After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery, pre-clinical development, and operational challenge...s of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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Alcohol use is deeply embedded in the social landscape of many societies, and some 2300 million people drink alcoholic beverages in most parts of the world. At the same time, more than half of the global population aged 15 years and older reported having abstained from drinking alcohol during the pr...evious 12 months. Several major factors have an impact on levels and patterns of alcohol consumption in populations – such as historical trends in alcohol consumption, the availability of alcohol, culture, economic status and implemented alcohol control measures. At the individual level the patterns and levels of alcohol consumption are determined by multiple factors that include gender, age and individual biological and socioeconomic vulnerability factors as well as the policy environment. Prevailing social norms that support drinking behaviour and mixed messages about the harms and benefits of drinking may encourage alcohol consumption, delay appropriate health-seeking behaviour and weaken community action.
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In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors...ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to ...sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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La prise en charge de la tuberculose représente un véritable défi en milieu carcéral et l’organisation de la continuité des soins à la sortie un enjeu majeur. Comme tout être humain, les détenus ont le droit de jouir du meilleur état de santé physique et mental possible. Ce droit est gar...anti par l’article 25 de la Déclaration universelle des droits de l’homme adoptée par l’Organisation des Nations Unies, et par l’article 12 du Pacte international relatif aux droits économiques, sociaux et culturels. Ce travail fait un état des lieux sur la prise en charge de la tuberculose en milieu carcéral au Sénégal, depuis les stratégies de dépistage jusqu’à la continuité des soins après la sortie de prison.
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La prise en charge de la tuberculose représente un véritable défi en milieu carcéral et l’organisation de la continuité des soins à la sortie un enjeu majeur. Comme tout être humain, les détenus ont le droit de jouir du meilleur état de santé physique et mental possible. Ce droit est gar...anti par l’article 25 de la Déclaration universelle des droits de l’homme adoptée par l’Organisation des Nations Unies, et par l’article 12 du Pacte international relatif aux droits économiques, sociaux et culturels. Ce travail fait un état des lieux sur la prise en charge de la tuberculose en milieu carcéral au Sénégal, depuis les stratégies de dépistage jusqu’à la continuité des soins après la sortie de prison.
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Esta guía trata de la primera ayuda psicológica, un modo práctico y humano para ayudar y apoyar a nuestros semejantes en graves situaciones de crisis. Se ha pensado para personas que se tienen la posibilidad de ayudar a
otras que han experimentado un hecho extremadamente angustiante. Proporciona... un marco de
trabajo para apoyar a las personas respetando su dignidad, cultura y capacidades. A pesar de su
nombre, la primera ayuda psicológica se ocupa tanto del apoyo social como del psicológico.
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Son 16 cartillas educativas que contiene la presente publicación y que se ponen a disposición del docente, como un mecanismo ágil y sencillo que permita la reflexión y el análisis de situaciones de la vida diaria, relacionadas a la salud, las cuales permitirán mediante una aplicación continua... , promover prácticas saludables fundamentales, para lograr una cultura en salud en los alumnos de las instituciones educativas públicas, lo cual permitirá mejorar su calidad de vida.
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Son 16 cartillas educativas que contiene la presente publicación y que se ponen a disposición del docente, como un mecanismo ágil y sencillo que permita la reflexión y el análisis de situaciones de la vida diaria, relacionadas a la salud, las cuales permitirán mediante una aplicación continua... , promover prácticas saludables fundamentales, para lograr una cultura en salud en los alumnos de las instituciones educativas públicas, lo cual permitirá mejorar su calidad de vida.
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Checklist to support the reopening of schools and preparation for resurgences of COVID-19 or similar public health crises.
O objetivo desta lista de verificação é reforçar a conformidade e a adesão às medidas de saúde pública delineadas no documento recentemente atualizado Considerations fo...r school-related public health measures in the context of COVID-19 [Considerações para medidas de saúde pública relacionadas a escolas no contexto da COVID-19], considerando-se principalmente as crianças menores de 18 anos em contextos educacionais e em escolas com recursos limitados. A lista de verificação foi elaborada de acordo com os princípios e as abordagens das escolas promotoras de saúde.7,8 Este documento destaca a importância da coordenação multinível (ou seja, nos níveis escolar, subnacional e nacional) e de abordagens participativas e cocriadas pelas várias partes interessadas (por exemplo, trabalhadores das escolas, professores, alunos e pais). Esta abordagem visa a otimizar o cumprimento das medidas sociais e de saúde pública baseadas nos contextos sociais e culturais, conforme descrito no documento Considerations for implementing and adjusting public health and social measures in the context of COVID-19 [Considerações para a implementação e ajuste de medidas sociais e de saúde pública no contexto da COVID-19].
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En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niveles de hace veinte años. Estas cifras no solo imp...lican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
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En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niveles de hace veinte años. Estas cifras no solo imp...lican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
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Children with disabilities are particularly vulnerable in humanitarian settings, yet they are often not able to access the services and protection they need. While multiple factors create these barriers, a major cause is how data about children with disabilities is collected and mapped. Data collect...ion processes often exclude or underrepresent the views of children with disabilities and thier caretakers. When the experiences of children with disabilities and their caretakers are not defined and collected, they become excluded from mainstreamed protective services, which are meant to serve all children. Children with disabilities also do not get the specialised interventions they need.
