Em meados de 2021, os programas nacionais de SIDA começaram a fazer a transição do tratamento para crianças que vivem com VIH dolutegravir (DTG) 10 mg sulcado, comprimidos dispersíveis, também conhecido como DTG pediátrico (pDTG). A rápida introdução e implementação do pDTG é uma priori...dade para implementar as diretrizes da Organização Mundial da Saúde (OMS) e garantir que as crianças que vivem com VIH recebam o melhor tratamento disponível da SIDA de primeira e segunda linha o mais rápido possível. É importante notar que uma única substituição pDTG deve ocorrer independentemente da disponibilidade de um teste/carga viral (CV), ou do valor do último resultado de CV, mantendo ou otimizando as crianças usando abacavir/lamivudina (ABC/3TC) como base. Atualmente, mais de 30 países têm planos de adoção e implementação do pDTG.
more
A maioria das infecções associadas a cuidados de saúde podem ser prevenidas com a correta higienização das mãos, ou seja, a limpeza das mãos nos momentos corretos, e da forma correta. As Diretrizes da OMS de higienização das mãos nos serviços de saúde incentivam a promoção e o aprimora...mento da higienização das mãos em instituições de saúde no mundo todo, e são complementadas pela estratégia multimodal da OMS para aprimoramento da higienização das mãos, bem como o respectivo guia e kit de implementação, que contêm diversas ferramentas práticas, prontas para serem usadas. Este módulo foi preparado para ajudar a resumir as diretrizes da OMS sobre higienização das mãos, as ferramentas associadas e ideias para uma implementação efetiva.
more
Cotonou Declaration oBuruli Ulcer
Cotonou, Benin, 30 March 2009
Neglected tropical diseases kill, weaken or incapacitate millions of people every year, causing permanent physical suffering, social stigmatization and reduced productive capacity. Buruli ulcer, one such disease, causes immense suffer...ing and disabilities, especially among children. Delayed schooling and loss of productivity are considerable among the affected populations. These adverse consequences tend to aggravate poverty in affected communities. Globally, the disease has been reported in 30 countries. In WHO’s African Region, Buruli ulcer has been confirmed in 12 countries and is suspected in 10 others.
Significant progress has been made in the past 10 years in knowledge of Buruli
ulcer, investments in related research, control of the disease, and improvement
of tools for case diagnosis and development of treatment protocols. Substantial achievements have been made in diagnosis, treatment, immunology and epidemiology. Despite these achievements, little is known about the exact mode of transmission of the disease, and there is no simple diagnostic test usable in the field.
The use of antibiotics has revolutionized treatment and contributed to reducing the need for surgery by half. However, efforts are still needed to develop simple diagnostic tools usable in the field as well as disability prevention methods. The Global Buruli Ulcer Initiative has adopted the strategy recommended by WHO. The strategy is based on early diagnosis of the disease and the use of antibiotics for treatment upon the onset of the first signs by improving access to screening and case management at the most peripheral level of the health system.
more
Mais pessoas morrem a cada ano de doenças cardiovasculares do que de qualquer outra causa. Mais de três quartos das mortes por doenças cardíacas e acidentes vasculares cerebrais ocorrem em países de baixa e média renda. A hipertensão - ou pressão alta - é uma condição médica grave que au...menta significativamente o risco de doenças cardíacas, cerebrais, renais e outras doenças. A hipertensão pode ser definida usando níveis específicos de pressão sistólica e diastólica ou o uso reportado de medicamentos anti-hipertensivos.
more
Le monde fait face aux conséquences graves du manque de services et de traitements de santé mentale disponibles. Les troubles mentaux touchent tous les pays, toutes les cultures et toutes les collectivités. Selon l’Organisation mondiale de la Santé (OMS), 10% de la charge mondiale de morbidit... est liée aux troubles mentaux, neurologiques et à l’usage de substances psychoactives.
Dans les pays à revenu faible ou intermédiaire, plus de 75% des personnes atteintes de troubles mentaux ne reçoivent aucun traitement. En 2020, en raison de la pandémie mondiale, 93% des pays ont déclaré que leurs services de santé mentale ont été suspendus ou interrompus (OMS, 2020e). L’OMS a signalé une hausse de 25% des cas de dépression et d’anxiété durant la pandémie. L’Organisation de coopération et de développement économiques (OCDE) estime que la dépression et l’anxiété coûtent à l’économie mondiale 1 000 milliards d’USD par an.
