Q7. SCOPING QUESTION: In adults with moderate-severe depressive disorder, what is the effectiveness and safety of antidepressant medication (ADM) in comparison with psychological treatment?
The WHO mhGAP programme’s existing guidelines recommend that either structured brief psychological treatm...ents (e.g., interpersonal psychotherapy or cognitive behavioural therapy, including behavioural activation) or antidepressant medication (e.g., SSRIsi and tricyclic antidepressants) be considered in adults with moderate-severe depression. Health care workers need to know whether these treatments have different effects, including side-effects, in treating depressive disorder in the short and long term, in order to improve clinical decision-making.
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The road map sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups as well as cross-cutting targets aligned with the Sustainable Development Goals. Three foundational pillars will support global efforts to achieve the targets: accelerate progra...mmatic action (pillar 1), intensify cross-cutting approaches (pillar 2) and change operating models and culture to facilitate country ownership (pillar 3).
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his first edition describes the standard operating procedures for health products for NTDs amenable to preventive chemotherapy and the medicines donated to treat them. These include albendazole for lymphatic filariasis and soil-transmitted helminthiases; azithromycin for trachoma and yaws; diethylca...rbamazine citrate for lymphatic filariasis; ivermectin for onchocerciasis and lymphatic filariasis; mebendazole for soil-transmitted helminthiases; praziquantel for schistosomiasis; and triclabendazole for foodborne trematodiases. Standard operating procedures for diseases amenable to case management will be covered in subsequent editions, including the application process for requesting medicines (Chapter 1). In the meantime, the procedures described in the rest of the document apply for both case management and preventive chemotherapy NTD health products.
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The WHO Global Antimicrobial Resistance and Use Surveillance System (GLASS) was launched in 2015 to foster AMR surveillance and inform strategies to contain AMR. The system started with surveillance of AMR in bacteria causing common human infections and has expanded its scope to include surveillance... of antimicrobial consumption (AMC), invasive fungal infections, and a One Health surveillance model relevant to human health. To meet future challenges, it is in continuous evolution to enhance the quality and representativeness of data to inform the AMR burden accurately. As of the end of 2022, 127 countries, territories and areas participate in GLASS.
The fifth GLASS report, produced in collaboration with Member States, summarizes 2020 data on AMR rates in common bacteria from countries, territories, and areas. The report brings new features, including analyses of population testing coverage or AMR trends. For the first time, the report presents 2020 data on AMC at the national level. A new interactive dashboard allow users to explore AMR and AMC global data, country profiles and download the data.
This report marks the end of the early implementation phase of GLASS. In addition to presenting data collected through the latest data call, this report provides a summary of five years of national AMR surveillance data contributed to GLASS from its initiation, presents AMR findings in the context of progress of country participation in GLASS and in global AMR surveillance coverage and laboratory quality assurance systems at (sub)national level.
Patterns of antimicrobial consumption are presented by country with a particular focus on antibacterials. The report also presents the antimicrobial consumption according to the WHO AWaRe antibiotic classification, for penicillins and cephalosporines. From a One Health perspective, the report presents antimicrobial consumption data in the human sector expressed in tons to allow a comparison with antimicrobial consumption from other sectors (not included in this report).
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Pathogens . 2021 Nov 16;10(11):1493.doi: 10.3390/pathogens10111493
.Chronic manifestations of Chagas disease present as disabling and life-threatening condi-tions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mech...anisms underlying Trypanosoma cruzi’s infection and the host-parasite interactions that follow, prompt diagnosis and treatment remain a challenge, particu-larly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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The sixteenth meeting of the Strategic and Technical Advisory Group for Neglected Tropical Diseases (STAG-NTD) was held as a hybrid meeting, 27–28 September 2022.
Dr Ren Minghui, Assistant Director-General, Universal Health Coverage/Communicable and Noncommunicable Diseases, welcomed participan...ts to the meeting. He said the World Health Organization’s Department of Control of Neglected Tropical Diseases (WHO/NTD) was in a state of transition. Following the death of the late esteemed Director Dr Mwelecele Ntuli Malecela earlier in the year, Dr Gautam Biswas had taken over as Acting Director but would soon retire; the appointment of a new Director was under way. Owing to rotation of STAG-NTD members, this would be the last meeting for some and the first meeting for several new participants. The work however would continue with the same commitment. Discussions over the next two days would focus on critical issues regarding recovery of NTD services following the disruptions caused by coronavirus disease (COVID-19), which had impacted many health services worldwide. He looked forward to receiving the advice and guidance of STAG-N
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Report of the WHO/Bill & Melinda Gates Foundation Consultation. The Consultation was organized back-to-back with the first annual meeting of the International Coordinating Group of the BMGF-funded project for human and dog rabies elimination in developing countries, held at WHO headquarters, Geneva,... Switzerland, from 5 to 7 October 2009. This allowed the Consultation to benefit from the participation of the national coordinators and advisers of the BMGF-funded projects in the Philippines, South Africa (KwaZulu-Natal) and the United Republic of Tanzania
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Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di...agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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Cutaneous leishmaniasis (CL) is a neglected infectious endemic disease that is transmitted through the bite of a vector insect (sandfly) of the Lutzomyia genus,typical of rural geographical territories, and causes disfiguring skin ulcers and disabilities. It is estimated that CL affects between 600...000 and 1 000 000 people a year around the world, mainly in the America s, the Mediterranean basin, the Middle East and Central Asia. Eighteen of the 21 countries that make up the Latin American (LA) region are considered endemic areas for this neglected tropical disease. Colombia is one of the countries that reports the majority of global cases with 6161 in 2020 and has the second highest number of cases in the Americas, after Brazil.
