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In Control: A Practical Handbook for Professionals Working in Health Emergencies Internationally RKI
The greatest risk to persons engaging in international medical emergency response is poor preparation.
The In Control handbook hopes to provide a remedy.
At the time of writing, we are living through the Coronavirus (COVID-19) pandemic, a health emergency that disregards physical borders, brin
...
gs into focus social inequalities and affects people on every continent. This shared challenge requires unprecedented measures and the collaboration of the brightest minds to support global health protection through this crisis and beyond. Healthcare infrastructures have to be strengthened, public health capacities and processes upgraded, medical countermeasures and vaccinations found and psychosocial side-effects treated.
Solidarity is the normative order of the day and the human species has to collaborate to face this invisible threat. Hiding and living in fear is not an option in this interconnected world. We have both a responsibility and an opportunity to make substantial contributions to a safer, healthier and more sustainable future for us all.
The existence of this handbook is an impressive example of solidarity. Over 50 authors from more than 15 institutes and organisations have come together voluntarily within a very short time to make their expertise available and enable cross-sectoral thinking. Knowledge is bundled, resources are combined, information gaps are filled. The In Control handbook is not a theoretical treatise of possible dangers, but a collection of subject-matter expertise, written by experts and practitioners who have shaped health topics over the past 20 years in the most diverse corners of the world.
The Centre for International Health Protection at the Robert Koch Institute (RKI) is collaborating with its partners and investing heavily in the build-up of operational know-how and capacity to support health crisis response abroad. This is done by preparing and enabling professionals to deploy safely across the world to assist those in need. In Control addresses the multi-faceted challenges of an international deployment. Readers will find not only technical medical information, but also insights into, for example, the fragility of our environment, the cultural differences that influence risk communication or the dilemmas arising from social distancing. Legal principles are highlighted, along with ethical guidance to ensure that our actions and decisions correspond to the highest moral standards.
more
Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery to
...
wards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
more
This paper introduces a new dataset of official financing—including foreign aid and other forms of concessional and non-concessional state financing—from China to 138 countries between 2000 and 2014. We use these data to investigate whether and to what extent Chinese aid affects economic growth
...
in recipient countries. To account for the endogeneity of aid, we employ an instrumental-variables strategy that relies on exogenous variation in the supply of Chinese aid over time resulting from changes in Chinese steel production. Variation across recipient countries results from a country’s probability of receiving aid. Controlling for year- and recipient-fixed effects that capture the levels of these variables, their interaction provides a powerful and excludable instrument. Our results show that Chinese official development assistance (ODA) boosts economic growth in recipient countries. For the average recipient country, we estimate that one additional Chinese ODA project produces a 0.7 percentage point increase in economic growth two years after the project is committed. We also benchmark the effectiveness of Chinese aid vis-á-vis the World Bank, the United States, and all members of the OECD’s Development Assistance Committee (DAC).
more
Little is known about foreign aid provided by private donors. This paper contributes to closing this research gap by comparing the allocation of private humanitarian aid to that of official humanitarian aid awarded to 140 recipient countries over the 2000-2016 period. We construct a new database tha
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t offers information on the country in which the headquarters of private donors are located to test whether private donors follow the aid allocation pattern of their home country. Our empirical results confirm that private aid “follows the flag.” This finding is robust against the inclusion of various fixed effects, estimating instrumental variables models, and disaggregating private aid into corporate aid and NGO aid. Donor country-specific estimations reveal that private aid from China, Sweden, the United Kingdom, and the United States “follow the flag.”
more
China and other so-called “emerging” donors and creditors are fundamentally changing the international development finance landscape; however, many of these actors do not participate in existing global reporting systems, such as the OECD’s Creditor Reporting System (CRS) and the International
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Aid Transparency Initiative (IATI).
To address this challenge and help those who seek to understand the nature, distribution, and effects of development finance from emerging donors and creditors, AidData developed the Tracking Underreported Financial Flows (TUFF) in collaboration with an international network of researchers from Harvard University, Heidelberg University, the University of Göttingen, the University of Cape Town, Brigham Young University, and William and Mary.
The methodology codifies a systematic, transparent, and replicable set of procedures that facilitate the collection of information about aid and credit from official sector donors and lenders who do not publish comprehensive or detailed information about their overseas activities. It does so by synthesizing and standardizing vast amounts of unstructured, open-source, project-level information published by governments, intergovernmental organizations, companies, nongovernmental organizations, journalists, and research institutions.
more
We combine data on Chinese development projects with data from Demographic and Health Surveys to study the impact of Chinese aid on household welfare in sub-Saharan Africa. We use a novel methodology to test the effect of Chinese aid on three important development outcomes: education, health, and nu
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trition. For each outcome, we use difference-in-difference estimations to compare household areas near Chinese project sites to control areas located farther away, before and after receiving Chinese aid. This empirical strategy rules out many confounding factors that can bias measuring the impact of Chinese aid on our outcome variables. First, we find that Chinese projects significantly improve education and child mortality in treatment areas, but do not significantly affect nutrition. Second, social sector projects have a larger effect on outcomes than economic projects. Third, we do not find significant effects for projects that ended more than five years before the post-treatment survey wave. Our results are robust to a host of robustness checks.
