Human schistosomiasis is caused mainly by 3 schistosome species: Schistosoma haematobium, S. mansoni and S. japonicum. S. guineensis, S. intercalatum and S. mekongi have a highly localized distribution in Central Africa and along the Mekong River in South-East Asia, respectively. Soil-transmitted h...elminthiases (STH) are infections caused by 4 parasite species: Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale and Necator americanus. The 2 latter species are indistinguishable microscopically and are usually reported together as “hookworms”. Schistosomiasis and STH are neglected tropical diseases (NTDs) and are transmitted mainly in areas with poor access to clean water and sanitation. The presence of an intermediate snail host in water is essential to allow Schistosoma to complete their life cycle. Schistosomiasis and STH can cause significant morbidity, including anaemia, nutritional disturbances and, in the case of schistosomiasis, granuloma, organ pathology and cancer, and an increased risk of acquisition of HIV. In women, urogenital schistosomiasis may cause vaginal bleeding, pain during sexual intercourse and nodules in the vulva, now described as female genital schistosomiasis. Groups at risk for STH and schistosomiasis are those in need of micronutrients: preschool-aged children (pre-SAC, 1–4 years of age), school-aged children (SAC, 5–14 years), women of reproductive age (WRA) and, in addition for schistosomiasis adult and entire communities in high-risk areas.
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Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the trend in CVD incidence, mortality, and mortality-to-...incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Background: Data on burden of peripheral artery disease (PAD) and its attributable risk factors are valuable for policymaking. We aimed to estimate the burden and risk factors for PAD from 1990 to 2019.
Methods: We extracted the data on prevalence, incidence, death, years lived with disability (YLD...s), and years of life lost (YLLs) from the Global Burden of Disease Study 2019 to measure PAD burden. Moreover, the attributable burden to PAD risk factors was also estimated.
Results: Globally, in 2019, 113,443,017 people lived with PAD and 10,504,092 new cases occurred, resulting in 74,063 deaths, 500,893 YLDs, and 1,035,487 YLLs. The absolute numbers of PAD prevalent and incident cases significantly increased between 1990 and 2019, contrasting with the decline trends in age-standardized prevalence and incidence rates. However, no statistically significant changes were detected in the global age-standardized death or YLL rates. The burden of PAD and its temporal trends varied significantly by location, gender, age group, and social-demographic status. Among all potentially modifiable risk factors, age-standardized PAD deaths worldwide were primarily attributable to high fasting plasma glucose, followed by high systolic blood pressure, tobacco, kidney dysfunction, diet high in sodium, and lead exposure.
Conclusion: PAD remained a serious public health problem worldwide. More strategies aimed at implementing cost-effective interventions and addressing modifiable risk factors should be carried out, especially in regions with high or increasing burden.
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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...eprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
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Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-lim...ited continent
Methods: This was a cross-sectional e-survey study conducted amongst cardiologists in African countries. The primary outcome was the change in service delivery in African cardiology units during the on-going COVID-19 pandemic. The secondary outcomes were the satisfaction of cardiologists with regards to the workload and factors associated with this satisfaction.
Results: There was a significant reduction in working time and the number of patients consulted by week during this pandemic (p<0.001). In general, there was a decrease in the overall activities in cardiovascular care delivery. The majority of cardiology services (76.5%) and consulting programs (85%) were adjusted to the pandemic. Only half of the participants were satisfied with their workload. Reconfiguration of the consultation schedule was associated with a reduced satisfaction of participants (p=0.02).
Conclusions: COVID-19 is associated with an overall reduction in cardiology services rendered in Africa. Since the cardiovascular burdens continue to increase in this part of the World and the risk of cardiovascular complications linked to SARS COV2 remains unchanged cardiology, departments in Africa should anticipate a significant surge of cardiology services demanded by patients after the COVID-19 pandemic.
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The document is part of the briefing package for Ethiopia's Water, Sanitation, and Hygiene (WASH) Cluster, which consists of resources that provide greater clarity and guidance to the cluster partners and other humanitarian actors.
The document is divided into four sections. Each section represen...ts the cluster’s coordination system (i) WASH Cluster coordination management, (ii) HPC process, (iii) Response monitoring, (iv) WASH response, and (v) Cluster meeting coordination.
Cluster Overview
The WASH Cluster in Ethiopia is part of and supports the Ministry of Water and Energy (MoWE). MoWE leads the WASH cluster emergency task force (ETF), which is co-led by the WASH Cluster secretariat hosted by UNICEF. In Ethiopia, the WASH Cluster was established with the activation of the cluster approach in 2006, and UNICEF, as the global Cluster Lead Agency, was assigned to appoint the WASH Cluster Coordinator.
