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Guiding the work of medica mondiale is an attitude of sensitivity towards both trauma and stress.
This stress- and trauma-sensitive approach has a strengthening and relieving effect on the affected
people and also the activists, specialist staff a
...
nd working groups. For medica mondiale, trauma as a
consequence of violence is not to be found exclusively in the area of (individual) psychology, but also
very significantly at the level of society and politics. For this reason, even a multi-sectoral approach
to supporting those affected by violence cannot stand alone: it must go hand in hand with measures
to bring about change in general political conditions, societal structures and public awareness.
more
INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat
...
e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
more
The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highligh
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ts the significant global impact of CRDs, including asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector
...
al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Learning objectives
• Promote respect and dignity for people with self-harm/suicide.
• Know the common presentations of self-harm/suicide.
• Know the principles of assessment of self-harm/s
...
uicide.
• Know the management principles of self-harm/suicide.
• Perform an assessment for self-harm/suicide.
• Assess and manage co-morbid physical health conditions
• Assess and manage emergency presentations of self-harm/suicide.
• Provide psychosocial interventions to persons with self-harm/suicide.
• Provide follow-up sessions for people with self-harm/suicide.
• Refer to mental health specialists and links to outside agencies
more
This guidance covers diagnosis and care of patients with long-term effects of COVID-19. It makes recommendations for the care of adults and children who have new or ongoing symptoms 4 weeks or more after the start of acute COVID-19. It is meant for
...
health and care practitioners. This interim document has been developed by the Africa Taskforce on Coronavirus Case Management Technical Working Group and will be continuously reviewed and updated in response to emerging evidence
more
Mental disorders impose an enormous burden on society, accounting for almost one in three years lived with disability globally. •In addition to their health impact, mental disorders cause a significant economic burden due to lost economic output a
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nd the link between mental disorders and costly, potentially fatal conditions including cancer, cardiovascular disease, diabetes, HIV, and obesity.•80% of the people likely to experience an episode of a mental disorder in their lifetime come from low- and middle-income countries.• Two of the most common forms of mental disorders, anxiety and depression, are prevalent, disabling, and respond to a range of treatments that are safe and effective. Yet, owing to stigma and inadequate funding, these disorders are not being treated in most primary care and community settings.
more
Tuberculosis (TB) is the deadliest infectious disease in most low- and middle-income countries, claiming more than 4,000 lives each day. The unprecedented COVID-19 pandemic has seriously impacted people wi
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th pre-existing health conditions. People with TB are usually more vulnerable to other infections, including the novel coronavirus, due to pre-existing lung damage. They are also at higher risk of developing complications from COVID-19.
more
June 2021
This ACTIVE toolkit provides evidence-based guidance on the key approaches to promote and enable older people to be physically active, regardless of who they are, where they live, or their intrinsic capacities (for example their visual or cognitive
...
abilities) or whether they live with chronic conditions (for example, diabetes, hypertension, and arthritis). It is designed to support all countries at national and subnational levels (particularly low- and middle-income countries with limited resources) to ensure that environments and settings support older people to be active, and that they provide physical activity services and programmes tailored to the needs, preferences and goals of all older people.
more
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
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with underlying noncommunicable diseases (NCDs), such as hypertension, cardiac disease, chronic lung disease and cancer.
more
Healthy people, healthy animals and a healthy environment worldwide with the One Health approach.
The COVID-19 pandemic has drastically demonstrated just how close the link is between humans, anima
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ls, and the environment, and has highlighted and aggravated existing challenges. The destruction of natural habitats and displacement of species, trade in wild animals, resource-intensive lifestyles and conditions, non-sustainable food systems and, in particular, industrial agriculture and intensive livestock farming are the causes of the emergence of zoonoses as well as numerous other communicable and non-communicable, chronic diseases.