more
Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental
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effects on ecosystems and biodiversity, and socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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Government health expenditure is a primary means of financing health services in many countries. Research assessing the relation between government health expenditure and development assistance for health channelled to governments (DAH-G) has produced contradictory conclusions. This research aims to
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credibly estimate displacement and measure if the DAH-G effect is symmetric or if increases and decreases in DAH-G have distinct effects.
more
Climate hazards, including extreme heat, are associated with increased risks of developing complications that lead to adverse maternal and perinatal outcomes. These may include multiple causes of maternal and neonatal morbidity and mortality such as gestational diabetes, hyper tensive disorders of p
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regnancy, preterm birth, low birth weight and stillbirth. In addition to the health risks related to poor nutrition, water, hygiene and sanitation, the effects of exposure to climate hazards and their aftermath during and after pregnancy can affect mental health and contribute to intergenerational trauma. They may increase stress, anxiety and depression – known risk factors for adverse perinatal outcomes.
more
Donor funding for HIV programs has increased rapidly over the past decade, raising questions about whether other health services in recipient-country health systems are being crowded out or strengthened. This article--an investigation of the impacts of increased HIV donor funding on non-HIV health s
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ervices in sub-Saharan Africa during 2003-10--provides evidence of both effects.
more
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit
...
h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
more
Long-term exposure of humans to air pollution enhances the risk of cardiovascular and respiratory diseases. A novel Global Exposure Mortality Model (GEMM) has been derived from many cohort studies, providing much-improved coverage of the exposure to fine particulate matter (PM2.5). We applied the GE
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MM to assess excess mortality attributable to ambient air pollution on a global scale and compare to other risk factors.
Methods and results
We used a data-informed atmospheric model to calculate worldwide exposure to PM2.5 and ozone pollution, which was combined with the GEMM to estimate disease-specific excess mortality and loss of life expectancy (LLE) in 2015. Using this model, we investigated the effects of different pollution sources, distinguishing between natural (wildfires, aeolian dust) and anthropogenic emissions, including fossil fuel use. Global excess mortality from all ambient air pollution is estimated at 8.8 (7.11–10.41) million/year, with an LLE of 2.9 (2.3–3.5) years, being a factor of two higher than earlier estimates, and exceeding that of tobacco smoking. The global mean mortality rate of about 120 per 100 000 people/year is much exceeded in East Asia (196 per 100 000/year) and Europe (133 per 100 000/year). Without fossil fuel emissions, the global mean life expectancy would increase by 1.1 (0.9–1.2) years and 1.7 (1.4–2.0) years by removing all potentially controllable anthropogenic emissions. Because aeolian dust and wildfire emission control is impracticable, significant LLE is unavoidable.
Conclusion
Ambient air pollution is one of the main global health risks, causing significant excess mortality and LLE, especially through cardiovascular diseases. It causes an LLE that rivals that of tobacco smoking. The global mean LLE from air pollution strongly exceeds that by violence (all forms together), i.e. by an order of magnitude (LLE being 2.9 and 0.3 years, respectively).
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This short brief describes the main findings and the key lessons learned from the research project "Evaluation of the impact of alcohol control policies on morbidity and mortality in Lithuania and other Baltic states", funded by the United States National Institute on Alcohol Abuse and Alcoholism fo
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r the period 2000–2025. The WHO-backed project aims to assess the effects of alcohol control policies implemented in Estonia, Latvia and Lithuania and to investigate the impact they have had on both people's health and the countries' economies, based on concrete actions taken. The key findings of the project demonstrate that alcohol control policies such as taxation and availability measures decrease all-cause mortality and reduce inequalities, and that dismantling alcohol control policies has the opposite effect on population health. They also highlight that consumption of unrecorded alcohol will not necessarily go up if taxation is increased and that specific countermeasures can be taken to prevent an increase in unrecorded consumption.
more
For thousands of years, humans have been using wildlife for commercial and subsistence purposes. Wildlife trade takes place at local, national and international levels, with different forms of wildlife, such as live animals, partly processed products and finished products. Wildlife is a vital source
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of safe and nutritious food, clothing, medicine, and other products, in addition to having religious and cultural value. Wildlife trade also contributes to livelihoods, income generation and overall economic development.
However, wildlife trade can have detrimental effects on species conservation, depleting natural resources, impoverishing biodiversity and degrading ecosystems (Morton et al., 2021). Wildlife trade, whether legal or illegal, regulated or unregulated, can pose threats to animal health and welfare. It also presents opportunities for zoonotic pathogens to spill over between wildlife and domestic animals, and for diseases to emerge with serious consequences for public or animal health and profound economic impacts (IPBES, 2020; Swift et al., 2007; Smith et al., 2009; Gortazar et al., 2014; Stephen, 2021; Stephen et al., 2022; FAO, 2020). The risk of pathogen spillover and disease emergence is amplified with increased interaction between humans, wildlife and domestic animals. The risk of pathogen spillover has also been exacerbated by climate change, intensified agriculture and livestock production, deforestation, and other land-use changes. Wildlife trade is also a risk to ecosystem biodiversity via the introduction of invasive species (Wikramanayake et al., 2021). Therefore, increased effort must be put into understanding the potential consequences of the wildlife trade, mapping and analysing the adjacent risks, and implementing strategies to manage those risks. Reducing wildlife-trade risks not only helps to limit disease but also minimises the negative effects of invasive species. Between 1960 and 2021, invasive alien species caused estimated cumulative damage of around 116 billion euros across 39 countries in the European Union alone, despite strict import regulations (Haubrock et al., 2021). The effect of invasive species is extremely apparent.
