This brief summarizes current evidence and guidance for maintaining safe and effective care across the spectrum of maternal, newborn and infant care while protecting mother and child and health care providers during COVID-19. Furthermore, implications of the principle of “do no harm” are reviewe...d for maternal, newborn and infant care delivery during COVID-19, so that this information is conveniently and readily available to clinical and health system policy leaders and stakeholders in countries and communities. Additionally, considerations for safe oxygen delivery as well as key Infection Prevention and Control (IPC) measures at home and in healthcare facilities for pregnant women, newborns and children are described in detail in the brief.
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The World Health Organization and the Global Fund to Fight AIDS, Tuberculosis and Malaria are part of a group of agencies working together to accelerate progress towards the health-related SDGs through the Global Action Plan for Healthy Lives and Well-being for All. Understanding patterns of inequal...ities in these diseases is essential for taking strategic, evidence-informed action to realize our shared vision of ending the epidemics of HIV, TB and malaria.
This report presents the first comprehensive analysis of the magnitude and patterns of socioeconomic, demographic and geographic inequalities in disease burden and access to services for prevention and treatment.
The results confirm there have been improvements in service coverage and decreased disease burden at the national level over the past decade. But they also reveal an uncomfortable reality: unfair inequalities between population subgroups within countries are widespread and have remained largely unchanged over the past decade. For some disease indicators, inequalities are even worsening.
Moreover, the report points to the persistent lack of available data to fully understand inequality patterns in HIV, TB and malaria. Collecting data to improve the monitoring of inequalities in these diseases is vital to develop targeted responses for impact.
There are, encouragingly, isolated successes in reducing inequities. Change is possible when deliberate action is taken to reach disadvantaged populations.
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This training guide applies a participatory approach, reflecting the considerable evidence that adults learn best by practicing and reflecting on their experiences. It thus emphasizes exercises to improve skills in counseling that support clients to adopt optimal nutrition practices. Women’s nutri...tion and infant feeding in the context of HIV are also addressed. Guidelines to link the prevention of malnutrition with treatment via the Integrated Management of Acute Malnutrition are also included. It can also be conducted with nutrition managers to equip them to provide supportive supervision to health and community workers.
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The roadmap describes the actions needed to
achieve the three development goals for TB
vaccines set by the WHO:
1. A safe, effective and affordable TB vaccine
for adolescents and adults.
2. An affordable TB vaccine for neonates and
infants with improved safety and efficacy.
3. A therapeutic v...accine to improve TB
treatment outcomes
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WHO-OHCHR launch new guidance to improve laws addressing human rights abuses in mental health care
Ahead of World Mental Health Day, the World Health Organization (WHO) and the Office of the High Commissioner on Human Rights (OHCHR) are jointly launching a new guidance, entitled "Mental health, h...uman rights and legislation: guidance and practice", to support countries to reform legislation in order to end human rights abuses and increase access to quality mental health care.
Human rights abuses and coercive practices in mental health care, supported by existing legislation and policies, are still far too common. Involuntary hospitalization and treatment, unsanitary living conditions and physical, psychological, and emotional abuse characterize many mental health services across the world.
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Objective: To identify gaps in national stroke guidelines that could be bridged to enhance the quality of stroke care services in low- and
middle-income countries.
Methods: We systematically searched medical databases and websites of medical societies and contacted international organizations.
Co...untry-specific guidelines on care and control of stroke in any language published from 2010 to 2020 were eligible for inclusion. We reviewed
each included guideline for coverage of four key components of stroke services (surveillance, prevention, acute care and rehabilitation).
We also assessed compliance with the eight Institute of Medicine standards for clinical practice guidelines, the ease of implementation of
guidelines and plans for dissemination to target audiences.
Findings: We reviewed 108 eligible guidelines from 47 countries, including four low-income, 24 middle-income and 19 high-income countries.
Globally, fewer of the guidelines covered primary stroke prevention compared with other components of care, with none recommending
surveillance. Guidelines on stroke in low- and middle-income countries fell short of the required standards for guideline development;
breadth of target audience; coverage of the four components of stroke services; and adaptation to socioeconomic context. Fewer low- and
middle-income country guidelines demonstrated transparency than those from high-income countries. Less than a quarter of guidelines
encompassed detailed implementation plans and socioeconomic considerations.
Conclusion: Guidelines on stroke in low- and middle-income countries need to be developed in conjunction with a wider category of
health-care providers and stakeholders, with a full spectrum of translatable, context-appropriate interventions.
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Asthma is one of the neglected diseases in Africa with a high prevalence. Allergic fungal diseases have been reported to complicate asthma progression and treatment outcomes. However, data about fungal asthma and its associated complications are limited in Africa. We aimed to estimate the burden of ...fungal asthma among adults and children in Africa using a systematic review.
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Birth defect has been an emerging major cause of child mortality in the region. Scarcity of the birth defects information hampers policy decisions and control measures at national level. In order to create evidence for action for birth defects prevention in the region, WHO-SEARO in collaboration wit...h CDC, USA has developed and launched a regional electronic database on birth defects. This surveillance database allows data collection on newborn health, birth defects and stillbirths cases and provides real time information at hospitals and national level.
Training of the hospital health staffs and data managers in the birth defects surveillance network; at regional, national and at hospital levels is recognized as essential for expansion of this database and to assure quality of data. A two days training module for hospital based birth defects surveillance was developed using a guide for operation and facilitator guide.