more
The year 2020 is the target date for the elimination of blinding trachoma as a public health problem. There has been great progress, and there is unprecedented funding available – particularly from DFID, the Queen Elizabeth Diamond Jubilee Trust, and USAID. There is also reason for optimism that, ...over the next five years, further success will be seen in many endemic countries. In order to achieve elimination,
more
Issue Brief 31: Antimicrobial resistance (AMR) can occur when viruses, bacteria, parasites and fungi change over time. There is no longer a response to medicines, and the infection treatment gets really difficult which increases the risk of a disesase spread, which can lead to severe health problems.... AMR is an increasing threat to global public health worldwide that requires cross-sectional and cross-disciplinary action. It is present in every country and is spurred by several human-made factors, including over- and/or inadequate use of antibiotics, poor hygiene and infection prevention control, and excessive usage of antibiotics outside the health care sector e.g. in life stock production.
more
El objetivo de esta nota conceptual y del marco que describe es la eliminación de un grupo de enfermedades transmisibles y los efectos negativos sobre la salud que generan que juntos crean una carga tangible en las personas afectadas, sus familias y comunidades, y en los sistemas de atención de sa...lud en toda la Región. Aunque no hay consenso sobre las mejores medidas que se deben usar para la salud de las personas y de acuerdo con la situación epidemiológica de un país, es habitual medir la carga de enfermedad mediante las tasas de enfermedad (incidencia, prevalencia, etc.), las tasas de mortalidad por enfermedad específica, las tasas de morbilidad y mortalidad comparativas, la distribución geográfica y los años de vida ajustados en función de la discapacidad (AVAD)…. Se analiza la situación epidemiológica actual, incluidos los datos sobre tasas de enfermedad o distribución geográfica para las enfermedades del cuadro 1. Hotez et al. (2008) fueron los primeros en examinar y comparar la carga de los AVAD en América Latina y el Caribe para las ETD, la infección por el VIH/sida, la malaria y la tuberculosis como era hace unos diez años atrás. Aunque la carga regional de tuberculosis, malaria y enfermedades infecciosas desatendidas (EID) es algo menor a la de hace diez años, se sigue perdiendo la posibilidad de trabajar (y de asistir a la escuela) debido a la enfermedad y muerte prematura o discapacidad, y la necesidad de acelerar los esfuerzos para eliminar las enfermedades es evidente en todas las comunidades en situación de vulnerabilidad.
more
El objetivo de esta nota conceptual y del marco que describe es la eliminación de un grupo de enfermedades transmisibles y los efectos negativos sobre la salud que generan que juntos crean una carga tangible en las personas afectadas, sus familias y comunidades, y en los sistemas de atención de sa...lud en toda la Región. Aunque no hay consenso sobre las mejores medidas que se deben usar para la salud de las personas y de acuerdo con la situación epidemiológica de un país, es habitual medir la carga de enfermedad mediante las tasas de enfermedad (incidencia, prevalencia, etc.), las tasas de mortalidad por enfermedad específica, las tasas de morbilidad y mortalidad comparativas, la distribución geográfica y los años de vida ajustados en función de la discapacidad (AVAD)…. Se analiza la situación epidemiológica actual, incluidos los datos sobre tasas de enfermedad o distribución geográfica para las enfermedades del cuadro 1. Hotez et al. (2008) fueron los primeros en examinar y comparar la carga de los AVAD en América Latina y el Caribe para las ETD, la infección por el VIH/sida, la malaria y la tuberculosis como era hace unos diez años atrás. Aunque la carga regional de tuberculosis, malaria y enfermedades infecciosas desatendidas (EID) es algo menor a la de hace diez años, se sigue perdiendo la posibilidad de trabajar (y de asistir a la escuela) debido a la enfermedad y muerte prematura o discapacidad, y la necesidad de acelerar los esfuerzos para eliminar las enfermedades es evidente en todas las comunidades en situación de vulnerabilidad.
more
Cutaneous Leishmaniasis (CL) is a painful disease that exerts a serious toll on societies around the world that are afflicted by it. Although not life-threatening, the skin ulcers and scars it causes can lead to isolation and psychosocial pathologies due to social stigma, and its occurrence is often... associated with regional conflicts. The Cutaneous Leishmaniasis Research Meeting was held on December 7, 2020, with participation by basic researchers, clinical researchers, and drug discovery experts involved in research and development related to CL under the auspices of the Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine. In addition, the CL Webinar was held on March 5, 2021, hosted by the Graduate School of Tropical Medicine and Global Health, co-hosted by the Institute of Tropical Medicine, and supported by Médecins Sans Frontières and DNDi.