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The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys
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tems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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The webpage provides detailed information about asbestosis, a lung disease caused by inhaling asbestos fibers. It outlines various asbestos-related diseases, including benign and malignant pleural conditions as well as lung cancer. Asbestosis is described as a diffuse fibrotic disease of lung tissue
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resulting from prolonged and intense exposure to asbestos fibers, progressing slowly over time. The page covers the causes, risk factors, and pathology of the disease, highlighting different types of asbestos fibers and their effects on the lungs. It also discusses symptoms, diagnostic procedures, and potential complications, such as the increased risk of lung cancer and mesothelioma. Preventive measures and recommendations for those affected are also included.
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This document is the ninth in a series of Tobacco Knowledge Summaries and is prepared with the objective to summarize the current evidence on the association between tobacco use and asthma. This is also intended as an advocacy tool to widely include health care professionals, in particular pulmonolo
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gists and respirologists, in the fight for tobacco control and prevention of tobacco related adverse health effects. This knowledge summary was prepared by World Health Organization in collaboration with the Forum of International Respiratory Societies, the Global Initiative for Asthma and The University of Tasmania.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –
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are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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Beat the heat: child health amid heatwaves in Europe and Central Asia finds that half of these children died from heat-related illnesses in their first year of life. Most children died during the summer months.
"Around half of children across Europe and Central Asia – or 92 million children –
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are already exposed to frequent heatwaves in a region where temperatures are rising at the fastest rate globally. The increasingly high temperatures can have serious health complications for children, especially the youngest children, even in a short space of time. Without care, these complications can be life-threatening,” said Regina De Dominicis UNICEF Regional Director for Europe and Central Asia.
Heat exposure has acute effects on children, even before they are born, and can result in pre-term births, low birth weight, stillbirth, and congenital anomalies. Heat stress is a direct cause of infant mortality, can affect infant growth and cause a range of paediatric diseases. The report also notes that extreme heat caused the loss of more than 32,000 years of healthy life among children and teenagers in the region.
As the temperatures continue to rise, UNICEF urges governments across Europe and Central Asia to:
- Integrate strategies to reduce the impact of heatwaves including through National Determined Contributions (NDC), National Adaptation Plans (NAP), and disaster risk reduction and disaster management policies with children at the centre of these plans
Invest in heat health action plans and primary health care to more adequately support heat-related illness among children
- Invest in early warning systems, including heat alert systems
- Adapt education facilities to reduce the temperatures in the areas children play in and equip teachers with skills to respond to heat stress
- Adapt urban design and infrastructure including ensuring buildings, particularly those housing the most vulnerable communities are equipped to minimize heat exposure
- Secure the provision of safe water, particularly in countries with deteriorating water quality and availability.
UNICEF works with governments, partners and communities across the region to build resilience against heatwaves. This includes equipping teachers, community health workers and families with the skills and knowledge to respond to heat stress.
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Planning for public health emergencies should ensure that capabilities developed during previous emergencies are maintained, incorporated, and put into practice when a new event of public health concern arises. Investments in pandemic preparedness lead to more rapid detection and a stronger response
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to public health threats, thereby shielding communities from the debilitating social and economic effects of epidemics and pandemics. The Pan American Health Organization (PAHO) recognizes the efforts of countries in the Region of the Americas to develop and/or strengthen their respiratory pathogen pandemic plans. PAHO supports planning activities with tools and expertise, aligning these efforts with the Preparedness and Resilience for Emerging Threats (PRET) initiative. The PRET initiative is an innovative approach to improving disease pandemic preparedness. It recognizes that the same systems, capacities, knowledge, and tools can be leveraged and applied for groups of pathogens based on their mode of transmission (respiratory, vector-borne, foodborne etc.). The PRET initiative incorporates the latest tools and approaches for shared learning and collective action established during the COVID-19 pandemic and other recent public health emergencies.
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Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Chi
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ldhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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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 treatment should be to achieve and maintain control of the
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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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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
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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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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading
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to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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The PDF "COLERA: Informação para Promotores de Saúde" provides essential guidance for health promoters and activists on cholera. It explains that cholera is characterized by severe watery diarrhea, often resembling rice water, and sometimes vomiting. If not treated promptly, it can lead to death
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within hours. The disease affects both adults and children and spreads through contaminated feces, poor hygiene, and unsafe water or food. To prevent cholera, the document emphasizes the importance of drinking treated or safe water, cooking food thoroughly and keeping it covered, washing hands with soap or ash after using the latrine and before handling food, and using proper latrines or sanitary facilities. It also highlights the role of vaccination, recommending the oral cholera vaccine "Shanchol," which requires two doses 2–3 weeks apart. The vaccine is suitable for individuals over one year old, including pregnant women, and has minimal side effects such as mild abdominal pain or diarrhea. This resource aims to empower health promoters with practical knowledge to prevent and manage cholera outbreaks effectively.
