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This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain
...
areas associated with mood regulation. Finally, I discuss several candidate gene polymorphisms that interact with childhood maltreatment to modulate vulnerability to major depression and PTSD and epigenetic mechanisms thought to transduce environmental stressors into disease vulnerability.
Neuron Review, vol. 89, March 2, 2016 pp.892-909
more
The Participation Handbook for humanitarian field workers contains detailed practical advice on the participation of affected people in humanitarian action. It has three sections:
Developing a participatory approach (main issues, key factors,
...
building mutual respect, communication methods and advice on reviewing your approach);
Implementing your participatory approach at every stage of the project cycle (initial assessment, project design, implementation, monitoring and final evaluation);
A list of tools and additional resources (books, internet sites, etc.)
more
Reduce Risk, Protect Health Facilities, Save Lives
This reference manual provides in-depth knowledge on the techniques, methodologies and best practices for using geospatial information in support of decision making for disaster risk management for specific hazards
Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approxim
...
ately twice as high as high-resource settings (15 out of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
more
Minimizing risk of developing antibiotic resistance and aquatic ecotoxicity in the environment resulting from the manufacturing of human antibiotic.
The Standard, facilitated by BSI Standards Limited (BSI), provides clear guidance to manufacturer
...
s in the global antibiotic supply chain to ensure that their antibiotics are made responsibly, helping to minimize the risk of AMR in the environment.
more
The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project
Kirenga, B.J.; Chakaya, J.; Yimer, G. et al.
Journal of Allergy and Clinical Immunology: Global
(2024)
CC
Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence,
mortality, and activity and work impairment) of severe asthma in 3
...
countries in East Africa: Uganda, Kenya, and Ethiopia using the American Thoracic Society/European Respiratory Society case definition of severe asthma.
more
Emerging evidence and experience to inform risk management in a warming world
NSW Disaster Mental Health Handbook 5
The Disaster Mental Health Manual and associated handbooks are intended as a resource for mental health staff who are seeking background information and practical guidance and resources to assist in a disaster
...
mental health response.
more
Manual for step-by-step risk management for safely managed sanitation systems. 2nd edition.
This Sanitation safety planning (SSP) manual provides practical, step-by-step guidance to assist in the implementation of the 2018 World Health Organization
...
(WHO) Guidelines on sanitation and health and the 2006 WHO Guidelines for safe use of wastewater, excreta and greywater in agriculture and aquaculture. The approach and tools should be applied to all sanitary systems to ensure that they are managed to meet health objectives.
The SSP manual is targeted at a variety of users at different levels including; health authorities and regulators, local authorities, sanitation utility managers, sanitation enterprises and farmers, community-based organizations, farmers associations and nongovernmental organizations.
more
The Middle East Program for Youth in Crisis at the Harvard Humanitarian Initiative
Brett D. Nelson, Maya Fehling, Margaret E. Tierna, Zina Maan Jarrah
Harvard Humanitarian Initiative
(2015)
Examining the needs of at‐risk youth in the Middle East and North Africa: A multi‐method landscape analysis and systematic literature review
Vitamin A deficiency is a risk factor for blindness and for mortality from measles and diarrhoea in children aged 6–59 months. We aimed to estimate trends in the prevalence of vitamin A defi ciency between 1991 and 2013 and its mortality burden in
...
low-income and middle-income countries.
more
Stress and Vulnerability to Posttraumatic Stress Disorder in Children and Adolescents
Silva, R.R., Alpert, M., Munoz, D.M., Singh, S., Matzner, F. & Dummit, S.
American Journal of Psychiatry
(2000)
CC
Objective: This study examined the experiential factors and interacting vulnerabilities that contribute to the development of posttraumatic stress disorder (PTSD) in children and adolescents
Am J Psychiatry 2000; 157:1229–1235)
In 2016, the risk of premature mortality1 from noncommunicable diseases (NCDs) in Ethiopia was 18.3%. The economic costs of NCDs are significant and are due principally to their impact on the non-health sector (reduced workforce and productivity). I
...
n this study, it is estimated that NCDs cost Ethiopia at least 31.3 billion birr (US$ 1.1 billion) per year, equivalent to 1.8% of the gross domestic product (GDP). Less than 15% of the costs are for health care.
more
13 July 2021
The module provides an overview of factors to consider when monitoring the safety of COVID-19 vaccines administered to pregnant and breastfeeding women. It describes how national routine AEFI surveillance should be adapted to cater fo
...
r this specific group of population using both passive and active surveillance methods. Specific considerations and limitations of each method are provided as well as tools for implementation.
more
Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of abou
...
t 10 million deaths annually in India. Fifty seven percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
more
Obesity and diabetes are affecting the peoples of the Americas at high and increasing rates. National surveys demonstrate that obesity is increasing in prevalence among all age groups; 7% to 12% of children under 5 years old and
one-fi fth of adolescents are obese, while rates of overweight and obe
...
