En este folleto se resume la situación de los sistemas y servicios de salud en la Región de las Américas en su progreso hacia el acceso universal a la salud y la cobertura universal de salud (la “salud universal”). Se presenta la situación previa a la pandemia de COVID-19, el efecto que ha t...enido en los sistemas de salud y las recomendaciones para encarar los retos actuales y futuros en la construcción de sistemas de salud resilientes que permitan seguir avanzando hacia la salud universal en la Región.
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Les pays progressent vers la réalisation de l’objectif mondial tendant à ce que, d’ici 2025, 95 pour cent des personnes qui vivent avec le VIH connaissent leur statut sérologique. Cependant, en 2020, on estimait encore à 6 millions le nombre de personnes séropositives non diagnostiquées da...ns le monde. Les hommes vivant dans des lieux où la prévalence du VIH est élevée et les hommes appartenant aux populations clés, tous lieux confondus, ont moins de chances de connaître leur séropositivité que les femmes. Ainsi, au niveau mondial, 78 pour cent des hommes de plus de 15 ans connaissent leur statut sérologique, contre 86 pour cent chez les femmes de cette même tranche d’âge.
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This project aimed to reduce the risk of vector-borne infection with Chagas disease by
controlling triatomine bugs, the vectors transmitting the parasite of Chagas disease, and
establishing an epidemiological surveillance system with community participation.
This analysis focused on the chronic form of HAT caused by T. b. gambiense, as it contributes to the majority of disease burden. Information from the literature review,
product development landscape, and stakeholder interviews was compiled to:
- Identify use cases and understand current diagnosti...c practices and tools associated with each use case.
- Analyze progress toward robust diagnostics for HAT across different biomarkers.
- Develop recommendations for steps to improve the availability, access, and adoption of HAT diagnostic tools.
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El objetivo de esta guía es brindar recomendaciones prácticas al personal de salud que se hace cargo de las actividades de preparación y respuesta a las enfermedades contagiosas para asegurar que se mantenga el acceso a servicios de aborto seguro (SAS) cuando surja un brote de enfermedades contag...iosas. Es una guía operativa que puede servir para apoyar a los actores de la salud para que los SAS se mantengan durante los brotes y asegurar que las consideraciones necesarias de SAS se integren dentro de la respuesta al brote; no es una guía clínica. El enfoque centrado en la ubicación de este documento se dirige a los asentamientos frágiles y de ayuda humanitaria; sin embargo, las recomendaciones pueden aplicarse a brotes de enfermedades contagiosas a cualquier población con escasez de recursos. Esta guía busca complementar el trabajo llamado La salud sexual y reproductiva y los derechos durante los brotes de enfermedades contagiosas: Guía operativa para escenarios frágiles y de ayuda humanitaria.
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Snakebite envenoming is a serious public health problem in Central America, where approximately 5,500 cases occur every year. Panama has the highest incidence and El Salvador the lowest. The majority, and most severe, cases are inflicted by the pit viper Bothrops asper (family Viperidae), locally kn...own as ‘terciopelo’, ‘barba amarilla’ or ‘equis’. About 1% of the bites are caused by coral snakes of the genus Micrurus (family Elapidae). Despite significant and successful efforts in Central America regarding snakebite envenomings in the areas of research, antivenom manufacture and quality control, training of health professionals in the diagnosis and clinical management of bites, and prevention of snakebites, much remains to be done in order to further reduce the impact of this medical condition. This essay presents seven challenges for improving the confrontation of snakebite envenoming in Central America. Overcoming these challenges demands a coordinated partnership of highly diverse stakeholders though inter-sectorial and inter-programmatic interventions.
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Taeniasis and cysticercosis caused by the parasite T. solium affect vulnerable populations,
mainly in Latin America, sub-Saharan Africa and Asia, where pigs (the intermediate host) roam
free and poor sanitation allows pigs access to human faeces.
