741 research outputs found
The impact of the first year of the COVID-19 pandemic on canine rabies control efforts: a mixed-methods study of observations about the present and lessons for the future
No full textAchieving zero human deaths from dog-mediated rabies has been set as a global target for 2030. However, the COVID-19 pandemic has disrupted essential health services across the world, with disproportionate impacts on Neglected Tropical Diseases. Through a mixed-method study using stakeholder questionnaires and in-depth interviews, we examined the scale and nature of disruption from the first year of the pandemic to rabies control programs, and reflected on lessons for the future. Study participants included practitioners and policymakers working in government, academia, international organizations, and the pharmaceutical industry across 48 countries, mainly in Africa and Asia. Mass dog vaccination, essential to rabies control, was most heavily impacted and in 2020, was carried out as planned in just 5% of surveyed countries. Access to post-exposure prophylaxis (PEP) also decreased due to fear of COVID-19 infection and difficulties in reaching health care centers. Dog vaccination and PEP delivery suffered from disruptions to the importation and distribution of vaccines. School closures affected rabies awareness activities and, when public events moved online, they could not reach the most disadvantaged groups. Surveillance, already weak, was severely disrupted by movement restrictions which, together with reduced demand for PEP, exacerbated under-reporting. Participants reported growing complaints around free-roaming dogs, with numbers likely to have increased in some settings. In some countries, dog rabies outbreaks and human rabies cases were already ascribed to the pandemic, but further impacts are likely still to be realized. Meanwhile, decreased demand for PEP from COVID-19 constraints could lead to reduced procurement in future. In the wake of post-COVID-19 demands on health services, there is an opportunity for veterinary services to show leadership in progressing the Zero by 30 agenda, particularly in scaling up mass dog vaccination within and across countries, as well as potential to make better use of community-based vaccinators. Countries must further secure stable procurement of dog and human vaccines, classifying them as essential goods prioritized for import and where needed, through sharing of stocks. Dedicated telemedicine services also show promise, for example through fostering participatory disease surveillance, including Integrated Bite Case Management, and delivering up-to-date instructions on the closest sources of PEP
WHO’s latest rabies recommendations and guidance save lives and reduce the cost of treatment
No full textRabies vaccination is a crucial part of rabies post-exposure prophylaxis (PEP), but it tends to consist of long and costly regimens of intramuscular (IM) injections. Most human rabies deaths are caused by delayed access, unaffordability or ineffective delivery of PEP. Reducing these barriers is crucial to ensure that this incurable yet preventable disease does not cost lives. In 2022, WHO published new guidance towards the introduction or expansion of rabies vaccination into national immunization programmes to systematically drive down human rabies deaths effectively and cost-efficiently. Such guidance grounds on the latest scientific recommendation provided by WHO’s Strategic Advisory Group of Experts in 2018. WHO recommends a shortened 1-week rabies vaccination schedule, with visits on days 0, 3 and 7. On each visit, a 2-site intradermal (ID) injection (using only 0.1 ml of vaccine in each site) is administered. ID administration allows for vials to be shared among several patients within a 6-8 hours timeline. Compared to IM administration, ID is cost- and dose-sparing, even in low-throughput clinics. Additionally, this regimen requires only 3 visits to the healthcare facility, improving patient compliance. However, the uptake of this shortened ID regimen remains limited. It should now be a matter of urgency for Health Ministries in rabies-endemic settings to adopt the WHO-recommended shortened ID vaccination schedule and ensure appropriate medical training to improve PEP delivery. This will enable countries to improve PEP delivery and allow underserved populations to access affordable, life-saving rabies vaccines
Accelerating programmatic progress and access to biologicals for the control of neglected tropical zoonoses
No full textRabies elimination: protecting vulnerable communities through their dogs – Authors' reply
No full textRabies post-exposure prophylaxis delivery to ensure treatment efficacy and increase compliance
No full textObjectives
Since rabies is lethal once symptoms appear, its prevention including community awareness, mass dog vaccination and post-exposure prophylaxis (PEP) is crucial. Although safe and potent rabies vaccines have long been available, the global rabies burden is still high and access to adequately-delivered PEP remains challenging. Here we offer healthcare providers up-to-date, simple, exhaustive, visual guidance on how to perform PEP steps correctly.
Protocol
PEP consists of 1) washing the wound with water and soap for 15 min, 2) assessing the need for rabies biologicals based on specific criteria; 3) administering, if required, rabies immunoglobulin or monoclonal antibodies deep in and around all wounds; 4) starting, if necessary, the WHO-recommended intradermal 1-week vaccination regimen; 5) informing patients adequately throughout the PEP process to increase compliance and avoid dangerous misconceptions about animal bite treatment and rabies risk.
Discussion
The intradermal 1-week vaccination regimen recommended by WHO is as safe as other regimens but carries important cost-, dose- and time-sparing benefits. As fundamental as the correct administration of rabies biologicals is clear doctor-patient communication and sharing of up-to-date knowledge among healthcare professionals.