sity among adults approach 60%. Obesity is the major modifi able risk factor for diabetes.
more
Hundreds of thousands of refugees are at risk of being pushed to return to Syria in 2018, despite ongoing violence, bombing and shelling that are endangering the lives of civilians, leading humanitarian agencies warn in a report released today. The
...
warning comes amid a global anti-refugee backlash, harsher conditions in neighbouring countries hosting Syrians, and Syrian government victories in the conflict that have fuelled misleading rhetoric suggesting Syria is safe for refugees to return.
more
This document provides guidance to Member States in the WHO European Region that wish to conduct behavioural insights studies related to COVID-19. Studies can be used to monitor public knowledge, risk perceptions, behaviours and trust with the overa
...
ll aim to inform national COVID-19 outbreak response measures, including policies, interventions and communications.
more
n light of the potential risk posed by SARS-CoV-2 variants, in January 2021 WHO organized an ad hoc consultation to discuss the development of an R&D agenda in response to existing and emerging SARS-CoV-2 variants.
The key objectives were to iden
...
tify the critical research questions related to variants and agree on a research approach to address them. Six breakout groups covered a range of specific issues related to COVID-19 variants: Epidemiology and mathematical modelling; evolutionary biology; animal models; assays and diagnostics; clinical management and therapeutics; and vaccines.
This report is a summary of presentations and panel discussions.
more
COVID-19 outbreak is associated with the generation of many types of infectious wastes, including infected masks, gloves and other protective equipment, together with a higher volume of general waste of the same nature.
Evidence shows that oral pre-exposure prophylaxis (PrEP) reduces the risk of contracting HIV during sexual intercourse by more than 90% when taken daily. It is for this reason the National HIV Prevention Strategy 2015-2020 (2018 Revision) emphasi
...
ses the role of preexposure prophylaxis (PrEP) in reducing new HIV infections in Malawi.
The Ministry of Health has prioritised PrEP use among the populations most at-risk of HIV infection in Malawi: young women ages 10 to 24 years, sero-discordant couples, female sex workers, men who have sex with men, and other priority populations (such as members of the uniformed services, prisoners, and mobile populations).
more
Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urb
...
anization, economic expansion, and population growth raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
more
Guideline: Nutritional care and support for patients with tuberculosis
Maria del Carmen Casanovas, Knut Lönnroth, Luz Maria De-Regil et al
World Health Organization
(2013)
C_WHO
Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with TB. It has been demonstrated that undernutrition is a
...
risk factor for progression from TB infection to active TB disease and that undernutrition at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
more
Undernutrition in Myanmar. Part 2: A Secondary Analysis of LIFT 2013 Household Survey Data
Zaw Win; Cashin, Jennifer
Leveraging Essential Nutrition Actions to Reduce Malnutrition (LEARN)
(2016)
C1
In order to better understand the contributing factors of undernutrition in LIFT program areas and the links between child nutritional status and independent variables of programmatic importance to LIFT (such as income, livelihoods, food security, a
...
nd water, sanitation and hygiene [WASH]), LEARN commissioned a secondary analysis of nutrition-related data from the 2013 LIFT Household Survey. The purpose of this report is to present the findings of this analysis.
more
People with asthma (PWA) generally are considered at higher risk from respiratory infections, as is seen annually with influenza. At the outset of the COVID-19 pandemic, PWA were widely assumed to be at increased
...
risk from COVID-19. However, as data emerged throughout 2020, the association between asthma and COVID-19 appeared less clear.
more
The pandemic has emphasized the high risk of avoidable harm to patients, health workers, and the general public, and has identified a range of safety gaps across all core components of health systems at all levels.
The rapid review ‘Implication
...
s of the COVID-19 pandemic for patient safety’ explores impacts that the COVID-19 pandemic did have on patient safety in terms of risks and avoidable harm, specifically in terms of diagnostic, treatment and care management related issues as well as highlights the main patterns of these implications within the broader health system context.
more
Step-by-step risk management guidance for drinking-water supplies in small communities.
Toward Resilience
recommended
Marilise Turnbull, Charlotte L. Sterrett, and Amy Hilleboe
Practical Action Publishing Ltd, Catholic Relief Services
(2013)
C1
A Guide to Disaster Risk Reduction and Climate Change Adaptation
2nd edition
WASH FIT is a risk-based, continuous improvement framework with a set of tools for undertaking water, sanitation and hygiene (WASH) improvements as part of wider quality improvements in health care facilities. It is aimed at small prima
...
ry, and in some instances secondary, health care facilities in low and middle income countries.
