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Arsenical monotherapies were previously very successful for treating human African trypanosomiasis (HAT).
Melarsoprol resistance emerged as early as the 1970s and was widespread by the late 1990s.
Melarsoprol resistance represents the only example of widespread drug resistance in HAT patients wher
...
e the genetic mechanism has been established.
The current goal of elimination of HAT as a public health problem by 2020 may be undermined by the emergence and spread of resistance to current or new drugs.
Insights into potential resistance mechanisms for current and new drugs will facilitate predictions of the likelihood of resistance and will also facilitate rational approaches to minimizing, monitoring, and tackling the future emergence of resistance.
more
Over the past twenty years, huge efforts made by a broad coalition of stakeholders curbed the last epidemic and brought the disease to the brink of elimination. In this paper, the latest figures on disease occurrence, geographical distribution and control activities are presented. Strong evidence in
...
dicates that the elimination of sleeping sickness ‘as a public health problem’ by 2020 is well within reach. In particular, fewer than one thousand new cases were reported in 2018, and the area where the risk of infection is estimated as moderate, high or very high has shrunk to less than 200,000 km2. More than half of this area is in the Democratic Republic of the Congo. The interruption of transmission of the gambiense form, targeted by the World Health Organization (WHO) for 2030, will require renewed efforts to tackle a range of expected and unexpected challenges. The rhodesiense form of the disease represents a small part of the overall HAT burden. For this form, the problem of under detection is on the rise and, because of an important animal reservoir, the elimination of disease transmission is not envisioned at this stage.
more
The COVID-19 pandemic has been the biggest disaster in living memory, on almost any measure. More than 6.5 million people are confirmed to have died in less than three years, and the pandemic’s indirect impacts have touched the lives of virtually every community on the planet.
Our World Disasters
...
Report 2022 focuses on the coronavirus pandemic and preparedness: both the ways preparedness ahead of COVID-19 was inadequate, and how the world can prepare more effectively for future public health emergencies.
more
Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health
...
issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwide represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Union Framework for Antimicrobial Resistance Control 2
...
020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
Africa bears a significant burden of infectious diseases, accounting for approximately 95% of malaria deaths, 70% of people living with HIV, and 25% of TB deaths globally. In 2019, AMR was linked to approximately 55,000 deaths from HIV, 30,000 from malaria, and 255,000 overall. Major drivers of AMR in the region include the overuse and misuse of antimicrobials in human and food systems, migration, suboptimal vaccination rates, and environmental contamination from hospital and pharmaceutical effluents. Additionally, there is a lack of access to quality-assured antimicrobials and diagnostics, compounded by inadequate knowledge about AMR. Unlike high-income countries, where indiscriminate antimicrobial use is the primary factor driving AMR, African countries face additional challenges, including a lack of access to clean and safe water, poor Water, Sanitation, and Hygiene (WASH) programs, inadequate infection prevention measures, and suboptimal vaccinations for preventable diseases. One in three hospitals in the region lacks clean, safe running water, and one in eight people defecate openly due to inadequate sanitation. Investments in WASH, infection prevention, and biosecurity could save approximately 700,000 lives annually.
Addressing AMR in Africa requires a comprehensive, multi-sectoral approach involving the entire society. Sustainable access to antimicrobials, including antibiotics, vaccines, and therapeutics, is crucial, as lack of access leads to more morbidity and mortality than AMR itself. Support for the region should focus on preventing infections, strengthening health and food systems, developing human resources, ensuring sustainable access to diagnostics and therapeutics, and investing in laboratory infrastructure to support surveillance and data generation.
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Population Size Estimation of Female Sex Workers In Tbilisi and Batumi, Georgia 2014
Dr. I. Chikovani; Dr. N. Shengelia; L. Sulaberidze; N. Tsereteli; et al.
The Global Fund To fight AIDS, Tuberculosis and Malaria; Curatio International Foundation; Tanadgoma
(2014)
C2
Study Report August 2014
Curatio International Foundation (CIF) and the Association Tanadgoma would like to acknowledge the financial support provided by GFATM under the project “Establishment of evidence base for national HIV/AIDS program by strengthening of HIV/AIDS
...
surveillance system in the country” (GEO-H-GPIC), which made this study possible.
The report was prepared by Dr. Ivdity Chikovani, Dr. Natia Shengelia, Lela Sulaberidze (CIF) and Nino Tsereteli (Tanadgoma).
Special thanks are extended to international consultants – Ali Mirzazadeh (MD, MPH, PhD Postdoctoral Scholar, University of California, San Francisco Institute for Health Policy Studies & Global Health Sciences) for his significant contribution in study preparation, protocol and questionnaire design and data analysis and Abu S. Abdul-Quader (PhD, Epidemiologist, Global AIDS Program Centers for Disease Control and Prevention) for his valuable input in refining methodology and overall guidance during the study implementation.
