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a systematic review and meta-analysis Derek K Chu et al. on behalf of the COVID-19 Systematic Urgent Review Group Effort (SURGE) study authors.
Published: The Lancet June 01, 2020 DOI: https://doi.org/10.1016S0140-6736(20)31142-9
'We did a systematic review of 172 observational studies in
...
health-care and non-health-care settings across 16 countries and six continents... Physical distancing of 1 m or more was associated with a much lower risk of infection, as was use of face masks (including N95 respirators or similar and surgical or similar masks [eg, 12–16-layer cotton or gauze masks]) and eye protection (eg, goggles or face shields)...'
more
While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.
...
In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
more
In India, in response to the above and guided by our counterparts in the government of India, the UN agencies have developed the Novel Coronavirus Disease Joint Health Response Plan by UN Agencies and Partners, led by WHO-India, in close collaborati
...
on with the Ministry of Health and Family Welfare, and with the support of other development partners. The UN in India is also preparing a COVID-19 Socio-economic Response and Recovery Plan, in partnership with the government.
more
Tuberculosis (TB) is the deadliest infectious disease in most low- and middle-income countries, claiming more than 4,000 lives each day. The unprecedented COVID-19 pandemic has seriously impacted people with pre-existing health conditions. People wi
...
th TB are usually more vulnerable to other infections, including the novel coronavirus, due to pre-existing lung damage. They are also at higher risk of developing complications from COVID-19.
more
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
...
patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
more
Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (
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SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World
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Health Organization (WHO) estimates that the number of cases reported worldwide represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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PEPFAR Malawi’s Country Operational Plan (COP) 2021 reflects a culmination of strong interagency collaboration between the PEPFAR Malawi team, Government of Malawi (GoM), and civil society organizations (CSOs) to mitigate the devastating impacts of COVID-19 and sustain progress achieved over the l
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ast two decades towards HIV epidemic control.
At the conclusion of the March 2020 Johannesburg Regional Planning Meeting, the PEPFAR Malawi team presented a COP20 surge strategy to improve client-centered care, mitigate treatment disruption, scale prevention programs to key and vulnerable populations, and strengthen national health systems.
Following this meeting, the first three COVID-19 cases were reported in Malawi and immediately thereafter, adaptations to the COP20 strategy became imperative to deliver safe, client-centered care.
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Integrating Clinical Research into Epidemic Response: The Ebola Experience
Gerald Keusch, Keith McAdam, Patricia Cuff, Michelle Mancher, and Emily R. Busta
National Academies of Sciences, Engineering, and Medicine
(2017)
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The 2014–2015 Ebola epidemic in western Africa was the longest and most deadly Ebola epidemic in history, resulting in 28,616 cases and 11,310 deaths in Guinea, Liberia, and Sierra Leone. The Ebola virus has been known since 1976, when two separate outbreaks were identified in the Democratic Repub
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lic of Congo (then Zaire) and South Sudan (then Sudan). However, because all Ebola outbreaks prior to that in West Africa in 2014–2015 were relatively isolated and of short duration, little was known about how to best manage patients to improve survival, and there were no approved therapeutics or vaccines. When the World Heath Organization declared the 2014-2015 epidemic a public health emergency of international concern in August 2014, several teams began conducting formal clinical trials in the Ebola affected countries during the outbreak.
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Cholera which disproportionally impacts poor countries and the most vulnerable continues to affect at least 47 countries across the globe, resulting in an estimated 1.3 – 4 million cases, and 21,000 - 143,000 deaths per year worldwide. In Ethiopia, despite major improvements seen in the increasing
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access to healthcare, clean water, and improvement in maternal and child health, the country continues to be significantly affected by cholera outbreaks. From 2015 – 2021 for example, several outbreaks of cholera have occurred in multiple parts of the country resulting in over 105,000 cases and thousands of deaths. Some of the risk factors associated with cholera in Ethiopia include inadequate access to clean water, practice of open defecation, poor household and environmental sanitation, unhygienic latrine and weak sanitation practise among communities.
