As part of a World Health Organization-led effort to update the empirical evidence base for the leishmaniases, national experts provided leishmaniasis case data for the last 5 years and information regarding treatment and control in their respective countries and a comprehensive literature review was conducted covering publications on leishmaniasis in 98 regional level between 2007 and 2011. Two questionnaires regarding epidemiology and drug access were completed by experts and national program managers. Visceral and cutaneous leishmaniasis incidence ranges were estimated by country and epidemiological region based on reported incidence, underreporting rates if available, and the judgment of national and international experts. Based on these estimates, approximately 0.2 to 0.4 cases and 0.7 to 1.2 million VL and CL cases, respectively, occur each year. More than 90% of global VL cases occur in six countries: India, Bangladesh, Sudan, South Sudan, Ethiopia and Brazil. Cutaneous leishmaniasis is more widely distributed, with about one-third of cases occurring in each of three epidemiological regions, the Americas, the Mediterranean basin, and western Asia from the Middle East to Central Asia. The ten countries with the highest estimated case counts, Afghanistan, Algeria, Colombia, Brazil, Iran, Syria, Ethiopia, North Sudan, Costa Rica and Peru, together account for 70 to 75% of global estimated CL incidence. Mortality data were extremely sparse and generally represent hospital-based deaths only. Using an overall case-fatality rate of 10%, we reach a tentative estimate of 20,000 to 40,000 leishmaniasis deaths per year. Although the information is very poor in a number of countries, this is the first in-depth exercise to better estimate the real impact of leishmaniasis. These data should help to define control strategies and reinforce leishmaniasis advocacy. Funding: The Spanish Agency for International Cooperation for Development (AECID) has provided generous support to the WHO Leishmaniasis program since 2005. This support permitted among many other activities regional meetings with the AFRO, EURO, PAHO and SEARO countries, and provided for short term contracts for IDV, MdB, MH and JS related to the preparation of the country profiles. Sanofi provided a grant for a regional meeting with the EMRO countries and various activities related to the control of cutaneous Leishmaniasis in the EMRO region. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Competing Interests: The authors have declared that no competing interests exist. * E-mail: alvarj@who.int . These authors contributed equally to this work " For a full list of the members of the WHO Leishmaniasis Control Team please see the Acknowledgments section.

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Leishmaniasis Worldwide and Global Estimates of Its Incidence

Background: The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascul...

Heart Disease and Stroke Statistics-2021 Update: A Report From the American Heart Association.

https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(05)67629-5.pdf

Advances in leishmaniasis.

The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy.Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics.The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions. 

https://www.ahajournals.org/doi/pdf/10.1161/CIR.0000000000001052

Heart Disease and Stroke Statistics—2022 Update: A Report From the American Heart Association

Visceral leishmaniasis (VL) is a systemic protozoan disease that is transmitted by phlebotomine sandflies. Poor and neglected populations in East Africa and the Indian sub-continent are particularly affected. Early and accurate diagnosis and treatment remain key components of VL control. In addition to improved diagnostic tests, accurate and simple tests are needed to identify treatment failures. Miltefosine, paromomycin and liposomal amphotericin B are gradually replacing pentavalent antimonials and conventional amphotericin B as the preferred treatments in some regions, but in other areas these drugs are still being evaluated in both mono- and combination therapies. New diagnostic tools and new treatment strategies will only have an impact if they are made widely available to patients.

http://www.bio.umass.edu/micro/klingbeil/590s/Reading/Leishdiag2007.pdf

Visceral leishmaniasis: what are the needs for diagnosis, treatment and control?

/pdf/cdc-report-regarding-selected-public-health-topics-affecting-1b0vw90g66.pdf

CDC report regarding selected public health topics affecting women's health

Infectious diseases are leading causes of death in developing countries. According to 1998 data from the World Health Organization, 1.2% of total deaths from infectious and parasitic diseases occurred in industrialized countries, compared to 43% in developing countries. Women in developing countries disproportionately suffer from a host of infectious diseases, including tuberculosis, upper respiratory tract infectious, skin infections, visceral leishmaniasis, malaria, sexually transmitted infections, and HIV/AIDS.

Poverty, poor education, low health knowledge, poor infrastructure, geographic factors, life style, and environmental factors (i.e., limited access to resources such as clean water) have been identified as primary factors contributing to the high incidence of infectious diseases among women in developing countries. Also, such women tend to have limited or no access to health care, be vitamin deficient, and have lower status in their communities.

