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1
In September, 2018, the first international Medicine Quality and Public Health Conference was held at Oxford University, UK, to discuss opportunities and solutions to ensure that all people have access to affordable and quality-assured medical produ
...
cts. Delegates developed the short Oxford Statement, calling for investment, policy change, and action to eliminate substandard and falsified medical products. The statement was born out of discussion between governments, national and international agencies, non-governmental organisations, professional associations, and academic institutions who together examined the latest evidence on the epidemiology and public health implications of substandard and falsified medical products.
more
Background: Despite several cycles of Mass Drug Administration (MDA), however, the prevalence of Soil-transmitted helminthiasis (STH) remains high in Bangladesh. A clear understanding of local knowledge, attitudes, and practices (KAP) related to the
...
acceptance and utilization of MDA is critical for effective implementation of this intervention.
Methods: This research, a cross-sectional descriptive study that utilized quantitative methods, was conducted between February and June 2017. A total of 380 questionnaire surveys were distributed to school-aged children (SAC), the parents of SAC, and school teachers.
Results: Out of 160 SACs, 81.9% knew of STH and 75.6% knew of MDA. SAC showed a high awareness of STH and recognized the importance of preventive measures and MDA. In terms of the parents of SAC and school teachers, close to half of the respondents were knowledgeable about STH and MDA. While nearly all of the participants held positive attitudes toward MDA, the respondents pointed out that school-based MDA presents severe limitations, as non-school-going children are neglected by this effort. A total of 68.3% of all school teachers and 56.8% of all parents of SAC found MDA efforts to be effective.
Conclusion: STH infections still remain a significant public health burden in Bangladesh. Reforming the MDA policy is necessary to achieve the target of STH elimination.
more
Since 1996, trachoma has been targeted for elimination as a public health problem worldwide. The active trachoma criterion for national elimination as a public health problem is a TF1–9 < 5%, sustained for at least two years in the absence of antibiotic mass drug
...
administration (MDA), in each formerly endemic EU. Using A, F and E, health ministries and their partners have made considerable progress towards achieving this criterion in formerly endemic EUs worldwide. In 2002, an estimated 1517 million people lived in EUs in which EU-wide implementation of the A, F and E components of SAFE were thought to be needed for the purposes of global elimination of trachoma as a public health problem; by June 2021, that number had fallen to 136.2 million, a 91% reduction. Approximately 85% of the 136.2 million people living in EUs needing A, F and E in June 2021 were in WHO’s African Region.
more
Supportive Practices for Mental Health Professionals During Pandemic-Related Social Distancing
Mental Health Technology Transfer Center Network
Funded by Substance Abuse and Mental Health Services Administration
(2020)
C1
Social distancing is the deliberate increasing of physical space between people to stop or slow down the spread of a highly contagious illness. It is a strategy sometimes recommended by public health officials during pandemics. For mental health pro
...
fessionals, the challenges that accompany social distancing can place significant roadblocks to daily work. Some agencies and organizations may struggle to continue to provide critical services while also protecting employees’ health.
more
"Achieving, maintaining and improving accuracy, timeliness and reliability are major challenges for health laboratories. Countries worldwide committed themselves to build national capacities for the detection of, and response to, public health event
...
s of international concern when they decided to engage in the International Health Regulations implementation process. Only sound management of quality in health laboratories will enable countries to produce test results that the international community will trust in cases of international emergency. This handbook is intended to provide a comprehensive reference on Laboratory Quality Management System for all stakeholders in health laboratory processes, from management, to administration, to bench-work laboratorians. This handbook covers topics that are essential for quality management of a public health or clinical laboratory. They are based on both ISO 15189 and CLSI GP26-A3 documents"--Page 7.
more
Les présentes lignes directrices ont pour objet de préparer les pays d’endémie à arrêter l’AMM à l’issue du traitement, à passer à la surveillance post-thérapeutique ainsi qu’à confirmer l’interruption de la transmission à l’issue de la phase 2 et à débuter la surveillance p
...
ost-élimination.
Le but est de fournir un outil actualisé pour atteindre et vérifier l’élimination de la
transmission d’Ovolvulus à l’issue des programmes d’élimination de l’onchocercose qui utilisent principalement l’AMM.