more
Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to pharmacopeia unopened insulin vials must be stored in a... refrigerator (2–8°C), while storage at ambient temperature (25–30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2–8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four–week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
more
Les présentes orientations de l’OMS portent sur la restriction du marketing (notamment le marketing numérique) dans les contextes des produits du tabac et des produits à base de nicotine, de l’alcool, des aliments et des boissons nocifs pour la santé, ainsi que des substituts du lait materne...l. Dans la Convention-cadre de l’OMS pour la lutte antitabac, les Parties reconnaissent que l’interdiction globale de la publicité, de la promotion et du parrainage intérieurs et transfrontaliers réduira la consommation des produits du tabac. Le plan d’action afin de mettre en œuvre de manière efficace la Stratégie mondiale visant à réduire l’usage nocif de l’alcool en tant que priorité de santé publique propose que les États Membres appliquent des restrictions ou des interdictions globales et strictes du marketing en faveur de l’alcool
more
The pamphlet "Alcohol and Depressants" explains the effects of depressants, including alcohol. Depressants slow brain activity by increasing the release of inhibitory neurotransmitters like GABA, leading to effects such as sedation, decreased anxiety, and reduced heart rate. Alcohol, a legal depress...ant, causes short-term effects like impaired judgment, vomiting, and blackouts, while long-term use can result in alcoholism, liver disease, strokes, and cancer. Alcohol withdrawal can be life-threatening, causing seizures and heart complications. The pamphlet emphasizes the importance of safe usage and provides resources for treatment and further information.
more
Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
more
Our spiritual health profoundly impacts our physical health, well-being, and quality of life. Just as medical professionals care for our bodies and minds, spiritual care practitioners care for our spirits. The increasing need for spiritual care makes these practitioners even more crucial. However, m...any of us have limited access to quality, professional spiritual care. At times of struggle, this lack of spiritual care can have a negative impact on our health and well-being.Investigators and researchers are creating a growing body of evidence for the innumerable benefits of professional spiritual care, yet many people still do not have a lot of accurate information about these practitioners. To create this publication, the six largest healthcare chaplaincy organizations in North America collaborated to share the facts about spiritual care and practitioners’ roles, training, and standards.By providing evidence and dispelling myths, the thousands of spiritual care practitioners represented by these organizations hope to increase access to spiritual care for the benefit of all.
accessed July 2020
more
Right now, we are facing an unpredictable and highly dynamic situation as a global community. However, as we have seen from the solidarity, support and power of communities in the HIV epidemic and already in communities responding to the COVID-19 pandemic, the response must not be fear and stigma. W...e need to build a culture of solidarity, trust and kindness. Our response to COVID-19 must be grounded in the realities of people’s lives and focused on eliminating the barriers people face in being able to protect themselves and their communities. Empowerment and guidance, rather than restrictions, can ensure that people can act without fear of losing their livelihood, sufficient food being on the table and the respect of their community. Ultimately it will give us a more effective, humane and sustainable response to the epidemic.
more
2023 will mark the 75th year of the World Health Organization. The world has achieved many public health milestones in these 75 years. In Science in 5 today we will take a look into the future - to understand what are the innovations we can expect and what will be some of our biggest challenges. Her...e to paint us a picture of what Health for All would look like in the future is WHO's Chief Scientist, Dr Soumya Swaminathan.
more
Carlos Chagas discovered American trypanosomiasis, also named Chagas disease (CD) in his honor, just over a century ago. He described the clinical aspects of the disease, characterized by its etiological agent (Trypanosoma cruzi) and identified its insect vector. Initially, CD occurred only in Latin... America and was considered a silent and poorly visible disease. More recently, CD became a neglected worldwide disease with a high morbimortality rate and substantial social impact, emerging as a significant public health threat. In this context, it is crucial to better understand better the epidemiological scenarios of CD and its transmission dynamics, involving people infected and at risk of infection, diversity of the parasite, vector species, and T. cruzi reservoirs. Although efforts have been made by endemic and non-endemic countries to control, treat, and interrupt disease transmission, the cure or complete eradication of CD are still topics of great concern and require global attention. Considering the current scenario of CD, also affecting non-endemic places such as Canada, USA, Europe, Australia, and Japan, in this review we aim to describe the spread of CD cases worldwide since its discovery until it has become a global public health concern.
more
Background
Four methods have previously been used to track aid for reproductive, maternal, newborn, and child health (RMNCH). At a meeting of donors and stakeholders in May, 2018, a single, agreed method was requested to produce accurate, predictable, transparent, and up-to-date estimates that coul...d be used for analyses from both donor and recipient perspectives. Muskoka2 was developed to meet these needs. We describe Muskoka2 and present estimates of levels and trends in aid for RMNCH in 2002–17, with a focus on the latest estimates for 2017.
