Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Africa is witnessing an epidemic of cardiovascular disease (CVD), with staggering morbidity and mortality. The spectrum of CVD includes hypertension, rheumatic heart disease, cardiomyopathy, atherosclerotic disease, congenital heart disease and tuberculous pericarditis. Opportunities exist to alter ...the trajectory of CVD epidemiology but require committed policy makers, functional health systems and an engaged citizenry.
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Spanish version of "Developing Pharmacy Practice" - WHO/FIP Joint handbook -
Este manual de introducción marca un nuevo paradigma en la práctica de farmacia. Intenta guiar a los formadores en atención farmacéutica para educar a los estudiantes de farmacia y a los farmacéuticos ya estableci...dos en la actualización de sus conocimientos. Este manual, que ofrece teoría y ejemplos prácticos, ha sido escrito como respuesta a la necesidad de definir, desarrollar y agrupar todos los conocimientos actuales sobre la atención farmacéutica.
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Introducción
Capítulo A.14
Edición: Matías Irarrázaval & Andres Martin
Revisión: Fernanda Prieto-Tagle & Neus Elias
Clinical guideline for paediatric care of tuberculosis and TB-HIV co-infection
Trastornos del desarrollo
Capítulo C.2
Traducción de la versión inglesa del 2014
Manual de Salud Mental Infantil y Adolescente de la IACAPAP
Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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In 2012, all Member States of the World Health Organization (WHO) endorsed a historical target to reduce premature mortality from noncommunicable diseases
(NCD). This commitment was echoed in 2015 by the United Nations Sustainable Development Goals, which included a target to reduce premature morta...lity (the
measure of unfulfilled life expectancy and deaths between the ages of 30 and 70 years) from NCD by 30% by the year 2030. The Sustainable Development Goals are especially relevant to cardiovascular disease (CVD), the leading cause of death globally, with increasing prevalence in low- and middle-income countries (LMIC).
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N Engl J Med 2019;380:2429-39.DOI: 10.1056/NEJMoa1901113
Washington, D.C., EUA, del 23 al 27 de septiembre del 2018
Punto 8.22 del orden del día provisional
CD56/INF/22 31 de agosto del 2018
Original: inglés/español
Durante muchos años, la enfermedad de Chagas ha sido una entidad olvidada en nuestro medio, pese a que Colombia posee las condiciones apropiadas para que esta infección se desarrolle y se perpetúe en el tiempo.
Esto se refleja en el poco conocimiento de la enfermedad y en la existencia de muchos... individuos que sufren una pérdida significativa de su calidad y esperanza de vida, así como en costos importantes para el sistema de salud.
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Considerando las repercusiones del cambio climático cada vez más intensas en todo el mundo, las naciones deben aumentar drásticamente la financiación y la implementación de medidas diseñadas para ayudar a las naciones y comunidades vulnerables a adaptarse a la tormenta de fenómenos climático...s extremos, señala un reciente informe del Programa de las Naciones Unidas para el Medio Ambiente (PNUMA).
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Orientaciones provisionales
9 de agosto de 2021
El presente documento tiene por objeto describir un conjunto mínimo de actividades de vigilancia recomendadas a nivel nacional para detectar y supervisar la prevalencia relativa de las variantes del SRAS-CoV-2 y esbozar un conjunto de actividades pa...ra la caracterización y evaluación del riesgo que plantean estas variantes. También se ofrece un conjunto de indicadores para normalizar la vigilancia y la notificación pública de la circulación de variantes.
El documento está dirigido principalmente a las autoridades de salud pública nacionales y subnacionales y a los socios que apoyan la aplicación de la vigilancia de las variantes del SRAS-CoV-2
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La crisis de personas refugiadas y migrantes venezolanos es una de las mayores crisis de desplazamiento externo en el mundo. La pandemia COVID-19 ha agravado la ya desesperada situación de muchas personas refugiadas y migrantes, así como la de los países de acogida, poniendo a prueba los sistemas... nacionales de salud y asistencia social, así como la capacidad de los países para apoyar a su población vulnerable.
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Introducción
Capítulo A.5
Edición: Matías Irarrázaval & Andres Martin
Traductores: Fernanda Prieto-Tagle & Carlos Llanes
In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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