World Health Organization

About: World Health Organization is a government organization based out in Islamabad, Pakistan. It is known for research contribution in the topics: Population & Public health. The organization has 13330 authors who have published 22232 publications receiving 1322023 citations. The organization is also known as: World Health Organisation & WHO.

Knowns and unknowns on burden of disease due to chemicals: a systematic review

Abstract: Continuous exposure to many chemicals, including through air, water, food, or other media and products results in health impacts which have been well assessed, however little is known about the total disease burden related to chemicals. This is important to know for overall policy actions and priorities. In this article the known burden related to selected chemicals or their mixtures, main data gaps, and the link to public health policy are reviewed. A systematic review of the literature for global burden of disease estimates from chemicals was conducted. Global disease due to chemicals was estimated using standard methodology of the Global Burden of Disease. In total, 4.9 million deaths (8.3% of total) and 86 million Disability-Adjusted Life Years (DALYs) (5.7% of total) were attributable to environmental exposure and management of selected chemicals in 2004. The largest contributors include indoor smoke from solid fuel use, outdoor air pollution and second-hand smoke, with 2.0, 1.2 and 0.6 million deaths annually. These are followed by occupational particulates, chemicals involved in acute poisonings, and pesticides involved in self-poisonings, with 375,000, 240,000 and 186,000 annual deaths, respectively. The known burden due to chemicals is considerable. This information supports decision-making in programmes having a role to play in reducing human exposure to toxic chemicals. These figures present only a number of chemicals for which data are available, therefore, they are more likely an underestimate of the actual burden. Chemicals with known health effects, such as dioxins, cadmium, mercury or chronic exposure to pesticides could not be included in this article due to incomplete data and information. Effective public health interventions are known to manage chemicals and limit their public health impacts and should be implemented at national and international levels.

Drug-Resistant Tuberculosis: Review of the Worldwide Situation and the WHO/IUATLD Global Surveillance Project

Abstract: The emergence of strains of Mycobacterium tuberculosis that are resistant to antimycobacterial agents is a worldwide problem whose global magnitude is not well described. We reviewed and tabulated 63 surveys of resistance to antituberculous drugs that were performed between 1985 and 1994. Rates of primary resistance to isoniazid, administered as a single agent, ranged from 0 to 16.9% (median rate, 4.1%); to streptomycin, 0.1%-23.5% (median, 3.5%); to rifampin, 0-3.0% (median, 0.2%); and to ethambutol, 0-4.2% (median, 0.1%). The rates of acquired resistance to these agents, which were higher than those of primary resistance, were as follows: isoniazid, 4.0%-53.7% (median rate, 10.6%); streptomycin, 0-19.4% (median, 4.9%); rifampin 0-14.5% (median, 2.4%); and ethambutol, 0-13.7% (median, 1.8%). The highest rates of multidrug-resistant tuberculosis have been reported in Nepal (48.0%), Gujarat, India (33.8%), New York City, (30.1%), Bolivia (15.3%), and Korea (14.5%). The WHO (World Health Organization) and the IUATLD (International Union Against Tuberculosis and Lung Disease) have established a global project of drug resistance surveillance that is based on standard epidemiological methods and quality control through an extensive network of reference laboratories. Accurate drug resistance surveillance data can be used to assess and improve national tuberculosis programs.

Programme costs in the economic evaluation of health interventions.

Abstract: Estimating the costs of health interventions is important to policy-makers for a number of reasons including the fact that the results can be used as a component in the assessment and improvement of their health system performance. Costs can, for example, be used to assess if scarce resources are being used efficiently or whether there is scope to reallocate them in a way that would lead to improvements in population health. As part of its WHO-CHOICE project, WHO has been developing a database on the overall costs of health interventions in different parts of the world as an input to discussions about priority setting. Programme costs, defined as costs incurred at the administrative levels outside the point of delivery of health care to beneficiaries, may comprise an important component of total costs. Cost-effectiveness analysis has sometimes omitted them if the main focus has been on personal curative interventions or on the costs of making small changes within the existing administrative set-up. However, this is not appropriate for non-personal interventions where programme costs are likely to comprise a substantial proportion of total costs, or for sectoral analysis where questions of how best to reallocate all existing health resources, including administrative resources, are being considered. This paper presents a first effort to systematically estimate programme costs for many health interventions in different regions of the world. The approach includes the quantification of resource inputs, choice of resource prices, and accounts for different levels of population coverage. By using an ingredients approach, and making tools available on the World Wide Web, analysts can adapt the programme costs reported here to their local settings. We report results for a selected number of health interventions and show that programme costs vary considerably across interventions and across regions, and that they can contribute substantially to the overall costs of interventions.

Options for Field Diagnosis of Human African Trypanosomiasis

Abstract: Human African trypanosomiasis (HAT) due to Trypanosoma brucei gambiense or T. b. rhodesiense remains highly prevalent in several rural areas of sub-Saharan Africa and is lethal if left untreated. Therefore, accurate tools are absolutely required for field diagnosis. For T. b. gambiense HAT, highly sensitive tests are available for serological screening but the sensitivity of parasitological confirmatory tests remains insufficient and needs to be improved. Screening for T. b. rhodesiense infection still relies on clinical features in the absence of serological tests available for field use. Ongoing research is opening perspectives for a new generation of field diagnostics. Also essential for both forms of HAT is accurate determination of the disease stage because of the high toxicity of melarsoprol, the drug most widely used during the neurological stage of the illness. Recent studies have confirmed the high accuracy of raised immunoglobulin M levels in the cerebrospinal fluid for the staging of T. b. gambiense HAT, and a promising simple assay (LATEX/IgM) is being tested in the field. Apart from the urgent need for better tools for the field diagnosis of this neglected disease, improved access to diagnosis and treatment for the population at risk remains the greatest challenge for the coming years.