Taenia saginata is a zoonotic tapeworm that is of economic importance in countries where cattle are kept. The parasite is transmitted from human tapeworm carriers (taeniosis) to bovines (cysticercosis) by excretion of eggs or proglottids containing eggs into the environment via the stool. Bovines ca...n then ingest the eggs through contaminated feed or water. After ingestion, the eggs hatch and release oncospheres in the small intestines, where the oncospheres penetrate the intestinal wall to reach the blood circulation. This distributes them throughout the body, but primarily to muscle tissue, where they develop into cysticerci. For humans to become infected with T. saginata, raw or undercooked bovine meat or offal containing infective cysts must be consumed. Bovine cysticercosis has been associated with various environmental factors related to water sources, such as animals having access to surface water, flooding of pastures and proximity to wastewater sources.
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The epidemiology of the disease is mediated by the interaction of the parasite (trypanosome) with the vectors (tsetse flies), as well as with the human and animal hosts within a particular environment. Related to these interactions, the disease is confined in spatially limited areas called “foci..., which are located
in Sub-Saharan Africa, mainly in remote rural areas. The risk of contracting HAT is, therefore, determined by the possibility of contact of a human being with an infected tsetse fly. Epidemics of HAT were described at the beginning of the 20th century; intensive activities have been set up to confront the disease, and it was under control in the 1960s, with fewer than 5,000 cases reported in the whole continent.
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Human rabies remains a significant public health problem in Africa with outbreaks reported in most countries. In Nigeria–the most populous country in Africa–rabies causes a significant public health burden partly due to perennial obstacles to implementing a national prevention and control progra...m.
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Rabies is a disease of animals but too often the outcome is gauged in terms of human suffering and
death. Despite this, in areas of the world where rabies is endemic there is often a lack of communication between veterinary and medical professionals, to the extent that the disease continues to thri...ve and potential victims are not treated. The problem is partly
exacerbated by a lack of awareness and experience of the disease and of what to do when confronted by suspect cases. In these technologically advanced days, although it is possible to learn “all there is to know” about almost any subject, it is sometimes difficult to distil the essence.
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A medida que el tratamiento antirretrovírico con dolutegravir se extiende a más personas que viven con el VIH en el
mundo, adquiere más importancia estimar la frecuencia con que surge la farmacorresistencia adquirida a este
antirretrovírico en las poblaciones tratadas con esquemas que lo conti...enen. Si bien no se ha detectado resistencia
al dolutegravir en los ensayos clínicos con poblaciones no tratadas antes con antirretrovíricos en las que se ha
detectado una viremia persistente pese al tratamiento, los datos indican que puede surgir en quienes toman esquemas
con dolutegravir. La OMS recomienda a los países que estén ampliando el tratamiento con dolutegravir que acompañen
su despliegue con la vigilancia sistemática de la farmacorresistencia.
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En la actualidad, los daños que sufren los pacientes a causa de una atención poco segura constituyen un desafío
importante y creciente para la salud pública mundial y son una de las principales causas de muerte y discapacidad
en todo el mundo. La mayor parte de estos daños son evitables. Ahor...a que los países se esfuerzan por alcanzar la
cobertura sanitaria universal y los Objetivos de Desarrollo Sostenible, los efectos beneficiosos de un mayor acceso
a los servicios de atención de la salud pueden verse socavados por una atención poco segura. Los incidentes
relacionados con la seguridad de los pacientes pueden causar muerte y discapacidad, así como sufrimiento a
las víctimas y sus familias. Los costos económicos que conllevan los fallos de seguridad son elevados. A menudo
se reduce la confianza del público en los sistemas de salud locales cuando se dan a conocer estos accidentes.
El personal de salud implicado en sucesos graves que implican la muerte o un daño grave a un paciente
también puede sufrir un deterioro psicológico duradero y sentimientos de culpa y autocrítica muy arraigados
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The WHO Living guideline: Drugs to prevent COVID-19 contains the Organization’s most up-to-date recommendations for the use of drugs to prevent COVID-19. The latest version of this living guideline is available in pdf format (via the ‘Download’ button) and via an online platform.
