Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi
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on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
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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-term consequences on the physical, mental, social,
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emotional and economic well-being of children, families and communities. In emergencies, the threat of all forms of child abuse and gender-based violence (GBV), including child sexual abuse, is acute and widespread.
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Diphtheria is caused by Corynebacterium species, mostly by toxin-producing Corynebacterium diphtheriae and rarely by toxin-producing strains of C. ulcerans and C. pseudotuberculosis. The most common type of diphtheria is classic respiratory diphtheria, whereby the exotoxin produced characteristicall
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y causes the formation of a pseudomembrane in the upper respiratory tract and damages other organs, usually the myocardium and peripheral nerves. Acute respiratory obstruction, acute systemic toxicity, myocarditis and neurologic complications are the usual causes of death. The infection can also affect the skin (cutaneous diphtheria). More rarely, it can affect mucous membranes at other non-respiratory sites, such as genitalia and conjunctiva.
C. diphtheriae is transmitted from person to person by intimate respiratory and direct contact; in contrast, C. ulcerans and C. pseudotuberculosis are zoonotic infections, not transmitted person-to-person. The incubation period of C. diphtheriae is two to five days (range 1– 10 days). A person is infectious as long as virulent bacteria are present in respiratory secretions, usually two weeks without antibiotics, and seldom more than six weeks. In rare cases, chronic carriers may shed organisms for six months or more. Skin lesions are often chronic and infectious for longer periods. Effective antibiotic therapy (penicillin or erythromycin) promptly terminates shedding in about one or two days.
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The Guidelines for drinking-water quality: small water supplies have been developed to address the needs and opportunities associated with small supplies to facilitate progressive improvement towards safe and sustainable drinking-water services for all. These Guidelines are based on the principal re
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commendation in the World Health Organization’s Guidelines for drinking-water quality, and they provide guidance on applying that recommendation to small water supplies in particular. These Guidelines aim to help governments and practitioners improve the safety of drinking-water delivered through small supplies.
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After introducing Ethiopia's WASH sector challenges and trends, the plan describes IRC Ethiopia's vision and strategy which draws from IRC and Water For People's joint framework - Destination 2030. It then details the organisational changes and business development needed to implement the strategic
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plan. Detailed targets are provided in the annexes.
At IRC, we believe that turning on a working tap should not be a surprise or cause for celebration. We believe in a world where water, sanitation and hygiene services are fundamental utilities that everyone is able to take for granted. For good.
We face a complex challenge. Every year, thousands of projects within and beyond the WASH sector fail – the result of short-term targets and interventions, at the cost of longterm service solutions.
This leaves around a third of the world’s poorest people without access to the most basic of human rights, and leads directly to economic, social and health problems on a global scale. IRC exists to continually challenge and shape the established practices of the WASH sector.
Through collaboration and the active application of our expertise, we work with governments, service providers and international organisations to deliver systems and services that are truly built to last.
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Around the world, more than 2 billion people lack access to safely managed water, sanitation and hygiene services, with conflicts and climate change exacerbating the issue.
Unsafe and insufficient WASH facilities, especially in rural and remote areas, can lead to increased health complications fo
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r older people, persons with disabilities and children. They also reinforce cycles of poverty, inequality and deprivation – particularly for women, children and marginalized groups, who are disproportionately impacted by a lack of equitable access to water and sanitation.
Launched on World Water Day, the guidelines address the knowledge gap on ways to practically implement inclusive approaches to WASH infrastructure development, particularly in developing countries and fragile contexts.
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The Infection Prevention and Control (IPC) Guidelines aim to support healthcare workers improve quality and safety health care. The Guidelines further aim to promote and facilitate the overall goal of IPC by providing evidence-based recommendations on the critical aspects of IPC, focusing on the fun
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damental principles and priority action areas. All health service organizations should consider the risk of healthcare-associated infection(s) (HAI) and antimicrobial resistance (AMR) transmission to implement these recommendations. The IPC Guidelines also set national standards for the prevention and control of HAIs and to ensure compliance to the National Quality Standards.
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Disability inclusive shelter programming enables persons with disabilities to contribute more to their communities, participate more in consultations and decision-making, and facilitate their own protection. The key concepts include: Disability inclusive shelter programming is both a process and an
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outcome. By engaging persons with disabilities in the process, we will also improve the outcomes for persons with disabilities.
The disability community has the slogan “Nothing about us without us,” reminding that we should include and work with persons with disabilities and their representative groups rather than plan or make decisions on their behalf. Persons with disabilities should be engaged throughout shelter programme planning, implementation, monitoring and evaluation.
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The Food and Agriculture Organization of the United Nations has launched a new Compendium of forgotten foods in Africa which is a first-of-its-kind comprehensive collection of 100 African forgotten food crops.