Les objectifs sont de :
• formuler des recommandations basées sur des preuves à l’intention des prestataires de soins et des décideurs en matière de politique pour démontrer et confirmer l’interruption de la transmission d’O. volvulus avant, pendant et après la surveillance post-thérapeutique ;
• informer les utilisateurs finaux des procédures nécessaires pour vérifier l’élimination de l’onchocercose humaine.
more
Ethiopia has seen high economic growth over the last decade, but remains a poor country with a high burden of disease. It has made considerable health gains in recent years, mainly by having health policies that focus on extending primary healthcare, using health extension workers. It
...
has made good use of existing resources,but has a low health expenditure (of around US$21 per capita, and totalling 4per centof GDP). It has a federal system with devolved healthcare financing, whereby block grants are allocated to sectors at regional and woreda(district) level. The challenge now,with the epidemiological transition (and a sense that the ‘low-hanging fruits’have already been gathered in relation to public health), is how Ethiopia, still poor, continuesto invest in health improvements?Human resources for health (HRH) are a critical pillar within any health system –the health staff combine inputs to provide the services, thus affecting how all other resources are used, and they make frontline (and back-office) decisions thatare importantdeterminants of servicequality,effectiveness and equity. HRH is usually the most resource-intensive element within the health system –commonly absorbing 50–70per centof public expenditure onhealth, although the proportions are very varied by individual countries and across regions. As they are commonly part of the public administration, reforms to HRH are also part of a complex political economy in most countries.Assessing value for money (VfM) in relation to HRH is correspondingly complex;across the value chain, manyfactors influence the conversion of inputs into outputs and outcomes (see Figure 1).A more detailed description of the HRH value chain can be found in Annex1.
more
Lymphatic filariasis is a neglected tropical disease that can cause permanent disability through disruption of the lymphatic system. This disease is caused by parasitic filarial worms that are transmitted by mosquitos. Mass drug administration (MDA)
...
of antihelmintics is recommended by WHO to eliminate lymphatic filariasis as a public health problem. This study aims to produce the first geospatial estimates of the global prevalence of lymphatic filariasis infection over time, to quantify progress towards elimination, and to identify geographical variation in distribution of infection.
more
Ethiopia GATS was implemented by Ethiopia Public Health Institute (EPHI) in collaboration with the Ethiopian Food, Medicine, Health Care Administration and Control Auth
...
ority (FMHACA), CSA, FMOH and the World Health Organization (WHO)country office. Technical assistance for the implementation of the survey was provided by the WHO, the U.S. Centers for Disease Control and Prevention (CDC), and RTI International. Program support was provided by the CDC Foundation.Financial support for Ethiopia GATS was provided by the CDC Foundation with a grant from the Bill & Melinda Gates Foundation.GATS enhances countries’ capacity to design, implement and evaluate tobacco control programs. It also assistscountries to fulfill their obligations under the WHO FCTC to generate comparable data within and across countries. In addition,it allows countries to implement the WHO MPOWER policy package. WHO MPOWERisa technical packagedevelopedtoassist countries in implementing selected demand reduction measures contained in the WHO Framework Convention on Tobacco Control(FCTC)(5).The six MPOWER evidence-based measures contained in the FCTC;
more
In 1989, the Republic of Benin was facing a great social and
economical crisis. Civil servants of all the sectors in public
administration were on strike. People did not know where to
go for thei
...
r health care. Salaries were not paid for more than
six months and life for the general population was very dificult.
The country was about to degenerate into civil war as a
result of the civil unrest in the country.
Thanks to the assistance from the French, and Canadian
and American Mennonite missionaries, the Bethesda Health
Centre was started in 1990 with US$ 1,000 granted by theses
partners. Today, the Health Centre of Bethesda has expanded
and has become a large Hospital in Cotonou. It hosts each
year about 100,000 patients and has developed the department
of paediatrics, ophthalmology, stomatology, cardiology,
obstetrical gynaecology, X-rays, etc. The Hospital has also
put in place an AIDS service which has been promoted by the
government to the status of an AIDS Treatment Centre.
In an integrated vision, Bethesda has established other departments.
In 1993, the Sanitation department was established
to implement sanitation and environmentally-friendly
projects aimed at reducing the high incidence of some diseases
frequently treated at the hospital. In 1996, the decision
was made to establish a micro-inance department called
PEBCo. This initiative, which currently has 10,000 clients,
uses community savings to promote income-generating activities.
