Excessive consumption of salt (more than 5 g per day) raises blood pressure, a major risk factor for cardiovascular diseases such as heart disease and stroke, and is the leading cause of death in the WHO European Region. Many countries in the Region have initiated national salt reduction strategies,... including public awareness campaigns, reformulation, and front-of-pack nutrition labelling. However, despite ongoing efforts, surveillance data indicate that salt intake still far exceeds the limits recommended by WHO to protect health.
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second edition
Included more self-measured blood pressure (SMBP)-focused content with tools and resources.
Showcased more tools to find patients with potentially undiagnosed HTN.
Added new strategies that focus on chronic kidney disease testing and identification.
For most people in displacement contexts, there are simply not enough vaccines available in the places where they are hosted: 85% of refugees are hosted in lower- and middle-income countries, while in the first six months of this year 85% of vaccines went to wealthy countries; lower- and middle inco...me countries have still received only a fraction of the vaccine doses they require.3 Shortages in these countries can also pose particular risks to vaccination campaigns aimed at displaced populations, as they can result in them being deprioritized.
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Access to safe blood and blood products is recognized as one of the key requirements for delivery of modern health care in the journey towards health for all. The foundation of safe and sustainable blood supplies depends on the collection of blood from voluntary non-remunerated and low-risk donors. ...Data from the WHO Global Database for Blood Safety (GDBS) brings out several inadequacies related to the supply and safety of blood and blood products. These inadequacies include a number of variations in safe blood practices across the world, including the quantity of blood donated (voluntary and replacement types), quality and adequate testing of the donated blood (immunohaematology [IH] and transfusion-transmitted infections [TTIs]), rational use of blood and blood components such as appropriate patient blood management protocols. These variations are very high in countries of the South-East Asian Region and most of them are either low- or middle-income countries (LMICs).
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This WHO laboratory manual provides the most up to date methods and procedures for the laboratory identification of yellow fever virus infection in humans. It provides guidance on the establishment and maintenance of an effective laboratory providing routine surveillance testing for yellow fever, wh...ich operates within the WHO coordinated Global Yellow Fever Laboratory Network (GYFLaN) capable of providing confirmation of yellow fever infection reliably and timely. This second edition supersedes the first edition of the 2004 WHO manual for the monitoring of yellow fever virus infection.
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When Ebola hit Liberia in 2014, an atmosphere of fear and confusion contributed to the spread of the virus by making people unwilling to come forward for testing and treatment. Oxfam trained and equipped community health volunteers to go door-to-door, giving information and advice, encouraging anyon...e showing symptoms to go for tests, and keeping their family members informed about the progress of their treatment. The approach won the trust of communities and helped to slow the spread of the disease. This case study gives an overview of the programme, including aims, results and a personal story.
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This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, preliminary studies and pilot testing, budgeting and accounting, intervention costing and economic analysis, and Phase IV studies. Before new interventions... are released into disease control programmes, it is essential that they are carefully evaluated in ‘field trials’. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. This manual was designed to provide guidance on the practical issues in great detail
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Barriers to the prompt and effective diagnosis and treatment of malaria exist at both the community and health facility level. Household surveys measure malaria case management at the population level with standard indicators that assess treatment-seeking behavior, access to diagnostic testing, and ...access to appropriate treatment. Performance on these indicators varies widely from country to country. Among countries with Demographic and Health Surveys (DHS) or Malaria Indicator Surveys (MIS) completed between 2014 and 2016, advice and treatment was sought for a median of 47% of children under age 5 with fever.
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The Venezuelan refugee and migrant crisis is one of the biggest external displacement crises in the world today. The COVID-19 pandemic has compounded an already desperate situation for many refugees and migrants, as well as their hosts, sorely testing health and social welfare systems and the abilit...y of countries to assist the vulnerable population.
