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1
SARS-CoV-2 infections among children and adolescents cause less severe illness and fewer deaths compared to adults. While a less severe course of infection is a positive outcome, there are concerns that mild symptoms may have led to less testing, re
...
sulting in fewer identified cases of COVID-19 in children. If children with mild or no symptoms transmit the disease, they may act as drivers of transmission within their communities. Understanding symptoms, infectivity and patterns of SARS-CoV-2 transmission in children and adolescents is essential for developing, adapting and improving control measures for COVID-19 across all ages. This is a summary of the current knowledge around SARS-CoV-2 infection acquisition and transmission and COVID-19 disease symptoms in children and adolescents. It aims to inform decisions, based on local contexts, on how to best keep schools, kindergarten and day-care facilities open and what advice to apply to intergenerational mixing.
more
SARS-CoV-2 infections among children and adolescents cause less severe illness and fewer deaths compared to adults. While a less severe course of infection is a positive outcome, there are concerns that mild symptoms may have led to less testing, re
...
sulting in fewer identified cases of COVID-19 in children. If children with mild or no symptoms transmit the disease, they may act as drivers of transmission within their communities. Understanding symptoms, infectivity and patterns of SARS-CoV-2 transmission in children and adolescents is essential for developing, adapting and improving control measures for COVID-19 across all ages. This is a summary of the current knowledge around SARS-CoV-2 infection acquisition and transmission and COVID-19 disease symptoms in children and adolescents. It aims to inform decisions, based on local contexts, on how to best keep schools, kindergarten and day-care facilities open and what advice to apply to intergenerational mixing.
more
Updated 2 June 2022.#
This entry contains the Status Report of WHO Collaborating Centres in the Americas by Country and a new document with information of Collaborating Centres by Outcome of the Strategic Plan of the Pan American Health Organizatio
...
n 2020‑2025.
more
Disability inclusive shelter programming enables persons with disabilities to contribute more to their communities, participate more in consultations and decision-making, and facilitate their own protection. The key concepts include: Disability inclusive shelter programming is both a process and an
...
outcome. By engaging persons with disabilities in the process, we will also improve the outcomes for persons with disabilities.
The disability community has the slogan “Nothing about us without us,” reminding that we should include and work with persons with disabilities and their representative groups rather than plan or make decisions on their behalf. Persons with disabilities should be engaged throughout shelter programme planning, implementation, monitoring and evaluation.
more
From channels to commissioning - a practical guide to epilepsy: lecture notes (Chapter 1 - The incidence and prevalence of epilepsy)
Neligan, A. & Sander, J.W.
International League Against Epilepsy (UK Chapter) and Epilepsy Society
(2015)
CC
This is the fifteenth edition of the lecture notes. They were first published in 1987 as a summary of the material used in the biannual epilepsy teaching weekend organised under the auspices of the UK Chapter of the International League against Epilepsy.
(Lecture series consist of a total of 59 cha
...
pters. Section one - introduction (chapter 1-2). Section two - basic science (chapters 3-5). Section (chapters 6-16). Section four - differential diagnosis (chapter 17-19). Section five - investigations (chapter 20-24). Section six - medical treatment of epilepsy (chapters 25-35). Section seven - outcome (chapters 36-40). Section eight - special groups (chapters 41-44). Section nine - surgical treatment of epilepsy (chapters 45-49). Section ten - social aspects (chapters 50-56). Section eleven - provision of care (chapters 57-59). All chapters available at: https://www.epilepsysociety.org.uk/lecture-notes-0#.Wq-cn8NubIU)
more
From channels to commissioning - a practical guide to epilepsy: lecture notes ( Chapter 2 - Classification and terminology to organise seizures and epilepsies)
Richardson, M.P., Chadwick, D.W. & Wehner, T.
International League Against Epilepsy (UK Chapter) and Epilepsy Society
(2015)
CC
This is the fifteenth edition of the lecture notes. They were first published in 1987 as a summary of the material used in the biannual epilepsy teaching weekend organised under the auspices of the UK Chapter of the International League against Epilepsy.
