WHO Expert Consultation on Rabies Organization, World Health
World Health Organization technical report series,
2013
982
eBook, Journal Article
Recenzirano
More than 99% of all human rabies deaths occur in the developing world and although effective and economical control measures are available the disease has not been brought under control throughout ...most of the affected countries. Given that a major factor in the low level of commitment to rabies control is a lack of accurate data on the true public health impact of the disease this report of a WHO Expert Consultation begins by providing new data on the estimated burden of the disease and its distribution in the world. It also reviews recent progress in the classification of rabies viruses rabies pathogenesis and diagnosis rabies pre- and post-exposure prophylaxis the management of rabies patients and canine as well as wildlife rabies prevention and control. _x000D__x000D_ _x000D__x000D_ The information in this report should be considered the most current data on rabies prevention and control and supersedes that of the report of the first WHO Expert Consultation on Rabies published in 2005.
IMPORTANCE: Previous research has documented significant variation in the prevalence of posttraumatic stress disorder (PTSD) depending on the type of traumatic experience (TE) and history of TE ...exposure, but the relatively small sample sizes in these studies resulted in a number of unresolved basic questions. OBJECTIVE: To examine disaggregated associations of type of TE history with PTSD in a large cross-national community epidemiologic data set. DESIGN, SETTING, AND PARTICIPANTS: The World Health Organization World Mental Health surveys assessed 29 TE types (lifetime exposure, age at first exposure) with DSM-IV PTSD that was associated with 1 randomly selected TE exposure (the random TE) for each respondent. Surveys were administered in 20 countries (n = 34 676 respondents) from 2001 to 2012. Data were analyzed from October 1, 2015, to September 1, 2016. MAIN OUTCOMES AND MEASURES: Prevalence of PTSD assessed with the Composite International Diagnostic Interview. RESULTS: Among the 34 676 respondents (55.4% SE, 0.6% men and 44.6% SE, 0.6% women; mean SE age, 43.7 0.2 years), lifetime TE exposure was reported by a weighted 70.3% of respondents (mean SE number of exposures, 4.5 0.04 among respondents with any TE). Weighted (by TE frequency) prevalence of PTSD associated with random TEs was 4.0%. Odds ratios (ORs) of PTSD were elevated for TEs involving sexual violence (2.7; 95% CI, 2.0-3.8) and witnessing atrocities (4.2; 95% CI, 1.0-17.8). Prior exposure to some, but not all, same-type TEs was associated with increased vulnerability (eg, physical assault; OR, 3.2; 95% CI, 1.3-7.9) or resilience (eg, participation in sectarian violence; OR, 0.3; 95% CI, 0.1-0.9) to PTSD after the random TE. The finding of earlier studies that more general history of TE exposure was associated with increased vulnerability to PTSD across the full range of random TE types was replicated, but this generalized vulnerability was limited to prior TEs involving violence, including participation in organized violence (OR, 1.3; 95% CI, 1.0-1.6), experience of physical violence (OR, 1.4; 95% CI, 1.2-1.7), rape (OR, 2.5; 95% CI, 1.7-3.8), and other sexual assault (OR, 1.6; 95% CI, 1.1-2.3). CONCLUSION AND RELEVANCE: The World Mental Health survey findings advance understanding of the extent to which PTSD risk varies with the type of TE and history of TE exposure. Previous findings about the elevated PTSD risk associated with TEs involving assaultive violence was refined by showing agreement only for repeated occurrences. Some types of prior TE exposures are associated with increased resilience rather than increased vulnerability, connecting the literature on TE history with the literature on resilience after adversity. These results are valuable in providing an empirical rationale for more focused investigations of these specifications in future studies.
The second WHO report on neglected tropical diseases builds on the growing sense of optimism_x000D__x000D_ generated by the 2012 publication of the WHO Roadmap. Commitments on the_x000D__x000D_ part ...of ministries of health in endemic countries global health initiatives funding_x000D__x000D_ agencies and philanthropists have escalated since 2010 as have donations of_x000D__x000D_ medicines from pharmaceutical companies and the engagement of the scientific_x000D__x000D_ community. _x000D__x000D_ This report marks a new phase and assesses opportunities and obstacles in the_x000D__x000D_ control elimination and eradication of several of these diseases. Unprecedented_x000D__x000D_ progress over the past two years has revealed unprecedented needs for_x000D__x000D_ refinements in control strategies and new technical tools and protocols. The_x000D__x000D_ substantial increases in donations of medicines made since the previous report_x000D__x000D_ call for innovations that simplify and refine delivery strategies. _x000D__x000D_ However some diseases including especially deadly ones like human African_x000D__x000D_ trypanosomiasis and visceral Leishmaniasis remain extremely difficult and costly_x000D__x000D_ to treat. The control of Buruli ulcer Chagas disease and yaws is hampered by_x000D__x000D_ imperfect technical tools although recent developments for yaws look promising._x000D__x000D_ The report highlights progress against these especially challenging diseases _x000D__x000D_ being made through the development of innovative and intensive management_x000D__x000D_ strategies. _x000D__x000D_ Innovations in vector control deserve more attention as playing a key part in_x000D__x000D_ reducing transmission and disease burden especially for Dengue Chagas disease_x000D__x000D_ and the Leishmaniases. _x000D__x000D_ Achieving universal health coverage with
essential health interventions for_x000D__x000D_ neglected tropical diseases will be a powerful equalizer that abolishes distinctions_x000D__x000D_ between the rich and the poor the young and the old ethnic groups and women_x000D__x000D_ and men.