Conclusions
This resource will help ensuring that no life is lost to rabies, an incurable yet preventable disease
Avant-propos de l’OMS
No full textCet ouvrage rend hommage aux progrès réalisés dans le changement de paradigme pour aborder de façon efficace la santé et le bien-être des personnes et des animaux dans l’environnement qu’ils partagent. Il s’agit d’une ressource précieuse non seulement pour les médecins et les vétérinaires, mais aussi pour l’ensemble de la collectivité qui reconnaît de plus en plus les avantages à relier différentes disciplines et différents secteurs ..
Estimating the burden of human leptospirosis
No full textLeptospirosis, a disease that is often under- or misdiagnosed, significantly impacts human health in many parts of the world and generally affects the most vulnerable communities. Obtaining reliable and comparable information about the occurrence of leptospirosis in populations, and detecting changing trends, are critical for setting policy and public health priorities. Traditional sources of information about the descriptive epidemiology, the disability attributed to leptospirosis infection, and associated risk factors are generally incomplete, fragmented and of uncertain reliability and comparability. Therefore, the global burden of disease concept and methodological framework will be used by the World Health Organization's (WHO) initiative to estimate the global burden of human leptospirosis. The aim of the initiative is to quantify and compare the health of populations by a summary measure of both mortality and disability, the disability-adjusted life year (DALY). WHO has established the Leptospirosis Burden Epidemiology Reference Group (LERG) to coordinate the assessment. The burden estimates provided by the LERG will guide public health policy on leptospirosis disease control and prevention, with the aim of reducing the impact on human healt
Prognostic Molecular Classification of Breast Cancer Based on Features Extracted from a Scale Space
No full textBreast cancer is one of the most prevalent cancers affecting females in the world. In recent years, many cancer researchers have been trying to determine molecular prognosis tools that predict cancer patient treatment response and/or chance of survival. In particular, the determination of gene expression signatures obtained by feature selection methods applied to large microarray datasets has shown potential. The main purpose of this study is to extend these gene signatures and molecular prognostic classifiers by investigating features constructed from a scale-space representation of the microarray data. Here, we construct a scale space by first mapping all genes to a one-dimensional functional space using protein family information. Next, we applied successive smoothing to the expression values resulting in one scale-space representation of the gene expression data from one sample. At the lowest scale, the scale space contains the original gene expression values, whereas at higher scales meta-features are formed, which are weighted sums of groups of genes. To test whether a scale-space representation is useful we performed feature selection and classification on a publicly available breast cancer expression dataset. We found that, instead of signatures consisting of single genes, meta-genes (i.e. groups of genes) that exist at higher scales were preferentially selected. We furthermore determined cross-validation errors using seven distinct classifiers (NMC, LDC, QDC, FISHERC, PARZENC, 3NNC, and LOGLC) and found that better performance is obtained using the scale-space representation than with the traditional representation of the gene expression data. As a result, we conclude that the scale-space analysis constitutes a potent way of selecting molecular signatures and is useful for prognostic classification.Pattern Recognition and BioinformaticsIntelligent SystemsElectrical Engineering, Mathematics and Computer Scienc
Elias Ekdikos as the Author of the Anthologium gnomicum (CPG 7716): A Research Update
No full textDespite different attributions to well-known writers of chapter collections, viz. Maximus the Confessor, John of Karpathos, Nilus of Ancyra, and Symeon the New Theologian, the Anthologium gnomicum (CPG 7716), a collection of ascetic and gnomic chapters from late 11th-early 12th century, should in all likelihood if not with certainty be attributed to Elias Ecdicus. In this article the author has sought to give a survey of the different attributions as well as a further identification of the author named Elias Ecdicus. For this purpose three kinds of sources have been used : the rich manuscript tradition of the Anthologium (12th-19th century), the collection’s reception by later Byzantine authors, and the arguments advanced by scholars from the 17th century up to now.Bien qu’attribué à différents auteurs de recueils de chapitres, à savoir Maxime le Confesseur, Jean de Karpathos, Nil d’Ancyre et Syméon le Nouveau Théologien, l’Anthologium gnomicum (CPG 7716), une collection de chapitres ascétiques et gnomiques de la fin du 11e-début du 12e siècle, doit selon toute vraisemblance, sinon avec certitude, être attribuée à Èlias Ekdikos. Dans cet article, l’auteur enquête sur ces différentes attributions et propose une identification plus poussée de l’auteur nommé Èlias Ekdikos. Dans ce but, trois type de sources ont été utilisées : la riche tradition manuscrite de l’Anthologie (12e-19e s.), la réception de la collection par des auteurs byzantins plus tardifs, et les arguments avancés par les chercheurs du 17e siècle à nos jours.De Ridder Eva. Elias Ekdikos as the Author of the Anthologium gnomicum (CPG 7716): A Research Update. In: Revue des études byzantines, tome 73, 2015. pp. 203-227
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