A review of policy and practice; zero Hunger Phase 1
54th directing council; 67th session of the regional Committee of WHO for the Americas
CD54/11, Rev. 1, 2 October 2015, Original: Spanish
Ginebra, 14-16 de marzo de 2011
Este documento apresenta um marco conceitual renovado das funções essenciais de saúde pública (FESP) para a Região das Américas, com o qual se pretende dar maior clareza conceitual e operacionalidade ao novo campo de atuação da saúde pública e preencher uma lacuna nas propostas conceituais... sobre o fortalecimento dos sistemas de saúde. O marco proposto apresenta um novo paradigma para a saúde pública, baseado em quatro pilares orientados para a ação: a necessidade de incorporar a abordagem dos direitos humanos às políticas públicas de saúde; a necessidade de a saúde pública ampliar seu enfoque para ter uma abordagem mais ampla dos determinantes sociais da saúde; o papel da saúde pública para garantir de forma integral e integrada o acesso a intervenções de base populacional e atenção individual de qualidade; e a necessidade de as autoridades de saúde atuarem em colaboração com outros setores e com a sociedade civil no desempenho das funções de saúde pública.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi...nes.
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Chagas disease caused by Trypanosoma cruzi is a public health issue in Latin America. This highly diverse parasite is divided into at least seven discrete typing units (DTUs) TcI-TcVI and Tcbat. Some DTUs have been associated with geographical distribution in epidemiological scenarios and clinical m...anifestations, but these aspects remain poorly understood. Many studies have focused on studying the parasite and its vectors/hosts, using a wide variety of genetic markers and methods. Here, we performed a systematic review of the literature for the last 20 years to present an update of DTUs distribution in the Americas, collecting ecoepidemiological information. We found that the DTUs are widespread across the continent and that there is a whole gamma of genetic markers used for the identification and genotyping of the parasite. The data obtained in this descriptor could improve the molecular epidemiology studies of Chagas disease in endemic regions.
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