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Therapeutics and COVID-19 (Living Guideline, 10 November 2023)

World Health Organization WHO (2023) C_WHO

WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines. Updated risk rates for hospital admission in patients with non-severe COVID...-19 The guidance includes updated risk rates for hospital admission in patients with non-severe COVID-19. The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients. This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines: **High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%. **Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%. Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk. Review of COVID-19 treatments for people with non-severe COVID-19 WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022. If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead. WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission. For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol. WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials. The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials. more

Cardiovascular Diseases

World Health Organization WHO (2023) C_WHO

The website provides information on cardiovascular diseases (key facts, definitions, risk factors etc.).

New Guideline Focuses on Causes of TIAs, Other Stroke Precursors

U.S. Pharmacist (2021) CC

Atlanta, GA—New stroke guidelines strongly encourage clinicians to prescribe antithrombotic therapy, including antiplatelet medications or anticoagulant medications, for nearly all at-risk patients who don’t have contraindications.

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WORLD HEART REPORT 2023 CONFRONTING THE WORLD’S NUMBER ONE KILLER

Cesare, M.D.; Bixby, H.; Gaziano, T. et al. World Heart Federation (2023) CC

Global progress against cardiovascular disease (CVD) is flatlining. Though rates of CVD deaths globally have fallen in the last three decades, this trend has begun to stall and, without concerted efforts, is at risk of reversing.

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A comparison of cardiovascular imaging practices in Africa, North America, and Europe: two faces of the same coin

Lakshmanan, S.; Mbanze, I. European Society of Cardiology (2023) CC

Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. There are significant differences in the burden of cardiovascular disease and associated risk factors, across high-income countries and low- and middle-income cou... more

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The Treatment of Heart Failure with Reduced Ejection Fraction

Berliner, D.; Hänselmann, A.; Bauersachs, J. Deutsches Ärzteblatt International (2020) CC

Background Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death. Methods This review is based on articles retriev... more

What Is Atherosclerosis?

National Heart, Lung, and Blood Institute (2022) CC

Webpage about Atherosclerosis, addressing symptoms, diagnosis, causes and risk factors, prevention, treatment, living with the disease.

Atherosclerosis - What Is Atherosclerosis?

National Heart, Lung, and Blood Institute (2022) CC

Webpage about Atherosclerosis, addressing symptoms, diagnosis, causes and risk factors, prevention, treatment, living with the disease.

ESC Clinical Practice Guidelines on Cardiovascular Disease Prevention in Clinical Practice: What Patients Need to Know

European Society of Cardiology (2022) CC

This guide for patients aims to provide you with an overview of the latest evidence-based recommendations for the prevention of cardiovascular disease. In particular, it should help you to understand: • how cardiovascular disease risk is assessed... more

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Policy Snapshot: Cholesterol Control and Management in Brazil

World Heart Federation (2015) CC

Worldwide, there are about 17 million deaths due to cardiovascular disease (CVD) each year and at least two or three times as many non-fatal events. Raised cholesterol greatly increases the risks of stroke and heart disease, causing a large health ... more

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Preventing the next Pandemic: the Case for Investing in Circulatory Health

Global Coalition for Circulatory Health (2024) CC

The Coronavirus Disease 2019 (COVID-19) has had a continuous and robust impact on world health. The resulting COVID-19 pandemic has had a devastating physical, mental and fiscal impact on the millions of people living with noncommunicable diseases (NCDs), as they have a higher ... of severe illness and death from COVID-19. COVID-19 has been associated with an excess in all-cause and cardiovascular disease (CVD) mortality beyond that related to the infection itself and its immediate consequences. Studies in the United Kingdom (UK) and United States of America (USA) have clearly shown increasing deaths from ischemic heart disease, stroke and hypertensive disease due to COVID-19. Overall, the impact has been greater in individuals with lower socioeconomic status, even in high income nations. more

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Cardiovascular diseases in Africa in the twenty-first century: Gaps and priorities going forward

Minja, N.W.; Nakagaayi, D.; Aliku, T. et al. Frontiers in Cardiovascular Medicine (2022) CC