(Lecture series consist of a total of 59 cha
...
pters. Section one - introduction (chapter 1-2). Section two - basic science (chapters 3-5). Section (chapters 6-16). Section four - differential diagnosis (chapter 17-19). Section five - investigations (chapter 20-24). Section six - medical treatment of epilepsy (chapters 25-35). Section seven - outcome (chapters 36-40). Section eight - special groups (chapters 41-44). Section nine - surgical treatment of epilepsy (chapters 45-49). Section ten - social aspects (chapters 50-56). Section eleven - provision of care (chapters 57-59). All chapters available at: https://www.epilepsysociety.org.uk/lecture-notes-0#.Wq-cn8NubIU)
more
This is the fifteenth edition of the lecture notes. They were first published in 1987 as a summary of the material used in the biannual epilepsy teaching weekend organised under the auspices of the UK Chapter of the International League against Epilepsy. You can download 59 different chapters in 11
...
sections: basic science; spectrum of epilepsy; differential diagnosis epilepsy; investigations; medical treatment of epilepsy; outcome; special groups; surgical treatment of epilepsy; social aspects; provision of care
more
The Newborn Situational Analysis reports of 2009 and 2011, as well as the “Bottleneck analysis on neonatal health” of 2013, culminated in the Nigeria launch of “Call to action on Newborn health” at the first National Newborn Health Conference in 2014. This call to action provided the framewo
...
rk for the development of the Nigeria Every Newborn Action
Plan (NiENAP). The NiENAP lays out a vision to end preventable stillbirths and newborn deaths by accelerating progress and scaling up evidence- based high-impact and cost effective interventions. The plan is guided by the principles of country-leadership, integration, accountability, equity, human rights, innovation and research. This blue print outlines our commitment as government and stakeholders to repositioning newborn health as we implement approaches that impact on the lives of newborns for improved health outcome.
more
Biodiversity and Health in the Face of Climate Change pp 47–66
This chapter reviews the emerging importance of pollen allergies in relation to ongoing climate change. Allergic diseases have been increasing in prevalence over the last decades, partly as the result of the impact of climate change.
...
Increased sensitisation rates and more severe symptoms have been the partial outcome of: increased pollen production of wind-pollinated plants resulting in long-term increased abundance of pollen in the air we breathe; earlier shifts of airborne pollen seasons making occurrence of allergic symptoms harder to predict and deal with efficiently; increased allergenicity of pollen causing more severe health effects in allergic individuals; introduction of new, invasive allergenic plant species causing new sensitisations; environment-environment interactions, such as plants and hosted microorganisms, i.e. fungi and bacteria, which comprise a complex and dynamic system, with additive, presently unforeseeable influences on human health; environment-human interactions, as the consequence of a combination of environmental factors, like air pollution, global warming, urbanisation and microclimatic variability, which create a multi-resolution spatiotemporal system that requires new processing technologies and huge data inflow in order to be thoroughly investigated. We suggest that novel, real-time, personalised pollen information services, like mobile-app risk alerts, must be developed to provide the optimum first line of allergy management.
more
According to the previous NHSSP 2014 - 2020, the long-term health sector objective is “the provision of adequate, effective and affordable health care for all Gambians.” The overall ob-jective for the previous plan 2014-20 was “to reduce inequalities in health care services and reverse the dow
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nward trend in health-related outcome indicators.”
more
Policy Brief November 2021 Available in English, Spanish and Portuguese
The COVID-19 pandemic has fueled the ongoing antimicrobial resistance (AMR) global crisis due to the increase in the use of antibiotics to treat COVID-19 patients, disruptions to infection prevention and control practices in o
...
verwhelmed health systems, and diversion of human and financial resources away from monitoring and responding to AMR threats. Moreover, AMR is likely to have caused more COVID-19 deaths, as secondary bacterial infections can worsen the outcome of severe and critical COVID-19 illness. Therefore, it is more urgent than ever to prioritize efforts towards AMR containment and support countries to improve the detection, characterization and rapid response to emerging AMR.