Since many women were obliged to use the loans for
family needs (health care, children schooling, etc.), they were
unable to reimburse them as planned. Hence the Bethesda
non-government organization (NGO) recently began an initiative
to provide a community-based health insurance option
for the population in 2006. There are now 12,000 members.
This paper focuses on the presentation of Benin and the program,
but also describes how the project could be better improved
and what were its beneits and impacts.
Field Actions Science Reports
The journal of field actions
Vol. 4 | 2010
Vol. 4
more
Integrated community-based intervention for urinary schistosomiasis and soil-transmitted helminthiasis in children from Caxito, Angola
Lemosa, M.; Fançonya, C.; Moura, S. et al
The royal society of tropical medicine and hygiene
(2020)
C2
Schistosomiasis and soil-transmitted helminths (STH) infections are major public health problems. We aimed to study the 6-mo impact of mass drug administration with praziquantel and albendazole on u
...
rinary schistosomiasis and STH.We examined children (aged 2–15 y) from one hamlet, who provided urine and faeces samples at baseline (n=197), 1 mo (n=102) and 6 mo (n=92); 67 completed the protocol.At baseline, 47/67 (70.1%) children presented Schistosoma haematobium (75.8% in the baseline total sample) and 12/67 (17.9%) with STH (30.5% in the initial sample, p=0.010). Among the children, 47.3% had heavy Schistosoma haematobium infection. The most frequent STH was Trichuris trichiura in 9.0%. We also found Hymenolepis nana (13.2%) and Plasmodium falciparum (9.1%) infections and anaemia (82.1%). One mo after chemotherapy there was a significant (p=0.013) reduction of Schistosoma haematobium prevalence (23.5%) and a high egg reduction rate (86.9%). Considering the sample of 67 children, the mean egg concentration was 498 at baseline, 65 at 1 mo and 252 at 6 mo (p<0.05). We also observed a reduction in STH infections, 50% in Ascaris lumbricoides, 33.3% in T. trichiura and 50% in hookworms. At 6 mo, the prevalence of Schistosoma haematobium (76.1%) was similar to the baseline and the STH reduction was not significant.Longitudinal studies have reported many losses in these settings, but we were able to show that mass drug administration for control of schistosomiasis and STH present low effectiveness, that reinfections occur rapidly and that stand alone anthelmintic therapy is not a sustainable choice.
more
Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
...
ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
more
L’enseignement des soins infirmiers se fait sous la tutelle du ministère de la Santé et de la Prévention médicale.Il est en pleine effervescence,mais seulement avec deux niveaux de formation.
- En premier lieu,il y a la formation initiale qu’une seule institution nationale a assurée de 195
...
2 à 1992.Avec la pénurie de la main-d’œuvre et la libéralisation de l’éducation,le Sénégal fait face depuis une quinzaine d’années à l’ouverture effrénée d’écoles privées dont la majorité dispose d’un agrément du ministère de la Santé.Le diplôme requis à l’entrée dans ces institutions de formation est le baccalauréat de l’enseignement général (13 ans de scolarité).La durée des études est de trois années sanctionnées par un diplôme d’État d’infirmier délivré par le ministère de la Santé et de la Prévention médicale,pour les diplômés des secteurs public et privé. - En deuxième lieu,il y a la formation continue spécialisée,dans les huit filières suivantes:enseignement et administration,anesthésie et réanimation,kinésithérapie,biologie,imagerie médicale,odontologie,ophtalmologie et néphrologie.Elle est offerte sur une période de deux ans,par l’École nationale de développement sanitaire et social (ENDSS).Le profil de sortie permet aux soignants d’exercer leur profession spécialisée avec le diplôme de technicien supérieur de santé.
more
Development and Introduction of the Filariasis Test Strip: A New Diagnostic Test for the Global Program to Eliminate Lymphatic Filariasis
Pantelias, A.; King, J.D.; Lammie, P.; Weil, G.J.
