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 worldwid...e 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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Abstract: Chagas disease is caused by infection with the protozoan Trypanosoma cruzi, and although over 100 years have passed since the discovery of Chagas disease, it still presents an increasing problem for global public health. A plethora of information concerning the chronic phase of human Chaga...s disease, particularly the severe cardiac form, is available in the literature. However, information concerning events during the acute phase of the disease is scarce. In this review, we will discuss the current status of acute Chagas disease cases globally, the immunological findings related to the acute phase and their possible influence in disease outcome, and reactivation of Chagas disease in immunocompromised individuals, a key point for transplantation and HIV invection management.
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Snakebite envenoming affects millions of people worldwide annually and is a significant source of mortality. Preventing and treating the problem is complex and requires collaboration among the fields of public health, medicine, ecology, and laboratory science. After being removed from the category A... neglected tropical disease (NTD) list in 2013, snakebite envenoming was reinstated in 2017 in response to antivenom shortages and advocacy from researchers and international NGOs. In 2019, the World Health Organization (WHO) set a target to halve the number of deaths and cases of snakebite envenoming by 2030.
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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.
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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.
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The sub-Saharan African region, carries 90% of the over 250 million cases of schistosomiasis occurring worldwide. In this region, after Nigeria, Tanzania is second country having the highest cases of schistosomiasis and approximately 51.5%0 of the Tanzanian population is either exposed or live in ar...eas with high risk of exposure. The country is endemic to both Schistosoma mansoni and Schistosoma haematobium, these infections are common in communities characterised with limited access to water, sanitation, hygienic practices and health services. Schistosoma mansoni infection is associated with hepatosplenic disease characterised with hepatomegaly, splenomegaly, progressive periportal fibrosis (PPF) which can lead to portal hypertension and its related sequelae, mainly ascites, liver surface irregularities, oesophageal varices and haematemesis. The main consequences of S. haematobium infection are haematuria, dysuria, nutritional deficiencies, urinary bladder lesions, hydronephrosis, urinary bladder squamous cell carcinoma and in children, growth retardation. Preventive chemotherapy using mass drug administration (MDA) of praziquantel targeting primary school aged children is the main strategy for controlling schistosomiasis in Tanzania.
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(African Development Bank policy research document 1)
The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without health aid. It also presents a theoretic...al model of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
Between 2000 and 2014, malaria control efforts were scaled up and worldwide deaths were cut in half. But declining health aid and deprioritized vertical aid (as for malaria), despite its potentially great efficiency, have led to rising numbers of cases. In 2016, 216 million cases of malaria were reported, up from 211 million in 2015. Africa was home to 90% of all malaria cases and 91% of malaria deaths in 2016. Progress appears to have stalled in the global fight against the disease.
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Countries, partners, and donors are committed to
the global elimination of blinding trachoma by 2020.
Achieving this public health milestone requires more
than funding; it requires health personnel with the
right mix of skills, and well supported and managed
health systems. Mass drug administra...tion (MDA)
with Zithromax®, the Pfizer, Inc. donated antibiotic,
is a key component of the SAFE strategy, endorsed
by the World Health Organization. There is growing
recognition that improving all aspects of MDA, from
planning to training, recording to reporting, and
receipt of drug to distribution (the supply chain), will
be necessary if MDA programmes are going to reduce
the community burden of Chlamydia trachomatis, and
eliminate trachoma as a cause of blindness by 2020.
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Practical guide intended for physicians, pharmacists, nurses and medical auxiliaries. This guide is not a dictionary of pharmacological agents. It is a practical manual intended for health professionals, physicians, pharmacists, nurses and health auxiliaries invoved in curative care and drug managem...ent. We have tried to provide simple, practical solutions to the questions and problems faced by field medical staff, using the accumulated field experience of Médecins Sans Frontières, the recommendations of reference organizations such as the World Health Organization (WHO) and specialized documentation in each field. Also available in French, Spanish and Arabic
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Climate information is critical towards strengthening the decision making among different users interested in mitigating impacts of climate related disasters. However, there is need for the climate users to have basic knowledge on weather and climate concepts and to a larger extend, early warning ea...rly action (EWEA) system and approach. This manual presents an opportunity for the climate users including communities to acquire basic knowledge on Early Warning Early Action and this entails; understanding risk areas, existing early warning systems, communication of early warning information and enhancing disaster preparedness through translating early warning into early actions. The EWEA manual largely target the users in different sectors and communities. The execution of the EWEA manual is planned for 3 days and this does incorporate different methods such as; PowerPoint presentation, group work discussions as well as practical exercises.
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First and foremost, Ukraine’s priority is winning the war and ensuring the safety and security of its people. Ukraine is facing a harsh winter and needs urgent aid and solutions including power generators, heating, and temporary housing to withstand freezing temperatures, ice, and snow. In additio...n to emergency support, the prime focus of Ukraine’s Western partners needs to be on military and economic aid to ensure Ukraine’s victory against Russian aggression and to support its economy in a time of war.
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This document is an addendum to the Revised Supplementary Appeal issued in April 2022, reflecting UNHCR’s updated financial requirements for the Ukraine situation for March to December 2022. UNHCR is appealing for an additional $170 million for activities within Ukraine, to scale up urgentlyneeded... winterization and other ongoing programmes, under the four-month extension of the Ukraine Flash Appeal issued in August 2022.
Updated situation
There are 17.7 million people in Ukraine in urgent need of protection and assistance, including 6.2 million who are internally displaced. Housing conditions for millions of people have become increasingly perilous since the start of the international armed conflict.