An app, for front line data collection is also available in the Android Google Play store or as a web app
more
A review of proactive risk assessment and risk management practices to ensure the safety of drinking-water
Based on information gathered from 118 countries representing every region of the glob ... e, this report provides a picture of WSP uptake worldwide. It presents information on WSP implementation and the integration of WSPs into the policy environment. It also explores WSP benefits, challenges and future priorities. more
Based on information gathered from 118 countries representing every region of the glob ... e, this report provides a picture of WSP uptake worldwide. It presents information on WSP implementation and the integration of WSPs into the policy environment. It also explores WSP benefits, challenges and future priorities. more
Severe cases of COVID-19 are associated with rehabilitation needs related to the consequences of ventilatory support, and prolonged immobilization and bed rest. These may include: − Impaired lung function; − Physical deconditioning and muscle we
...
akness; − Delirium and other cognitive impairments; − Impaired swallow and communication; and − Mental health disorders and psychosocial support needs. − Rehabilitation needs may be amplified by underlying health conditions and decrements in health associated with ageing, − Rehabilitation professionals play an important role in facilitating early discharge, which is especially critical in the context of hospital bed shortages. − Rehabilitation needs of people with severe COVID-19 exist during the acute, sub-acute and long-term phases of care; rehabilitation professionals should be positioned in ICUs, hospital wards, stepdown facilities and in the community. − Particularly in the acute phase, rehabilitation interventions for patients with severe COVID-19 requiring ventilatory support generally require a particular skill-set acquired through specialist training.
more
Primary care health centers and providers who care for individuals with hypertension and cardiovascular disease have an important role to play in ensuring continued access to care, reducing the risk of coronavirus infection, and appropriately managi
...
ng people with these co-morbidities who acquire COVID-19. This guidance includes these considerations
more
People with asthma (PWA) generally are considered at higher risk from respiratory infections, as is seen annually with influenza. At the outset of the COVID-19 pandemic, PWA were widely assumed to be at increased
...
risk from COVID-19. However, as data emerged throughout 2020, the association between asthma and COVID-19 appeared less clear.
more
The global burden of disease associated with air pollution exposure exacts a massive toll on human health worldwide: exposure to air pollution is estimated to cause millions of deaths and lost years of healthy life annually. The burden of disease at
...
tributable to air pollution is now estimated to be on a par with other major global health risks such as unhealthy diet and tobacco smoking, and air pollution is now recognized as the single biggest environmental threat to human health.
more
The study sought to understand the factors that facilitate women to adhere to treatment and return to health facilities for routine care from their own perspective. The researchers focused on Malawi, Uganda and Zambia, early adopters of the global g
...
uidance to provide lifelong treatment for pregnant women living with HIV (Option B+) and spoke to women living with HIV, healthcare workers and programme managers to discover which factors and practices show promise in supporting women to initiate and remain in care.
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment. more
This study found that women living with HIV who access these services to prevent vertical transmission have a strong sense and understanding of what factors support their retention and how health facilities, the wider community and their friends and relations can best support them. This report shares their words to describe how it feels to walk in their shoes on the path of life long treatment. more
Thematic Report– 3 April 2020
ACAPS Risk Analysis: COVID19
info@acaps.org
UNHCR invested significantly in risk mitigation, prevention and response to sexual exploitation and abuse (SEA) in the Europe region in 2022-2023, in particular in connection with the Ukraine emergency, where the risks were considered high due to th
...
e unprecedented scale and speed of displacement, mostly women and children, combined with high turnover of humanitarian staff and the range of new and untraditional actors involved in the response. PSEA also remains a priority for UNHCR’s work for other refugees, internally displaced and stateless persons across the region.
This compilation highlights the 10 most promising practices that were initiated by UNHCR and its partners in the Europe region in 2022-2023. These practices are shared with the aim to inspire further work on PSEA in the region and elsewhere and encourage continuous learning and exchange.
more
ECDC Technical Report
In line with ECDC’s recommendations provided in the ’Risk Assessment of HTLV-1/2 transmission by tissue/cell transplantation’ dated 14 March 2012, this Directive replaces the term ‘incidence’ with ‘prevalence ... in the description of endemic areas of HTLV-1/2 infection. According to the new requirements ‘HTLV-1 antibody testing must be performed for donors living in, or originating from high-prevalence areas or with sexual partners originating from those areas or where the donor’s parents originate from those areas’ and this applies to both donors of non-reproductive tissues and cells and reproductive cells.
ECDC contracted experts from the Institut Pasteur in Paris to systematically review the published evidence on the distribution of HTLV-1 infection prevalence throughout the world and to identify high-prevalence countries and areas. more
In line with ECDC’s recommendations provided in the ’Risk Assessment of HTLV-1/2 transmission by tissue/cell transplantation’ dated 14 March 2012, this Directive replaces the term ‘incidence’ with ‘prevalence ... in the description of endemic areas of HTLV-1/2 infection. According to the new requirements ‘HTLV-1 antibody testing must be performed for donors living in, or originating from high-prevalence areas or with sexual partners originating from those areas or where the donor’s parents originate from those areas’ and this applies to both donors of non-reproductive tissues and cells and reproductive cells.
