The purpose of the situation assessment was to execute a situation analysis for Autism and Neurodevelopment Disorder (NDD) in Bangladesh. The situation assessment covers the following areas: a review of the scale and prevalence of NDD with trends of the disorder in the recent past in Bangladesh (see... page 17); estimation of likely disease burden in the near future (see page 27); assessment of the social response to NDD in Bangladesh (see page 67); overview of the support and services required by persons with NDD (see page 79); an inventory of service providers working with NDD in Bangladesh (see page 85); an assessment of the adequacy of the existing services and support available for addressing NDD in country (see page 97); an overview of the role and preparedness of MOHFW and other stakeholders in addressing NDD in Bangladesh (see page 108); recommendations for monitoring, supervision and reporting mechanisms for NDD services at the national level (see page 167); and recommended key activities that should be undertaken by the Health and other relevant ministries in the short and medium term (see page 167).
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Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP)..., which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes.
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A National Service Programme for All Children with Special Needs and their Families
In Myanmar, we estimate that at least 40% of children require ECI services for short to longer periods of time. At present, 35.1% of Myanmar children are moderately to severely stunted; all of these children are l...ikely to have one or more developmental delays. In addition, at least 5% to 12% of the nation’s children will be identified to have disabilities, chronic diseases or atypical behaviours.
Over time, approximately 70% of the children who will be served will improve in their development, attain expected levels of development for their age, and will consolidate their gains within one to two years. Other children, approximately 30%, will have lifelong disabilities or other conditions, and ECI services usually greatly improve their development and help them to achieve their full potential.
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Rehabilitation in health systems provides recommendations for Member States and other relevant stakeholders to strengthen and expand the availability of quality rehabilitation services. Currently, there is a significant unmet need for rehabilitation services and it is frequently undervalued in the h...ealth system. As populations age and the prevalence of noncommunicable diseases and injuries increases, and the demand for rehabilitation grows, strengthening rehabilitation in health systems becomes ever more paramount.
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This Review summarizes many of the persistent biological alterations associated with childhood maltreatment including changes in neuroendocrine and neurotransmitter systems and pro-inflammatory cytokines in addition to specific alterations in brain areas associated with mood regulation. Finally, I d...iscuss several candidate gene polymorphisms that interact with childhood maltreatment to modulate vulnerability to major depression and PTSD and epigenetic mechanisms thought to transduce environmental stressors into disease vulnerability.
Neuron Review, vol. 89, March 2, 2016 pp.892-909
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Large-Scale UN Response Needed to Address Health and Food Crises
This report is based on interviews with more than 150 health care professionals, Venezuelans seeking or in need of medical care who recently arrived in Colombia and Brazil, representatives from international and nongovernmental humani...tarian organizations. In addition, researchers analyzed data on the situation inside Venezuela from official sources, hospitals, international and national organizations, and civil society organizations.
We found a health system in utter collapse with increased levels of maternal and infant mortality; the spread of vaccine-preventable diseases, such as measles and diphtheria; and increases in numbers of infectious diseases such as malaria and tuberculosis (TB). Although the government stopped publishing official data on nutrition in 2007, research by Venezuelan organizations and universities documents high levels of food insecurity and child malnutrition, and available data shows high hospital admissions of malnourished children.
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MICROBIAL DRUG RESISTANCEVolume 24, Number 5, 2018ªMary Ann Liebert, Inc.DOI: 10.1089/mdr.2017.0383
Antibiotic resistance (ABR) is a worldwide publichealth concern, with serious health, economic, and so-cietal repercussions. Its emergence is attributed to the se-lective pressure exerted by antib...iotic use in the community, hospitals, veterinary health, agriculture, aquaculture, and the environment. Additionally aggravating the situation is the fact that very few new antibiotics have recently been produced by pharmaceutical companies. It is widely acknowledged that food animals are key reservoirs of antibiotic-resistant bacteria and that antibiotic usage in this population favors the emergence, selection, and spread of resistance among animals and humans, both through zoonoses (infectious diseases trans-mitted between animals and humans) and the food chain.
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ObjetivoEl objetivodel documento es servir de guía de actuación para el manejo casos de COVID-19 en atención primaria.3.Recomendaciones generalesSe recomienda la colocación de información visual (carteles, folletos, etc.) en lugares estratégicosde los centros de atenció...n primaria (de ahora en adelante CAP)para proporcionar a la poblaciónlas instrucciones sobre higiene de manosehigiene respiratoria.Se ofrecerá una mascarilla quirúrgica a aquellos pacientes que acudan al centro sanitario con síntomas de infección respiratoria aguda.Se debedisponer de dispensadores con solución hidroalcohólica al alcance de la poblacióny el personal. Se deberá disponer de contenedores de residuos, con tapa de apertura con pedal, para la eliminación de los residuos generados.