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Under the theme “Stronger Together”, the campaign aims to offer information and strategies to assist communities in the region in better coping with the psychological impact of adverse events before, during and after a disaster situation. It also aims to raise awareness to reduce the stigma abou
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t seeking mental health and psychosocial support.
You can download a wide range of communication material: videos, posters, radio jingles, guidebooks.
The Caribbean is highly prone to natural hazards, including seismic activity, hurricanes, landslides and floods. These events have resulted in lost lives, serious injuries and severe damage to housing and infrastructure. A single hurricane event can affect more than one island, and completely erase the gains of many years of productivity. As a result, these unpredictable hazards create disruption and have an ongoing impact on people’s lives - affecting their mental health and psychosocial well-being.
Although everyone is affected in some way by disaster events, there are a wide range of reactions and feelings that a person can experience. People may feel overwhelmed, confused or very uncertain about what is happening. They can also feel very fearful, anxious, numb or detached. People who feel safe, connected, calm and hopeful, have access to social, physical and emotional support and find ways to help themselves after a disaster, however, will be better able to recover long-term from mental health effects
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Accessed on 06.03.2022
Air pollution is contamination of the indoor or outdoor environment by any chemical, physical or biological agent that modifies the natural characteristics of the atmosphere. Household combustion devices, motor vehicles, industrial facilities and forest fires are common sou
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rces of air pollution. Pollutants of major public health concern include particulate matter, carbon monoxide, ozone, nitrogen dioxide and sulfur dioxide. Outdoor and indoor air pollution cause respiratory and other diseases and is an important source of morbidity and mortality.
Air pollution kills an estimated seven million people worldwide every year. WHO data shows that almost all of the global population (99%) breathe air that exceeds WHO guideline limits containing high levels of pollutants, with low- and middle-income countries suffering from the highest exposures. WHO is supporting countries to address air pollution.
From smog hanging over cities to smoke inside the home, air pollution poses a major threat to health and climate. The combined effects of ambient (outdoor) and household air pollution cause millions of premature deaths every year, largely as a result of increased mortality from stroke, heart disease, chronic obstructive pulmonary disease, lung cancer and acute respiratory infections.
Website
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Comparison of the Influence of Different Nucleic Acid Extraction Assays on the Sensitivity of Trypanosoma cruzi-Specific Real-Time PCR
Kann, S.; Zabala-Monterroza, W.; García, C. et al.
Multidisciplinary Digital Publishing Institute MDPI
(2022)
CC
For the molecular diagnosis of Chagas disease by real-time PCR (polymerase chain reaction), optimization of diagnostic accuracy is desirable. The detection limit of real-time PCR assays for the diagnosis of Trypanosoma cruzi in human serum is affected by various influences including the choice of th
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e nucleic acid extraction assay. In this study, three nucleic acid extraction assays were compared regarding their influence on the sensitivity of a T. cruzi-specific real-time PCR with 62 reference sera containing T. cruzi target DNA (deoxyribonucleotide acid). More than 95% of the positive sera were correctly identified after all three nucleic acid extraction strategies with a detection rate ranging from 96.8% (60/62) for the worst assay to 100% (62/62) for the best one. A matched pairs analysis for the comparison of the cycle threshold (Ct) values obtained with the 59 reference samples with positive real-time PCR results after all three nucleic acid extraction schemes indicated differences in a range of about 3 Ct steps. Summarized, all three compared nucleic acid extraction schemes were basically suitable for T. cruzi-specific PCR from serum with some minor differences. However, in the case of low quantities of circulating parasite DNA in the serum of a patient with Chagas disease, even minor effects can make a difference in the individual diagnosis.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u
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se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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It is widely understood that the food insecurity crisis in the Sahel and the Horn of Africa is one of the world’s fastest growing and most neglected crises. It lacks sufficient global focus, resources and urgency. As in so many crises, women and girls are disproportionately affected and shoulder t
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he consequences of protracted neglect, with unconscionable impacts on their safety, life chances and agency.
Gaining a holistic view of the gendered drivers, risks and impacts of food insecurity in the Sahel and the Horn of Africa is difficult. This is due to a lack of data and prioritization, and the large geographical and socioeconomic terrain covered by both regions. However, what we do know about this crisis is more than enough to urgently address the needs of women and girls.
An OCHA discussion paper on this topic (which will be published imminently, and from which this policy brief is drawn) found that there is:
A strong risk of profound regression in gender equality gains made to date in the countries of concern, including on education, sexual and reproductive health, and the economic independence of women and girls (with knock-on effects on broader humanitarian and development outcomes).