This guidance note explores how to use qualitative methods to create more robust assessment processes to ensure more effective programming and services for children with disabilities. This note provides promising practices for engaging with children with disabilities and includes sample tools that can be tailored to fit the needs of a particular assessment process. The note also explores the importance of thoughtful cross-sectoral responses so that children with disabilities, and their families, are carefully considered in areas like water, sanitation, and hygiene (WASH), education, health, and nutrition, and therefore receive the holistic support they need and deserve.
This note is intended for a broad audience of relevant child protection actors, including practitioners, coordination groups, researchers, and donors. The information is not limited to one type of humanitarian setting, geographic region, or culture. As a result, the practices and guidance should be adapted to each specific context, ideally in partnership with well-informed local actors, such as representatives from local organisations for persons with disabilities.
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The environment in which young people live, learn and play significantly affects their decisions about whether to consume alcohol. Environmental factors are the main risk factors driving alcohol consumption and related harm among young people. Environments that normalize alcohol consumption – term...ed alcogenic environments – include contexts with unregulated advertising and marketing of alcoholic beverages, higher alcohol outlet density, products designed to facilitate affordability and low prices of alcoholic beverages. A recent body of research evidence has emerged related to the measurement, functional significance and consequences of living in alcogenic environments. This includes findings on the complex and bidirectional interactions among alcohol acceptability, availability and affordability and how they create and perpetuate alcogenic environments. Comprehensive and enforced alcohol control policies are effective at delaying the age of onset and lowering alcohol prevalence and frequency among young people. Evidence consistently confirms the effectiveness of designing and implementing alcohol control policies that regulate upstream the drivers of alcogenic environment, including alcohol availability, acceptability and affordability. These policies need to be multipronged and address the complex interactions between these drivers and the local alcohol culture
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African countries, like many regions of the world, are affected by the legacy of atrocity crimes. Genocide, the transatlantic slave trade and slavery, colonialism and post-independence violence committed during dictatorships, not to mention civil war and violent extremism, have severely violated hum...an rights and left devastating marks on societies across the continent. The way in which societies deal with violent pasts has profound implications for the present and the future, as well as their chances of building sustainable peace.
Strengthening education about atrocity crimes, including genocide, crimes against humanity and war crimes, is an essential part of addressing violent pasts and preventing future atrocity crimes. Echoing a series of United Nations resolutions on the importance of educational measures for genocide prevention,1 in 2013, the Secretary-General’s annual report Responsibility to protect: State responsibility and prevention included the recommendation: “Education curriculums should include instruction on past violations and on the causes, dynamics and consequences of atrocity crimes” as an important means to promote societal resilience to atrocity crimes.
This recognition is in line with the Education 2030 Agenda and, more specifically, target 4.7 of Sustainable Development Goal (SDG) 4 on Education. This target calls on countries to promote education that fosters sustainable development, human rights, gender equality, a culture of peace, global citizenship and an appreciation of cultural diversity.
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The risk factors for CVD include behavioural factors, such as tobacco use, an unhealthy diet, harmful use of alcohol and inadequate physical activity, and physiological (metabolic) factors, including high blood pressure (hypertension), high blood cholesterol and high blood sugar or glucose. Both kin...ds of factor are linked to underlying social determinants and drivers. This module focuses on the behavioural risk factors and provides information on: • tobacco use, unhealthy diet, insufficient physical activity and harmful use of alcohol as important contributors to CVDs • behavioural change, brief interventions for counselling and key points for motivational interviewing • the theory of the 5As for brief interventions, as well as sample brief interventions for each risk factor, using the 5As. Target users of this module This module is intended for trainers of primary health care workers, including physicians, nurses, and other health workers. Primary care workers should be trained on the risk factors and counselling approaches, adapting to local customs, culture and context. NCD programme managers may also use it for planning purposes.
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See how people really live. Imagine the world as a street. All houses are lined up by income, the poor living to the left and the rich to the right. Everybody else somewhere in between. Where would you live? Would your life look different than your neighbours’ from other parts of the world, who sh...are the same income level?
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Department of Behavioural Medicine, Lagos State University College of Medicine Ikeja, Lagos Nigeria
Global Mental Health (2015), 2, e5, page 1 of 12. doi:10.1017/gmh.2015.8;
Received 29 January 2015; Revised 8 April 2015; Accepted 15 April 2015
LIGHT FOR THE WORLD is a European confederation of national development NGOs committed to saving eyesight, improving the quality of life and advocating for the rights of person with disabilities in the underprivileged regions of our world. The guidelines reflect both the ongoing developments within ...CBR during recent years and the strategic debates between CBR practitioners from around the world as to the very ideology behind CBR. The goal of the new CBR guidelines is to assist with the development of CBR practice in the many countries around the world where it is practiced.
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