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The report finds that, as of 3 November, in 87 countries with age-disaggregated data, children and adolescents under 20 years of age accounted for 1 in 9 of COVID-19 infections, or 11 per cent of the 25.7 million infections reported by these countries. More reliable, age-disaggregated data on infect...ion, deaths and testing is needed to better understand how the crisis impacts the most vulnerable children and guide the response
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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Yaws is targeted for eradication by 2030, using a strategy based on mass drug administration (MDA) with azithromycin. New diagnostics are needed to aid eradication. Serology is currently the mainstay for yaws diagnosis; however, inaccuracies associated with current serological tests makes it difficu...lt to fully assess the need for and impact of eradication campaigns using these tools. Under the recommendation of the WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases(NTDs), a working group was assembled and tasked with agreeing on priority use cases for developing target product profiles (TPPs) for new diagnostics tools.
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Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of ind...ividuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
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Barriers to HIV Services and Treatment for Persons with Disabilities in Zambia
The 80-page report documents the obstacles faced by people with disabilities in both the community and healthcare settings. These include pervasive stigma and discrimination, lack of access to inclusive HIV prevention ed...ucation, obstacles to accessing voluntary testing and HIV treatment, and lack of appropriate support for adherence to antiretroviral treatment. The report also describes the sexual and intimate partner violence women and girls with disabilities face, and the need for the government and international donors to do more to ensure inclusive and accessible HIV services.
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Recent systematic reviews and meta-analysis of the impact of chemical-based mollusciciding (King et al., 2015, Sokolow et al., 2016) have concluded that regular mollusciciding is likely to contribute significantly towards elimination of schistosomiasis in high-risk areas. The WHO roadmap’s new foc...us on “transmission control, wherever possible” (WHO, 2012a) reinforces the need to promote intermediate-host snail control to prevent schistosomiasis transmission.
This operational manual is intended to facilitate the reintroduction of practices and protocols for use of molluscicides in the field in schistosomiasis control programmes. It is complemented by guidelines on the laboratory and field testing of the efficacy of molluscicides for schistosomiasis control (WHO, 2017 [in preparation]).
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Maldives has made significant strides in the area of infectious disease prevention and control. This is exemplified by elimination of malaria from Maldives in 2015 and successes in TB control. In addition, Maldives is a front runner in infectious disease prevention through successful water, sanitati...on, hygiene and vaccination campaigns and coverage. However, given the limited evidence that exists with respect to the occurrence of resistant organisms in the nation, it is hard to estimate the exact antimicrobial resistance (AMR) scenario. Also, it becomes difficult to compare the current situation with other countries in the region. Moreover, limited evidence exists on the trends of use of antimicrobial agents (AMA) in Maldives. Although, recent prescription audits have indicated overuse of antibiotics, especially for common conditions such as flu, cough and fever.
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Updated 10 August 2020
This document presents an essential medicines list (EML) to manage patients in intensive care units (ICUs) with suspected or confirmed COVID-19 diagnosis, which includes active ingredients with dosage form and concentration, and are preferably in the WHO Model Lists of Essent...ial Medicines 2019; based on clinical presentations and symptoms identified and prioritized in World Health Organization (WHO) and Surviving Sepsis Campaign (SSC) guidelines and the evidence presented in these guidelines.
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Sudan recorded the first COVID-19 case on 13 March 2020 and, at the beginning of July, the Federal Ministry of Health had confirmed that nearly 10,000 people had contracted the virus, including over 600 who died from the disease across the country. Although more than 70 per cent of the confirmed cas...es are in the Khartoum area, COVID-19 has spread throughout the country, with the highest numbers recorded in the central and eastern states. With extremely low testing capacity — around 800 samples per day, the lowest in the region — the official figures of confirmed cases likely underestimate the extent of the pandemic and the actual situation is unknown.
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The COVID-19 pandemic has led to large increases in healthcare waste, straining under resourced healthcare facilities and exacerbating environmental impacts from solid waste. This report quantifies the additional COVID-19 healthcare waste generated, describes current healthcare waste management syst...ems and their deficiencies, and summarizes emerging best practices and solutions to reduce the impact of waste on human and environmental health. The recommendations included in the report build on actions in the WHO manifesto for a healthy recovery from COVID-19: prescriptions and actionables for a healthy and green recovery. They target the global, national and facility levels to promote a “win–win” scenario for COVID-19 PPE use, testing and vaccinations that are safe and support environmental sustainability.
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Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures—and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, informa...tion will be needed to support a potential campaign to promote vaccination.
Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects.
Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile.
Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies.
Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
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