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Since the first edition of the CDAC snapshot of communication, community engagement and accountability (CCEA) across the Ukraine response was published in May 2022, a conscious effort has been made by international, national and local responders to ramp up CCEA action. Progress has been made in esta...blishing coordination mechanisms and launching activities, particularly around accountability to affected people (AAP). As CCEA work continues to scale up on the ground, a greater focus and more effort are still needed on community-facing information and two-way communication; this should be accorded a higher priority than at present.
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Over the last decade, there have been numerous disasters and major emergencies that have profoundly impacted the lives of millions of people worldwide. To support these crises, national and international emergency medical teams (EMTs) are often deployed to assist disaster affected populations. EMTs ...are teams of healthcare professionals composed most frequently of doctors, nurses, psychologists and others to provide direct clinical care to people affected by disasters and conflicts and to support local health systems. In agreement with the World Health Organization’s (WHO) Global Health Emergency Health Workforce programme, any health professional coming from another country to practice health care in a disaster setting must be part of a team that is qualified, trained, equipped, resourced, and meets minimum acceptable standards to practice.
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The compendium provides guidance on low-cost handwashing facilities that can be widely used in low and middle-income countries. We hope that this can be shared extensively as governments and agencies tackle the crisis in low and middle-income countries where handwashing facilities are urgently neede...d in households, communities, schools and healthcare facilities.
The compendium includes information and further reading on: handwashing facilities – including facilities that are accessible for all, environmental cues to reinforce handwashing behaviours, physical distancing hygiene promotion.
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Technical Note: Cholera treatment facilities provide inpatient care for cholera patients during outbreaks. Proper case management and isolation of cholera patients is essential to prevent deaths and help control the spread of
the disease. Traditionally, these structures have been referred to as ch...olera treatment centres (CTCs) and
cholera treatment units (CTUs). CTCs are usually large structures set up at central level (e.g. urban areas),
while CTUs are smaller structures set up in the periphery (e.g. peri-urban or rural areas). CTCs/CTUs can
be set up as independent structures in tents or within existing buildings or wards of health structures.
Whatever the structure, the principles described in this document should be respected
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Briefing Note 8.
Ecosystem-based adaptation (EbA) is a strategy for adapting to the adverse impacts of climate change by harnessing nature and the services it can provide. This strategy is crucial for cities and peri-urban areas, threatened by a multitude of climate hazards and home to more than ha...lf the human population as of 2018. Despite some outmigration from the largest cities during the COVID-19 pandemic, urbanization will continue, and by 2035, 62.5 percent of the world’s population is expected to reside in urban areas. However, given the need to retrofit, replace and upgrade deteriorating urban infrastructure, and to meet the challenges of climate change, including the urban heat island effect, droughts and more intense flooding, many experts and policymakers see in these demands an opportunity to reinvent cities as greener, less prone to pandemics, and more liveable.
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This diagnostic and treatment manual is designed for use by medical professionals involved in curative care at the dispensary and hospital levels. We have tried to respond in the simplest and most practical way possible to the questions and problems faced by field medical staff, using the accumulate...d field experience of Médecins Sans Frontières, the recommendations of reference organizations such as the World Health Organization (WHO) and specialized works in each field.
Available in English, French, Spanish and Arabic
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J Bras Pneumol. 2022;48(2):e20220082
The spread of Severe Acute Respiratory Syndrome - Coronavirus 2 (SARS-CoV-2) continues to progress, causing damage in several countries of the world due to its rapid transmissibility and significant mortality rates, despite government measures to contain its tra...nsmission, such as movement control, the closing of schools, bans on travel and public gatherings, the mandatory use
of masks, and hand hygiene. The coronavirus disease (COVID-19) has clinical manifestations that are similar to those found in other infections also transmitted through the airways, such as pulmonary tuberculosis (TB) Although TB is a global health problem, it is a curable disease, with affordable treatment and prevention. Nonetheless, it remains one of the leading
causes of death from a single infectious agent worldwide, a situation threatened by COVID-19.
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The United Nations Children's Fund (UNICEF), the International Organization for Migration (IOM), Georgetown University, and the United Nations University have today launched new guidelines to provide the first-ever global policy framework that will help protect, include, and empower children on the ...move in the context of climate change.
The Guiding Principles for Children on the Move in the Context of Climate Change provides a set of 9 principles that address the unique and layered vulnerabilities of children on the move both internally and across borders as a result of the adverse impacts of climate change. Currently, most child-related migration policies do not consider climate and environmental factors, while most climate change policies overlook the unique needs of children.
The guidelines note that climate change is intersecting with existing environmental, social, political, economic, and demographic conditions contributing to people’s decisions to move. In 2020 alone, nearly 10 million children were displaced in the aftermath of weather-related shocks. With around one billion children – nearly half of the world’s 2.2 billion children – living in 33 countries at high risk of the impacts of climate change, millions more children could be on the move in the coming years.
Developed in collaboration with young climate and migration activists, academics, experts, policymakers, practitioners, and UN agencies, the guiding principles are based on the globally ratified Convention on the Rights of the Child and are further informed by existing operational guidelines and frameworks.
Recommendations for safeguarding the rights and well-being of children regardless of their location or migration status.
The guiding principles provide national and local governments, international organizations and civil society groups with a foundation to build policies that protect children’s rights. The organizations and institutions are calling on governments, local and regional actors, international organizations, and civil society groups to embrace the guiding principles to help protect, include, and empower children on the move in the context of climate change.
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