Guidelines ...regarding the use of drugs to treat (rather than prevent) COVID-19 are included in a separate WHO document, Therapeutics and COVID-19: living guideline, that can via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform). Guidelines regarding the clinical management of COVID-19 patients are included in a further document, COVID-19 Clinical management: Living guideline, that can be accessed via an online platform and in pdf format (or click ‘PDF’ in top right corner of online platform).
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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The Operational guide: use of referral laboratories for the analysis of foodborne hazards in the Pacific aims to strengthen the food analysis capacity of Pacific Island countries and areas by identifying national and reference laboratories capable of testing for priority foodborne hazards. The Pacif...ic Island countries and areas are often vulnerable to food safety incidents and emergencies due to their geographical distribution and dependence on food imports. The guide outlines key considerations for selecting referral laboratories and submitting samples to them, enabling continuous improvement of food safety systems and providing safe food for all. The target audiences are health and food safety authorities.
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The Pharmaceutical Forum of the Americas (PFA) has previously published guidelines and organised campaigns for community pharmacists on the prevention, detection and control of arbovirus infections in 2018 with a grant from the FIP Foundation for Pharmacy Education and Research. Building on that exp...ertise, FIP joined efforts with the PFA and is now publishing its first-ever handbook to support pharmacists in the
area of vector-borne diseases. As the integration of the regional forums in FIP advances, such collaborative projects are tangible results of an increasingly regionally informed and regionally targeted work by FIP.
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Traditional food markets play important economic, cultural, and social role and are sources of livelihood for millions of people in urban and rural areas. The manual Five keys for safer traditional food markets: risk mitigation in traditional food markets in the Asia-Pacific Region aims to support a...nd guide local authorities, market community, and consumers to transform these markets into safer and healthier places through practical risk mitigation measures and community engagement strategies. The manual provides guidance on the implementation of five keys to promote public health and safety, particularly, in the context of food safety, zoonoses diseases, and infectious respiratory diseases.
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En la Región de las Américas, las poblaciones están envejeciendo y se está experimentando una rápida transición demográfica. El índice de envejecimiento, que refleja el tamaño de los grupos de mayor edad por 100 en comparación con los menores de 15 años, demuestra claramente el aumento de... las personas de 60 años o más. En comparación con las tendencias mundiales, la Región tendrá un mayor número de personas de 60 años o más que de menores de 15 años para el 2030, aproximadamente 25 años antes que el promedio mundial. La pandemia de COVID-19 ha dado pie a una crisis de salud sin precedentes en todo el mundo. Sus efectos en las personas mayores y aquellas con enfermedades subyacentes han puesto de manifiesto los desafíos de abordar sus necesidades durante una emergencia de salud pública. Dada esta transición demográfica, es fundamental reflexionar acerca de la preparación de los sistemas y servicios con vistas a atender las necesidades de este grupo de población, incluidas la mejora de la planificación para casos de emergencia y la protección de las personas mayores.
Esta publicación forma parte de una serie titulada La Década del Envejecimiento Saludable en las Américas: situación y desafíos
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Throughout the Americas, populations are aging and the Region is undergoing a rapid demographic transition. The aging index, which reflects the size of the older age groups per 100 compared to children under age 15, clearly demonstrates the increase in people aged 60 and older. Compared to global tr...ends, the Region of the Americas will have a larger number of people aged 60 and older than children under 15 by 2030, which is approximately 25 years before the global average. The COVID-19 pandemic has presented an unparalleled health crisis around the world. The impact on older persons and those with underlying health conditions has highlighted the challenges of addressing the needs of older populations during a public health emergency. Given this demographic transition it is essential to think about preparedness of systems and services to address this population’s needs, including an increase in emergency planning and protection of older populations.
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