The WASH Cluster aims to provide guidance and support to its partners to ensure well-coordinated, quality assistance reaches those in need in accordance with humanitarian standards and principles. Conflict, severe drought conditions, seasonal flooding, and Cholera remain the key drivers of WASH needs in Ethiopia.
In 2024, the WASH Cluster aims to work with 79 partners to preserve life, well-being, and dignity and reduce the risk of WASH-related disease through timely interventions to vulnerable populations and preparedness to respond to shocks. Significant humanitarian WASH needs in 2024 are projected with a rigorous HPC process in Ethiopia.
The Humanitarian Program Cycle
The humanitarian program cycle (HPC) is a coordinated series of actions to help prepare for, manage, and deliver humanitarian response. It consists of five coordinated elements, each step logically building on the previous and leading to the next. Successful implementation of the HPC depends on effective emergency preparedness, effective coordination with national/local authorities and humanitarian actors, and information management. Affected people are central to the response; preparedness, coordination, and information management processes continually occur.
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Diabetes mellitus is a leading cause of mortality and reduced life expectancy. We aim to estimate the burden of diabetes by type, year, regions, and socioeconomic status in 195 countries and territories over the past 28 years, which provide information to achieve the goal of World Health Organizatio...n Global Action Plan for the Prevention and Control of Noncommunicable Diseases in 2025. Data were obtained from the Global Burden of Disease Study 2017. Overall, the global burden of diabetes had increased significantly since 1990. Both the trend and magnitude of diabetes related diseases burden varied substantially across regions and countries. In 2017, global incidence, prevalence, death, and disability-adjusted life-years (DALYs) associated with diabetes were 22.9 million, 476.0 million, 1.37 million, and 67.9 million, with a projection to 26.6 million, 570.9 million, 1.59 million, and 79.3 million in 2025, respectively. The trend of global type 2 diabetes burden was similar to that of total diabetes (including type 1 diabetes and type 2 diabetes), while global age-standardized rate of mortality and DALYs for type 1 diabetes declined. Globally, metabolic risks (high BMI) and behavioral factors (inappropriate diet, smoking, and low physical activity) contributed the most attributable death and DALYs of diabetes. These estimations could be useful in policy-making, priority setting, and resource allocation in diabetes prevention and treatment.
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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... 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 IDF Diabetes Atlas is intended to support the diabetes community in advocating for more action to identify undiagnosed diabetes, prevent type 2 diabetes in people at risk, and improve care for all people with diabetes. It also aims to support the development of high quality diabetes data in all ...countries and territories, in order to fill the gaps in knowledge that currently exist.
The 10th edition of the IDF Diabetes Atlas reports a continued global increase in diabetes prevalence, confirming diabetes as a significant global challenge to the health and well-being of individuals, families and societies.
The IDF Diabetes Atlas 10th Edition and other resources are available for download.
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Terminology used to describe the transmission of pathogens through the air varies across scientific disciplines, organizations and the general public. While this has been the case for decades, during the coronavirus disease (COVID-19) pandemic, the terms ‘airborne’, ‘airborne transmission’ a...nd ‘aerosol transmission’ were used in different ways by stakeholders in different scientific disciplines, which may have contributed to misleading information and confusion about how pathogens are transmitted in human populations.
This global technical consultation report brings together viewpoints from experts spanning a range of disciplines with the key objective of seeking consensus regarding the terminology used to describe the transmission of pathogens through the air that can potentially cause infection in humans.
This consultation aimed to identify terminology that could be understood and accepted by different technical disciplines. The agreed process was to develop a consensus document that could be endorsed by global agencies and entities. Despite the complex discussions and challenges, significant progress was made during the consultation process, particularly the consensus on a set of descriptors to describe how pathogens are transmitted through the air and the related modes of transmission. WHO recognizes the important areas where consensus was not achieved and will continue to address these areas in follow-up consultations.
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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High blood pressure, or hypertension, is one of the most serious risks factors for death from heart diseases and strokes, responsible for 13% of all deaths globally. In South Africa more than 1 in 3 adults live with high blood pressure and it is responsible for 1 in every 2 strokes and 2 in every 5 ...heart attacks. High blood pressure is known as a 'silent killer' because there are rarely any symptoms or visible signs to warn that blood pressure is high. That is why more than 50% of people with high blood pressure are unaware of their condition. In some cases, typically with very high blood pressure, symptoms such as headaches, visual disturbances, nose bleeds, nausea, vomiting, facial flushing and sleepiness may be experienced. Do not wait for symptoms to appear. High blood pressure becomes more likely with older age, but anyone, no matter their age, gender, fitness level or lifestyle can develop high blood pressure. Blood pressure should be measured at least once every year, so don’t delay!