ECDC contracted experts from the Institut Pasteur in Paris to systematically review the published evidence on the distribution of HTLV-1 infection prevalence throughout the world and to identify high-prevalence countries and areas. more
Contact tracing – along with robust testing, isolation and care of cases – is a key strategy for interrupting chains of transmission of SARS-CoV-2 and reducing mortality associated with COVID-19.
NSW Disaster Mental Health Handbook 4
The Disaster Mental Health Manual and associated handbooks are intended as a resource for mental health staff who are seeking background information and practical guidance and resources to assist in a disaster
...
mental health response.
more
Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy)
and more specific
...
interventions, such as carotid revascularization or anticoagulation for atrial fibrillation. The objective of this review is to discuss effective interventions for optimal primary and secondary stroke prevention.
more
A guide to facilitating community-managed disaster risk reduction in the Horn of Africa.
This manual describes how to help communities implement disaster risk reduction activities. It was written f
...
or development workers and community-based organizations in the Horn of Africa, but practitioners can use it to implement activities around the world
more
Strengthening HIV prevention among most-at-risk populations (MARPs) in the Syrian Arab Republic:
The objective of this guidance document is to support the public health professionals
in implementing effective surveillance of cholera in at-risk, endemic and epidemic
areas. This document has been developed by the Surveillance Working Group of t
...
he
Global Task Force for Cholera Control (GTFCC) at the World Health Organization based
on the existing documents, guidelines, tools and articles related to surveillance of
cholera disease, as well as technical discussions with experts held during GTFCC
meetings.
more
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 n
...
eed 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.
more
Poor sanitary conditions in disaster-stricken areas result in higher risk for diarrheal illness in vulnerable populations, especially children. This disease negatively impacts the nutritional status of affected children and cause
...
s significant morbidity and mortality. Early diagnosis and treatment are thus essential to reduce the impact of diarrheal diseases on people affected by disasters. Early identification of cases allows the implementation of measures needed to prevent or lessen outbreaks that can occur in displaced populations in this context. The use of primary care management tools, such as the Integrated Management of Childhood Illness (IMCI) strategy is highly important.This module will first discuss diarrheal diseases and their management, and dehydration and its treatments.
more
MAMI refers to the management of small and nutritionally at risk infants under six months of age (infants u6m) and their mothers.
Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an
...
d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
more
Surgical site infections (SSI) are a serious problem globally; they are the most frequent type of health care-associated infection (HAI) observed on admission in low- and middle-income countries (LMICs). Approximately one in 10 people who have surge
...
ry in LMICs acquire an SSI, and SSI is reported as the second most common HAI in Europe and the United States of America. Therefore, it is crucial to include SSI prevention activities in your overall IPC programme.
more
This short guide to the Global Diabetes Compact explains what diabetes is and why action to improve prevention efforts, diagnosis and treatment is so urgent. It outlines the key asks associated with the Compact and emphasizes that increasing access
...
to insulin, strengthening health systems and meaningfully engaging with people affected by diabetes are key to success.
more
The target audience of this document (and the associated online companion tool) includes WHO country offices
in Member States of the African Region; Member States’ ministries of health and their public health emergency
operation centres; relev
...
ant external assessment teams; and partners looking to identify preparedness gaps and
support interventions that help address them. In the event of a suspected or confirmed VHF case, the document also serves to provide any intervening partner with a sense of what structures should be in place, in order to guide
scale-up activities in line with regional and national plans.
more
NSW Disaster Mental Health Handbook 1
The Disaster Mental Health Manual and associated handbooks are intended as a resource for mental health staff who are seeking background information and practical guidance and resources to assist in a disaster
...
mental health response.
more
Male circumcision reduces a man’s risk of heterosexual acquisition of HIV by about 60%. This guideline provides an evidence-based recommendation on the use of adult male circumcision devices for HIV prevention in public health programmes in high H
...
IV prevalence, resource-limited settings. It also presents key programmatic considerations for the introduction and use of these devices in public health HIV prevention programmes. The primary audiences are policy- and decision-makers, programme managers, health-care providers, donors and implementing agencies.
more
WHO and UNICEF have established recommendations for breastfeeding practices. Although every mother decides how to feed her child, this decision is strongly influenced by economic, environmental, social and political factors. The Global Breastfeeding
...
Scorecard analyzes indicators on how countries protect, promote and support breastfeeding through funding or policies.
more
The 2012 NDRMP lays out the Disaster Risk Management (DRM) architecture of the country and provides guidance for DRM intervention at all levels. However, implementation has been slow and resource challenges exist throughout the government.