An increasing challenge to reverse what must be recognized as a protracted and growing gender-based violence (GBV) emergency in the Sahel and the Horn of Africa.
The food insecurity crisis in the Sahel and the Horn of Africa is protracted, multidimensional and highly gendered, with spiralling impacts on gender equality and food security outcomes. It is driven by interwoven and overlapping factors, including climate change, political instability, conflict, socioeconomic conditions, migration and displacement and, more recently, COVID-19 and the war in Ukraine. Interlinked with these factors are gendered structural drivers of food insecurity, including deeply entrenched gender inequalities and harmful social norms. Gendered risks and impacts of food insecurity include alarming limitations on access to education, sexual and reproductive health rights, women’s agency and participation, and dramatic increases in different existing forms of GBV and the emergence of new ones. Recognition of such gendered dimensions of food insecurity and of the need for a multisectoral approach in the response is key to addressing the crisis, along-side sustained commitment and adequate allocation of resources. This policy brief draws out key findings from the OCHA discussion paper on this topic, which includes a desk review of studies, assessments and reports, and interviews with local women’s organizations on the front lines of the food insecurity crisis in communities across both regions.
Below are the most pressing gendered drivers, risks and impacts of food insecurity (not in order of priority), as well as key gaps in the current humanitarian response to food insecurity, and recommendations to take forward.
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Cardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. The term “cardiovascular disease” is used throughout the report to refer to cardiac disease, vascular diseases of the brain and kidney, and peripheral vascular disease. The report’s main focus is
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on the major contributors to global CVD mortality, coronary heart disease and stroke, and on the major modifiable risk factors for cardiovascular diseases. In fact, as the leading cause of death worldwide, CVD now has a major impact not only on developed nations but also on low and middle income countries, where it accounts for nearly 30 percent of all deaths. The terms “developed” and “high income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as high income economies. The terms “developing” and “low and middle income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as low, lower middle, and upper middle income economies. The increased prevalence of risk factors for CVD and related chronic diseases in developing countries, including tobacco use, unhealthy dietary changes, reduced physical activity, increasing blood lipids, and hypertension, reflects significant global changes in behavior and lifestyle. The term “chronic diseases” is used throughout the report to refer to CVD and the following related chronic diseases that share many common risk factors: diabetes, cancer, and chronic respiratory disease. These changes now threaten once-low-risk regions, a shift that is accelerated by industrialization, urbanization, and globalization. The potentially devastating effects of these trends are magnified by a deleterious economic impact on nations and households, where poverty can be both a contributing cause and a consequence of chronic diseases. The accelerating rates of unrecognized and inadequately addressed CVD and related chronic diseases in both men and women in low and middle income countries are cause for immediate action.
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Although air pollution is well known to be harmful to the lung and airways, it can also damage most other organ systems of the body. It is estimated that about 500,000 lung cancer deaths and 1.6 million COPD deaths can be attributed to air pollution, but air pollution may also account for 19% of all
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cardiovascular deaths and 21% of all stroke deaths. Air pollution has been linked to other malignancies, such as bladder cancer and childhood leukemia. Lung development in childhood is stymied with exposure to air pollutants, and poor lung development in children predicts lung impairment in adults. Air pollution is associated with reduced cognitive function and increased risk of dementia. Particulate matter in the air (particulate matter with an aerodynamic diameter < 2.5 μm) is associated with delayed psychomotor development and lower child intelligence. Studies link air pollution with diabetes mellitus prevalence, morbidity, and mortality. Pollution affects the immune system and is associated with allergic rhinitis, allergic sensitization, and autoimmunity. It is also associated with osteoporosis and bone fractures, conjunctivitis, dry eye disease, blepharitis, inflammatory bowel disease, increased intravascular coagulation, and decreased glomerular filtration rate. Atopic and urticarial skin disease, acne, and skin aging are linked to air pollution. Air pollution is controllable and, therefore, many of these adverse health effects can be prevented.
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Assessing the Impact of Workforce Nutrition Programmes on Nutrition, Health and Business Outcomes: A Review of the Global Evidence and Future Research Agenda
Dhillon, C.N.; Ortenzi, F.
International Journal of Environmental Research and Public Health
(2023)
CC
One in three people globally suffers from at least one form of malnutrition, leading to poor health outcomes and low productivity in the workplace. The workplace offers an important, relatively unexploited opportunity to address malnutrition in all its forms. This narrative literature review aims to
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understand the impact of workforce nutrition programmes on nutrition, health, and business outcomes, based on high-strength-of-evidence studies. We used PubMed as our primary research database, complemented by Google Scholar, to identify systematic reviews, meta-analyses, and randomised controlled trials published between January 2010 and October 2021. In total, 26 records were included. We found that comprehensive workforce nutrition programmes, including a variety of intervention areas, and/or programmes targeting high-risk categories of workers (overweight/obese or (pre-)diabetic) were more likely to be effective on nutrition, health, and business outcomes. Within comprehensive and targeted programmes, individualised counselling and worksite environmental modifications were often mentioned as the most effective components. However, a high degree of heterogeneity in outcome measures and programme designs made it difficult to draw strong conclusions on the impact of workforce nutrition interventions. Limited evidence was found on business outcomes, longer-term effects of interventions, and programme implementation in LMICs. Therefore, further research is needed to address these evidence gaps.