more
Chromoblastomycosis (CMB) is a chronic fungal infection of the skin and the subcutaneous tissue caused by a transcutaneous traumatic inoculation of a specific group of dematiaceous fungi occurring mainly in tropical and subtropical zones worldwide. If not diagnosed at early stages, patients with CBM
...
require long term therapy with systemic antifungals, sometimes associated with physical methods. Unlike other neglected endemic mycoses, comparative clinical trials have not been performed for this disease. Nowadays, therapy is based on a few open trials and on expert opinion. Itraconazole either as monotherapy or associated with other drugs, or with physical methods, is widely used. Recently, photodynamic therapy has been successfully employed in combination with antifungals in patients presenting with CBM. In the present revision the most used therapeutic options against CBM are reviewed as well as the several factors that may have impact on the patient's outcome.
more
Leishmaniasis is a vector-borne tropical/subtropical disease caused by an intracellular parasite transmitted to humans by sand fly bite. It is endemic in Asia, Africa, the Americas, and the Mediterranean region. Worldwide reports include 1.5–2 million new cases each year, more than 300 million at
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risk of acquiring the disease, and 70,000 deaths per year. Clinical features depend on the Leishmania species and immune response of the host, varying from localized cutaneous disease to visceral form with potentially fatal outcome; however, the common presentation is either cutaneous, mucocutaneous, or visceral leishmaniasis. Many therapeutic agents are being used in Leishmania treatment, but the only effective treatment is achieved with current pentavalent antimonials. WHO considers Leishmaniasis as one of the “Neglected Tropical Diseases” that continues to be prevalent despite international, national, and local efforts towards its control and elimination over the last decade. This chapter reviews the global perspective of Leishmaniasis with increasing recognition of emerging “Atypical forms” and new surge of disease across the world mainly due to increasing conflicts in endemic areas leading to forced migration among other causes. All these challenges related to environment, disease, and vector pose major implications on WHO’s leishmaniasis control and elimination plan.
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The Financing for Sustainable Development Report is produced in collaboration with over 60 agencies of the United Nations system and other international organizations. It brings together a wide range of expertise and perspectives to provide recommendations for countries and the international communi
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ty. The report begins with an assessment of the global macroeconomic context (Chapter I). The thematic chapter (Chapter II) explores how countries can finance sustainable industrial transformations through a new generation of sustainable industrial policies, in response to requests included in the outcome of the 2022 ECOSOC Financing for Development Forum. The remainder of the report (Chapters III.A to III.G and IV) discusses progress in the seven action areas of the Addis Agenda, and on data.
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Background
The objective of this study was to investigate the effects of reduction, cessation, and resumption of smoking on cancer development.
Methods
The authors identified 893,582 participants who currently smoked, had undergone a health screening in 2009, and had a follow-up screening in 20
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11. Among them, 682,996 participated in a third screening in 2013. Participants were categorized as quitters, reducers I (≥50% reduction), reducers II (<50% reduction), sustainers (referent), or increasers (≥20% increase). Outcome data were obtained through December 31, 2018.
Results
Reducers I exhibited a decreased risk of all cancers (adjusted hazard ratio [aHR], 0.96; 95% confidence interval [CI], 0.93-0.99), smoking-related cancers (aHR, 0.95; 95% CI, 0.92-0.99), and lung cancer (aHR, 0.83; 95% CI, 0.77-0.88). Quitters had the lowest risk of all cancers (aHR, 0.94; 95% CI, 0.92-0.96), smoking-related cancers (aHR, 0.91; 95% CI, 0.89-0.93), and lung cancer (aHR, 0.79; 95% CI, 0.76-0.83). In further analysis with 3 consecutive screenings, additional smoking reduction (from reducers II to reducers I) lowered the risk of lung cancer (aHR, 0.74; 95% CI, 0.58-0.94) in comparison with sustainers. Quitting among reducers I further decreased the risk of all cancers (aHR, 0.90; 95% CI, 0.80-1.00), smoking-related cancers (aHR, 0.81; 95% CI, 0.81-0.92), and lung cancer (aHR, 0.66; 95% CI, 0.52-0.84) in comparison with sustainers. Smoking resumption after quitting, even at a lower level, increased the risk of smoking-related cancers (aHR, 1.19; 95% CI, 1.06-1.33) and lung cancer (aHR, 1.48; 95% CI, 1.21-1.80) in comparison with sustained quitting.
