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1.
Washington, D.C.; OPS; 2022-07-02. (OPS/PHE/IMS/22-0011).
No convencional | PAHO-IRIS | ID: phr-56133

RESUMEN

El propósito de esta publicación es presentar unas orientaciones para el diagnóstico clínico de la viruela símica a fin de ayudar al adecuado manejo de los pacientes y a la aplicación de las prácticas de control de infecciones. Además, dado que la apariencia y evolución de las lesiones cutáneas típicas de esta enfermedad viral son variables, se incluye una selección de fotografías de distintos casos que servirán de ayuda para el diagnóstico diferencial.


Asunto(s)
Viruela de los Simios , Virus de la Viruela del Simio , Virus de la Viruela del Simio , Enfermedades Transmisibles , Orthopoxvirus
2.
Washington, D.C.; PAHO; 2022-07-01. (PAHO/HSS/MT/COVID-19/22-0022).
en Inglés | PAHO-IRIS | ID: phr-56132

RESUMEN

The Pan American Health Organization presents this information sheet with recommendations on the use of molnupiravir addressed to patients. Molnupiravir is a prodrug that significantly inhibits SARS-CoV-2 replication. It is used for the treatment of mild and moderate COVID-19 in patients who are at high risk of complications, and has shown a significant reduction in the rate of hospitalization or death of patients with COVID-19.


Asunto(s)
COVID-19 , SARS-CoV-2 , Profármacos , Embarazo , Accesibilidad a los Servicios de Salud
3.
Washington, D.C.; Organisation panaméricaine de la Santé; 2022-06-30. (OPS/NMH/MH/COVID-19/20-0032).
en Francés | PAHO-IRIS | ID: phr-56131

RESUMEN

La pandémie mondiale de COVID-19 nous a forcés à explorer des options pour fournir des interventions de santé mentale et de soutien psychosocial à distance (numériques ou en ligne), en raison des mesures de santé publique nécessaires pour maintenir la distanciation physique. Dans ce contexte, et si les services de santé mentale nécessitent des professionnels spécialisés ou d’autres prestataires de soins de santé formés en santé mentale, les agents communautaires peuvent fournir des interventions psychosociales telles que les premiers secours psychologiques et le soutien mutuel.


Asunto(s)
COVID-19 , Coronavirus , Pandemias , Factores de Riesgo , Salud Mental , Telemedicina , Teleurgencia , Telemedicina
4.
Artículo en Inglés | PAHO-IRIS | ID: phr-56130

RESUMEN

Dear editor, We read with interest the article entitled “The HEARTS app: a clinical tool for cardiovascular risk and hypertension management in primary health care” by Ordunez and colleagues, published on March 28th, 2022 (1). This article describes a recently developed app to assess cardiovascular disease (CVD) risk, as well as its use, potential functionality, and validation process. Despite the central role of the HEARTS initiative in the Americas and in the vulnerable region of Latin America and the Caribbean (LAC), we believe that the interpretation of the findings of this study requires some caution. There are some methodological issues in this manuscript that could compromise the strong conclusion that “the HEARTS app is an essential step in the journey towards eliminating preventable CVD in the Americas.” First, the risk prediction models that inform this app are derived from 85 cohorts from high-income countries in the Emerging Risk Factors Collaboration study (2). Of these, we were only able to identify the Puerto Rico Heart Health Program study as directly representative of the LAC region. Therefore, the lack of representativeness of the models for risk-prediction should be made more explicit. At the same time, the important role of the STEPwise approach to surveillance to obtain population-level indicators and trends, as well as calibration of the risk-prediction models should be both considered as potential solutions to this issue. Second, the authors state that “the app is intended to be used in clinical practice, especially at the primary health care level” although it can also “be used by anyone in the general population.” If the use of the app is available to the general public, this could systematically exclude underrepresented groups by creating differential engagement and generating digital inequity (3). Hence, the “ideal” target population of the app in low- and middle-income countries should be specified. Third, the language of the article should reflect the uncertainty regarding the long-term success of this digital health application in the region, which will likely depend on how it is implemented and maintained over time, and the promptness of the initiation of effective pharmacological treatment after the obtention of a risk score. Several barriers to the implementation of CVD risk calculators in primary care have been described, including time constraints, lack of electronic health records integration, and patient fears (4). Low-resource contexts potentially require tailoring of the app to address some of these barriers and ensure sustainability. The burden of CVD in LAC, estimated at 3 497.14 disabilityadjusted life years per 100 000 (range, 3 226.2 – 3 790.1), appears to be highly influenced by the years lived with disability due to ischemic heart disease (5) and by the increasing impact of high systolic blood-pressure (≥110-115 mmHg according to the Global Burden of Disease definition) as the leading mortality risk factor in the region. This public health scenario presents both a tremendous challenge and an opportunity for improvement. The HEARTS app is a promising driver of change. However, its validity should be evaluated in view of some methodological caveats and its implementation capacity should stress the letter “A” of its acronym to advocate for equitable “access to essential medicines and technology” in places where the availability and affordability of generic drugs is still scarce. To read the complete letter, please download the manuscript using the link on the left.