The American Journal of Tropical Medicine and Hygiene
(2022)
CC
Lymphatic filariasis (LF) is a parasitic disease that is a major cause of chronic disability in the developing world. According to the 2021–2030 road map for neglected tropical diseases (NTDs) published by the World Health Organization (WHO), the global goal for LF is elimination as a
...
public health problem by 2030 through repeated rounds of mass drug administration (MDA). Critical components of any elimination program are monitoring and surveillance. Appropriate assessment tools and methods are needed for each stage of an elimination program; mapping to identify which areas require intervention, monitoring to assess the impact of interventions, and post-intervention surveillance to validate elimination or detect recrudescence.
more
Lymphatic filariasis (LF), a neglected tropical disease, is targeted for global elimination as a public health problem. This article reviews the history of LF control and elimination activities in the countries of the World Health Organization's (WH
...
O) Eastern Mediterranean Region (EMR) over the last 2 decades. In 2000, the estimated at-risk population in EMR countries was 12.6 million people, accounting for approximately 1% of the global disease burden. Of the 22 EMR countries, 3 countries (Egypt, Sudan and Yemen) were LF endemic and the disease was suspected in 4 other countries (Djibouti, Oman, Somalia and Saudi Arabia). After almost 2 decades of implementing sustained control and prevention measures, Egypt and Yemen were successfully validated by the WHO as having achieved the elimination criteria in 2017 and 2019, respectively. In 2018, Sudan completed mapping of LF, reaching 26.2% geographical coverage where mass drug administration (MDA) is required and is scaling-up MDA. Extensive epidemiological assessment indicated the absence of LF transmission in the four suspected countries and no MDA required. Challenges faced during the elimination and post-elimination phases are described and discussed
more
African regional progress and status of the programme to eliminate lymphatic filariasis: 2000–2020
Deribe K., Bakajikaa D. K., Zourea H. MG. et al
The royal society of tropical medicine and hygiene
(2021)
C2
To eliminate lymphatic filariasis (LF) by 2020, the World Health Organization (WHO) has launched a campaign against the disease. Since the launch in 2000, significant progress has been made to achieve this ambitious goal. In this article we review the progress and status of the LF programme in Afric
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a through the WHO neglected
tropical diseases preventive chemotherapy databank, the Expanded Special Project for Elimination of Neglected Tropical Diseases (ESPEN) portal and other publications. In the African Region there are 35 countries endemic for LF. The Gambia was reclassified as not requiring preventive chemotherapy in 2015, while Togo and Malawi eliminated LF as a public health problem in 2017 and 2020, respectively. Cameroon discontinued mass drug administration (MDA) and transitioned to post-MDA surveillance to validate elimination. The trajectory of coverage continues to accelerate; treatment coverage increased from 0.1% in 2000 to 62.1% in 2018. Geographical coverage has also significantly increased, from 62.7% in 2015 to 78.5% in 2018. In 2019, 23 of 31 countries requiring MDA achieved 100% geographic coverage. Although much remains to be done, morbidity management and disability prevention services have steadily increased in recent years. Vector control interventions conducted by other programmes, particularly malaria vector control, have had a profound effect in stopping transmission in some endemic countries in the region. In conclusion, significant progress has been made in the LF programme
in the region while we identify the key remaining challenges in achieving an Africa free of LF.
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Keeping communities at the centre of efforts to eliminate lymphatic filariasis: learning from the past to reach a future free of lymphatic filariasis
Krentel, A.; Gyapong, M.; McFarland, D.A.; Ogundahunsi, O.; Titaley, C.R.; Addiss, D.G.
Oxford Academic - International Health
(2021)
CC
Since the launch of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) in 2000, more than 910 million people have received preventive chemotherapy for lymphatic filariasis (LF) and many thousands have received care for chronic manifestations of the disease. To achieve this, millions of c
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ommunity drug distributors (CDDs), community members and health personnel have worked together each year to ensure that at-risk communities receive preventive chemotherapy through mass drug administration (MDA). The successes of 20 y of partnership with communities is celebrated, including the application of community-directed treatment, the use of CDDs and integration with other platforms to improve community access to healthcare. Important challenges facing the GPELF moving forward towards 2030 relate to global demographic, financing and programmatic changes. New innovations in research and practice present opportunities to encourage further community partnership to achieve the elimination of LF as a public health problem. We stress the critical need for community ownership in the current Covid-19 pandemic, to counter concerns in relaunching MDA programmes for LF.