Often, infectious diseases may run a substantially longer course for women in developing countries because of stigma, family needs, and shame. Another important barrier to combating infectious diseases among women in developing countries is the lack of use and the misuse of prescription medication. A substantial percentage of women rely on traditional treatment methods. When women do seek healthcare services and are prescribed medication, women frequently do not adhere to the dosage and quantities prescribed.

Disparities in Infectious Diseases among Women in Developing Countries1

This paper discusses the collaborative efforts among the Centers for Disease Control and Prevention the Cooperative for Assistance and Relief Everywhere (CARE) and the Ministry of Health (MOH) to help minimize the high maternal mortality rate in Tanzania. This effort was made possible through the Community-Based Reproductive Health Project (CBRHP) funded by the US Agency for International Development. The collaboration was initiated in 1996 to improve the health status of mothers and newborns in Kwimba and Missungwi. Part of the project was the Training of Trainers Workshop conducted and attended by representatives from CARE MOH nongovernmental organizations focusing on womens issues local elected officials and community development officers. The CBRHP continues to work with communities to develop their own indicators for monitoring and evaluating their transport and supervision plans. Finally an assessment will be made on the role of CARE field officers in working with communities to resolve barriers in implementing transportation and supervision plans.

Community empowerment: CDC collaboration with the CARE Community-Based Reproductive Health Project in two districts in Tanzania. Observations from the CDC.

According to the WHO, the Region of the Americas has the second lowest tobacco use prevalence of any WHO region.1 WHO projections based on trends since 2000 indicate that the Region of the Americas, which includes both North and South America, is the only region expected to achieve a 30% relative reduction in tobacco use by 2025.1 However, there are approximately 127 million persons who report smoking tobacco in the Americas Region,2 a majority of whom reside in North America.3 North America consists of 23 countries with a combined population of nearly 600 million people, or approximately 7.5% of the world’s population in 2019.4 Among North American countries, data from 2017 for persons aged 15 years or older show current tobacco smoking prevalence ranged from 6.0% in Panama to 27.8% in Cuba.5 Among students aged 13–15 years old in North American countries with available data through 2017, current tobacco smoking prevalence ranged from 4.4% in Dominican Republic to 18.1% in Mexico.5 Tobacco smoking among adults is higher among males than females across North America. However, the difference in prevalence between sexes in the Region of the Americas is among the lowest of any WHO region5; this pattern is particularly pronounced among youth, where tobacco smoking among girls is similar to or higher among boys in most countries.2 5

Despite lower tobacco use relative to other regions, and future projected reductions,1 challenges remain to combating the tobacco epidemic in North America, including diversification of the product landscape, tobacco industry interference and uneven application of evidence-based strategies. This commentary discusses these challenges, as well as opportunities for future action to reduce the burden of tobacco use in North America.

Over the past decade and a half, the tobacco and nicotine product landscape has evolved …

Combating the tobacco epidemic in North America: challenges and opportunities.

Objectives We sought to examine postpartum contraceptive use among women who reported physical intimate partner violence (IPV) during or within 12 months before pregnancy compared with women who did not report physical IPV and to identify factors associated with nonuse of contraception among women who reported physical IPV. Methods Data were obtained from women with a recent live birth from 2012 to 2015 who participated in the Pregnancy Risk Assessment and Monitoring System. We described characteristics of women and postpartum contraceptive use by method effectiveness (most effective [female sterilization, male sterilization, intrauterine device, implant], moderately effective [injectable, pill, patch, ring], less effective [condoms, natural family planning, withdrawal, other]) or no method, stratified by reported physical IPV. Multivariable logistic regression was used to examine characteristics associated with nonuse of contraception among women who reported physical IPV. Results The proportion of women using most or moderately effective contraception was similar for women reporting and not reporting physical IPV. Less effective contraceptive use was lower among women who reported physical IPV (13.9%) than those who did not report physical IPV (25.1%) (p  Conclusions The higher proportion of contraception nonuse among women who reported physical IPV indicates a potential unmet need for contraception among this vulnerable population. Recommended screening for IPV and counseling about the full range of contraceptive methods should begin during pregnancy and continue through the postpartum period.

Indu B. Ahluwalia

Papers

CDC report regarding selected public health topics affecting women's health

Disparities in Infectious Diseases among Women in Developing Countries1

Community empowerment: CDC collaboration with the CARE Community-Based Reproductive Health Project in two districts in Tanzania. Observations from the CDC.

Combating the tobacco epidemic in North America: challenges and opportunities.

Intimate Partner Violence around the Time of Pregnancy and Postpartum Contraceptive Use.