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More than one million people each year become infected by parasites that cause the disease cutaneous leishmaniasis (CL). This disease manifests as one or more skin lesions or ulcers that are slow to heal with variable response rates to drug treatments. Thus far, little attention has been paid to how... the cultural effects of gender shape perceptions and experiences of CL. This review aims to bring together and analyse existing studies which use qualitative data to explore these differences. These studies offered insights into our specific research questions.
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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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Rabies is a fatal viral zoonosis and serious public health problem.1 All mammals are believed to be susceptible to the disease, and for the purposes of this document, use of the term animal refers to mammals. The disease is an acute, progressive encephalitis caused by viruses in the genus Lyssavirus....
2 Rabies virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are maintained in wild mammalian reservoir populations such as raccoons, skunks, foxes, and bats. Although the United States has been declared free from transmission of canine rabies virus variants, there is always a risk of reintroduction of these variants.The rabies virus is usually transmitted from animal to animal through bites. The incubation period is
highly variable. In domestic animals, it is generally 3 to 12 weeks, but can range from several days to months, exceeding 6 months.8 Rabies is communicable during the period of salivary shedding of rabies virus. Experimental and historic evidence documents that dogs, cats, and ferrets shed the virus for a few days prior to the onset of clinical signs and during illness. Clinical signs of rabies are variable and include inappetance, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs.
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A group of enzootic and zoonotic protozoan infections, the leishmaniases constitute among the most severely neglected tropical diseases (NTDs) and are found in all continents except Oceania. Representing the most common infectious diseases, NTDs comprise an open-ended list of some 20 parasitic, bact...erial, viral, protozoan and helminthic infections. Called “diseases of the poor,” because of their characteristic prevalence in poor populations regardless of a country's income status, they infect over one billion people in over 140 countries, with about 90% of the global burden in Africa. While NTDs do not contribute significantly to global deaths, they are debilitating and remain the most common infections among the poor worldwide, preventing them from escaping poverty by impacting livelihoods such as agriculture and livestock, and affecting cognitive, developmental and education outcomes.
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Despite the existence of criminal law, which is an important aspect of anti-FGM policies and programmes, there is not much research on the effects of cross-border practices that invalidate the law as a deterrent. Much remains unknown about the practice of cross-border FGM, specifically about gaps in... existing policy and legislation for managing cross-border FGM, as well as whether the existing interventions in the cross-border areas are sufficiently targeted to facilitate changes in social norms
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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More than 700 000 people lose their life to suicide every year. A core foundation of suicide prevention is the timely registration and regular monitoring of suicide and self-harm. Surveillance data can be used to show important progress towards reaching global targets, such as reducing the suicide r...ate by one third by 2030 as articulated in the UN SDGs and in the WHO Mental Health Action Plan 2013-2030. However, there are considerable discrepancies in the quality of data on suicide and self-harm globally. The aim of this training manual is to equip fieldworkers and supervisors with the skills to collect and manage data on suicide and self-harm in the community via key informants, health-care facilities and police records. In doing so, the value and overall goal is to strengthen the surveillance of suicide and self-harm in communities, particularly in LMICs and hard-to-reach communities where CRVS systems are weak or absent.
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Rabies remains an under-reported neglected zoonosis with a case-fatality rate of almost 100% in humans and animals. Dog-mediated human rabies causes tens of thousands of human deaths annually despite being 100% preventable. More than 95% of human cases are caused by the bite of a rabies-infected dog.... Dog-mediated human rabies disproportionately affects rural communities, particularly children, and economically disadvantaged areas of Africa and Asia, where awareness of the disease and access to appropriate post-exposure prophylaxis (PEP) can be limited or nonexistent.
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В дорожной карте по борьбе с забытыми тропическими болезнями на 2021–2030 гг. («дорожная карта») определены глобальные цели и основные этапы в отношении борьбы с 20 бол...знями и группами болезней, их элиминации или полной ликвидации. В ней также определены сквозные целевые показатели, согласованные с Тринадцатой общей программой работы ВОЗ и Целями в области устойчивого развития, а также стратегии по достижению этих целевых
показателей в течение ближайших десяти лет.
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There is an expanding market of no- and low-alcohol beverages (NoLos). However, their effects on global ethanol consumption and public health are still questioned. Policies and regulations about NoLos’ availability, acceptability and affordability are lacking and evidence about their benefits is l...imited. Concerns have been raised about the impact of NoLos in reducing alcohol consumption and its associated harm and the possible drawbacks and implications, such as misleading minors, pregnant women, abstainers or those seeking to stop drinking about their actual ethanol content. Further, there are concerns about the implications of NoLo branded products being displayed close to the brand’s main alcoholic beverages and their potential to subtly lead to new occasions of drinking. There is a need to monitor their consumption and impact on aggregated alcohol consumption to understand the public health implications of NoLos. The alcohol by volume content of NoLos must be defined, harmonised and clearly labelled. NoLo marketing needs to be regulated to protect children, pregnant women and those seeking to stop drinking. Fiscal and pricing policies to reduce the affordability of products with higher strengths of ethanol may favour a shift towards lower alcohol strength beverages.
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The availability of controlled medicines is crucial for patients requiring palliative care, pain relief and symptom management. Many individuals worldwide, especially in low- and middle-income countries, continue to experience limited access to these essential medicines. Enhancing access to controll...ed medicines is paramount in promoting universal health coverage. This report offers a detailed situational analysis of policies and programmes aimed at improving access to affordable, high-quality controlled medicines for pain management in the WHO South-East Asia Region. The report identifies the existing barriers, challenges and possible solutions to facilitate access to such medicines across all Member States.
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