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Background: Worldwide, maternal hypertensive disorders complicate one in ten pregnancies. As a result of changes in the life styles of society, currently, it is becoming a common public life encounter. However, Ethiopia lacks comprehensive and compa
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rable maternal hypertensive disorders, causing burden and health loss to inform policy and practice.
Objective: To describe the incidence and prevalence of maternal hypertensive disorders and deaths, Disability Adjusted Life Years, and Years Life Lost attributable to maternal hypertensive disorders in Ethiopia and its regional distributions from 1990 to 2019 as part of a collaborative Global Burden of Diseases, (2019) Study.
Methods: The data for this study were collected from surveys, demographic surveillances, medical record reviews, health facility observations and interviews socio-demographic, health care service utilization, and other data sources such as case notifications, scientific literature, and unpublished data as per the Global Burden of Disease protocol and analysis techniques to produce national and regional estimates of maternal hypertensive disorders in Ethiopia. Cause of death ensemble modeling and Bayesian meta-regression disease modeling was employed to ascertain cause of death and morbidity. Each metric was estimated per 100,000 populations with a 95% uncertainty interval (UI).
Results: In the last thirty years, in Ethiopia, , the incidence of maternal hypertensive disorders among young women was raised by 52,596 cases per 100,000 population [199,707 (95% UI 150,261-267,221) to 252,303 (95% UI 191,335-332,524)], while decreased among adolescent women from 67,206 (95% UI 46,887-90,883) to 64, 622 (95% UI; 47,587-84,664) per 100,000 population. The prevalence among women of reproductive age had increased from 94, 818 (95% UI 59,434-135,332) in 1990 to 138, 263 (95% UI 88,447-196,029) in 2019. Between 1990 and 2019, deaths attributable to maternal hypertensive disorders among adolescents and young women had increased by 1.5 and 1.17 times, respectively. In 2019, disability adjusted life years among adolescent, young women and women of reproductive age due to maternal hypertensive disorders was 8,493 (UI 95% 5,370-12,849), 21,812 (UI 95% 14,682-32,139) and 57,867 (UI 95% 41,751-79,165) respectively. The highest daily adjusted life years due to maternal hypertensive disorders had occurred among young women, 13,319 (UI 95% 8,592-19,931) which was higher than 1990 whereas the young women years of life lost had increased.
Conclusions: Based on the finding, increasingly high new cases, prevalence and burden of maternal hypertensive disorders and significant health loss were observed in the last three decades in Ethiopia. Hence, prevention of cases, disabilities, deaths and health losses caused by maternal hypertensive disorders can be prevented by properly advocating lifestyle modifications with specifically designed age-specific interventions. On the top of continuing prevention efforts with newly devised magnesium sulphate administration in the new ANC initiative of the ministry, contextualized, need based, localized, and targeted interventions could be reconstituted. [Ethiop. J. Health Dev. 2023;37 (SI-2)]
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The Western Pacific Region is the largest and most diverse region in the world, made up of 37 countries and territories in the Pacific, Oceania and parts of Asia, with a population of more than 1.9 billion people stretching over an area from China and Mongolia in the north to New Zealand in the sout
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h. In 1999, 22 countries and territories in the Pacific joined together and launched the Pacific Programme to Eliminate Lymphatic Filariasis. Shortly after, the Global Programme to Eliminate Lymphatic Filariasis was launched in 2000. In 2004, 12 countries in the Asia subregion of the Western Pacific Region and Southeast Asian Region joined and developed the Mekong-Plus Strategic Plan for Elimination of Lymphatic Filariasis. Since then, significant efforts have been made by all endemic countries, with annual mass drug administration (MDA) as a principal strategy, through strong partnership with the WHO and other donors and partners. As a result, by the end of 2019, 10 of 22 endemic countries in the region, including 8 of 16 countries in the Pacific and 2 countries in the Asia subregion, achieved WHO validation for elimination of lymphatic filariasis (LF) as a public health problem. All the other countries are either progressing with post-MDA surveillance or accelerating efforts by adoption of the new triple drug therapy strategy and enhancement of MDA campaigns to tackle persistent transmission. Some 85% of the originally endemic implementation units have stopped MDA and the number of people requiring MDA for LF in the Western Pacific Region was reduced by 72% from 2000 to 2018. This paper reviews the progress, key success factors and remaining challenges and indicates the way forward to achieve LF elimination in the Western Pacific Region.
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