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The IDF Diabetes Atlas report highlights the disproportionate prevalence of type 2 diabetes (T2D) among Indigenous Peoples globally. It emphasizes the social and health disparities resulting from colonization, loss of traditional practices, and systemic inequities. The report includes prevalence dat...a across various Indigenous populations, identifying significant variability and often higher rates among Indigenous women compared to men. The report calls for culturally responsive and community-driven interventions to address diabetes prevention and management while advocating for better data collection and representation to support Indigenous communities worldwide.
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In 2020, emissions of all key air pollutants in the 27 Member States of the EU (EU-27) continued to decline, maintaining a trend seen since 2005. This was the case despite an increase in gross domestic product (GDP) over the same period.
Residential, commercial and institutional energy consumption ...was the principal source of particulate matter in 2020. The manufacturing and extractive industry was also a significant source, while agriculture was an equally important source of PM10. Between 2005 and 2020, emissions of particulate matter, PM10 and PM2.5, fell by 30% and 32%, respectively.
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The report provides an overview of alcohol consumption, related health harm, and policy responses in 30 European countries (EU Member States, Norway, and Switzerland). It highlights the high levels of alcohol consumption in the WHO European Region, which contribute to a ...hlight medbox">significant disease burden compared to other regions. The report covers trends in alcohol consumption and harm between 2010 and 2016, noting some progress in reducing alcohol-attributable mortality but stagnation in consumption reduction and heavy episodic drinking.
The assessment of alcohol policies shows variability in implementation across countries, particularly in areas like pricing and reducing the negative consequences of drinking. It emphasizes the need for stronger evidence-based policies, such as better regulation, taxation, and accessibility restrictions, to further reduce alcohol-related harm and achieve health-related Sustainable Development Goals.
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The document presents a systematic analysis of dietary risks and their health impacts in 195 countries from 1990 to 2017. It highlights that suboptimal diets, such as those high in sodium and low in whole grains, fruits, and vegetables, significantl...y contribute to non-communicable diseases like heart disease, stroke, and diabetes. The study emphasizes the urgent need for improved dietary habits and policy interventions to reduce diet-related mortality and morbidity globally.
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The document addresses the pressing issues of global malnutrition and the urgent need to build workforce capacity in public health nutrition, particularly in low- and middle-income countries. It highlights the dual burden of malnutrition, characterized by the coexistence of undernutrition and overnu...trition. While maternal and child undernutrition remain critical concerns, there is a growing prevalence of chronic diseases linked to overnutrition, even in resource-limited settings.
A significant gap exists in the availability of trained nutrition professionals. Many countries lack sufficient numbers of nutritionists, particularly at the undergraduate level, and existing training programs often focus on curative rather than preventive approaches. This leaves health workers inadequately prepared to address complex public health nutrition challenges.
To address these issues, the document recommends increasing the number of trained nutritionists, incorporating updated nutrition training into medical and nursing curricula, and developing competency frameworks and hybrid training programs. Accreditation systems for nutrition professionals are also proposed to ensure standardized and effective training.
Sustainability remains a challenge, with the need for long-term financing and better integration of nutrition programs into health systems. The document calls for systemic approaches to strengthen workforce capacity, enabling countries to effectively tackle the underlying causes of malnutrition.
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The article "Can we prevent cardiovascular diseases in low- and middle-income countries?" by Claude Lenfant discusses the growing threat of cardiovascular diseases (CVDs) in developing countries. It highlights that while CVD is already the leading cause of death globally, low- and middle-income coun...tries are now facing rising CVD rates due to lifestyle changes associated with urbanization and economic growth. Lenfant advocates for a dual approach: identifying and treating high-risk individuals and promoting broad, population-wide prevention efforts focused on lifestyle changes such as reducing smoking, lowering salt intake, and increasing physical activity. He emphasizes that early, affordable preventive measures are essential to mitigate the impending CVD epidemic in these countries and prevent significant healthcare and economic strain.
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Past the crucial midpoint to the SDGs, the 2024 SDG3 GAP progress report, ‘Aligning for country impact’, focuses on alignment as the overarching principle linking efforts to deliver greater impact in countries on the health-related SDGs. It contributes to the basis for further discussions among ...the 13 signatory agencies, on how to further improve the alignment and collaboration across multilateral agencies, as will the forthcoming Independent Evaluation findings due in late 2024.
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