Mpox continues to affect people around the world. A new framework released today by WHO will guide health authorities, communities and other stakeholders in preventing and controlling mpox outbreaks, eliminating human-to-human transmission of the disease, and reducing spillover of the virus from ani...mals to humans.
Mpox is a viral illness caused by the monkeypox virus (MPXV). It can cause a painful rash, enlarged lymph nodes and fever. Most people fully recover, but some get very sick. The virus transmits from person to person through close, including sexual, contact. It also has animal reservoirs in east, central and west Africa, where spillovers from animals to humans can occasionally occur, sparking further outbreaks.
There are two different clades of the virus: clade I and clade II. Clade I outbreaks are deadlier than clade II outbreaks.
A major emergence of mpox linked to clade II began in 2017, and since 2022, has spread to all regions of the world. Between July 2022 and May 2023, the outbreak was declared a Public Health Emergency of International Concern. While that outbreak has largely subsided, cases and deaths continue to be reported today, illustrating that low-level transmission continues around the world.
Currently, there is also a major outbreak of clade I virus in the Democratic Republic of the Congo (DRC), where cases have been on the rise for decades. Since the beginning of the year, over 6500 cases and 345 deaths have been reported in the DRC. Almost half of these are among children under the age of 15 years.
The Strategic framework for enhancing prevention and control of mpox (2024–2027) provides a roadmap for health authorities, communities, and stakeholders worldwide to control mpox outbreaks in every context, advance mpox research and access to countermeasures, and to minimize zoonotic transmission.
more
Nutrición de menores de 2 de edad
Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r...egion in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
more
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 treatment 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.
more
Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to ...sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
more
interim guidance, 25 November 2024