The One Health approach focuses precisely on such interaction between humans, animals, and the environment.
more
People with underlying noncommunicable diseases (NCDs) such as hypertension, diabetes, cardiovascular disease, chronic respiratory disease and canc
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er have a high risk for developing severe and even fatal COVID-19. It is important for them to strictly follow basic protective measures and make sure their chronic diseases are well managed. However, pandemics cripple health systems and compromise provision routine medical care. This technical note gives general guidance to people living with NCDs, their caregivers and family members, the public, health programme managers and health-care workers on how to reduce risks of a COVID-19 infection and maintain care for people living with NCDs during the outbreak.
more
About six to seven million people worldwide, mostly in Latin America, are estimated to be infected with
Trypanosoma cruzi, the parasite that causes Chagas disease (WHO data from 2021). Chagas disea
...
se is
found mainly in endemic areas of 21 Latin American countries. Chagas disease was once entirely
confined to rural areas but in the last decades, due to population movements, most infected people live
in urban settings and the disease has spread to other continents. The burden of disease is due to its
chronic progression with people still suffering years later after initial infection.
more
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the na
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tional demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
more
Lymphatic filariasis (LF) is an avoidable, debilitating, disfiguring disease caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi and B. timori. Globally, 51.4 million people
...
are
estimated to be infected. Lymphoedema and hydrocoele are the visible, chronic clinical consequences of the lymphatic vessel impairment caused by infection with these parasites. Mosquitos in the genera Culex, Anopheles, Mansonia and Aedes transmit the parasites from person to person. 2020 marked the 20th year since WHO established the Global Programme to Eliminate Lymphatic Filariasis (GPELF) which aims to stop transmission of infection with mass drug administration (MDA) and to alleviate suffering among people affected by the disease through morbidity management and disability prevention (MMDP).
more
Colombia is characterized by a fragile and prolonged humanitarian context marked by recurrent multi-hazards affecting its territories and combined with severe structural and systemic challenges within the health system. Recent shocks, including the
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COVID-19 pandemic, growing violence within the Colombian territories and along the border with Venezuela (Bolivarian Republic of), and repetitive hydro-meteorological disasters over the last 12 months aggravate such chronic challenges.
In 2022, the number of people in need of humanitarian assistance increased by 300 000 due to deteriorating indicators of maternal and child mortality, pregnancy in adolescent girls, human immunodeficiency virus (HIV), suicides, sexually transmitted
infections (STIs), gender-based and sexual violence, and communicable diseases. increasing population trends, primarily due to mass migration movements and the persistence of armed conflicts, create access barriers to essential health services, mobility restrictions, and forced displacement, further impacting the health, lives, and well-being of populations in vulnerable situations. In many territories, geographical distance to health facilities and attacks against medical missions hinder providing appropriate healthcare.
more
WHO guideline on preventive chemotherapy for public health control of strongyloidiasis
recommended
Human strongyloidiasis is a chronic parasitic disease caused by infection with Strongyloides stercoralis, a soil-transmitted helminth that is estimated to infect 300–600 million
...
people worldwide. This neglected tropical disease (NTD) is endemic globally, predominately in the South-East Asia, African and Western Pacific regions, and in South and Central America. Strongyloidiasis has a wide range of clinical presentations, including subclinical disease, symptomatic disease (often with diarrhoea, abdominal pain and urticaria) and a rare but deadly complication of hyperinfection with disseminated disease. The feared complication of disseminated strongyloidiasis can occur in the setting of immunocompromising conditions (e.g. human T-cell lymphotropic virus type 1 infection and malignancies) or immunosuppressive medications (e.g. steroids) and has an estimated case-fatality rate exceeding 60%. The standard treatment for chronic S. stercoralis infection is oral medication with ivermectin.
more
The war is having a devastating impact on health and human capital in Ukraine and is expected to affect generations to come. The most obvious effects on health are immediate: an estimated 4,339 conflict-related deaths and 5,246 people injured. Less
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visible is the illness caused, and exacerbated, by people not being able to access care for acute and chronic conditions.
more
The document provides comprehensive guidance for people with COPD, covering treatment and medication management, oxygen therapy, mucus control, exercise, smoking cessation, nutrition, associated
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conditions, and strategies to prevent exacerbations. It emphasizes patient education, self-management, and working closely with healthcare providers to enhance well-being and control of the disease.
more