The PN ... G government’s policy and institutional framework for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks. more
The PN ... G government’s policy and institutional framework for DRM still faces numerous obstacles. The main challenges in moving towards a more proactive and systematic approach to manage risks and build resilience include 1.) the limited coordination between DRM and Climate Change Adaptation agencies; 2.) the slow migration from emphasis on response to risk reduction and management; 3.) the limited institutional capacity for planning and design of risk informed investments; and 4.) the lack of available historic natural hazard data, which hinders the assessment of risks. more
Management of epilepsy in women of child bearing age
World Health Organization
(2012)
C_WHO
Q11: 11a). In women with epilepsy, should antiepileptic therapy be prescribed as monotherapy or polytherapy to decrease the risk of fetal malformations?
11b). Does the use of folic acid preconceptually decrease the
...
risk of foetal malformations in women with epilepsy?
11c). Do phenytoin, phenobarbital, valproic acid or carbamazepine enter breast milk in quantities which are clinically significant to the baby?
more
Children living in humanitarian crises face an increased risk of abuse. While the threats of harm are increasing, the established systems in place to protect them are breaking down. Faced with the COVID-19 pandemic and its impacts, vulnerable famili
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es suffer multiple hardships. Schools are closed and families have been pushed to the brink of poverty, sometimes having been denied the opportunity to protect and provide for their children.
The report provides an in-depth analysis of 19 Humanitarian Response Plans and Refugee Response Plans from 2019
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No country can claim to be free from health-care associated infections, therefore, improvement of infection prevention and control (IPC) strategies is essential. WHO recommends the use of multimodal improvement strategies to implement IPC interventi
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ons. These include each item of standard and transmission-based precautions according to national guidelines or standard operating procedures and under the coordination of the national IPC focal point (or team, if existing). This publication consists of three focused improvement tools, called “aide-memoires”, which focus on 1) respiratory and hand hygiene, 2) personal protective equipment, and 3) environmental cleaning, waste and linen management, all elements of standard, droplet/contact and airborne precautions.
more
This report provides an overview of air pollution levels and associated health impacts in cities around the world. Since urban areas are often hotspots for poor air quality, city-level data can help to inform targeted efforts to curb urban air pollu
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tion and improve public health. This report draws on data from the Global Burden of Disease project and from peer-reviewed analyses led by Susan Anenberg of the George Washington University.
more
This project aimed to reduce the risk of vector-borne infection with Chagas disease by
controlling triatomine bugs, the vectors transmitting the parasite of Chagas disease, and
establishing an epidemiological surveillance system with community p
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articipation.
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Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk
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for Chagas disease transmission is also expected over the next several decades under climate change scenarios. Of particular interest is the predicted northern shift of triatomine species to central regions of the United States with historically unsuitable climates for T. cruzi vectors. The weight of evidence regarding the influences climate change may pose on T. cruzi vector species distributions demonstrates the sensitivity of Chagas disease transmission to future climate variability. In order to advance forecasts for the impact climate change may have on Chagas disease transmission in the Americas, it is imperative to
further develop, utilize, and perhaps combine predictive species distribution modeling approaches that integrate accurate, long term data on climate variables, vector species distributions, Chagas disease incidence, as well as other socio-ecological variables.
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The COVID-19 HEalth caRe wOrkErs Study (HEROES): Regional Report from the Americas is a multicenter prospective cohort study to assess the impact of the COVID-19 pandemic on the mental health of health care workers in 26 countries on four continents and how it is affected by several
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factors at different interrelated levels: individual, family, occupational, and social. This brief report presents the evidence generated from the baseline survey of 11 participating countries in the Region of the Americas. Using validated scales, the findings show high rates of depressive symptoms, suicidal ideation, and psychological distress in several countries of the Region. The spirit of the project is not only to generate quality scientific evidence on the mental health of health care workers, but also to help develop interventions (both individual and institutional) and policies to address the negative impacts of the COVID-19 pandemic on mental health.
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Diabetes is a major public health problem. The rising incidence of Diabetes Type 2 is related to the effects of urbanization and unhealthy lifestyles. Research studies show that healthy eating and regular physical activity can prevent or delay the onset of Diabetes Type 2, even in high-
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risk individuals.
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This document aims to describe a minimum set of surveillance activities recommended at the national level to detect and monitor the relative prevalence of SARS-CoV-2 variants and outline a set of activities for the characterization and assessment of risk
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posed by these variants. A set of indicators is also provided to standardize monitoring and public reporting of variant circulation.
The document is primarily intended for national and sub-national public health authorities and partners who support implementation of surveillance for SARS-CoV-2 variants
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The Guidelines for drinking-water quality: small water supplies have been developed to address the needs and opportunities associated with small supplies to facilitate progressive improvement towards safe and sustainable drinking-water services for
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all. These Guidelines are based on the principal recommendation in the World Health Organization’s Guidelines for drinking-water quality, and they provide guidance on applying that recommendation to small water supplies in particular. These Guidelines aim to help governments and practitioners improve the safety of drinking-water delivered through small supplies.
