The global cost of communicable diseases is expected to rise. SARS has put the world on alert. We have now Avian Flu on the watch. Recognizing the global nature of threats posed by new and re-emerging infectious diseases and the fact that many recent occurrences originated in the Asia Pacific regions, there has been an increased interest in learning and knowing about disease surveillance and monitoring progresses made in these regions. Such knowledge and awareness is necessary to reduce conflict, discomfort, tension and uneasiness in future negotiations and global cooperation. Many people are talking about the GIS and public and environmental health. The way we make public policies on health and environmental matters is changing, and there is little doubt that GIS provides powerful tools for visualizing and linking data in public health surveillance. This book is a result of the International Conference in GIS and Health held on 27-29 June 2006 in Hong Kong. The selected chapters are organized into four themes: GIS Informatics; Human and Environmental Factors; Disease modeling; and Public health, population health technologies, and surveillance.
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This document was prepared for the World Health Organization (WHO) Global Malaria Programme by Amy Barrette and Pascal Ringwald and was reviewed by Rick Fairhurst (National Institute of Allergy and Infectious Diseases) Arjen Dondorp (Mahidol–Oxford Tropical Medicine Research Unit); Patrick ; Kachur, John MacArthur, Laurence Slutsker (Malaria Branch, Centers for Disease Control and Prevention); Christopher Plowe (University of Maryland); Christopher Dye, Kamini Mendis, Robert Newman, Peter Olumese, Jackson Sillah and Mariam Warsame (WHO). The Global Malaria Programme wishes to thank the ministries of health, nongovernmental organizations, pharmaceutical companies, public private partnerships, research institutes, subregional networks and WHO regional offices that kindly shared their data. Financial support for the preparation of this document and the WHO global database on antimalarial drug efficacy was provided by the Bill & Melinda Gates Foundation and the United States Agency for International Development
The Stop TB Department of the World Health Organization gratefully acknowledges the members of the Guidelines Group (listed in Annex 6), including Jeremiah Muhwa Chakaya, the Chairperson. Richard Menzies (McGill University, Montreal, Canada), Karen Steingart and Phillip Hopewell (University of California, San Francisco, USA) and Andrew Nunn and Patrick Phillips (British Medical Research Council) led the teams that compiled, synthesized and evaluated the evidence underlying each recommendation. Suzanne Hill and Holger Schünemann facilitated the meeting of the Guidelines Group. Useful feedback was obtained from the External Review Group (also listed in Annex 6). Additional feedback and support were provided by the Guidelines Review Committee (Chair, Suzanne Hill; Secretariat, Faith McLellan). Publication of the guidelines was supported in part by a financial contribution from the Global Fund to Fight AIDS, Tuberculosis and Malaria. The document was prepared by Sarah Royce and Malgorzata Grzemska. Dorris Ortega provided secretarial support.
The primary aim of this report is to share survey and surveillance data on drug resistance in tuberculosis (TB). The data presented here are supplied largely by the programme managers who have led the work on surveys, but also by heads of reference laboratories and by principal investigators who may have been hired to assist the national TB programmes with the study. We thank all of them, and their staff, for their contributions. The World Health Organization/International Union Against Tuberculosis and Lung Disease (WHO/UNION) Global Project on Anti-Tuberculosis Drug Resistance Surveillance is carried out with the financial backing of United States Agency for International Development (USAID) and Eli Lilly and Company as part of the Lilly multidrug resistant (MDR)-TB Partnership. Drug resistance surveys were supported financially by the Dutch Government, the Global Fund, Japan International Cooperation Agency (JICA), Kreditanstalt für Wiederaufbau (KfW Entwicklungsbank), national TB programmes and USAID). The Supranational Reference Laboratory Network provided the external quality assurance, as well as technical support to many of the countries reporting. Technical support for surveys was provided by the Centers for Disease Control and Prevention (CDC), JICA, the Royal Netherlands Tuberculosis Association (KNCV), and WHO. Data for the WHO European Region were collected and validated jointly with EuroTB (Paris) — a European TB surveillance network funded by the European Commission.
