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.

Evolution of tuberculosis control and prospects for reducing tuberculosis incidence, prevalence, and deaths globally.

Abstract: ContextThe United Nations Millennium Development Goals (MDGs) are stimulating more rigorous evaluations of the impact of DOTS (the WHO-recommended approach to tuberculosis control based on 5 essential elements) and other possible strategies for tuberculosis (TB) control.ObjectiveTo evaluate the prospects for detecting 70% of new sputum smear–positive cases and successfully treating 85% of these by the end of 2005, for reducing TB incidence, and for halving TB prevalence and deaths globally between 1990 and 2015, as specified by the MDGs.Data SourcesTB case notifications (1980-2003) from DOTS and non-DOTS programs and cohort treatment outcomes (1994-2002) reported annually to the World Health Organization (WHO) by up to 200 countries, TB death registrations, and prevalence surveys of infection and disease.Study SelectionCase notification series that reflect trends in incidence, treatment outcomes from DOTS cohorts, death statistics from countries with WHO-validated vital registration systems, and national prevalence surveys of infection and disease.Data ExtractionCase reports, treatment outcomes, prevalence surveys, and death registrations from WHO's global TB database covering 1990-2003 to estimate TB incidence, prevalence, and death rates through 2015 for 9 epidemiologically different world regions.Data SynthesisTB incidence increased globally in 2003, but incidence, prevalence, and death rates were approximately stable or decreased in 7 of 9 regions. The exceptions were regions of Africa with low (<4% in adults 15-49 years) and high rates (≥4%) of HIV infection. The global detection rate of new smear-positive cases by DOTS programs increased from 11% in 1995 to 45% in 2003 (with the lowest case-detection rates in Eastern Europe and the highest rates in the Western Pacific) and could reach 60% by 2005. More than 17 million patients were treated in DOTS programs between 1994 and 2003, with overall treatment success rates more than 80% since 1998. In 2003, overall reported treatment success was 82%, with much variation among regions. The highest rates were reported in the Western Pacific region (89%) and lowest rates in African countries with high and low HIV infection rates (71% and 74%, respectively), in established market economies (77%), and in Eastern Europe (75%). To halve the prevalence rate by 2015, TB control programs must reach global targets for detection (70%) and treatment success (85%) and also reduce the incidence rate by at least 2% annually. To halve the death rate, incidence must decrease more steeply, by at least 5% to 6% annually.ConclusionReduction of TB incidence, prevalence, and deaths by 2015 could be achieved in most of the world, but the challenge will be greatest in Africa and Eastern Europe.

Epidemics after natural disasters.

Abstract: The relationship between natural disasters and communicable diseases is frequently misconstrued. The risk for outbreaks is often presumed to be very high in the chaos that follows natural disasters, a fear likely derived from a perceived association between dead bodies and epidemics. However, the risk factors for outbreaks after disasters are associated primarily with population displacement. The availability of safe water and sanitation facilities, the degree of crowding, the underlying health status of the population, and the availability of healthcare services all interact within the context of the local disease ecology to infl uence the risk for communicable diseases and death in the affected population. We outline the risk factors for outbreaks after a disaster, review the communicable diseases likely to be important, and establish priorities to address communicable diseases in disaster settings.

Global monitoring of antimicrobial resistance based on metagenomics analyses of urban sewage

Abstract: Antimicrobial resistance (AMR) is a serious threat to global public health, but obtaining representative data on AMR for healthy human populations is difficult. Here, we use metagenomic analysis of untreated sewage to characterize the bacterial resistome from 79 sites in 60 countries. We find systematic differences in abundance and diversity of AMR genes between Europe/North-America/Oceania and Africa/Asia/South-America. Antimicrobial use data and bacterial taxonomy only explains a minor part of the AMR variation that we observe. We find no evidence for cross-selection between antimicrobial classes, or for effect of air travel between sites. However, AMR gene abundance strongly correlates with socio-economic, health and environmental factors, which we use to predict AMR gene abundances in all countries in the world. Our findings suggest that global AMR gene diversity and abundance vary by region, and that improving sanitation and health could potentially limit the global burden of AMR. We propose metagenomic analysis of sewage as an ethically acceptable and economically feasible approach for continuous global surveillance and prediction of AMR.

Latent Mycobacterium tuberculosis Infection

Abstract: The natural history of tuberculosis begins with the inhalation of Mycobacterium tuberculosis organisms; a period of bacterial replication and dissemination ensues, followed by immunologic containment of viable bacilli. The result of this process is asymptomatic latent tuberculosis infection, which is defined as a state of persistent bacterial viability, immune control, and no evidence of clinically manifested active tuberculosis. 1 Currently, it is not possible to directly diagnose M. tuberculosis infection in humans; therefore, latent tuberculosis infection is diagnosed by response to in vivo or in vitro stimulation by M. tuberculosis antigens with the use of the tuberculin skin test or interferon-γ release assays (IGRAs). Studies suggest that active tuberculosis will develop in 5 to 15% of persons with latent infection during their lifetimes 2 (and a higher percentage if the persons are immunocompromised); thus, persons with latent infection serve, according to Osler, as the “seedbeds” of tuberculosis in the community. 3 This article will review the pathogenesis, epidemiology, diagnosis, and treatment of latent tuberculosis infection. It will address critical gaps in the understanding of this complex condition and propose the necessary research agenda.

Global and regional hearing impairment prevalence: an analysis of 42 studies in 29 countries

Abstract: Background: Hearing impairment is a leading cause of disease burden, yet population-based studies that measure hearing impairment are rare. We estimate regional and global hearing impairment prevalence from sparse data and calculate corresponding uncertainty intervals. Methods: We accessed papers from a published literature review and obtained additional detailed data tabulations from investigators. We estimated the prevalence of hearing impairment by region, sex, age and hearing level using a Bayesian hierarchical model, a method that is effective for sparse data. As the primary objective of modelling was to produce regional and global prevalence estimates, including for those regions with scarce to no data, models were evaluated using cross-validation. Results: We used data from 42 studies, carried out between 1973 and 2010 in 29 countries. Hearing impairment was positively related to age, male sex and middle- and low-income regions. We estimated that the global prevalence of hearing impairment (defined as an average hearing level of 35 decibels or more in the better ear) in 2008 was 1.4% (95% uncertainty interval 1.0–2.2%) for children aged 5–14 years, 9.8% (7.7–13.2%) for females >15 years of age and 12.2% (9.7–16.2%) for males >15 years of age. The model exhibited good external validity in the cross-validation analysis, with 87% of survey estimates falling within our final model's 95% uncertainty intervals. Conclusion: Our results suggest that the prevalence of child and adult hearing impairment is substantially higher in middle- and low-income countries than in high-income countries, demonstrating the global need for attention to hearing impairment.