Cotonou Declaration oBuruli Ulcer
Cotonou, Benin, 30 March 2009
Neglected tropical diseases kill, weaken or incapacitate millions of people every year, causing permanent physical suffering, social... stigmatization and reduced productive capacity. Buruli ulcer, one such disease, causes immense suffering and disabilities, especially among children. Delayed schooling and loss of productivity are considerable among the affected populations. These adverse consequences tend to aggravate poverty in affected communities. Globally, the disease has been reported in 30 countries. In WHO’s African Region, Buruli ulcer has been confirmed in 12 countries and is suspected in 10 others.
Significant progress has been made in the past 10 years in knowledge of Buruli
ulcer, investments in related research, control of the disease, and improvement
of tools for case diagnosis and development of treatment protocols. Substantial achievements have been made in diagnosis, treatment, immunology and epidemiology. Despite these achievements, little is known about the exact mode of transmission of the disease, and there is no simple diagnostic test usable in the field.
The use of antibiotics has revolutionized treatment and contributed to reducing the need for surgery by half. However, efforts are still needed to develop simple diagnostic tools usable in the field as well as disability prevention methods. The Global Buruli Ulcer Initiative has adopted the strategy recommended by WHO. The strategy is based on early diagnosis of the disease and the use of antibiotics for treatment upon the onset of the first signs by improving access to screening and case management at the most peripheral level of the health system.
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Mycetoma is a specific chronic, granulomatous, inflammatory disease. It usually involves the subcutaneous tissue, most probably after traumatic inoculation of the causative organism. It has a prolon...ged, progressive, and indolent course, and, if untreated, it ultimately leads to destruction of the deeper tissues and bone, resulting in deformity and disability that may necessitate amputation of the affected parts with all the social and economic implications of this. The disease is characterized by tumefaction, draining sinuses, and the presence of grains.
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The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, wat...er, sanitation and hygiene, logistics, community engagement and risk communication. All efforts must be well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
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Each year, the WHO Global TB Report provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment ...medbox">of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
The 2021 edition of the report has been produced in a new and more web-centric format. This is designed to make the content available in smaller (more “bite-sized”) chunks that are easier to read, digest, navigate and use. There is a short and slim report PDF with 30 pages of main content plus six short annexes. This is accompanied by expanded and more detailed digital content on web pages. The total amount of content remains similar to that of previous years.
Available in English, French, Arabic and Chinese
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In Kenya, the bacterial infections that contribute most to human disease are often those in which re-‐sistance is most evident. Examples are multidrug-‐resistant enteric ... bacterial pathogens such as typhoid, diarrhoeagenic Escherichia coli and invasive non-‐typhi salmonella, penicillin-‐resistant Streptococcus pneu-‐moniae, vancomycin-‐resistant enterococci, methicillin-‐resistant Staphylococcus aureus and multidrug-‐re-‐sistant Mycobacterium tuberculosis. Resistance to medicines commonly used to treat malaria is of particu-‐lar concern, as is the emerging resistance to anti-‐HIV drugs. Often, more expensive medicines are required to treat these infections, and this becomes a major challenge in resource-‐poor settings.
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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. ...The prenatal and early childhood period represents
a window of particular vulnerability, where environmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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Environmental Research Volume 151, November 2016, Pages 115-123
Dengue is the world’s most important arboviral disease in terms of number of peo...ple affected. Over the past 50 years, incidence increased 30-fold: there were approximately 390 million infections in 2010. Globalization, trade, travel, demographic trends, and warming temperatures are associated with the recent spread of the primary vectors Aedes aegypti and Aedes albopictus and of dengue. Overall, models project that new geographic areas along the fringe of current geographic ranges for Aedes will become environmentally suitable for the mosquito’s lifecycle, and for dengue transmission. Many endemic countries where dengue is likely to spread further have underdeveloped health systems, increasing the substantial challenges of disease prevention and control. Control focuses on management of Aedes, although these efforts have typically had limited effectiveness in preventing outbreaks. New prevention and control efforts are needed to counter the potential consequences of climate change on the geographic range and incidence of dengue, including novel methods of vector control and dengue vaccines.
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The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma a...nd Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (The Union) to monitor asthma and improve asthma care, particularly in low- and middle-income countries (LMICs).
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This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This... is followed by key figures for the region, the role of WHO in country support and, recognizing the importance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
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Mosquitoes, flies, bugs and other vectors transmit viruses, parasites and bacteria that infect millions of people globally. They cause many diseases, including malaria, dengue, leishmaniases, Chagas... disease and Zika virus disease.