Also referred to as neglected, underutilized or orphan crops, these species offer valua
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ble benefits, including nutrition and diet diversification, while supporting resilient, climate-smart agriculture but they are at risk of being lost as foods such as maize, rice and wheat dominate African diets.
The compendium list includes details on each crop's botanical classification, agroecological suitability, agronomic requirements, traditional and medicinal uses, value-added prospects and nutritional content. Among the entries are: African locust beans, African nightshade, baobab, Bambara nut, bush mango, cassava, fonio, marula, moringa, teff and tigernut.
Produced by the Food and Agriculture Organization (FAO)'s Regional Office for Africa with the Forum for Agricultural Research in Africa (FARA), the Compendium is a direct response to the UN Food Systems Summit and the Call for Collective Action in the Global Manifesto on Forgotten Foods.
Embracing both agricultural heritage and innovation can transform agrifood systems across Africa. By cataloguing these forgotten or underutilized crops, traditional knowledge is being honoured in the push to unlock the potential for better nutrition, sustainable agriculture, and resilience against the climate crisis.
In a joint foreword to the publication, FAO Assistant Director-General and Regional Representative for Africa Abebe Haile-Gabriel and FARA Executive Director Aggrey Agumya urged the mainstreaming of forgotten foods into African agrifood systems.
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The Resolution Population and Individual Approaches to the Prevention and Management of Diabetes and Obesity was approved by the 48th Directing Council of the Pan American Health Organization, September 29- October 3, 2008, in response to the epidemic of obesity and diabetes currently affecting the
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countries of the Americas. Its main goal is to call on Member States to prioritize the prevention of obesity and diabetes and their common risk factors by establishing and/or strengthening policies and programs, integrating them into public and private health systems and working to ensure adequate allocation of resources to carry out such policies and programs.
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At the global, national, and regional levels, there are several guidelines and guides regarding the preparedness, prevention, surveillance, and control of diseases caused by respiratory viruses; most initiatives focus on specific virus events or cases. During the coronavirus disease 2019 (COVID-19)
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pandemic, it has been found that even when there are strategies designed and planned for pandemics, it is necessary to strengthen and improve them. Planning for imminent threats, including those posed by respiratory viruses, contributes to strengthening the core capacities of the International Health Regulations (IHR [2005])
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab
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ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera
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lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South
American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention
and rehabilitation (CVDPR). In the context of the imple
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mentation of a regional and national health policy in Latin American
countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on
Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation
of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline
and adapt it to the national reality.
The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine
clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World
Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025.
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Since the discovery of insulin nearly 100 years ago, advances in diabetes treatments and therapies have transformed the lives of people
with diabetes (PwD), notably reducing the daily burden of its management.
Newer technologies, including those driven by artificial intelligence, have the potentia
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l to further improve the quality of life of PwD and help
identify and diagnose people at risk of developing Type 2 diabetes and diabetes-related complications early. However, medical and technological advances alone are not enough to fix the diabetes challenge. It is also critical to acknowledge the complexity and the seriousness of diabetes, its impact on the quality of life and well-being of over 32 million PwD in the EU and the financial burden it represents for health systems and society at large.
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Asia remained the world’s most disaster-hit region from weather, climate and water-related hazards in 2023. Floods and storms caused the highest number of reported casualties and economic losses, whilst the impact of heatwaves became more severe, according to a new report from the World Meteorolog
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ical Organization (WMO).
The State of the Climate in Asia 2023 report highlighted the accelerating rate of key climate change indicators such as surface temperature, glacier retreat and sea level rise, which will have major repercussions for societies, economies and ecosystems in the region.
In 2023, sea-surface temperatures in the north-west Pacific Ocean were the highest on record. Even the Arctic Ocean suffered a marine heatwave.
Asia is warming faster than the global average. The warming trend has nearly doubled since the 1961–1990 period.
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was
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the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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Produced by UNICEF and IRC, with the support of the German Corporation for International Cooperation GmbH (GIZ) and the generous funding from the German Federal Ministry of Economic Cooperation and Development (BMZ), the Caring for Child Survivors of Sexual Abuse (CCS) Resource Package (Second Editi
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on, 2023) is a revision of the original CCS Guidelines and associated Training (First Edition, 2012). The Second Edition offers an up-to-date global technical guidance on providing a model of quality care for children and families affected by sexual abuse in humanitarian settings. The new resources include both revised and content additions based on practitioner feedback, the most recent evidence and learning. In particular, the Guidelines aim to bring a stronger focus on gender inequality, intersectionality, as well as the connections between the best interests of the child and a survivor-centered approach.
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sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support
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optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven
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percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
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