Epidemiological Update
Dengue
7 February 2020
Situation summary
In the Region of the Americas, between epidemiological week (EW) 1 and EW 521 of 2019, a total of 3,139,335 cases of dengue have been reported (321.58 cases per 100,000 population), including 1,538 deaths. Of the total cases, 1,367,...353 (43.6%) were laboratory-confirmed and 28,169 (0.9%) were classified as severe dengue. The case-fatality rate was 0.049%.
more
La sécurité du traitement hospitalier et la réalité des soins sont des
préoccupations majeures dans les systèmes de santé. La transfusion sanguine a fait l’objet de procédures juridiques et d’études
au Canada, en Angleterre, en France, en Irlande et dans d’autres
pays. Il conviendr...ait que les hôpitaux soient à même de montrer
que leurs méthodes de transfusion sanguine sont sûres, cliniquement effectives et efficaces. En voici les raisons.
more
This thematic brief accompanies the Working for Health 2022–2030 Action Plan, serving as a rationale to the related actions of the Working for Health progression model (see Annex). The brief aims to inform Member States, non-state actors and other users of the Action Plan to guide action on inves...tments on strengthening protection and performance of the health and care workforce, including the relevant policy landscape, key challenges and future directions.
In doing so, it provides an expanded exploration of the themes beyond what is provided in the Action Plan itself and reflects the topical issues and considerations that shaped its design, including those issues identified in the World Health Assembly Resolution WHA74.14 to protect, safeguard and invest in the health and care workforce (1). The importance of these themes was again emphasized at the Seventy-fifth World Health Assembly, when Resolution WHA75.17: Human resources for health was co-sponsored by over 100 Member States, calling for the adoption and implementation of the Working for Health 2022–2030 Action Plan and utilization of the related Global Health and Care Worker Compact
more
Human schistosomiasis, a parasitic and often chronic illness, is one of the major neglected tropical diseases worldwide. It is estimated that 240 million people suffer from schistosomiasis, with more than 200000 fatalities recorded each year. Schistosomiasis is caused by an infection of the blood fl...uke Schistosoma and is transmitted to humans through direct contact with infected water.
more
The introduction of vaccines for coronavirus disease 2019 (COVID-19) added another measure to the existing set of
recommended preventive measures (wearing a mask in public, keeping a distance from other people and regular handwashing). The roll-out of the vaccines, however, raised concerns that vac...cination may lead to lower adherence to the existing
preventive measures. The advice from the World Health Organization (WHO) was to continue these public health and
social measures after being vaccinated.1 However, evidence from other epidemics suggests that there is lower adherence to
preventive measures when some level of protection exists (for example, individuals who use human immunodeficiency virus
pre-exposure prophylaxis
more
Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control tec...hnology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
more
Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT ...control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
more
This guideline provides evidence-based recommendations on parenting interventions for parents and caregivers of children aged 0–17 years that are designed to reduce child maltreatment and harsh parenting, enhance the parent–child relationship, and prevent poor mental health among parents and emo...tional and behavioural problems among children.
more
Research and Reports in Tropical Medicine 2022:13 25–40.
Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the South of the United States. It is an important cause of early mortality and morbidity, and it is associated with po...verty and stigma. A third of the cases evolve into chronic cardiomyopathy and gastrointestinal disease. This review proposes strategies to address challenges faced by non-endemic countries
more
In response to the recent publication “Is onchocerciasis elimination in Africa feasible by 2025: a perspective based on lessons learnt from the African control programmes” by Dadzie et al., it is important to clarify and highlight the positive and unequivocal research and operational contributio...ns from the American experience towards the worldwide elimination of human onchocerciasis (river blindness).
more
This brochure presents a summary of the situation of health systems and services in the Americas as they progress toward the achievement of universal access to health and universal health coverage (universal health). The information provided presents an overview of the situation before the COVID-19 ...pandemic, how the pandemic has impacted health systems, and recommendations to address current and future challenges for building resilient health systems to advance toward universal health in the Americas.
more
Every day in 2020, approximately 800 women died from preventable causes related to pregnancy and childbirth - meaning that a woman dies around every two minutes.
Sustainable Development Goal (SDG) target 3.1 is to reduce maternal mortality to less than 70 maternal deaths per 100 000 live births by ...2030.