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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant
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asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
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ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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31 March 2021
This article is part of a series of explainers on vaccine development and distribution. Learn more about vaccines – from how they work and how they’re made to ensuring safety and equitable access – in WHO’s Vaccines Explained series.
Vaccines are a critical tool in the battl
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e against COVID-19, and getting vaccinated is one of the best ways to protect yourself and others from COVID-19.
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Cet article fait partie d’une série d’explications à propos de la mise au point et de la distribution des vaccins.
Европейскому региону ВОЗ принадлежит незавид-ное первенство среди регионов мира по количеству потребляемого алкоголя и масштабам вреда, обусловленного употребл
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нием алкоголя. Это проблема, требующая решительных действий. Такие действия, даже относительно простые и малозатратные, могут привести к быстрому и существенному улучшению здоровья и благополучия населения, повышению уровня занятости и производительности труда, большей экономии ресурсов в секторе здравоохранения и социального обеспечения, большему равенству в отношении здоровья и экономического положения, более высокому уровню социальной сплоченности и вовлечения всех социальных групп в жизнь общества
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Previous crises, such as the Ebola virus disease (EVD) in West Africa in 2014, indicate the direct impact movement restrictions and disease containment efforts have on food availability, access, utilization and violence – particularly gender-based violence (GBV). The importance of maintaining and
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upscaling food security interventions for the most vulnerable populations, alongside the health sector’s efforts to avert disease spread, is therefore undeniable. The COVID-19 outbreak in South Sudan threatens to paralyze an already fragile food system and negatively impact more than 6.5 million people in South Sudan who remain vulnerable. At the same time, the core national capacities for prevention, preparedness and response for public health events is limited, and the healthcare system has been weakened by years of conflict, poor governance and low investments.
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Global and regional estimates of violence against women
he report presents the first global systematic review of scientific data on the prevalence of two forms of violence against women: violence by an intimate partner (intimate partner violence) and sexual violence by someone other than a partner
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(non-partner sexual violence). It shows, for the first time, global and regional estimates of the prevalence of these two forms of violence, using data from around the world. Previous reporting on violence against women has not differentiated between partner and non-partner violence. You can download the report in different languages
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24 May 2021
Cet article fait partie d’une série de notes explicatives sur la mise au point et la distribution de vaccins.
This review examines high-quality research evidence that synthesises the efects of extreme heat on human health in tropical
Africa. Web of Science (WoS) was used to identify research articles on the efects extreme heat, humidity, Wet-bulb Globe
Temperature (WBGT), apparent temperature, wind, Heat
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Index, Humidex, Universal Thermal Climate Index (UTCI), heatwave, high temperature and hot climate on human health, human comfort, heat stress, heat rashes, and heat-related morbidity
and mortality
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Wait-Room-Poster
Brochure for Patients and General Public
По оценкам, от вредного употребления алкоголя ежегодно умирают 2,5 миллиона человек, значительную долю из которых составляет молодежь. Употребление алкоголя являе
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ся третьим ведущим фактором риска плохого состояния здоровья во всем мире. Самые разнообразные проблемы на почве алкоголя могут иметь тяжелейшие последствия для индивидов и их семей и серьезно влиять на жизнь общины.
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Rural Development through decent work
Themes: Rural Policy Briefs
7 April 2021
Based on current information, a causal relationship between the vaccine and the occurrence of blood clots with low platelets is considered plausible but is not confirmed.
Available in Englisch, French and Russian
Vaccine hesitancy
recommended
April 19,2021
MEDBOX Issue Brief no.12
A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021
recommended
WHO has developed a clinical case definition of post COVID-19 condition by Delphi methodology that includes 12 domains, available for use in all settings. This first version was developed by patients, researchers and others, representing all WHO regions, with the understanding that the definition ma
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y change as new evidence emerges and our understanding of the consequences of COVID-19 continues to evolve.
Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.
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Клиническое определение случая состояния после COVID-19 методом дельфийского консенсуса, 6 октября 2021 г.
recommended
WHO has developed a clinical case definition of post COVID-19 condition by Delphi methodology that includes 12 domains, available for use in all settings. This first version was developed by patients, researchers and others, representing all WHO regions, with the understanding that the definition ma
...
y change as new evidence emerges and our understanding of the consequences of COVID-19 continues to evolve.
Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.
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Klinische Falldefinition einer Post-COVID-19-Erkrankung gemäß Delphi-Konsens, 6.Oktober 2021
recommended
Die WHO hat mit Hilfe der Delphi-Methode eine klinische Falldefinition für das Post-COVID-19-Syndrom entwickelt, die 12 Domänen umfasst und in allen Bereichen verwendet werden kann. Diese erste Version wurde von Patienten, Forschern und anderen Personen aus allen WHO-Regionen entwickelt, wobei dav
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on ausgegangen wird, dass sich die Definition ändern kann, wenn sich neue Erkenntnisse ergeben und sich unser Verständnis der Folgen von COVID-19 weiterentwickelt.