IMPORTANCE: Community-based studies have linked psychotic experiences (PEs) with increased risks of suicidal thoughts and behaviors (STBs). However, it is not known if these associations vary across ...the life course or if mental disorders contribute to these associations. OBJECTIVE: To examine the temporal association between PEs and subsequent STBs across the life span as well as the influence of mental disorders (antecedent to the STBs) on these associations. DESIGN, SETTING, AND PARTICIPANTS: A total of 33 370 adult respondents across 19 countries from the World Health Organization World Mental Health Surveys were assessed for PEs, STBs (ie, ideation, plans, and attempts), and 21 DSM-IV mental disorders. Discrete-time survival analysis was used to investigate the associations of PEs with subsequent onset of STBs. MAIN OUTCOMES AND MEASURES: Prevalence and frequency of STBs with PEs, and odds ratios and 95% CIs. RESULTS: Of 33 370 included participants, among those with PEs (n = 2488), the lifetime prevalence (SE) of suicidal ideation, plans, and attempts was 28.5% (1.3), 10.8% (0.7), and 10.2% (0.7), respectively. Respondents with 1 or more PEs had 2-fold increased odds of subsequent STBs after adjusting for antecedent or intervening mental disorders (suicidal ideation: odds ratio, 2.2; 95% CI, 1.8-2.6; suicide plans: odds ratio, 2.1; 95% CI, 1.7-2.6; and suicide attempts: odds ratio, 1.9; 95% CI, 1.5-2.5). There were significant dose-response relationships of number of PE types with subsequent STBs that persisted after adjustment for mental disorders. Although PEs were significant predictors of subsequent STB onset across all life stages, associations were strongest in individuals 12 years and younger. After adjustment for antecedent mental disorders, the overall population attributable risk proportions for lifetime suicidal ideation, plans, and attempts associated with temporally prior PEs were 5.3%, 5.7%, and 4.8%, respectively. CONCLUSIONS AND RELEVANCE: Psychotic experiences are associated with elevated odds of subsequent STBs across the life course that cannot be explained by antecedent mental disorders. These results highlight the importance of including information about PEs in screening instruments designed to predict STBs.
Substance use is a major cause of disability globally. This has been recognized in the recent United Nations Sustainable Development Goals (SDGs), in which treatment coverage for substance use ...disorders is identified as one of the indicators. There have been no estimates of this treatment coverage cross‐nationally, making it difficult to know what is the baseline for that SDG target. Here we report data from the World Health Organization (WHO)'s World Mental Health Surveys (WMHS), based on representative community household surveys in 26 countries. We assessed the 12‐month prevalence of substance use disorders (alcohol or drug abuse/dependence); the proportion of people with these disorders who were aware that they needed treatment and who wished to receive care; the proportion of those seeking care who received it; and the proportion of such treatment that met minimal standards for treatment quality (“minimally adequate treatment”). Among the 70,880 participants, 2.6% met 12‐month criteria for substance use disorders; the prevalence was higher in upper‐middle income (3.3%) than in high‐income (2.6%) and low/lower‐middle income (2.0%) countries. Overall, 39.1% of those with 12‐month substance use disorders recognized a treatment need; this recognition was more common in high‐income (43.1%) than in upper‐middle (35.6%) and low/lower‐middle income (31.5%) countries. Among those who recognized treatment need, 61.3% made at least one visit to a service provider, and 29.5% of the latter received minimally adequate treatment exposure (35.3% in high, 20.3% in upper‐middle, and 8.6% in low/lower‐middle income countries). Overall, only 7.1% of those with past‐year substance use disorders received minimally adequate treatment: 10.3% in high income, 4.3% in upper‐middle income and 1.0% in low/lower‐middle income countries. These data suggest that only a small minority of people with substance use disorders receive even minimally adequate treatment. At least three barriers are involved: awareness/perceived treatment need, accessing treatment once a need is recognized, and compliance (on the part of both provider and client) to obtain adequate treatment. Various factors are likely to be involved in each of these three barriers, all of which need to be addressed to improve treatment coverage of substance use disorders. These data provide a baseline for the global monitoring of progress of treatment coverage for these disorders as an indicator within the SDGs.
