
...
eated, it ultimately leads to destruction of the deeper tissues and bone, resulting in deformity and disability that may necessitate amputation of the affected parts with all the social and economic implications of this. The disease is characterized by tumefaction, draining sinuses, and the presence of grains.
more
Lymphatic filariasis (LF) is an avoidable, debilitating, disfiguring disease caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi and B. timori. Globally, 51.4 million people are
estimated to be infected. Lymphoedema
...
and hydrocoele are the visible, chronic clinical consequences of the lymphatic vessel impairment caused by infection with these parasites. Mosquitos in the genera Culex, Anopheles, Mansonia and Aedes transmit the parasites from person to person. 2020 marked the 20th year since WHO established the Global Programme to Eliminate Lymphatic Filariasis (GPELF) which aims to stop transmission of infection with mass drug administration (MDA) and to alleviate suffering among people affected by the disease through morbidity management and disability prevention (MMDP).
more
This policy brief describes key HIV viral load thresholds and the available viral load testing approaches for monitoring how well antiretroviral therapy is working for people living with HIV. It provides clarification for and elaborates upon the cur
...
rent treatment monitoring algorithm from the Consolidated guidelines on HIV prevention, testing, treatment, service delivery and monitoring: recommendations for a public health approach.
This information can help people living with HIV to live healthy lives, ensure that HIV is not transmitted to other people and support policy-makers in determining the optimal allocation of resources for viral load testing and communicating the results.
more
The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, water, sanitation and hygiene, logistics, community en
...
gagement and risk communication. All efforts must be well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
more
Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall
...
y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
more
Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this
...
burden, we posit that studies evaluating cardiovascular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
more
Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update
Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al.
African Journal of Thoracic and Critical Care Medicine
(2021)
CC
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support
...
optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart
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disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
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Communicable and non-communicable diseases in Africa in 2021/22
World Health Organization Africa Region; WHO Africa
World Health Organization Africa Region; WHO Africa
(2023)
C_WHO
This report is one of the first major products of the newly established Precision Public Health Metrics unit of the UCN cluster of the WHO Regional Office for Africa. The report presents national trends in communicable and non-communicable disease b
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urden and control in the WHO African region. It tracks progress made with respect to disease burden reduction, elimination and eradication. It also highlights major emerging threats, opportunities and priorities in the fight against commu- nicable and non-communicable diseases in the region. It covers the period 2000-2022, but for some indicators, information is available only up to 2021.
The report shows the number of reported cases for malaria and vaccine preventable diseases (meningitis, measles, yellow fever, pertussis, diphtheria, tetanus, and polio); disease incidence due to HIV, tuberculosis and four major noncommunicable diseases (cardiovas- cular diseases, cancers, diabetes and chronic respira- tory diseases).
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Noncommunicable diseases (NCDs) – chief among them, cardiovascular diseases (heart disease and stroke), cancer, diabetes and chronic respiratory diseases – along with mental health, cause nearly three quarters of deaths in the world. Their drive
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rs are social, environmental, commercial and genetic, and their presence is global. Every year 17 million people under the age of 70 die of NCDs, and 86% of them live in low- and middle-income countries (LMICs).
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Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worl
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dwide, particularly for low-middle income countries where the problem seems to be worsening. Globally, research demonstrates that the vast majority of people with NCDs receive suboptimal care. Many people living with chronic conditions remain undiagnosed and unaware of their condition, while many others remain untreated or with inadequate control. Meanwhile the premature mortality caused by NCDs remains high in many countries. In response to the global epidemic of NCDs, the World Health Organization (WHO) launched the Global Strategy for the Prevention and Control of Noncommunicable Diseases in 2012, which establishes 9 voluntary global targets and indicators to be considered by Member States when formu- lating national plans to combat NCDs.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatme
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nt should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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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
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negative
impact on families and societies. Women 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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As our world changes, so too does the burden of disease. Globalisation, evolving trade and consumption patterns, and increased access to life-saving medical care are just some of the factors that have transformed the global health landscape.
Laboratory diagnosis of Buruli ulcer
recommended
A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists w
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orking on this disease, the manual details the exact procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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