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The only way to prevent future Ebola epidemics of this magnitude is to address the fundamental social and political vulnerabilities that have allowed the virus to flourish, such as weak health systems and local services, poor governance, chronic pov
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erty, and a legacy of conflict and social divisions
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Sectors in which Priority Adaptation Projects should be implemented first include:
- 1) Agriculture, Early Warning Systems and Forest (First Priority Level Sectors). This is followed by:
- 2) Public Health and Water Resources (Second Pri ... ority Level Sectors);
- 3) Coastal Zone (Third Priority Level Sector); and
- 4) Energy and Industry, and Biodiversity (Fourth Priority Level Sectors). more
- 1) Agriculture, Early Warning Systems and Forest (First Priority Level Sectors). This is followed by:
- 2) Public Health and Water Resources (Second Pri ... ority Level Sectors);
- 3) Coastal Zone (Third Priority Level Sector); and
- 4) Energy and Industry, and Biodiversity (Fourth Priority Level Sectors). more
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
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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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Growing evidence indicates that large proportions of children around the world experience physical, sexual and emotional violence every year, with enormous implications for human rights, public health and economic and social development.1 Over the l
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ast five years, national governments and Together for Girls – a global public-private partnership comprising UNICEF,
other United Nations (UN) agencies, the United States (US) Government and various private sector agencies – have worked to mobilize and sustain a global movement to end violence against children, with a focus on sexual violence against girls.
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This five-day child protection case management training manual was developed to meet the needs of community child protection workers and other social workers working in tandem with the justice, health and law enforcement systems in Malawi.
Chapter · January 2009 DOI: 10.1007/978-0-387-72711-0_25
D.D. Celentano and C. Beyrer (eds.), Public Health Aspects of HIV/AIDS in Low and Middle Income Countries, DOI: 10.1007/978-0-387-72711-0 25, c Springer Science+Business Media, LLC 2008
Antimicrobial resistance (AMR) is a global threat that requires urgent collaborative action within and among countries. AMR makes standard treatments ineffective and facilitates the spread of antimicrobial resistant infections rendering communities vulnerable. The Ministry of
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Health (MOH) and Ministry of Agriculture, Livestock, Fisheries & Blue Economy (MALF) recognized antimicrobial resistance as a priority following findings from status reports and studies from Ministries, Departments, Agencies and Stakeholders.
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Antimicrobials are precious agents for combating infectious diseases and had saved millions of lives throughout the world. However, the current trend of increasing antimicrobial resistance (AMR) has become a global health problem with increased mor
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bidity and mortality in infectious diseases. Sri Lanka is not an exemption and face many health related issues with multidrug resistant (MDR) organisms. Currently there is a global effort in combating antimicrobial resistance. WHO extends its fullest support and plays a major role in motivating the countries to combat antimicrobial resistance with national action plans in place. Sri Lanka has initiated combating AMR with multisectoral collaboration, under one health concept. The development of the National Strategic Plan (NSP) 2017-2022 provides the roadmap to combat AMR.
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Antibiotics and other antimicrobial agents are invaluable life savers, particularly in resource-limited countries where infectious diseases are abundant. Both uncomplicated and severe infections are potentially curable as long as the aetiological agents are susceptible to the
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antimicrobial drugs. The rapid rate with which antimicrobial agents are becoming ineffective due to resistance acquired as a result of unchecked overuse and misuse threatens to undo the benefit of controlling infections. The evidence for resistant microorganisms, many times to more than a single antimicrobial agent, has been observed globally. In Tanzania, there is evidence in the form of few scattered studies conducted in different parts of the country in a multitude of settings including health care facilities, the community, domesticated animals and wild animals
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Event-based surveillance (EBS) is defined as the organized collection, monitoring, assessment and interpretation of mainly unstructured ad hoc information regarding health events or risks, which may represent an acute risk to
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health. Both indicator-based and event-based surveillance components serve the early warning and response (EWAR) function of the public health surveillance system. The Framework for Event-based Surveillance offers guidance to public health practitioners seeking to implement EBS at each administrative level in their countries.
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