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1
Delivery of comprehensive arrhythmia care requires the simultaneous presence of many resources. These include complex hospital infrastructure, expensive implantable equipment, and expert personnel. In many low- and middle-income countries (LMICs), at least 1 of these components is often missing, res
...
ulting in a gap between the demand for arrhythmia care and the capacity to supply care. In addition to this treatment gap, there exists a training gap, as many clinicians in LMICs have limited access to formal training in cardiac electrophysiology. Given the progressive increase in the burden of cardiovascular diseases in LMICs, these patient care and clinical training gaps will widen unless further actions are taken to build capacity. Several strategies for building arrhythmia care capacity in LMICs have been described. Medical missions can provide donations of both equipment and clinical expertise but are only intermittently present and therefore are not optimized to provide the longitudinal support needed to create self-sustaining infrastructure. Use of donated or reprocessed equipment (eg, cardiac implantable electronic devices) can reduce procedural costs but does not address the need for infrastructure, including diagnostics and expert personnel. Collaborative efforts involving multiple stakeholders (eg, professional organizations, government agencies, hospitals, and educational institutions) have the potential to provide longitudinal support of both patient care and clinician education in LMICs.
more
The World Health Organization's Regional Office for Africa webpage on diabetes provides an overview of the disease's impact in the African Region. It highlights that diabetes is a serious, chronic, and costly condition, with projections estimating cases to
...
rise to 23.9 million by 2030. The page outlines risk factors such as physical inactivity, overweight and obesity, tobacco use, and diets high in unhealthy fats and calories. It also discusses the three main types of diabetes: type 1, type 2, and gestational diabetes. Recent surveys indicate that up to 15% of adults aged 25 to 64 in the region have diabetes, with many unaware of their condition. The lack of access to proper treatment and medications, especially insulin, often leads to complications like neurological, vascular, or visual disorders, heart disease, stroke, lower limb amputation, and kidney failure.
more
Cervical cancer is the second most common cancer among women worldwide and causes a significant number of deaths in the South-East Asia Region. Nearly 200 000 new cases of cervical cancer occurred in SEA Region Member States in 2008, giving an incidence of almost 25 per 100
...
000 and a mortality rate of almost 14 per 100 000. Cervical cancer can be prevented by early screening and vaccination. However, due to poor access to screening and treatment services, the vast majority of these deaths occur in women from nine Member States of the South-East Asia Region which account for more than one third of the global burden of cervical cancer.
more
WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the
...
treatment of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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Nigeria reported its first case of COVID-19 at the end of February 2020 and subsequently experienced
four waves, with peaks in June 2020 and January, August and December 2021. The COVID-19 pandemic
severely impacted the economy of Nigeria and caused disruption of health services nationwide. During
...
the crisis, many Nigerians failed to access routine health
services due to decreased income and lockdown
restrictions. The most significant service disruptions
were in maternal and newborn health, vaccination,
sick childcare, family planning and noncommunicable
disease treatment services (1). Pregnant women
were anxious about contracting COVID-19 during
2020, and as a result, many avoided attending health
facilities for antenatal (ANC) and postnatal care (PNC).
Disruptions in the medical supply chain and diversion
of resources to COVID-19 management impacted on
essential health services. Health workers were often
unable to go to work because of transport disruptions
or illness
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Issue Brief 33: Since 21 June 2023, 57 024 new cholera cases, including 399 new death have been reported worldwide (European Center for Disease Prevention and Control). In total, 25 countries have reported cases since the beginning of 2023. The major underlying causes of potential outbreaks are poor
...
environmental infastructure, lack of health care services, lack of save water and sanitation as well as increase population movement. Climate change becomes an additional trigger, as extreme climate events like cyclones,floods and droughts reduce access to clean water and create an ideal environment for cholera to thrive. The overall capacity to respond to the multiple outbreaks is obstructed by a global lack of resources.
