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A systematic review of clinical and observational antiparasitic treatment studies to assess the potential for establishing an individual participant-level data platform.
Chagas disease (CD), caused by the parasite Trypanosoma cruzi, affects ~6–7
...
million people worldwide. Significant limitations still exist in our understanding of CD. Harnessing individual participant data (IPD) from studies could support more in-depth analyses to address the many outstanding research questions. This systematic review aims to describe the characteristics and treatment practices of clinical studies in CD and assess the breadth and availability of research data for the potential establishment of a data-sharing platform.
more
At the forefront of DNDi’s efforts to develop new treatments is the need to understand the realities and treatment needs of patients and health care staff in the field. The ultimate goal for human African trypanosomiasis (HAT) is a truly simplifie
...
d
treatment which can be orally administered, implemented at the primary health care level, and effective against both stages of the disease.
more
After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge
...
s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
more
Tsetse Control and Gambian Sleeping Sickness; Implications for Control Strategy
Tirados, I.; Esterhuizen, J.; Kovacic, V.; Mangwiro, TNC.; Vale, GA et al.
PLOS Neglected Tropical Diseases
(2015)
CC
Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a ful
...
l scale field trial of a refined vector control technology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
more
Background
The core clinical symptoms of addiction include an enhanced incentive for drug taking (craving), impaired self-control (impulsivity and compulsivity), emotional dysregulation (negative mood) and increased stress reactivity. Symptoms related to impaired self-control involve reduced activi
...
ty in anterior cingulate cortex (ACC), adjacent prefrontal cortex (mPFC) and other brain areas. Behavioral training such as mindfulness meditation can increase the function of control networks including those leading to improved emotion regulation and thus may be a promising approach for the treatment of addiction.
Methods
In a series of randomized controlled trials (RCTs), we tested whether increased ACC/mPFC activity is related to better self-control abilities in executive functions, emotion regulation and stress response in healthy and addicted populations. After a brief mindfulness training (Integrative Body-Mind Training, IBMT), we used the Positive and Negative Affect Schedule (PANAS) and Profile of Mood States (POMS) to measure emotion regulation, salivary cortisol for the stress response and fMRI for brain functional and DTI structural changes. Relaxation training was used to serve as an active control.
Results
In both smokers and nonsmokers, improved self-control abilities in emotion regulation and stress reduction were found after training and these changes were related to increased ACC/mPFC activity following training. Compared with nonsmokers, smokers showed reduced ACC/mPFC activity in the self-control network before training, and these deficits were ameliorated after training.
Conclusions
These results indicate that promoting emotion regulation and improving ACC/mPFC brain activity can help for addiction prevention and treatment.
more
Severe Acute Malnutrition (SAM) is one of the greatest child survival challenges in the world today and
reportedly affects more than 16.2 million children each year1. High impact, proven treatment interventions exist
yet sadly approximately only 3
...
.2 million children with SAM have access to treatment each year2. Thus, there
is a need to scale up interventions to improve coverage and access across high burden countries. While efforts
are currently underway to expand services in many countries, obstacles remain.
One critical barrier to expanding SAM treatment services is the acceptance, accessibility and utilisation of
ready-to-use therapeutic food (RUTF). In some countries and contexts, RUTF is still not fully accepted by
community members; while other countries face problems with procurement, storage and supply chain
management which impact on availability and use3. Reports from Ghana and Zambia highlighted that stock-
outs and logistical challenges are often noted as key contributors to high default rates in outpatient treatment
centres4.
more
Health and Quality of Life Outcomes
Van der Molen, T.; Willemse, B.; Schokker, S.; et al.
Health and Quality of Life Outcomes
(2003)
CC2
The new Global Obstructive Lung Disease (GOLD) guidelines advice to focus treatment in Chronic Obstructive Pulmonary Disease (COPD) on improvement of functional state, prevention of disease progression and minimization of symptoms. So far no validat
...
ed questionnaires are available to measure symptom and functional state in daily clinical practice. The aim of this study was to develop and validate the Clinical COPD Questionnaire (CCQ).
more
Demographic and socioeconomic data Progress towards HIV testing and treatment cascade targets by 2025 (2023) Health sector cascade (2023) Estimated number of people newly infected with HIV
Médecins Sans Frontières (MSF) has set up a 20-bed cholera treatment unit (CTU) at the Renk Civil Hospital in South Sudan, in response to a cholera outbreak declared by the Ministry of Health (MoH) on 28 October. We call on all organisations in Up
...
per Nile state to help prevent the spread of the disease within Upper Nile State and beyond.
more
Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capabil
...
ity for burns care from clinical, human resources and operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
more
Guidelines for essential trauma care
recommended
The Guidelines for essential trauma care seek to set achievable standards for trauma treatment services which could realistically be made available to almost every injured person in the world. They then seek to define the resources that would be nec
...
essary to assure such care. These include human resources (staffing and training) and physical resources (infrastructure, equipment and supplies).
more
Update September 2021. Safe management of health care waste practices play an essential role in protecting human health during all disease outbreaks, including during Ebola Virus Disease (EVD) outbreaks. This question and answer document provides practical, evidence-based recommendations on minimum
...
requirements and best practices for health care waste management in facilities and communities. It was originally developed in 2014 during the West Africa Ebola Outbreak and has been updated in 2021 to reflect lessons learned and new operational research data, including on the use of low-cost treatment technologies . The key recommendations on health care waste remain the same.
more
Zika virus (English)
recommended
Fact sheet on Zika virus containing recommendations for pregnant women and information for the treatment, prevention and control of the disease.
This factsheet is also available in Spanish, Portuguese and French!
Fact sheet on Zika virus containing recommendations for pregnant women and information for the treatment, prevention and control of the disease. This factsheet is also available in English, Spanish, Portuguese and French!
This guidance provides an overview of interventions to improve early diagnosis of TB and treatment completion in these populations, as well as factors to consider when developing programmes for health communication, awareness and education, and prog
...
ramme monitoring and evaluation
more
Towards Universal Access to Prevention, Diagnosis and Treatment
Mental disorders are important public health concern in Bangladesh with a substantial treatment gap due to shortage of resources and trained relevant professionals, such as psychiatrists, psychologists, social psychologists, psychiatric nurses and o
...
ccupational therapists.
This manual is developed in Bangla focusing on common mental disorders prevailing in Bangladesh. The objective of the initiative is to build the capacity of nurses and paramedics to identify common mental disorders and to take appropriate steps including referral.
more
Regulation of the Minister of Health of the Republic of Indonesia on Guidelines for Antiretroviral Treatment
A survey of prevention, testing and treatment policies and practices
The study sought to understand the factors that facilitate women to adhere to treatment and return to health facilities for routine care from their own perspective. The researchers focused on Malawi, Uganda and Zambia, early adopters of the global g
...
uidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment. more
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment. more