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Se sabe que las mujeres embarazadas experimentan cambios inmunológicos y fisiológicos que pueden hacerlas más susceptibles a las infecciones respiratorias virales, incluido COVID-19. Varios estudios revelaron que las mujeres embarazadas con diferentes enfermedades resp...iratorias virales tenían un alto riesgo de desarrollar complicaciones obstétricas y resultados adversos perinatales en comparación con las mujeres no grávidas, debido a los cambios en las respuestas inmunes. También sabemos que las mujeres embarazadas pueden estar en riesgo de enfermedad grave, morbilidad o mortalidad en comparación con la población general, tal y como se observa en los casos de otras infecciones por coronavirus
5relacionadas [incluido el coronavirus del síndrome respiratorio agudo severo (SARS-CoV) y el coronavirus del síndrome respiratorio del Medio Oriente (MERS-CoV)] y otras infecciones respiratorias virales, como la gripe, durante el embarazo.
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The era of effective antibiotics is coming to a close. In just a few generations, many “miracle medicines”have been beaten into ineffectiveness by the bacteria they were intended to eradicate. Bacteria quickly adapt to the presence of antibacterial agents in order ...to survive. The misuse of antibiotics,which is an international problem, only exacerbates the steady evolution of resistance. In August 2010, the journal Lancet Infectious Diseases posed the question "Is this the end of antibiotics?" documentingthe rapid spread of multidrug-resistant bacteriaand predicting that 10 years remain in the useful life of many agents.
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The most significant finding of the case study for integrating antimicrobial resistance (AMR)into existing programs and mobilising resources for funding in Nigeria, is that most of the AMR activities within the Nigerian National Action Plan (NAP)canalready be incorporated within exi...sting programs of the Federal Ministry of Health (FMOH), Federal Ministry of Agriculture and Rural Development (FMARD) and their agencies or institutes. Certain programs and initiatives already have an AMR element incorporated or could,with little effort,include some additional AMR actions, however much is already being planned and has started with existing federal funding and existing staffing and other resources including development partner support and is being driven by significant political will from the ministries as well as implementation support from the Nigerian Centers for Disease Control as the focal point.
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Lignes directrices provisoires
17 janvier 2020
Le présent document a été rédigé en s’appuyant sur divers documents existants de l’OMS, y compris les lignes directrices de l’OMS relatives au dépistage en laboratoire du MERS-CoV (1-11). À mesure que de nouvelles informations seront r...ecueillies concernant l’étiologie, les manifestations cliniques et la transmission de la maladie dans le groupe de patients atteints de maladie respiratoire à Wuhan, l’OMS continuera de suivre l’évolution de la situation et révisera si nécessaire les présentes recommandations.
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Esta é a primeira edição de orientações sobre estratégias de prevenção e controle de infecção (PCI) para utilizar quando houver suspeita de infecção por um novo coronavírus (2019-nCoV). Foi adaptado do guia da OMS de Prevenção e controle de infecções durante os cuidados de saúde pa...ra casos prováveis ou confirmados da infecção pelo coronavírus que causa a síndrome respiratória do Oriente Médio (MERS--CoV)1, com base no conhecimento atual da situação na China e em outros países onde foram identificados casos e experiências com a síndrome respiratória aguda grave (SARS)-CoV e MERS-CoV. A OMS atualizará essas recomendações assim que novas informações estiverem disponíveis. Esta orientação destina-se a profissionais de saúde, gerentes de saúde e equipes de PCI na atenção básica em saúde, mas também é relevante para os níveis nacional e subnacional. Diretrizes completas estão disponíveis na OMS.
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.... In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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Au cours de la dernière décennie, les données de séquençage génétique des agents pathogènes ont gagné en importance et contribuent désormais de façon déterminante à la détection et à la maîtrise des flambées de maladies infectieuses, en facilitant la mise au point de ...produits de diagnostic, de médicaments et de vaccins et en guidant lesactivités de riposte aux flambées(1-11). L’émergence du nouveau coronavirus, par la suite désigné « coronavirus 2 du syndrome respiratoire aigu sévère » (SARS-CoV-2), a encore accentué l’importance des données de séquençage génétique.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Left unabated, climate change will have catastrophic effects on the health of present and future generations. Such effects are already seen in Europe, through more frequent and severe extreme weather events, alterations to water and food systems, and changes in the environmental suitability for infe...ctious diseases. As one of the largest current and historical contributors to greenhouse gases and the largest provider of financing for climate change mitigation and adaptation, Europe’s response is crucial, for both human health and the planet. To ensure that health and
wellbeing are protected in this response it is essential to build the capacity to understand, monitor, and quantify health impacts of climate change and the health co-benefits of accelerated action.
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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.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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9 March 2022, Timely and accurate diagnostic testing for SARS-CoV-2 is an essential part of a comprehensive COVID-19 response strategy. Ag-RDTs can be performed by individuals in which they collect their own specimen, perform a simple rapid test and interpret their test result themselves at a time a...nd place of their choosing, termed COVID-19 self-testing. This interim guidance provides a new recommendation that COVID-19 self-testing, using SARS-CoV-2 Ag-RDTs, should be offered as part of SARS-CoV-2 testing services. It also includes implementation considerations that can guide decisions on whether, and how, to adopt self-testing in different contexts, including the populations being prioritized; the disease prevalence in that population; and the impact on accessibility of testing, health care services and result reporting.
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