This issue brief provides an overview of the current outbreaks, treatment guidelines, information material, countries strategies and more.
more
Hypertension is the main risk factor for developing cardiovascular disease. Each year 1.6 million deaths befall from cardiovascular disease in the region of the Americas, of which about half a million occur in people under age 70, which is considered premature and preventable death. Hypertension aff
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ects between 20-40% of the adult population of the region, meaning that in the Americas around 250 million people suffer from high blood pressure. Hypertension is preventable or can be postponed by a set of preventive interventions, among which include the reduction of salt intake, a diet rich in fruits and vegetables, exercise and maintaining a healthy body weight. PAHO promotes policies and projects to impact on public health the prevention of hypertension through policies to reduce salt intake, to promote healthy eating, physical activity and to prevent obesity. Promotes and supports projects that facilitate access to essential medicines for the treatment of hypertension and promotes the development of human resources in health.
more
The article examines the epidemiology of chronic obstructive pulmonary disease (COPD) in the Middle East, North Africa, and Turkey. It provides an overview of COPD prevalence, associated risk factors, and challenges in diagnosis and treatment across
...
these regions. The study highlights smoking and environmental exposures, such as dust and pollution, as significant contributors to COPD. It also points out the gaps in awareness, healthcare infrastructure, and the availability of diagnostic tools, which hinder effective management of the disease. The authors emphasize the need for comprehensive public health strategies, education, and improved access to healthcare to address the COPD burden in these areas.
more
Policy Brief.
WHO recommends that pregnant women receive testing for HIV, syphilis and hepatitis B (HBSAg) at least once during pregnancy, preferably in the first trimester.
Dual HIV/syphilis rapid diagnostic tests (RDTs) can be used as the first test for pregnant women as part of antenatal care (
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ANC).
These simple tests can be used at the point-of-care and are cost-saving compared to standard testing in ANC. They enable more women to be diagnosed with HIV and syphilis so that they can access treatment and prevent transmission to their children.
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The article "An Official ATS Workshop Report: Issues in Screening for Asthma in Children" summarizes discussions from a workshop organized by the American Thoracic Society (ATS) on the challenges of asthma screening in children. The report reviews the effectiveness of population-based asthma screeni
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ng programs, highlights the limitations of current methods, and discusses case detection as an alternative. It assesses asthma's impact as a public health issue, explores the feasibility of screening tests, and examines the economic and practical challenges. The workshop concludes that broad population-based screening may not be justified without better evidence and targeted efforts to improve follow-up care and treatment access.
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The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
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Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
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Background: East African trypanosomiasis is an uncommon, potentially lethal disease if not diagnosed and treated in a timely manner. South Africa, as a centre for emergency medical evacuations from much of sub-Saharan Africa, receives a high proportion of these patients, mostly tourists and expatria
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te residents.
Methods: The cases of East African trypanosomiasis patients evacuated to South Africa, for whom diagnostic and clinical management advice was provided over the years 2004–2018, were reviewed, using the authors’ own records and those of collaborating clinicians.
Results: Twenty-one cases were identified. These originated in Zambia, Malawi, Zimbabwe, Tanzania, and Uganda. Nineteen cases (90%) had stage 1 (haemolymphatic) disease; one of these patients had fatal myocarditis. Of the two patients with stage 2 (meningoencephalitic) disease, one died of melarsoprol encephalopathy. Common problems were delayed diagnosis, erroneous assessment of severity, and limited access to treatment.
Conclusions: The key to early diagnosis is recognition of the triad of geographic exposure, tsetse fly bites, and trypanosomal chancre, plus good microscopy. Elements for successful management are rapid access to specific drug treatment, skilled intensive care, and good laboratory facilities. Clinical experience and the local stock of antitrypanosomal drugs from the World Health Organization have improved the chance of a successful outcome in the management of East African trypanosomiasis in South Africa; the survival rate over the period was 90.5%.
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa
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ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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Readily access selected guidelines, reports and other knowledge resources to enhance evidence-informed, multisectoral, and multistakeholder initiatives in NCD prevention and control – curated by W
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HO's Global NCD Platform and supported by GCM Participants.
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Adherence to Treatment for HIV A Training Curriculum for Counselors - Facilitator Guide
F. Saini; Dr. V. R. Kandula; G. Venugopal
Engender Health Society (Improving Women's Health Worldwide); CII Confederation of Indian Industry; Population Foundation of India; et al.
(2006)
C2
Adherence to Treatment for HIV A Training Curriculum for Counselors - Participant Manual
F. Saini; Dr. V. R. Kandula; G. Venugopal
Engender Health Society (Improving Women's Health Worldwide); CII Confederation of Indian Industry; Population Foundation of India; et al.
(2006)
C2
Scientific Paper