Methods
Muskoka2 is an automated algorithm that generates disaggregated estimates of aid for reproductive health, maternal and newborn health, and child health at the global, donor, and recipient-country levels. We applied Muskoka2 to the Organisation for Economic Co-operation and Development's Creditor Reporting System (CRS) aid activities database to generate estimates of RMNCH disbursements in 2002–17. The percentage of disbursements that benefit RMNCH was determined using CRS purpose codes for all donors except Gavi, the Vaccine Alliance; the UN Population Fund; and UNICEF; for which fixed percentages of aid were considered to benefit RMNCH. We analysed funding by donor for the 20 largest donors, by recipient-country income group, and by recipient for the 16 countries with the greatest RMNCH need, defined as the countries with the worst levels in 2015 on each of seven health indicators.
Findings
After 3 years of stagnation, reported aid for RMNCH reached $15·9 billion in 2017, the highest amount ever reported. Among donors reporting in both 2016 and 2017, aid increased by 10% ($1·4 billion) to $15·4 billion between 2016 and 2017. Child health received almost half of RMNCH disbursements in 2017 (46%, $7·4 billion), followed by reproductive health (34%, $5·4 billion), and maternal and newborn health (19%, $3·1 billion). The USA ($5·8 billion) and the UK ($1·6 billion) were the largest bilateral donors, disbursing 46% of all RMNCH funding in 2017 (including shares of their core contributions to multilaterals). The Global Fund and Gavi were the largest multilateral donors, disbursing $1·7 billion and $1·5 billion, respectively, for RMNCH from their core budgets. The proportion of aid for RMNCH received by low-income countries increased from 31% in 2002 to 52% in 2017. Nigeria received 7% ($1·1 billion) of all aid for RMNCH in 2017, followed by Ethiopia (6%, $876 million), Kenya (5%, $754 million), and Tanzania (5%, $751 million).
Interpretation
Muskoka2 retains the speed, transparency, and donor buy-in of the G8's previous Muskoka approach and incorporates eight innovations to improve precision. Although aid for RMNCH increased in 2017, low-income and middle-income countries still experience substantial funding gaps and threats to future funding. Maternal and newborn health receives considerably less funding than reproductive health or child health, which is a persistent issue requiring urgent attention.
Funding
Bill & Melinda Gates Foundation; Partnership for Maternal, Newborn & Child Health.
more
La serovigilancia es una herramienta que complementa los métodos tradicionales de salud pública para la vigilancia de las enfermedades transmisibles y proporciona información valiosa sobre la transmisión de enfermedades en los grupos de la población; por ejemplo, para detectar brechas en la inm...unidad frente a las enfermedades prevenibles mediante vacunación. Esta información es útil para hacer un seguimiento de la exposición de la población a enfermedades como la malaria, las enfermedades infecciosas desatendidas, las enfermedades transmitidas por alimentos, agua y vectores, así como las enfermedades infecciosas emergentes. Como muchas enfermedades infecciosas están o han estado presentes en grupos que viven en entornos donde se superponen diversos factores de riesgo, la serovigilancia integrada facilita las sinergias y optimiza la utilización de los recursos de salud pública. Este conjunto de herramientas se elaboró para facilitar el diseño, la puesta en marcha, el análisis, la interpretación y el uso de los resultados de las encuestas serológicas integradas para reforzar las capacidades de los países con vistas a la eliminación de las enfermedades transmisibles. En la primera parte se describen los conceptos básicos sobre encuestas y vigilancia serológicas, sus usos, ventajas y desafíos, formas de mejorar su eficiencia, así como su potencial para contribuir a la toma de decisiones de salud pública. Posteriormente, se presenta un proceso gradual para la puesta en marcha de la vigilancia serológica integrada basada en encuestas serológicas. Incluye recomendaciones sobre cómo determinar la necesidad y el propósito de recopilar información serológica; el diseño y la metodología de la encuesta; los métodos del laboratorio; las consideraciones prácticas para la realización de encuestas; el análisis e interpretación de los datos y el uso de los resultados para respaldar la toma de decisiones. Su objetivo principal es apoyar a los directores de programas y equipos que participan en el control y eliminación de las enfermedades transmisibles. Se elaboró para ser usado, entre otros, por los coordinadores de enfermedades transmisibles, enfermedades infecciosas desatendidas y programas de vacunación; directores de vigilancia epidemiológica; personal de laboratorios de salud pública; y otros profesionales de los ministerios de salud y autoridades nacionales y subnacionales de salud que puedan estar interesados en incorporar la vigilancia serológica integrada como parte de las herramientas de sus sistemas de vigilancia, para obtener información adicional sobre la transmisión de enfermedades infecciosas en la población.
more