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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 of individualized glycemic targets, lifestyle interventions like diet and exercise, and the use of medicatio
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ns 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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Alcohol consumption is deeply embedded in the social landscape of many societies. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availabilit
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y of alcohol, culture, economic status and trends in the marketing of alcoholic beverages, as well as implemented alcohol control measures. At the individual level, the patterns and levels of alcohol consumption are determined by many different factors, including gender, age and individual biological and socioeconomic vulnerability factors, as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking encourage alcohol consumption delay appropriate health-seeking behaviour and weaken community action
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"This Code provides practical guidance on how to manage health and safety risks associated with hazardous
chemicals for persons conducting a business or undertaking who use chemicals in their workplace."
Long-lasting insecticide-treated nets and/or indoor residual spraying, associated with case
management, are key interventions in the control of malaria in Africa. The objective of this
study is to comment on the role of social and behavior change
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communication as a potential
key intervention in the control of malaria in Mozambique.
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People with mental disorders in low-income countries are at risk of being left behind during efforts to expand universal health coverage. Aim is to propose context-relevant strategies for moving towards universal health coverage for people with ment
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al disorders in Ethiopia.
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As of 15 May 2020, more than 4 million confirmed cases of COVID-19, including more than 285,000 deaths have been reported to WHO. The risk of severe disease and death has been highest in older people and in persons with underlying noncommunicable di
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seases (NCDs), such as hypertension, cardiac disease, chronic lung disease and cancer.
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Slideset updated regularly to include the latest data and guidance on COVID-19 risk and management in special populations, including children and pregnant women, and persons with comorbidities.
Despite some improvements, current levels of air pollution still pose a considerable risk to the environment and to human health in the WHO European Region. One issue of concern is that monitoring of particulate matter is very limited in the countri
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es of eastern Europe, the Caucasus and central Asia. This paper summarizes the evidence about the health effects of air pollution from particulate matter and presents the policy implications, the aim being to stimulate policy-makers to develop more effective strategies to reduce air pollution and its health effects in those countries.
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National Guidelines for the Treatment of Malaria - 2019
South African Malaria Elimination Committee (SAMC)
National Department of Health South Africa
(2019)
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These guidelines are based on the 3rd Edition of the WHO Guidelines (Published 2015) World Health Organization’s Guidelines for the treatment of malaria. Additional literature surveys have been undertaken. Factors that were considered in the choic
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e of therapeutic options included effectiveness, safety, and impact on malaria transmission and on the emergence and spread of antimalarial drug resistance. On-going surveillance is critical given the spread of artemisinin resistance in Southeast Asia, although not yet confirmed anywhere in Africa. The guidelines on the treatment of malaria in South Africa aim to facilitate effective, appropriate and timeous treatment of malaria, thereby reducing the burden of this disease in our communities. This is essential to further reduce the malaria case fatality rates currently recorded in South Africa, to decrease malaria transmission and to limit resistance to antimalarial drugs.
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This report’s central premise is that diagnostics and therapeutics, and associated test to treat strategies, are fundamental components of the pandemic response, both for COVID-19 and for future health threats. Two years into the COVID-19 pandemic
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, this report reflects on the main challenges and key solutions on the road to equitable access to diagnostics and therapeutics.
This report draws from experience gained through the Access to COVID-19 Tools (ACT) Accelerator Diagnostics and Therapeutics pillars, and includes the perspectives of collaborating stakeholders (countries, civil society representatives and the private sector). Building on these findings, this report proposes sixteen recommended actions to address what have been identified as key structural challenges and specifies a potential owner for each action.
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Obesity in all age groups, including children and adolescents, is a public health challenge across all settings. Obesity is now classified as a complex multifactorial chronic disease and not just a risk factor for other noncommunicable diseases and
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comorbidities. Recognizing the significance of primary health care for an effective and efficient response to the obesity epidemic, the World Health Organization (WHO) has developed guidance on how to build capacity in the health system to deliver health services for prevention and management of obesity across the life course. This policy brief discusses the challenges and opportunities for preventing obesity in children and adolescents, and providing health services to treat and manage those already living with obesity. It outlines possible interventions through the primary health care approach.
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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 Organizat
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ion has identified control of cholesterol as part of a Total Risk Approach to the prevention of CVD as a public health priority.
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The goal of this addendum is to help management and staff
minimize the risk of TB transmission at facilities in resource limited settings in which a.) HIV-infected persons receive diagnosis, care, treatment,
and/or support, and b.) there is a
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high prevalence of HIV infection, both known
and undiagnosed, in settings such as prisons, jails, other
detention centers, and drug rehabilitation centers.
more
Building Capacity for Disability Inclusion in Gender-based Violence (GBV) Programming in Humanitarian Settings
recommended
Leora Ward, Emma Pearce, Dale Buscher et al.
Women’s Refugee Commission (WRC) and The International Rescue Committee (IRC)
(2015)
C1
Women and girls with mental and intellectual disabilities were perceived to be most at risk of sexual violence, and family and service providers may only become aware of sexual violence against them when they become pregnant.