Die Post-COVID-19-Erkrankung tritt bei Personen mit einer wahrscheinlichen oder bestätigten SARS-CoV-2-Infektion in der Anamnese auf, in der Regel drei Monate nach dem Auftreten von COVID-19 mit Symptomen, die mindestens zwei Monate anhalten und nicht durch eine andere Diagnose erklärt werden können. Zu den häufigen Symptomen gehören Müdigkeit, Kurzatmigkeit, kognitive Störungen, aber auch andere Symptome, die sich im Allgemeinen auf das tägliche Leben auswirken. Die Symptome können nach der anfänglichen Genesung von einer akuten COVID-19-Episode neu auftreten oder nach der ersten Erkrankung fortbestehen. Die Symptome können auch schwanken oder im Laufe der Zeit wieder auftreten.
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L'OMS a développé une définition de cas clinique de l'état post COVID-19 par la méthodologie Delphi qui comprend 12 domaines, disponible pour une utilisation dans tous les contextes. Cette première version a été élaborée par des patients, des chercheurs et d'autres personnes, représentant
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toutes les Régions de l'OMS, étant entendu que la définition peut changer à mesure que de nouvelles preuves apparaissent et que notre compréhension des conséquences de la COVID-19 continue d'évoluer.
L'état post COVID-19 survient chez les personnes ayant des antécédents d'infection probable ou confirmée par le CoV-2 du SRAS, généralement 3 mois après l'apparition de symptômes qui durent au moins 2 mois et ne peuvent être expliqués par un autre diagnostic. Les symptômes courants comprennent la fatigue, l'essoufflement, le dysfonctionnement cognitif mais aussi d'autres et ont généralement un impact sur le fonctionnement quotidien. Les symptômes peuvent être d'apparition récente après le rétablissement initial d'un épisode aigu de COVID-19 ou persister depuis la maladie initiale. Les symptômes peuvent également fluctuer ou rechuter au fil du temps.
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La OMS ha elaborado una definición de caso clínico de la afección posterior a la COVID-19 mediante la metodología Delphi que incluye 12 dominios, disponible para su uso en todos los entornos. Esta primera versión fue elaborada por pacientes, investigadores y otras personas, en representación d
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e todas las regiones de la OMS, en el entendimiento de que la definición puede cambiar a medida que surjan nuevas pruebas y siga evolucionando nuestra comprensión de las consecuencias de la COVID-19.
La afección posterior a la COVID-19 se produce en personas con antecedentes de infección probable o confirmada por el CoV-2 del SRAS, normalmente a los 3 meses de la aparición de la COVID-19 con síntomas y que duran al menos 2 meses y no pueden explicarse por un diagnóstico alternativo. Los síntomas más comunes son la fatiga, la dificultad respiratoria y la disfunción cognitiva, pero también otros, y generalmente tienen un impacto en el funcionamiento diario. Los síntomas pueden ser de nueva aparición tras la recuperación inicial de un episodio agudo de COVID-19 o persistir desde la enfermedad inicial. Los síntomas también pueden fluctuar o recaer con el tiempo.
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A clinical case definition of post COVID-19 condition by a Delphi consensus, 6 October 2021 (Arabic Version)
recommended
WHO has developed a clinical case definition of post COVID-19 condition by Delphi methodology that includes 12 domains, available for use in all settings. This first version was developed by patients, researchers and others, representing all WHO regions, with the understanding that the definition ma
...
y change as new evidence emerges and our understanding of the consequences of COVID-19 continues to evolve.
Post COVID-19 condition occurs in individuals with a history of probable or confirmed SARS CoV-2 infection, usually 3 months from the onset of COVID-19 with symptoms and that last for at least 2 months and cannot be explained by an alternative diagnosis. Common symptoms include fatigue, shortness of breath, cognitive dysfunction but also others and generally have an impact on everyday functioning. Symptoms may be new onset following initial recovery from an acute COVID-19 episode or persist from the initial illness. Symptoms may also fluctuate or relapse over time.
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The consequences of the failing health system has immediate and longer-term impacts on children . April 2022
Available in English and Arabic
This report provides an overview of air pollution levels and associated health impacts in cities around the world. Since urban areas are often hotspots for poor air quality, city-level data can help to inform targeted efforts to curb urban air pollution and improve public health. This report draws o
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n data from the Global Burden of Disease project and from peer-reviewed analyses led by Susan Anenberg of the George Washington University.
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Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e200460, 2022
Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness
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, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.
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Manual:
Know How to Use Your Asthma Inhaler.
Using a metered dose inhaler (inhaler in mouth).
Community based psychosocial services in humanitarian assistance. A facilitator's guide
Agni, Kathy; et al.
LutherahjalpenChurch of Sweden; Norwegian Church Aid and Presbyterian Disasters Assistance
(2005)
C2
This expansive facilitator's guide deals with psychosocial interventions concerning multiple causes of trauma such as HIV and AIDS and post-conflict situations. The guide offers technical advice to the implementor which is usefully augmented by diagrams, ideas for games and other useful intervention
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s
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The WHO guidelines provide recommended steps for safe phlebotomy and reiterate accepted principles for drawing, collecting blood and transporting blood to laboratories/blood banks.