In 2015, the United Nations set important targets to reduce premature cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately bears the brunt of CVD burden and has one of the highest risks of dying from non-communicable dise...ases (NCDs) worldwide. There is currently an epidemiological transition on the continent, where NCDs is projected to outpace communicable diseases within the current decade. Unchecked increases in CVD risk factors have contributed to the growing burden of three major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age standardized disability-adjusted life years (DALYs) due to hypertensive heart disease (HHD) were recorded in Africa. The contributory causes of heart failure are changing—whilst HHD and cardiomyopathies still dominate, ischemic heart disease is rapidly becoming a significant contributor, whilst rheumatic heart disease (RHD) has shown a gradual decline. In a continent where health systems are traditionally geared toward addressing communicable diseases, several gaps exist to adequately meet the growing demand imposed by CVDs. Among these, high-quality research to inform interventions, underfunded health systems with high out-of-pocket costs, limited accessibility and affordability of essential medicines, CVD preventive services, and skill shortages. Overall, the African continent progress toward a third reduction in premature mortality come 2030 is lagging behind. More can be done in the arena of effective policy implementation for risk factor reduction and CVD prevention, increasing health financing and focusing on strengthening primary health care services for prevention and treatment of CVDs, whilst ensuring availability and affordability of quality medicines. Further, investing in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on interventions. This review summarizes the current CVD burden, important gaps in cardiovascular medicine in Africa, and further highlights priority areas where efforts could be intensified in the next decade with potential to improve the current rate of progress toward achieving a 33% reduction in CVD mortality. more

La ingesta total de grasas en la prevención del aumento de peso malsano en adultos y niños: resumen de la directriz de la OMS

World Health Organisation (WHO) (2023) C_WHO

This guideline provides updated, evidence-informed guidance on the percentage of total fat in the diet to reduce the risk of unhealthy weight gain. This guideline is intended for a wide audience involved in the development, design and implementat... more

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War in Cities: Persons with disabilities and the role of the International Red Cross and Red Crescent Movement

International Committee of the Red Cross (2023) CC

When war breaks out in cities, the complexity and interconnectedness of the urban environment poses many problems for civilians. For persons with disabilities, the impact can be even worse and aggravate existing barriers and risks. Armed forces, aut... more

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Guidance: Integrating MHPSS and Peacekeeping: a Mapping and Recommendations for Practitioners - IASC Reference Group on Mental Health and Psychosocial Support in Emergency Settings (January 2024)

Inter-Agency Standing Committee (2024) C1

A major problem facing the world is how to build peace following the ravages of increasingly protracted armed conflict. Armed conflicts leave behind shattered, divided societies that are at risk of repeating cycles of violence, and therefore need co... more

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Caring for child survivors of sexual abuse guidelines

International Rescue Committee; UN Children's Fund (2024) CC

Sexual abuse perpetrated against children is one of the most significant crises of our time. Child sexual abuse is a significant risk factor for children, in common with other forms of child maltreatment. Sexual abuse can have severe short- and long... more

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Sanitary inspection packages – A supporting tool for the Guidelines for drinking water quality: Small water supplies

World Health Organization WHO (2024) C_WHO

A sanitary inspection is a simple, on-site evaluation (traditionally using a checklist) to help identify and support the management of priority risk factors that may lead to contamination of a drinking-water supply. Sanitary inspections are a well-e... more

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Infection prevention and control and water, sanitation and hygiene measures in health-care settings and shelters/congregate settings in Gaza: Technical note, 22 February 2024

World Health Organization WHO (2024) C_WHO

The situation in the Gaza Strip is dire, with syndromic surveillance revealing high rates of infectious diseases. The risk of further spread may be exacerbated by several factors, including overcrowding, inadequate water and sanitation, disruption o... more

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The Global Burden of Disease Study at 30 years

Murray, C.J.L. nature medicine (2022) CC

The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases... more

Epidemiology of type 2 diabetes in India

Pradeepa, R.; Mohan, V. Indian Journal of Ophthalmology 69(11):p 2932-2938, November 2021. (2021) CC2

The burden of diabetes is high and increasing globally, and in developing economies like India, mainly fueled by the increasing prevalence of overweight/obesity and unhealthy lifestyles. The estimates in 2019 showed that 77 million individuals had diabetes in India, which is expected to rise to over... more