The World Health Organization (WHO) has developed a new strategy to strengthen vector control worldwide. Member States welcomed this integrated approach at the 2017 World Health Assembly and adopted a resolution to support the strategy.
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Psoriasis, which can involve the skin, nails and joints, is a chronic, painful, disfiguring and disabling noncommunicable disease (NCD) for which there is no cure. It negatively impacts on quality of...> life. Some of those who suffer from the disease develop chronic, inflammatory arthritis (psoriatic arthritis) that leads to joint deformations and disability. People with psoriasis are also reported to be at increased risk of developing other serious clinical conditions such as cardiovascular and other NCDs
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The Global Sexual and Reproductive Health Service Package for Men and Adolescent Boys has been developed to support providers of sexual and reproductive health (SRH) services to increase the range and quality ...ox">of services to meet the specific and diverse needs of men and adolescent boys. This package focuses specifically on the provision of such services integrated
within clinical and non-clinical contexts and follows a gender-transformative approach. It covers men and adolescent boys in all their diversity and takes a positive approach to SRH, seeing this not just as the absence of disease, but the positive expression of one’s gender, sex and sexuality. In doing so, this service package contributes to efforts to ensure universal access to sexual and reproductive health and rights (SRHR) as prioritized in the Sustainable Development Goals. This package is in no way intended to detract from the sexual and reproductive health and rights of women and adolescent girls, nor to divert resources, funding or attention from much-needed SRH services and programmes for women and adolescent girls.
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Advances have been made through expanded interventions delivered through five public health approaches: innovative and intensified disease management; preventive chemotherapy; vector ecology and management; veterinary public health services; and the... provision of safe water, sanitation and hygiene. In 2015 alone nearly one billion people were treated for at least one disease and significant gains were achieved in relieving the symptoms and consequences of diseases for which effective tools are scarce; important reductions were achieved in the number of new cases of sleeping sickness, of visceral leishmaniasis in South-East Asia and also of Buruli ulcer.
The report also considers vector control strategies and discusses the importance of the draft WHO Global Vector Control Response 2017–2030.
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Public Health is the science field dedicated to promoting health and well-being, and preventing disease within the human population to ultimately increase the quality of our livelihood and life span.... Public Health does not focus on individual patients or diseases, but rather a given population and health system. The discipline is community-centered in its interventions and seeks to improve the health status of whole populations...
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Each year, 33000 people die from an infection due to bacteria resistant to antibiotics. The burden of infections with bacteria resistant to antibiotics on the European population is comparable to th...at of influenza, tuberculosis and HIV/AIDS combined.
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Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious ...t medbox">diseases is greater and exacerbated by limited access to, and availability and affordability of, antimicrobials required to treat infections caused by AMR organisms. With drugs not listed on the essential drugs list (EDL), problems of increased morbidity, costs of extended hospitalisation and mortality are extremely serious. The problem of susceptibility to and spread of infections caused by multidrug-resistant (MDR) infectious agents is fuelled by factors such as limited access to clean water and sanitation to ensure personal hygiene, malnutrition, and the HIV/TB epidemic.
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease... can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of transmission, context and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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WHO published guidance for clinicians and health care decision-makers on the use of corticosteroids in patients with COVID-19.
We recommend systemic corticosteroids for the treatment of patients ...with severe and critical COVID-19. We suggest not to use corticosteroids in the treatment of patients with non-severe COVID-19 as the treatment brought no benefits, and could even prove harmful. Treatment should be under supervision of a clinician.
Corticosteroids are listed in the WHO model list of essential medicines, readily available globally at a low cost. WHO encourages countries to maintain sufficient stocks of corticosteroids to treat COVID-19 and the other disease for which they are effective, while not maintaining excessive stocks which could deny other countries access.
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BMJ Global Health, Vol.5 No. 12Spatial subdivision of the camp (‘sectoring’) was able to ‘flatten the curve’, reducing peak infection by up to 70% and delaying peak infection by up to several months. The use ...ht medbox">of face masks coupled with the efficient isolation of infected individuals reduced the overall incidence of infection, and sometimes averted epidemics altogether. These interventions must be implemented quickly in order to be maximally effective. Lockdowns had only small effects on COVID-19 dynamics.
Conclusions
Agent-based models are powerful tools for forecasting the spread of disease in spatially structured and heterogeneous populations. Our findings suggest that feasible interventions can slow the spread of COVID-19 in a refugee camp setting, and provide an evidence base for camp managers planning intervention strategies. Our model can be modified to study other closed populations at risk from COVID-19 or future epidemics.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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