This report provides a review and analysis of the research landscape for three diseases – Chagas disease, human African trypanosomiasis and leishmaniasis – that disproportionately afflict poor and remote populations with limited access to health services. It represents the work of the disease re...ference group on Chagas Disease, Human African Trypanosomiasis and Leishmaniasis (DRG3) which was established to identify key research priorities through review of research evidence and input from stakeholders' consultations.
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Two adjectives raise an issue for communicators working on Chagas disease (CD): “invisible and silent”. Two adjectives that can be ascribed to other neglected tropical diseases (NTD), but which are part of the essence of CD. Bringing CD out of its situation of neglect and oblivion is a mission e...ntrusted mainly to the world of communication as well as of science, politics and financial resources. However, communication has not always been considered among the priorities in the approach to the disease, except in valuable exceptions, some of which we have seen in the preceding article.
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Epidemiology
Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or... drink.1-4 The hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
Vector-borne transmission occurs only in the Americas, where an estimated 8 to 10 million people have Chagas disease.5 Historically, transmission occurred largely in rural areas in Latin America, where houses built of mud brick are vulnerable to colonization by the triatomine vectors.4 In such areas, Chagas disease usually is acquired in childhood. In the last several decades, successful vector control programs have substantially decreased transmission rates in much of Latin America, and large-scale migration has brought infected individuals to cities both within and outside of Latin America.
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Chagas disease (American trypanosomiasis) is caused by the protozoan parasite Trypanosoma cruzi, and transmitted to humans by infected triatomine bugs, and less commonly by transfusion, organ transplant, from mother to infant, and in rare instances, by ingestion of contaminated food or drink.1-4 The... hematophagous triatomine vectors defecate during or immediately after feeding on a person. The parasite is present in large numbers in the feces of infected bugs, and enters the human body through the bite wound, or through the intact conjunctiva or other mucous membrane.
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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 detecting outbreaks, and after detection,
investig...ating and containing them.
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Revised and expanded version of the Guidelines
Access to health workers who are fit for purpose, motivated and protected is a fundamental force of health service delivery and the achievement of universal health coverage and the health and health-related Sustainable Development Goals. Data and knowledge of the distribution, skill mix and future d...evelopment needs of the health workforce can mean the difference between enabling or impeding health systems performance, inclusive economic growth and global health security preparedness and response
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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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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a...dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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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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These guidelines have been compiled for education ministries or other educational leaders (including development partners, non-governmental or private organizations working with schools or directly with caregivers) who want to adapt and adopt resources to support the marginalized caregivers of child...ren with disabilities.
The guidance presented in this document was developed by a team of international and national experts following a proof-of-concept pilot4 of the resources in two countries. The work was carried out between February 2021 and January 2022. The pilots demonstrated that principles and activities described in the resources could be carried out, in practical terms, in line with existing government programmes supporting the implementation of disability-inclusive education.
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This sourcebook aims to detail why health needs to be part of urban and territorial planning and how to make this happen. It brings together two vital elements we need to build habitable cities on a habitable planet: 1) Processes to guide the development of human settlements – in this document ref...erred to as “urban and territorial planning (UTP)”; and 2) concern for human health, well-being and health equity at all levels – from local to global, and from human to planetary health.
This sourcebook identifies a comprehensive selection of existing resources and tools to support the incorporation of health into UTP, including advocacy frameworks, entry points and guidance, as well as tools and illustrative case studies. It does not provide prescriptions for specific scenarios – these should be determined by context, people and available resources.
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Ce guide de référence a pour objectif d’expliquer en détail pourquoi la santé doit être intégrée dans la planification urbaine et territoriale et comment y parvenir. Il réunit deux éléments essentiels dont nous avons besoin pour construire des villes habitables sur une planète habitable... : les processus pour guider le développement des établissements humains — appelés dans cet ouvrage « Planification Urbaine et Territoriale » (PUT) ; et le souci de la santé humaine, du bien-être et de l’équité en matière de santé à tous les niveaux – du local au mondial et de la santé humaine à la santé planétaire.