Confronting the gender impact of Ebola virus disease in Guinea, Liberia, and Sierra Leone
UN Development Programme
(2015)
UNDP Africa Policy Note
Where Women Have No Doctor - Chapter 31 - Use of Medicines in Women’s Health
recommended
A. August Burns, Sandy Nieman, Elena Metcalf, Ronnie Lovich, Jane Maxwell, Katharine Shapiro
Hesperian Health Guides
(2014)
C1
This chapter talks about how to safely use the medicines mentioned in the book to treat women’s health problems. It also provides information to help decide when to use medicines to improve women’s health.
The report focuses on antibacterial resistance (ABR) in common bacterial pathogens. There is a major gap in knowledge about the magnitude of this problem. Antimicrobial resistance (AMR) threatens the effective revention and treatment of an ever-increasing range of infections caused by bacteria, para
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sites, viruses and fungi. This WHO report, produced in collaboration with Member States and other partners, provides for the first time, as accurate a picture as is presently possible of the magnitude of AMR and the current state of surveillance globally. It examines the information on AMR, in particular antibacterial resistance (ABR), at country level worldwide.
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This is a detailed manual giving a step by step approach to undertaking the pharmacovigilance of antiretrovirals. It is intended to be a source of practical advice for Pharmacovigilance Centres and health professionals involved in HIV/AIDS prevention and treatment programmes. A number of WHO publica
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tions are available that provide a background to pharmacovigilance and, as far as possible, that material will not be repeated here. Health officials, planners, the staff of Pharmacovigilance Centres, public health teams and all health workers should become familiar with these publications, which are: • Safety of Medicines: A guide to detecting and reporting adverse drug reactions
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Therapeutics Information and Pharmacovigilance Centre | TIPC
STATUTORY INSTRUMENTS | SUPPLEMENT No. 8 28th March, 2014 | STATUTORY INSTRUMENTS SUPPLEMENT | to The Uganda Gazette No. 18 Volume CVII dated 28th March, 2014 | Printed by UPPC, Entebbe, by Order of the Government. | STATUTORY INSTRUMENTS | 2014 No. 37.
Joining efforts to control two trelated global epidemics.
Trials (2017) 18:152, DOI 10.1186/s13063-017-1881-z
Take Action on Antimicrobial Resistance. For Veterinarians and Veterinarian students
This document is written for local and international staff running nutrition programmes in emergencies, and for local, regional and national authorities and donors involved in such programmes.
The note explains why nutrition programmes need to include early childhood development (ECD) activities t
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o maximize the child’s development.
It provides practical suggestions as to what simple steps are necessary to create integrated programmes in situations of famine or food insecurity and it gives examples of how such integrated programmes have been established in other situations.
This document is also available in Arabic: http://www.who.int/mental_health/emergencies/ecd_why_what_how_arabic.pdf?ua=1
;and in French: http://www.who.int/mental_health/emergencies/ecd_why_what_how_french.pdf?ua=1
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Following a radiation incident such as an improvised nuclear device (IND) detonation, state and local response authorities will need to establish one or more population monitoring and decontamination facilities to assess
people for radioactive exposure, contamination, and the need for
decontamin
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ation or other medical follow-up. These facilities are known as community reception centers (CRCs). The basic services offered at a CRC include the following: screening people for radioactive contamination, assisting people with washing or decontamination, registering people for subsequent follow-up, and prioritizing people for further care. This guide
describes the function of each station of a CRC and provides a question bank and other information to guide data collection at each station. A question bank format was chosen to provide the user the ability to tai
lor the data collection tool to fit a particular incident and/or locality.
The CRC data collection tool is designed for CRC staff to fill out the information collected from the individual being assessed.
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Detonation of a nuclear weapon or activation of a radiological dispersal device could cause radioactively contaminated decedents. These guidelines are designed to address both of these scenarios. They could also be applicable in other instances where decedents’ bodies are contaminated with radioa
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ctive material (e.g. reactor accidents, transportation accidents involving radioactive material, or
the discharge of a decedent from a hospital after injection or implantation of a radiopharmaceutical). These guidelines suggest ways for medical examiners, coroners, and morticians to deal with loose surface contamination, internal contamination, or shrapnel on or in decedents’ bodies.
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On January 14-16, 2003, the Centers for Disease Control and Prevention (CDC) held a communications roundtable in Atlanta, Georgia, to explore hospitals' challenges in communicating with internal and external audiences in communitywide emergencies involving radioactive materials. The roundtable, Hosp
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ital Communications in a Mass Casualty Radiological Incident, is part of CDC's effort to help prepare the nation's public health community for threats of terrorism.
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This brief report examines the extent to which community-based treatment and integration support are provided for people living with mental illness across 15 selected Asia-Pacific economies. Some of the key findings are discussed in light of the diversity of economies and cultural contexts.
BJPSYCH
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INTERNATIONALVOLUME 15 NUMBER 4 NOVEMBER 201
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