Discrimination by GBV
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service providers, family and community members was the most common barrier to access. Inadequate transportation and inappropriate communication approaches were also common impediments.
On this website you can download the report in different languages,
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The aim of this document is to provide interim guidance for interventions to reduce the risk of maternal Zika virus infection and to manage potential complications during pregnancy. This guidance is based on the best available research evidence and
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covers areas prioritized by an international, multidisciplinary group of health care professionals and other stakeholders. Specifically, it presents guidance for preventing Zika virus infection;antenatal care and management of women with infection; and care during pregnancy for all pregnant women living in affected areas, with the aim of optimizing health outcomes for mothers and newborns.
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Conceived as part of the CWS-A/P project on regional security and risk management, this book presents a
collection of testimonies from aid workers in some of the most insecure and volatile environments in the world.
The participants recount a broa
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d array of security incidents, such as kidnappings, suicide bombings, mob
violence, road ambushes, and point-blank range shootings. Their narrative provides valuable information on
how organizations can manage security risks and streamline safety policies.
more
Cambodia drafted and adopted the National Action Plan for Disaster Risk Reduction 2014-2018 in 2014. This plan finalized the required policies and legal processes to strengthen DRM in Cambodia. It also focused on capacity building at national and su
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b-national levels and provided dedicated resources for strengthening the NCDM and the Sub-National Committees for Disaster Management. Cambodia’s legislature then passed the Law on Disaster Management in June 2015. This legal framework for disaster management assigns legally binding roles and responsibilities, establishes institutions, and assists with the allocation of resources and coordination. NCDM is Cambodia’s lead government agency for emergency preparedness and relief. The NCDM provides the overall leadership of the Plan of Action for Disaster Risk Reduction (DRR) coordination in Cambodia. Cambodia has adopted the Cambodia Red Cross (CRC) as the primary partner for relief operations.
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Pandemics and outbreaks have differential impacts on women and men. From risk of exposure and biological susceptibility to infection to the social and economic implications, individuals’ experiences are likely to vary according to
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their biological and gender characteristics and their interaction with other social determinants. Because of this, global and national strategic plans for COVID-19 preparedness and response must be grounded in strong gender analysis and must ensure meaningful participation of affected groups, including women and girls, in decision-making and implementation.
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The COVID-19 pandemic has affected everyone, including key populations at higher risk of HIV. And the gains made against other infectious diseases, including HIV, are at risk of being reversed as a
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result of disruptions caused by COVID-19. This is the background to a new report published by FHI 360, in collaboration with UNAIDS, which gives advice on how to minimize the impacts of COVID-19 on key populations.
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In its report from 2014, the Working Group outlines the various factors influencing vaccine acceptance or refusal, and what can be done to create social norms around vaccine acceptance and to encourage the general public regarding the necessity of v
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accination.
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This guidance addresses rationale, risk-based scenarios, practical considerations prior to adoption of the self-testing products, quality assurance, safety and ethical considerations, and data management considerations for COVID-19 self-testing. The
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Africa CDC recommends the use of rapid antigen self-testing within two key scenarios. The first includes testing for case identification within scenarios with a high risk of infection, including symptomatic cases and contacts of a confirmed case. The second scenario involves general screening within scenarios of low or unknown risk exposure allowing for self-care such as before gatherings with at-risk individuals and prior to participation in events involving members of different households. Within these scenarios, a positive test result indicates likelihood of current infection, while a negative test result indicates a lower risk of active infection, though it does not rule out infection altogether. All positive cases should be managed following the national COVID-19 management protocol of Member States.ssur
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Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise
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potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
more
Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women
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and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
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Young children are especially susceptible to exposure to trauma. Rates of abuse and neglect among this population are staggering. This article presents a review of relevant literature, including research findings specific to early childhood vulnerability to trauma, symptoms
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associated with traumatic events, diagnostic validity of early childhood trauma, and treatments for young children. In the past, misconceptions about the mental health of young children have hindered accurate diagnosis and treatment of trauma-related mental illness. Due to the prevalence of trauma exposure in early childhood, counselors are encouraged to become familiar with ways that clients and families are impacted and methods for treatment. Implications for future research also are presented.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi
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ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local and national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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Laboratory biosafety manual
recommended
4th edition
The WHO Laboratory Biosafety Manual (LBM) has been in broad use at all levels of clinical and public health laboratories, and other biomedical sectors globally, serving as a de facto global standard that presents best practices and sets trends in biosafety.
LBM encouraged countries t
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o accept and implement basic concepts in biological safety and to develop national codes of practice for the safe handling of biological agents in laboratories within their geographical borders.
This fourth edition of the manual builds on the risk assessment framework introduced in the third edition. A thorough, evidence-based and transparent assessment of the risks allows safety measures to be balanced with the actual risk of working with biological agents on a case-by-case basis.