The United Nations Maternal Mortality Estimation Inter-Agency Group (MMEIG) – comprising WHO, the United Nations Children’s Fund (UNICEF), the United Nations Population Fund (UNFPA), the World Bank Group and the United Nations Department of Economic and Social Affairs, Population Division (UNDESA/Population Division) has collaborated with external technical experts on a new round of estimates covering 2000 to 2020. The estimates represent the most up to date, internationally-comparable MMEIG estimates of maternal mortality, using refined input data and methods from previous rounds.
The report presents internationally comparable global, regional and country-level estimates and trends for maternal mortality between 2000 and 2020.
more
Countries are making progress toward the global goal of 95% of people living with HIV knowing their status by 2025. However, considerable gaps remain in achieving these goals globally. Men in high HIV burden settings and men from key populations in all settings are consistently less likely to know t...heir HIV status than women. Globally, 78% of men ages 15 years and older who are living with HIV are aware of their HIV status, compared with 86% of women with HIV of these ages.
Offering HIV testing services, including HIV self-testing, at formal and informal workplaces has emerged as an effective, acceptable and feasible approach for reaching men. A 2018 World Health Organization (WHO) and International Labour Organization (ILO) policy brief provides key guiding principles for HIVST implementation at workplaces. Building on the 2018 policy brief, this brief captures early experience with HIVST implementation at workplaces and discusses emerging approaches of sustainable financing that can be adapted for HIV self-testing at workplaces.
The primary audiences for this policy brief are ministries of health and labour, national HIV programmes, employers’ organizations, workers’ organizations (labour unions), enterprises, implementing partners, including civil society organizations, and health insurance agencies.
more
Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrom...e, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status
more
The objectives of the meeting were:
1. To step up the commitment of national authorities and technical and financial partners toWHO’s elimination objective for g-HAT.
2. To share achievements, challenges and views on the elimination goal among countries and implementing partners.
3. To assess t...he status of critical technical aspects to be solved in research and development of drugs and diagnostic tools, epidemiology, vector control and animal reservoirs.
4. To define the mechanisms for strengthening and organizing collaboration and coordination among stakeholders.
more
The objectives of the meeting were:
1. To update the current status of the disease transmission, country capacities and plans for tackling the disease.
2. To understand the epidemiology including disease distribution and risk, the models
for estimating under-detection, the geographical variati...ons of in clinical presentation,
the roles of domestic and wild animal reservoirs and the subsequent different
transmission patterns and control approaches, including vector control.
3. To update current research and development efforts for improving diagnostic and
treatment tools.
4. To define the goals for achieving the control of r-HAT, the need for a multisectoral
approach and to discuss the strategy for controlling r-HAT and the coordination
mechanisms.
more
Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
more
Rabies is a devastating and societally important zoonotic disease, which is transmitted principally to humans through the bite of infected dogs. This acute, progressive viral encephalitis has the highest case fatality of any infectious disease and kills tens of thousands of people annually, with chi...ldren and impoverished communities being affected disproportionately.
more
Rabies is a fatal viral zoonosis and serious public health problem.1 All mammals are believed to be susceptible to the disease, and for the purposes of this document, use of the term animal refers to mammals. The disease is an acute, progressive encephalitis caused by viruses in the genus Lyssavirus....
2 Rabies virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are maintained in wild mammalian reservoir populations such as raccoons, skunks, foxes, and bats. Although the United States has been declared free from transmission of canine rabies virus variants, there is always a risk of reintroduction of these variants.The rabies virus is usually transmitted from animal to animal through bites. The incubation period is
highly variable. In domestic animals, it is generally 3 to 12 weeks, but can range from several days to months, exceeding 6 months.8 Rabies is communicable during the period of salivary shedding of rabies virus. Experimental and historic evidence documents that dogs, cats, and ferrets shed the virus for a few days prior to the onset of clinical signs and during illness. Clinical signs of rabies are variable and include inappetance, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs.
more
The conditionality of this recommendation is largely driven by the current higher unit cost of pyrethroid-PBO ITNs compared
to pyrethroid-only LLINs and therefore the uncertainty of their cost-effectiveness. Furthermore, as PBO is less wash-resistant
than pyrethroids, its bioavailability declines ...faster over the three-year estimated life of an ITN; therefore, the added impact of
pyrethroid-PBO ITNs over that of pyrethroid-only LLINs may decline over time. The evidence comes from two sites in
eastern Africa with pyrethroid resistance and not from other geographies where transmission levels and vector characteristics
may vary. PBO acts by inhibiting certain metabolic enzymes, primarily oxidases, and so are likely to provide greater protection
than pyrethroid-only LLINs where mosquitoes display mono-oxygenase-based insecticide resistance mechanisms.
more