Institution
World Health Organization
Government•Islamabad, Pakistan•
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.
Topics: Population, Public health, Health care, Health policy, Global health
Papers published on a yearly basis
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University College London1, University of London2, World Health Organization3, Federal University of Rio de Janeiro4, Uganda Virus Research Institute5, University of Montpellier6, Universidad del Valle de Guatemala7, University of Amsterdam8, Seattle Children's Research Institute9, University of Washington10, University of KwaZulu-Natal11, Centre for the AIDS Programme of Research in South Africa12, University College Hospital13, Tufts University14, Tufts Medical Center15
TL;DR: In 2016, the prevalence of pretreatment NNRTI resistance was near WHO's 10% threshold for changing first-line ART in southern and eastern Africa and Latin America, underscoring the need for routine national HIV drug-resistance surveillance and review of national policies for first- line ART regimen composition.
Abstract: BACKGROUND: Pretreatment drug resistance in people initiating or re-initiating antiretroviral therapy (ART) containing non-nucleoside reverse transcriptase inhibitors (NNRTIs) might compromise HIV control in low-income and middle-income countries (LMICs). We aimed to assess the scale of this problem and whether it is associated with the intiation or re-initiation of ART in people who have had previous exposure to antiretroviral drugs. METHODS: This study was a systematic review and meta-regression analysis. We assessed regional prevalence of pretreatment drug resistance and risk of pretreatment drug resistance in people initiating ART who reported previous ART exposure. We systematically screened publications and unpublished datasets for pretreatment drug-resistance data in individuals in LMICs initiating or re-initiating first-line ART from LMICs. We searched for studies in PubMed and Embase and conference abstracts and presentations from the Conference on Retroviruses and Opportunistic Infections, the International AIDS Society Conference, and the International Drug Resistance Workshop for the period Jan 1, 2001, to Dec 31, 2016. To assess the prevalence of drug resistance within a specified region at any specific timepoint, we extracted study level data and pooled prevalence estimates within the region using an empty logistic regression model with a random effect at the study level. We used random effects meta-regression to relate sampling year to prevalence of pretreatment drug resistance within geographical regions. FINDINGS: We identified 358 datasets that contributed data to our analyses, representing 56 044 adults in 63 countries. Prevalence estimates of pretreatment NNRTI resistance in 2016 were 11·0% (7·5-15·9) in southern Africa, 10·1% (5·1-19·4) in eastern Africa, 7·2% (2·9-16·5) in western and central Africa, and 9·4% (6·6-13·2) in Latin America and the Caribbean. There were substantial increases in pretreatment NNRTI resistance per year in all regions. The yearly increases in the odds of pretreatment drug resistance were 23% (95% CI 16-29) in southern Africa, 17% (5-30) in eastern Africa, 17% (6-29) in western and central Africa, 11% (5-18) in Latin America and the Caribbean, and 11% (2-20) in Asia. Estimated increases in the absolute prevalence of pretreatment drug resistance between 2015 and 2016 ranged from 0·3% in Asia to 1·8% in southern Africa. INTERPRETATION: Pretreatment drug resistance is increasing at substantial rate in LMICs, especially in sub-Saharan Africa. In 2016, the prevalence of pretreatment NNRTI resistance was near WHO's 10% threshold for changing first-line ART in southern and eastern Africa and Latin America, underscoring the need for routine national HIV drug-resistance surveillance and review of national policies for first-line ART regimen composition. FUNDING: Bill & Melinda Gates Foundation and World Health Organization.
277 citations
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TL;DR: The Trial aims to determine the effect of early administration of tranexamic acid on mortality, hysterectomy and other morbidities in women with clinically diagnosed postpartum haemorrhage in a large, pragmatic, randomised, double blind, placebo controlled trial among 15,000 women.