This novel evidence- and risk-based approach will allow optimised resource use and sustainable laboratory biosafety and biosecurity policies and practices that are relevant to their individual circumstances and priorities, enabling equitable access to clinical and public health laboratory tests and biomedical research opportunities without compromising safety.
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The Indonesian government has reformed its laws, policies, and institutions to better manage disaster risk since the significant 2004 Indian Ocean Tsunami. The Government of Indonesia now has contingency plans for every disaster-prone city which ide
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ntifies its vulnerabilities, outlines the relief response, and builds overall preparedness. In 2007, the government introduced a disaster management bill that incorporated disaster management prevention into disaster management response. In 2008, Indonesia created the National Disaster Management Agency (Badan Nasional Penanggulangan Bencana, BNPB). The new shift led to the strengthening of the country’s disaster management agency, and the addition of district branches and representatives. Despite the progress made, more work is needed at the local level as well as integration of disaster risk reduction in government departments.11 Under Indonesia’s 2007 Disaster Management law, provincial and district administrations are mandated to head disaster management during a crisis.
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Background: Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at-risk youth. We used a meta-analytic approach to examine longit
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udinal changes in youth PTSD prevalence and symptoms over the first 12 months posttrauma.
Journal of Child Psychology and Psychiatry57:8 (2016), pp 884–898
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The 2014-2015 outbreak of Ebola virus disease (EVD) in Liberia resulted in over 10,000 cases and 5,000 deaths. Recognizing the importance of addressing children’s trauma, the Ebola recovery and restoration trust fund (EERTF) funded the implementation of a Comfort for kids (C4K) program which encou
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rages psychological healing, and promotes resilience in children who have experienced a crisis or disaster. The C4K program in Liberia was implemented between January 2015 and December 2016 in fifteen townships in Montserrado County through a collaboration between Mercy Corps Liberia, the World Bank’s Liberian health task team, and the government of Liberia. C4K primarily centers on the My Story workbook and associated classroom activities, which provide children with the opportunity to express their emotions about their experiences through drawing, writing, and facilitated discussion. C4K also provides capacity building for parents, teachers, and other caretakers on how to identify and more effectively respond to children’s trauma responses and to support their recovery
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Proc Natl Acad Sci U S A v.110(21); 2013 May 21 PMC3666729 ;
A systematic review was conducted by a multidisciplinary team to analyze qualitatively best available scientific evidence on the effect of agricultural intensification and environmental changes on the
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risk of zoonoses for which there are epidemiological interactions between wildlife and livestock.
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Current Environmental Health Reports volume 7, pages 363–370 (2020)
Climate change has direct impacts on human health, but those impacts vary widely by location. Local health impacts depend on a large number of factors including specific regional
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climate impacts, demographics and human vulnerabilities, and existing local adaptation capacity. There is a need to incorporate local data and concerns into climate adaptation plans and evaluate different approaches.
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Hypertension is referred to as a “silent killer”. Most people with hypertension are unaware of their condition as in most cases, they experience no warning signs or symptoms hence they are not identified or treated. Hypertention is associated wi
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th a number of conditions, disability, and causes of death. These include: strokes; myocardial infarction; end-stage renal disease; congestive heart failure; peripheral vascular disease and blindness. According to Stats SA, in 2017, hypertensive disorders resulted in 19 900 deaths with a further 44 357 deaths associated with cerebrovascular diseases and other heart diseases. This means around 30% of all deaths in 2017 were associated with increased blood pressure.
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primary prevention of diabetes (WHO Collaborating Centre for Research, Education & Training in Diabetes
Tharker, S.; Nandhini, Mrs.; Satyavani, K.; et al.
M. V. Hospital for Diabetes & Diabetes Research Centre (WHO Collaborating Centre for Research, Education & Training in Diabetes)
(2023)
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It is now well known that there is a pandemic of Type 2 Diabetes in the world particularly in developing countries. This fact has several implications for the health care system in the developing countries because this condition is associated with m
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etabolic and vascular complications which in turn increases the mortality and health care costs and compromises the quality and life expectancy of the society.
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Long Acting Muscarinic Antagonists (LAMA) such as tiotropium and glycopyrronium are used in the management of COPD1. They have been shown to improve lung function, quality of life and exercise tolerance. They have also been associated with reduced C
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OPD-related exacerbations, associated hospitalisations and duration of hospital stay. Both the South African Thoracic Society (SATS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD), guidelines recommend the use of long acting anticholinergic drugs (or long acting beta agonists) in moderate to very severe disease as defined by lung function (FEV1). The most up to date guideline, utilizing the GRADE methodology (European Respiratory Society guidelines of 2017), confirms their superiority over long acting β agonists (LABA) as monotherapy for COPD in that LAMA's have demonstrated greater efficacy in terms of exacerbation reduction, with similar safety profile.2 These recommnedations are supported by published peer-reviewed
evidence including individual papers and Cochrane reviews.
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