Special thanks are extended to international consultants – Abu S. Abdul-Quader (PhD, Epidemiologist, Global AIDS Program, Centers for Disease Control and Prevention) for his valuable input in refining methodology and overall guidance during the study implementation and Ali Mirzazadeh (MD, MPH, PhD Postdoctoral Scholar, University of California, San Francisco Institute for Health Policy Studies & Global Health Sciences) for his significant contribution in the NSU study preparation, protocol and questionnaire design and data analysis.
Authors appreciate a highly professional work of Tanadgoma staff: the survey coordinator KhatunaKhazhomia; the interviewers: Ketevan Tchelidze, Nino Kipiani, Koba Bitsadze, Kakhaber Akhvlediani, ZazaBabunashvili, Rati Tsintsadze and the social workers: Archil Rekhviashvili, Tea Chakhrakia, Irina Bregvadze, Kakhaber Kepuladze, Ketevan Jibladze and Shota Makharadze for their input in the recruitment process.
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Integrating Clinical Research into Epidemic Response: The Ebola Experience
Gerald Keusch, Keith McAdam, Patricia Cuff, Michelle Mancher, and Emily R. Busta
National Academies of Sciences, Engineering, and Medicine
(2017)
C1
The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Repub
...
lic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014–2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak.
more
Emergence of antimicrobial resistance is a result of the use, overuse and misuse of antibiotics both in humans and animals. In Ethiopia, there are indications on the misuse of antibiotics by health care providers’, unskilled practitioners, and dru
...
g consumers. These coupled with rapid spread of resistant bacteria and inadequate surveillance contributed to the problem. Bacterial infections are the major causes of death in Ethiopia. Studies on antibacterial resistance and on bacterial infections have shown that emerging antibacterial resistance threatens the management of bacterial infections; however, the prevention and containment has received far too little attention.
more
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
...
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.
more
The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance
...
networks for 2013–2015. AMC in both sectors, expressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
more
Haematologica has published European guidelines for empirical and targeted antibacterial therapy forfebrile neutropenic patients in the era of emerging resistance (ECIL-4). Indeed, collateral damage by broad-spectrum antibiotic therapy includes selection of multidrugresistant pathogens, and incr
...
eased predisposition to infec-tion by fungi and Clostridium difficile. Antibiotic resistance has become a major public health concern, with fears expressed that we will soon run out of antibiotics.
Haematologica December 2013 98: 1821-1825; doi:10.3324/haematol.2013.091769
more
Environment International Volume 86, January 2016, Pages 14-23
Climate change refers to long-term shifts in weather conditions and patterns of extreme weather events. It may lead to changes in health threat to human beings, multiplying existing
...
health problems. This review examines the scientific evidences on the impact of climate change on human infectious diseases. It identifies research progress and gaps on how human society may respond to, adapt to, and prepare for the related changes. Based on a survey of related publications between 1990 and 2015, the terms used for literature selection reflect three aspects — the components of infectious diseases, climate variables, and selected infectious diseases. Humans' vulnerability to the potential health impacts by climate change is evident in literature. As an active agent, human beings may control the related health effects that may be effectively controlled through adopting proactive measures, including better understanding of the climate change patterns and of the compound disease-specific health effects, and effective allocation of technologies and resources to promote healthy lifestyles and public awareness. The following adaptation measures are recommended: 1) to go beyond empirical observations of the association between climate change and infectious diseases and develop more scientific explanations, 2) to improve the prediction of spatial–temporal process of climate change and the associated shifts in infectious diseases at various spatial and temporal scales, and 3) to establish locally effective early warning systems for the health effects of predicated climate change.
more
Chagas disease (CD) is endemic in the Americas, being present in 21 countries, where it affects about 6 million
people.(1) With such relevant numbers of people affected and disability adjusted life years lost, CD is a poverty-related
and poverty-promoting disease.
Although data describe a relevan
...
t ongoing public health problem for the American continent, significant results
in the interruption of transmission has been achieved by coordinated multi-country programs. In particular, the
Southern Cone Initiative (SCI), officially formalised in November 1991 by the Ministers of Health of Argentina, Brazil, Bolivia, Chile, Paraguay and Uruguay, has shown how a well-designed control program can significantly reduce
CD transmission.(2) Before this initiative, in these countries, there were 11 million infected persons and 50 million at
risk, 62% of the infected individuals of the whole continent.
more
Worldwide, there are about 17 million deaths due to cardiovascular disease (CVD) each year and at least two or three times as many non-fatal events. Raised cholesterol greatly increases the risks of stroke and heart disease, causing a large
health
...
burden across the world. The World Health Organization has identified control of cholesterol as part of a Total Risk Approach to the prevention of CVD as a public health priority.
more
Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan
Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV.