A UNIQUE TEXT THAT BRIDGES THE GAP BETWEEN BASIC AND CLINICAL ANATOMY
Filled with 50 cases that consider 130 possible diagnoses, and more than 250 illustrations, this concise, highly accessible book is a must for medical students and professionals preparing for their courses, boards, and practice. With each chapter, you will gain insight into the fundamentals of human anatomy and–just as importantly–its relevance to actual clinical practice. Clinical Anatomy features an intuitive body region organization, which is consistent with the common instructional approach of medical gross anatomy courses. No other guide offers you the opportunity to interact with clinical conditions on a level that so closely approximates clinical practice.
"Background: The global Tuberculosis (TB) control strategy recommended by the WHO, DOTS, is based on identification of sputum smear-positive pulmonary TB cases by self- referral to health services. The target set by the WHO is to detect 70% of all sputum smear- positive TB cases. Currently global case detection is estimated to 40% of an approximated 8.74 million new sputum smear-positive pulmonary TB cases yearly. Vietnam reports to have reached 80% case detection. About 2/3 of the detected and reported TB cases, world-wide and in Vietnam, are men and 1/3 is women. Whether this in all contexts represents a true difference in incidences or if there is an under-detection of female TB cases is not known. Aim: This thesis analyses and assesses how case detection of tuberculosis is influenced by gender as a structural factor, including differences between women and men in tuberculosis epidemiology, and health-seeking behaviour in a low-income setting. Methods: Within the setting of a demographic surveillance site in Bavi district, Northern Vietnam, we performed two cross-sectional population-based surveys (papers I-III). Among 35,000 adults, individuals with cough of more than three weeks’ duration were interviewed about their health seeking behaviour and knowledge in TB characteristics. TB diagnostics were offered to all cases with cough and sputum production (paper III). To explore doctors’ views and explanations for a longer doctor’s delay among female than male TB patients, clinicians in Quang Ninh were interviewed in focus group discussions and in-depth interviews. Content analysis was used to describe the findings (paper IV). In paper V we examined the chest x-rays of 299 men and 67 women diagnosed with sputum smear-positive TB at TB units in four Vietnamese provinces. Results: Crude prolonged cough prevalence was 1.4% and did not differ between men and women. We estimated the true prevalence of sputum smear positive TB in this population to 90/100.000 among men and 110/100.000 among women, representing a male: female ratio of 0.8:1 to be compared with the ratio within the district TB programme of 2.7:1. Case detection of smear-positive TB in this district was low among both men, 39%, and women, 12%. Possible reasons for this under-detection of especially female TB cases could be identified in gender specific barriers faced by the female TB suspect, and in health care providers’ actions. Women took more health care actions than men, but did more often choose to visit unregulated providers where quality has proven to be low. Women spent less per health care action and women reported less knowledge in medical TB characteristics than men. More men than women reported providing a sputum sample for TB diagnosis. The interviewed doctors emphasised their equal treatment of men and women in any situation, though some doctors recognised that gender specific needs might exist among TB suspects. In addition we found chest x-ray presentations to differ among male and female TB patients, with men having more advanced findings, including more frequently pleurosis and miliary disease. Conclusions: So far, the WHO recommended DOTS strategy based on self-referral has prevailed. The under-detection of women found in Bavi highlights a need for a discussion on gender equity aspects of the internationally recommended strategy. We have identified several factors that determine possibilities to get adequate care within the diversified health care system of Vietnam. Gender interacts with poverty and creates a situation in which women more often than men face important barriers towards adequate health care. An increased understanding of the socio-cultural or biological factors in Vietnam, influencing the woman or man with TB should not be regarded as the goal in itself, but rather as a way of identifying processes, leading to the ‘structural violence’, that actually creates inequities detrimental to health.