Abstract This article presents the World Health Organization’s (WHO) recommendations on the use of human papillomavirus (HPV) vaccines excerpted from the WHO position paper on Human papillomavirus ...vaccines: WHO position paper, May 2017, published in the Weekly Epidemiological Record 1 . This position paper replaces the 2014 WHO position paper on HPV vaccines 2. The position paper focuses primarily on the prevention of cervical cancer, but also considers the broader spectrum of cancers and other diseases preventable by HPV vaccination. It incorporates recent developments concerning HPV vaccines, including the licensure of a nonavalent (9-valent) vaccine and recent data on vaccine effectiveness, and provides guidance on the choice of vaccine. New recommendations are proposed regarding vaccination strategies targeting girls only or both girls and boys, and vaccination of multiple birth cohorts 3. Footnotes to this paper provide a number of core references including references to grading tables that assess the quality of the scientific evidence, and to the evidence-to-recommendation table. In accordance with its mandate to provide guidance to Member States on health policy matters, WHO issues a series of regularly updated position papers on vaccines and combinations of vaccines against diseases that have an international public health impact. These papers are concerned primarily with the use of vaccines in large-scale immunization programmes; they summarize essential background information on diseases and vaccines, and conclude with WHO's current position on the use of vaccines in the global context. Recommendations on the use of HPV vaccines were discussed by SAGE in October 2016; evidence presented at these meetings can be accessed at: www.who.int/immunization/sage/meetings/2016/october/presentations_background_docs/en/.
This edition of the World Malaria Report summarizes thecurrent status of malaria control worldwide. It reviews progresstowards internationally agreed goals and targets anddescribes trends in funding ...intervention coverage andmalaria cases and deaths. In 2013 there are 97 countries and territories with ongoingmalaria transmission and 6 countries in the prevention of reintroductionphase making a total of 103 countries and territoriesin which malaria is presently considered endemic. Globally an estimated 3.4 billion people are at risk of malaria. WHO estimatesthat 207 million cases of malaria occurred globally in 2012(uncertainty range 135?287 million) and 627 000 deaths (uncertaintyrange 473 000?789 000). Most cases (80%) and deaths (90%) occurred in Africa andmost deaths (77%) were in children under 5 years of age. The World Malaria Report presents a critical analysis and interpretationof data provided by national malaria control programmes(NMCPs) in endemic countries. Standard reporting forms weresent in April 2013 to the 97 countries with ongoing malariatransmission and to 5 of the countries that recently entered theprevention of reintroduction phase. Information was requestedon (i) populations at risk; (ii) vector species; (iii) number of cases admissions and deaths for each parasite species; (iv) completenessof outpatient reporting; (v) policy implementation; (vi)commodities distributed and interventions undertaken; (vii)results of household surveys; and (viii) malaria financing.Table 1.2 summarizes the percentage of countries respondingby month and by WHO region in 2012.Information from household surveys was used to complementdata submitted by NMCPs notably the demographic and healthsurveys (DHS) multiple indicator cluster surveys (MICS) andmalaria indicator surveys (MIS). These surveys provide informationon the percentage of the population
that sleeps under amosquito net and the percentage of children with fever who aretreated and the medication they receive. Information on malariafinancing was obtained from the Organisation for EconomicCo-operation and Development (OECD) database on foreignaid flows and directly from the Global Fund to Fight AIDS Tuberculosis and Malaria (Global Fund) and the US President?sMalaria Initiative (PMI).Data were analysed by WHO staff at headquarters and regionaloffices with extensive consultation with WHO country officesand NMCPs regarding the interpretation of country information.Assistance in data analysis and interpretation was also providedby the African Leaders Malaria Alliance (ALMA) the Child HealthEpidemiology Reference Group (CHERG) the Institute of HealthMetrics and Evaluation (IHME) the Malaria Atlas Projectthe US Centers for Disease Control and Prevention (CDC) andthe Global Fund. The following chapters consider the policies and interventionsrecommended by WHO the implementation of interventions and the impact of these interventions on malaria cases anddeaths from a global and a regional perspective.Chapter 2 summarizes the WHO policy-setting process and thepolicies and strategies recommended by WHO to achieve theinternationally agreed goals for malaria control and elimination.It describes the goals and targets for malaria control and elimination and recommended indicators of progress.Chapter 3 reviews recent trends in international and domesticfinancing in relation to the resource requirements for meetingglobal malaria control targets. It examines the distribution ofmalaria funding by WHO region by gross national income (GNI)per capita and by malaria mortality rate of a country. It alsoreviews endemic countries? willingness to pay for malaria control.Chapter 4 reviews the commodity needs for malaria vectorcontrol. It considers the policies