Objective The objective of this initiative was to improve reporting of adverse events (A
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Es) by strengthening passive safety
surveillance via PV training and mentoring of local PV stakeholders and healthcare providers (HCPs) at their own healthcare
facilities (HCFs).
Methods An 18-month PV training and mentoring programme was implemented in collaboration with national stakeholders,
and in partnership with the Ministry of Health, GSK and PATH. Two-day training was provided to Expanded Programme on
Immunisation coordinators, identified as responsible for AE reporting, and four National Regulatory Authority representa-
tives. Abridged PV training and mentoring were provided regularly to HCPs. Support was given in upgrading the national
PV system. Key performance indicators included the number of AEs reported, transmission of AE forms, completeness of
reports, serious AEs reported and timeliness of recording into VigiFlow.
Results In 18 months, 443 HCPs at 61 HCFs were trained. The number of reported AEs increased from 22 (January 2000 to
October 2016) to 228 (November 2016 to May 2018), enabling Malawi to become a member of the World Health Organization
Programme for International Drug Monitoring. Most (98%) AE report forms contained mandatory information on reporter,
event, patient and product, but under 1% were transmitted to the national PV office within 48 h.
Conclusion Regular PV training and mentoring of HCPs were effective in enhancing passive safety surveillance in Malawi,
but the transmission of reports to the national PV centre requires further improvement.
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The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of
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the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
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As the number of transboundary pest and animal and foodborne disease outbreaks rises, so does the number of people who are chronically hungry due to these and other factors. The correlation can be explained by the link between our health and that of
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the planet. We rely on land and sea for the production of safe and quality foods for our daily nourishment. Pests and disease epidemics negatively impact the quality, quantity and safety of our food sources, and cripple economic growth and efficiencies in production. Furthermore, the epidemic and endemic levels of the pathogens and disease vectors can be difficult to control. This is why FAO stresses and promotes the special efforts required for cost-effective preventive measures rather than the more expensive control, disinfestation, treatment and disposal measures. When preventive measures are late or difficult, preparedness and contingency plans must be in place to enable rapid response. Early warning systems, based on close monitoring, surveillance, and timely reporting are fundamental to warn and empower communities to safeguard their livelihoods and assets by enhancing disease and pest prevention measures and for government services to take immediate measures to protect communities and national economies.
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Brazil‘s Social Policy Response to Covid-19: Healthcare and Poverty Alleviation
Massard da Fonseca, E.; Arantes Beatriz, L. B.; Portella, C.
Global Dynamics of Social Policy; Deutsche Forschungsgemeinschaft
(2022)
CC
During the pandemic, Brazil has provided its citizens with support in the areas of long-term care and disability, the labor market, social assistance, education, and pensions. This report focuses on two social policy areas, health-care and family be
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nefits (including labor policies), as these were the most crucial social policies implemented in Brazil during the Covid-19 pandemic in terms of the resources allocated and the magnitude of social impact. Brazil’s relatively generous social policies were uncoordinated with public health interventions, which contributed to poor compliance with these public health interventions. This suggests that social policy initiatives alone are insufficient in mitigating the social consequences of the pandemic. They need to be accompanied by and coordinated with public health measures, including regulations on testing, social distancing and mask wearing.
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PLoS Neglected Tropical diseases August 16, 2021 https://doi.org/10.1371/journal.pntd.0009697
Chagas disease, also known as American trypanosomiasis, is a neglected tropical disease transmitted by triatomine insects, first identified in 1909. Chagas disease affects approximately 6–7 million peop
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le globally and is highly prevalent in Latin America where most cases are reported. However, there is increasing evidence that Chagas disease is now an important public health issue outside the “classical” endemic countries due to population migration. Our understanding of Chagas disease, including its pathologies and factors relating to progression, remains to date limited, and is also challenged by lack of diagnosis and highly effective treatment. This systematic review aims to describe studies with Chagas patients receiving antiparasitic treatment. Databases were searched for relevant studies published after 1997, and the results of these searches were screened.
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While the full extent of Cyclone Ida’s impact is still being assessed, early reports indicate significant damage to infrastructure and livelihoods, with an estimated 3,000km2 of land submerged. Preliminary government reports as of 24 March indicate that more than 58,600 houses have been damaged, i
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ncluding 36,747 totally destroyed, 19,733 partially destroyed and 2,184 flooded. More than 500,000 hectares of crops have been damaged, which is expected to significantly increase food insecurity given that the flooding has coincided with the annual harvest season. More than 3,100 schools have been damaged, along with at least 45 health centres.
Nearly 110,000 people remained displaced in more than 130 accommodation centres – mostly schools and other public buildings – in Sofala (90), Manica (26), Zambezia (10) and Tete (4), where humanitarian needs are acute and both the risk of communicable disease outbreaks and protection risks – particularly for women and girls – are high
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