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Senegal has adopted the World Health Organization–Joint United Nations Programme on HIV/AIDS recommended 90-90-90 targets.5 The adoption of this strategy means that the country is expected, by 2020, to have 90% of its population living with HIV diagnosed, 90% of all those diagnosed receiving susta...ined HIV treatment, and 90% of those receiving antiretroviral therapy having suppressed viral load measures.5 To achieve these outcomes, having good clinical laboratory services for diagnosis and follow-up will be critical.6 More specifically, investments will be needed to improve laboratory infrastructure, and to facilitate the access and availability of routine viral load and early infant diagnosis (EID) measures through the implementation of point-of-care (POC) diagnostic platforms along with an efficient and sustainable quality assurance programme.
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Advising principles. The purpose of this document is to support competent authorities in charge of IHR implementation to improve national capacities for the prevention, detection and control of events, by strengthening communications and coordination between points of entry and the national health s...urveillance system
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"Some of the problems with our current drug policies stem from the fact that these policies have been largely bifurcated between two different and often contradictory approaches. One treats drug use as a crime that cannot be tolerated and should be punished; the other views addiction as a chronic re...lapsing health or behavioral condition requiring ongoing treatment and support. Neither of these views is all encompassing—it should be recognized that there are patterns of drug use that do not result in significant harm or health problems and therefore require no intervention. The public health approach presented here takes the view that our focus should be on the harm caused by drug use and the harm caused by our policy responses to it. We have focused specifically on illicit drugs, not because they are by themselves more harmful (in fact, tobacco causes more morbidity and mortality than any illicit drug), but because it has become increasingly clear that our current policies to manage illicit drugs are failing."
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LEAVING NO-ONE BEHIND | “A Journey to End NTDs – Elimination and Care” records what we have achieved over the last year and where we are now. It presents our plan of action for the coming years, bringing our ‘traditional’ NTD work together with ‘Disease Management Disability and Inclusio...n’ (DMDI), Community Based Inclusive Development (CBID) and Livelihoods. We care for those affected and we’re working to enhance community and government ownership through national
health system strengthening, community engagement and cross-sectoral action. Ultimately, we are working to free future generations from these menacing diseases, improving prevention and treatment, without forgetting those for whom prevention and treatment are too late because they already have a disability.
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This topic last updated: Apr 28, 2020.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or condi...tions.
View in: English, Italian, French, German, Japanese, Brazilian Portuguese, Video in Spanish
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This topic last updated: Apr 28, 2020.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditi...ons.
View in: English, Italian, French, German, Japanese, Brazilian Portuguese, Video in Spanish
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Tuberculosis (TB) prevention is essential for reaching the End TB targets in the South-East Asia Region (SEAR) of World Health Organization (WHO)1. The targets of 80% reduction in TB incidence rate and 90% reduction in TB mortality by 2030 (compared to 2015 levels) can be achieved only with addition...al interventions aimed at preventing TB, according to epidemiological modelling studies commissioned by the WHO South-East Asia Regional Office (WHO SEARO). Optimal implementation of TB preventive treatment (TPT) is a critical intervention to accelerate reduction in TB burden in the SEA Region, which bears nearly 43% of the global TB burden. TPT by itself has the potential to reduce the overall annual TB incidence rates by 8.3% (95% CrI 6.5–10.8) relative to 2015.
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Mycetoma is a chronic, progressively destructive infectious disease of the subcutaneous tissues, affecting skin, muscle and bone. Mycetoma occurs in tropical and subtropical environments characterized by short rainy seasons and prolonged dry seasons that favour the growth of thorny bushes. Global bu...rden is not known, but the disease is endemic; it has been reported from countries in Africa, Asia, Europe and Latin America. This course addresses the epidemiology of mycetoma, clinical features, diagnosis, treatment, and public health interventions.
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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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Occasional anxiety is a normal part
of life. You might worry about things
like health, money, or family
problems. But people with
generalized anxiety disorder (GAD)
feel extremely worried or feel
nervous about these and other
things—even when there is little or
no reason to worry about the...m.
People with GAD find it difficult to
control their anxiety and stay
focused on daily tasks.
The good news is that GAD is
treatable. Call your doctor to talk
about your symptoms so that you
can feel better.
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9 April 2020
WHO has published the guidance “Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected” This document is intended for clinicians taking care of hospitalized adult and paediatric patients with severe acute respiratory infection (SARI) whe...n COVID-19 infection is suspected. Optimized supportive care should be provided to ensure the best possible chance for survival of COVID-19 patients as described in the WHO guidance:
1. Management of severe COVID-19 requires oxygen therapy and monitoring. Supplemental oxygen therapy should be given immediately to patients with SARI and respiratory distress, hypoxaemia or shock.
2. Management of critical COVID-19 (acute respiratory distress syndrome (ARDS)) requires advanced oxygen/ventilatory support.
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Over the past twenty years, huge efforts made by a broad coalition of stakeholders curbed the last epidemic and brought the disease to the brink of elimination. In this paper, the latest figures on disease occurrence, geographical distribution and control activities are presented. Strong evidence in...dicates that the elimination of sleeping sickness ‘as a public health problem’ by 2020 is well within reach. In particular, fewer than one thousand new cases were reported in 2018, and the area where the risk of infection is estimated as moderate, high or very high has shrunk to less than 200,000 km2. More than half of this area is in the Democratic Republic of the Congo. The interruption of transmission of the gambiense form, targeted by the World Health Organization (WHO) for 2030, will require renewed efforts to tackle a range of expected and unexpected challenges. The rhodesiense form of the disease represents a small part of the overall HAT burden. For this form, the problem of under detection is on the rise and, because of an important animal reservoir, the elimination of disease transmission is not envisioned at this stage.
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