Abstract: Each year, worldwide about 530,000 women die from causes related to pregnancy and childbirth. Of the deaths 99% are in low and middle income countries. Obstetric haemorrhage is the leading cause of maternal mortality, most occurring in the postpartum period. Systemic antifibrinolytic agents are widely used in surgery to prevent clot breakdown (fibrinolysis) in order to reduce surgical blood loss. At present there is little reliable evidence from randomised trials on the effectiveness of tranexamic acid in the treatment of postpartum haemorrhage. The Trial aims to determine the effect of early administration of tranexamic acid on mortality, hysterectomy and other morbidities (surgical interventions, blood transfusion, risk of non-fatal vascular events) in women with clinically diagnosed postpartum haemorrhage. The use of health services and safety, especially thromboembolic effect, on breastfed babies will also be assessed. The trial will be a large, pragmatic, randomised, double blind, placebo controlled trial among 15,000 women with a clinical diagnosis of postpartum haemorrhage. All legally adult women with clinically diagnosed postpartum haemorrhage following vaginal delivery of a baby or caesarean section will potentially be eligible. The fundamental eligibility criterion is the responsible clinician's 'uncertainty' as to whether or not to use an antifibrinolytic agent in a particular woman with postpartum haemorrhage. Treatment will entail a dose of tranexamic acid (1 gram by intravenous injection) or placebo (sodium chloride 0.9%) will be given as soon as possible after randomisation. A second dose may be given if after 30 minutes bleeding continues, or if it stops and restarts within 24 hours after the first dose. The main analyses will be on an 'intention to treat' basis, irrespective of whether the allocated treatment was received or not. Subgroup analyses for the primary outcome will be based on type of delivery; administration or not of prophylactic uterotonics; and on whether the clinical decision to consider trial entry was based primarily on estimated blood loss alone or on haemodynamic instability. A study with 15,000 women will have over 90% power to detect a 25% reduction from 4% to 3% in the primary endpoint of mortality or hysterectomy. Current Controlled Trials: ISRCTN76912190 and Clinicaltrials.gov ID: NCT00872469
277 citations
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TL;DR: Two new reports that use available data about the course of SARS infection to model the SARS epidemic are discussed.
Abstract: Epidemiologists are still trying to understand how and why the SARS coronavirus has spread so readily throughout Asia and certain other regions of the world. In their Perspective,
Dye and Gay
discuss two new reports that use available data about the course of SARS infection to model the SARS epidemic (
Lipsitch
et al.,
Riley
et al.).
277 citations
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TL;DR: The results of the WPA-WHO Global Survey of 4,887 psychiatrists in 44 countries regarding their use of diagnostic classification systems in clinical practice, and the desirable characteristics of a classification of mental disorders are described.
276 citations
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TL;DR: In this paper, the authors proposed that some variants of concern may emerge with dangerous resistance to the immunity generated by the current vaccines to prevent coronavirus disease 2019 (Covid-19).
Abstract: Viral variants of concern may emerge with dangerous resistance to the immunity generated by the current vaccines to prevent coronavirus disease 2019 (Covid-19). Moreover, if some variants of concern have increased transmissibility or virulence, the importance of efficient public health measures and vaccination programs will increase. The global response must be both timely and science based.
276 citations
Authors
Showing all 13385 results
Name | H-index | Papers | Citations |
---|---|---|---|
Christopher J L Murray | 209 | 754 | 310329 |
Michael Marmot | 193 | 1147 | 170338 |
Didier Raoult | 173 | 3267 | 153016 |
Alan D. Lopez | 172 | 863 | 259291 |
Zulfiqar A Bhutta | 165 | 1231 | 169329 |
Simon I. Hay | 165 | 557 | 153307 |
Robert G. Webster | 158 | 843 | 90776 |
Ali H. Mokdad | 156 | 634 | 160599 |
Matthias Egger | 152 | 901 | 184176 |
Paolo Boffetta | 148 | 1455 | 93876 |
Jean Bousquet | 145 | 1288 | 96769 |
Igor Rudan | 142 | 658 | 103659 |
Holger J. Schünemann | 141 | 810 | 113169 |
Richard M. Myers | 134 | 496 | 137791 |
Majid Ezzati | 133 | 443 | 137171 |