Ce guide de référence identifie une sélection complète de ressources et d’outils existants pour soutenir l’intégration de la santé dans la PUT : notamment des activités de plaidoyers, des points d’entrées et des conseils, ainsi que des outils et des études de cas illustratifs. Toutefois, il ne fournit pas de prescriptions pour des scénarios spécifiques – ceux-ci doivent être déterminés par le contexte, les personnes et les ressources disponibles.
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Este libro de consulta tiene como objetivo detallar por qué la salud debe ser parte de los procesos de planificación urbana y territorial y cómo hacer que esto suceda. Reúne dos elementos vitales que necesitamos para construir ciudades habitables y un planeta habitable: 1) Procesos para guiar el... desarrollo de asentamientos humanos - en este documento denominado “planificación urbana y territorial”; y 2) Importancia de la salud humana, el bienestar y la equidad sanitaria en todos los niveles, desde el local al mundial, y desde la salud humana a la planetaria.
Este libro de consulta identifica una selección completa de recursos y herramientas existentes para apoyar la incorporación de la salud en la planeación urbana y territorial, incluidos marcos de promoción, puntos de entrada y orientación, así como herramientas y estudios de casos ilustrativos. No proporciona prescripciones para escenarios específicos; estos deben estar determinados por el contexto, las personas y los recursos disponibles.
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These country profiles present progress on implementation of policy recommendations of the Global Action Plan on Physical Activity (GAPPA) 2018-2030 in each country. They also present an estimate of the cost to health systems of not taking action to improve physical activity levels and reinforce th...e urgency to position physical activity as a shared, whole-of-government priority, and to strengthen coordination and partnerships to promote physical activity.
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Anopheles stephensi, a highly competent vector of Plasmodium falciparum and P. vivax, is considered an efficient vector of urban malaria. Until 2011, the reported distribution of An. stephensi was confined to certain countries of South Asia and parts of the Arabian Peninsula. Since then, the vector ...has been collected in Djibouti (2012), Ethiopia (2016), Sudan (2016), Sri Lanka (2017), Somalia (2019), and most recently Nigeria (2020) and Yemen (2021). WHO considers the spread of An. stephensi to be a major potential threat to malaria control and elimination in Africa and southern Asia and has recently launched an initiative against the spread of this vector in Africa.
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This document focuses on the management of patients affected by gambiense HAT and
constitutes an update to the WHO therapeutic guidance issued in 2013. The main changes in recommendations concern the criteria and methods for deciding the treatment among the new set of therapeutic options and the pa...rticular conditions that apply to treatment with fexinidazole, as outlined below. Because HAT is a serious, life-threatening disease and because the efficacy of fexinidazole depends on swallowing the medicine after an appropriate intake of food as well as on completing the full 10-day
treatment schedule, the recommendations regarding fexinidazole administration are considered key elements that must be carefully followed. When the conditions listed in these guidelines are not met for any individual patient, the alternative available treatments should be prescribed.
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This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita...ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
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This thematic brief accompanies the Working for Health 2022–2030 Action Plan, serving as a rationale to the related actions of the Working for Health progression model (see Annex). The brief aims to inform Member States, non-state actors and other users of the Action Plan to guide action on inves...tments on strengthening protection and performance of the health and care workforce, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan itself and reflects the topical issues and considerations that shaped its design, including those issues identified in the World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce (1). The importance of these themes was again emphasized at the Seventy-fifth World Health Assembly, when Resolution WHA75.17: Human resources for health was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact
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This thematic brief accompanies the Working for Health 2022–2030 Action Plan, providing a rationale for the related actions of the Working for Health progression model (see Annex). This brief aims to inform Member States, non-state actors and other stakeholders vested in implementing the Action ...Plan to consider the context of planning and financing for the health and care workforce, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan Itself, and reflects the topical issues and considerations that shaped its design, including those issues identified in the World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce. The importance of these themes was again emphasized at the Seventy-fifth WHA, when Resolution WHA75.17: Human resources for health, was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact.
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