Conclusions
Smoking cessation and, to a lesser extent, smoking reduction decreased the risks of cancer. Smoking resumption increased cancer risks in comparison with sustained quitting.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence
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-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Background: East African trypanosomiasis is an uncommon, potentially lethal disease if not diagnosed and treated in a timely manner. South Africa, as a centre for emergency medical evacuations from much of sub-Saharan Africa, receives a high proportion of these patients, mostly tourists and expatria
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te residents.
Methods: The cases of East African trypanosomiasis patients evacuated to South Africa, for whom diagnostic and clinical management advice was provided over the years 2004–2018, were reviewed, using the authors’ own records and those of collaborating clinicians.
Results: Twenty-one cases were identified. These originated in Zambia, Malawi, Zimbabwe, Tanzania, and Uganda. Nineteen cases (90%) had stage 1 (haemolymphatic) disease; one of these patients had fatal myocarditis. Of the two patients with stage 2 (meningoencephalitic) disease, one died of melarsoprol encephalopathy. Common problems were delayed diagnosis, erroneous assessment of severity, and limited access to treatment.
Conclusions: The key to early diagnosis is recognition of the triad of geographic exposure, tsetse fly bites, and trypanosomal chancre, plus good microscopy. Elements for successful management are rapid access to specific drug treatment, skilled intensive care, and good laboratory facilities. Clinical experience and the local stock of antitrypanosomal drugs from the World Health Organization have improved the chance of a successful outcome in the management of East African trypanosomiasis in South Africa; the survival rate over the period was 90.5%.
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Cardiovascular diseases (CVD) represent the highest burden of disease globally. Medicines are a critical intervention used to prevent and treat CVD. This review describes access to medication for CVD from a health system perspective and strategies that have been used to promote access, including pro
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viding medicines at lower cost, improving medication supply, ensuring medicine quality, promoting appropriate use, and managing intellectual property issues. Using key evidence in published and gray literature and systematic reviews, we summarize advances in access to cardiovascular medicines using the 5 health system dimensions of access: availability, affordability, accessibility, acceptability, and quality of medicines. There are multiple barriers to access of CVD medicines, particularly in low- and middle-income countries. Low availability of CVD medicines has been reported in public and private healthcare facilities. When patients lack insurance and pay out of pocket to purchase medicines, medicines can be unaffordable. Accessibility and acceptability are low for medicines used in secondary prevention; increasing use is positively related to country income. Fixed-dose combinations have shown a positive effect on adherence and intermediate outcome measures such as blood pressure and cholesterol. We have a new opportunity to improve access to CVD medicines by using strategies such as efficient procurement of low-cost, quality-assured generic medicines, development of fixed-dose combination medicines, and promotion of adherence through insurance schemes that waive copayment for long-term medications. Monitoring progress at all levels, institutional, regional, national, and international, is vital to identifying gaps in access and implementing adequate policies.
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With development, people around the world have become wealthier and live longer. At the same time, development can lead to growing inequalities within and between nations. This paper analyses inequalities related to disability and how they vary across countries by development level. Using internatio
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nally comparable data on disability inequalities in 40 countries, we assess disability inequalities through the use of regression analyses with a variety of development measures. Results support the hypothesis only partially: disability inequalities related to education, employment, and multidimensional poverty are found to be significantly larger in countries at higher levels of development. However, this is not the case for rates of access to water, sanitation, clean fuel, electricity, housing, and assets. These results, overall, hold when using different development and
outcome indicators, and when focusing on specific subgroups of the population. The potential implications of these findings are discussed. Further research is needed to understand, for education and employment, the factors and processes that contribute to larger disability inequalities in countries at higher levels of development and what strategies might be pursued to reduce them.
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