that national programmes haveadopted for vector control implementation and the progressmade towards universal access to ITNs and IRS. An update isprovided on the growing problem of insecticide resistance andthe appropriate monitoring and management of resistance.Chapter 5 reviews progress in implementation of chemoprevention particularly the intermittent preventive treatment ofmalaria in pregnancy and in infants and the introduction ofseasonal chemoprevention in older children. It also reports onthe current status of malaria vaccine development.Chapter 6 reviews the commodity needs for malaria diagnostictesting and treatment. It reports on the extent to which nationalprogrammes have adopted policies for universal diagnostictesting of suspected malaria cases and examines trends in theavailability of parasitological testing. It also reviews the adoptionof policies and implementation of programmes for improvingaccess to effective treatment for malaria. Finally this chapterreports on progress in the withdrawal of oral artemisinin-basedmonotherapies from the market the current status of drug efficacymonitoring recent trends in antimalarial drug resistanceand efforts to contain artemisinin resistance.Chapter 7 examines the extent to which data are available formonitoring progress towards international targets and how thishas changed since 2000.Chapter 8 reviews trends in reported malaria cases for 62 countriesthat have reported consistently between 2000 and 2012. For countries with low numbers of cases it summarizes theirprogress towards elimination. This chapter also presents an analysisof the estimated numbers of cases and deaths for countrieswith ongoing transmission between 2000 and 2012.Regional profiles are provided. These summarize the epidemiologyof malaria in each WHO region trends in malaria caseincidence and the links between malaria trends
and malariaprogramme implementation. Country profiles are also provided for countries with ongoingmalaria transmission and those recently progressing to theprevention of reintroduction phase. These profiles are followedby Annexes which give data by country for the malaria-relatedindicators.
Aim
The A/goose/Guangdong/1/96‐like hemagglutinin (HA) genes of highly pathogenic avian influenza (HPAI) A(H5) viruses have continued to rapidly evolve since the most recent update to the H5 clade ...nomenclature by the WHO/OIE/FAO H5N1 Evolution Working Group. New clades diverging beyond established boundaries need to be identified and designated accordingly.
Method
Hemagglutinin sequences deposited in publicly accessible databases up to December 31, 2014, were analyzed by phylogenetic and average pairwise distance methods to identify new clades that merit nomenclature changes.
Results
Three new clade designations were recommended based on division of clade 2·1·3·2a (Indonesia), 2·2·1 (Egypt), and 2·3·4 (widespread detection in Asia, Europe, and North America) that includes newly emergent HPAI virus subtypes H5N2, H5N3, H5N5, H5N6, and H5N8.
Conclusion
Continued global surveillance for HPAI A(H5) viruses in all host species and timely reporting of sequence data will be critical to quickly identify new clades and assess their potential impact on human and animal health.
Illness and death from diseases caused by contaminated food are a constant threat to public health and a significant impediment to socio-economic development worldwide. To measure the global and ...regional burden of foodborne disease (FBD), the World Health Organization (WHO) established the Foodborne Disease Burden Epidemiology Reference Group (FERG), which here reports their first estimates of the incidence, mortality, and disease burden due to 31 foodborne hazards. We find that the global burden of FBD is comparable to those of the major infectious diseases, HIV/AIDS, malaria and tuberculosis. The most frequent causes of foodborne illness were diarrheal disease agents, particularly norovirus and Campylobacter spp. Diarrheal disease agents, especially non-typhoidal Salmonella enterica, were also responsible for the majority of deaths due to FBD. Other major causes of FBD deaths were Salmonella Typhi, Taenia solium and hepatitis A virus. The global burden of FBD caused by the 31 hazards in 2010 was 33 million Disability Adjusted Life Years (DALYs); children under five years old bore 40% of this burden. The 14 subregions, defined on the basis of child and adult mortality, had considerably different burdens of FBD, with the greatest falling on the subregions in Africa, followed by the subregions in South-East Asia and the Eastern Mediterranean D subregion. Some hazards, such as non-typhoidal S. enterica, were important causes of FBD in all regions of the world, whereas others, such as certain parasitic helminths, were highly localised. Thus, the burden of FBD is borne particularly by children under five years old-although they represent only 9% of the global population-and people living in low-income regions of the world. These estimates are conservative, i.e., underestimates rather than overestimates; further studies are needed to address the data gaps and limitations of the study. Nevertheless, all stakeholders can contribute to improvements in food safety throughout the food chain by incorporating these estimates into policy development at national and international levels.
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Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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