L'eau potable et les services d'assainissement et d'hygiène (WASH) sont essentiels à la prévention des 17 maladies tropicales négligées (MTN) pour lesquelles une intensification de la lutte ou l'élimination sont prévues à l'horizon 2020.
La fourniture d’eau potable et de services d’
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assainissement et d’hygiène est l’une des cinq interventions clés inscrite dans la feuille de route mondiale contre les MTN. Pourtant, à ce jour, la composante WASH de la stratégie n’a reçu que peu d’attention et le potentiel lié à la mise en commun des efforts WASH et MTN reste largement inexploité.
Des efforts ciblés sur la composante WASH sont nécessaires de toute urgence pour atteindre les cibles de la feuille de route mondiale contre les MTN.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites
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of medical societies and contacted international organizations.
Country-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countries, the causes
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of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel smoke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa.
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Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still nee
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ds substantial improvement. From infancy to the teenage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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The guide aims to provide health and DRM practitioners, planners and policymakers across sectors with targeted information to help them strengthen national health systems and integrate the risks of disease outbreaks in national DRR strategies
The
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following are some of the principles and approaches that have been based on lessons learned to date and may be considered to ensure effective all-hazards health EDRM, including prevention and preparedness for disease outbreaks, are addressed as part of the multihazard, multisectoral approach to developing or updating DRR strategies
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The workshop aimed to support countries in the prioritization and acceleration of NCD prevention and management with a specific focus on accelerating the prevention and control of hypertension and d
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iabetes, identifying the most impactful NCD interventions within their context, closing the gaps in cancer care services through regional collaboration and integrating NCD services in when responding to emergencies.
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The document discusses the complexities of managing patients with COPD and multiple comorbidities, highlighting the importance of personalized care and the appropriate use
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of inhaled corticosteroids (ICS). It outlines common comorbidities, such as asthma, osteoporosis, and diabetes, and offers guidance on optimizing treatment regimens while minimizing risks and polypharmacy in primary care settings.
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This guideline for the prevention and control of chikungunya fever
(CF) is intended for use by all peripheral health workers in the Region and
is based on the strategy outlined above. This document will focus mainly
on preventing, predicting and
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detecting outbreaks, and after detection,
investigating and containing them.
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The document "Management of Type 2 Diabetes Mellitus" provides comprehensive guidelines for the diagnosis, prevention, and treatment of type 2 diabetes in adults. It emphasizes the importance
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of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medications such as metformin, SGLT2 inhibitors, and GLP1 receptor agonists to manage blood sugar levels and reduce long-term complications. The document also discusses the screening and management of comorbidities such as hypertension, hyperlipidemia, and diabetic complications like retinopathy, neuropathy, and nephropathy. It highlights the role of diabetes self-management education and support in improving adherence to treatment and patient outcomes. The guidelines are evidence-based and aim to reduce morbidity and mortality associated with type 2 diabetes.
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A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists w
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orking on this disease, the manual details the exact procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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The document, "Sustainable Management of Radiotherapy Facilities and Equipment," by WHO and IAEA, provides guidelines for managing radiotherapy equipment and facilities to ensure effective and safe cancer treatment. It covers essential aspects like
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preventive and corrective maintenance, funding, infrastructure, and staffing requirements for sustainable operation. The document aims to support radiotherapy departments, especially in low-resource settings, by outlining strategies for equipment procurement, maintenance, and replacement, emphasizing safety, quality assurance, and optimal patient care.
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The article "Under- and over-diagnosis of COPD: a global perspective" reviews the worldwide variation in the prevalence of chronic obstructive pulmonary disease (COPD) and issues related to its misd
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iagnosis. It highlights that COPD is under-diagnosed due to factors such as limited access to spirometry and variable diagnostic criteria, especially in low- and middle-income countries. Conversely, over-diagnosis often results from reliance on non-standard criteria or inadequate spirometry use. The article discusses key risk factors, including age, gender, exposure to pollutants, and comorbidities, and emphasizes the need for standardized diagnostic practices to better address and manage COPD globally.
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This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aime
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d particularly at district health care providers. A comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r
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egion in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
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Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful
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research has outlined the different molecular mechanisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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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 su
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stainable experiences, with higher social awareness, 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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The “ActiveAge Handbook” is an outcome of the “ActiveAge Project, which was carried out from January 2013 until June 2014 in the frame of “2012 Preparatory Actions in the Field
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of Sport” of the European Commission Directory General Education and Cul-
ture (DG EAC) in cooperation with 13 European partners under the leadership of the German Gymnastic Federation (DTB). “ActiveAge” was set up as a transnational project that fosters the exchange of knowledge and experience to counteract the physical inactivity of elderly people through capacity building for physical activities and sport programs of aging people in well-
structured and wide-spread settings, with the starting point in sport-organizations.
The handbook is intended to be used as a guideline for further activities of the “European Platform Active Aging in Sport” (EPAAS), which will continue the mission of the ActiveAge Project. Furthermore the handbook should serve as well for any other stakeholder interested to promote physical activities and sport for elderly people.
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BMJ Glob Health 2017;2:e000345. doi:10.1136/bmjgh-2017-000345. WHO's 2020 milestones for Chagas disease include having all endemic Latin American countries certified with no intradomiciliary Trypanosoma cruzi transmission, and infected patients under care. Evaluating the variation in historical expo
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sure to infection is crucial for assessing progress and for understanding the priorities to achieve these milestones.
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Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause
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of early mortality and morbidity, and it is associated with poverty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
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April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cr
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uzi transmission in Latin American settings where the disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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