Asunto(s)
Enfermedades no Transmisibles , Enfermedades Cardiovasculares , Factores de Riesgo de Enfermedad Cardiaca , Hipertensión , Aplicaciones de la Informática Médica , Calidad de la Atención de Salud , Américas
5.
Artículo en Inglés | PAHO-IRIS | ID: phr-56129

RESUMEN

Dear editor, Thanks for the opportunity to reply to the letter from Muñoz Laguna J and Banegas JR (1) regarding the HEARTS app (2). First, the risk score used in the HEARTS app is utterly based on the World Health Organization Cardiovascular Disease (CVD) Risk Chart Working Group study. It is, so far, the most updated, robust, and accessible CVD risk charts for the low-middle income countries globally (3). Indeed, these risk models were first derived in well-established international cohorts with baseline information on all the risk factor variables for the prediction models, had at least one year of follow-up, and provided detailed information on cause-specific mortality and non-fatal CVD events. Moreover, for the recalibration of the models, age and sex-specific incidences of myocardial infarction and stroke from each of the 21 global regions defined by the Global Burden of Disease were used. This was further completed by averaging country-specific risk factor values from the Non-Communicable Disease Risk Factor Collaboration. Therefore, Latin America and the Caribbean (LAC) regional data was used for calibration if not for the initial derivation models due to the lack of available cohort information from this Region at the study time. Finally, the models underwent external validation using individual participant data from 19 other cohorts. Although these countries did not include any from LAC, the external validation results were robust with good C indices. When available and well-established, prediction models using data from the Region may improve the score over time. The risk prediction models in the future could be further calibrated and revised according to country-specific CVD incidence. In summary, the WHO prediction models used by the HEARTS app offer a simple and reliable estimate for risk estimation for the time being. To read the complete letter, please download the manuscript using the link on the left.


Asunto(s)
Enfermedades no Transmisibles , Enfermedades Cardiovasculares , Factores de Riesgo de Enfermedad Cardiaca , Hipertensión , Aplicaciones de la Informática Médica , Calidad de la Atención de Salud , Américas
6.
Washington, D.C.; PAHO; 2022-06-29. (PAHO/HSS/HS/COVID-19/22-0023).
No convencional en Inglés | PAHO-IRIS | ID: phr-56128

RESUMEN

The COVID-19 pandemic continues to expose the limitations of health systems across the Region of the Americas, and globally. COVID-19 vaccination programs have been rolled out in most countries, but concerns remain in terms of production, delivery, and equitable access. At the same time, new outbreaks and variants continue to emerge. Health systems are therefore still facing a dual burden as they strive to ensure the continuity of essential health services while combating the COVID-19 pandemic. Changes in care provision to meet increased demand for COVID-19 care have challenged local and national capacities to maintain access to essential health services across all priority areas in most countries of the Region. In this context, the World Health Organization (WHO) developed the global pulse survey on continuity of essential health services during the COVID-19 pandemic to help monitor and manage the extent of the disruptions to essential health services caused by the COVID-19 pandemic. The Pan American Health Organization (PAHO) has been supporting the implementation of the survey in the countries of the Region. The three rounds of the survey provide an opportunity to assess how the pandemic’s impact has evolved over time regarding disruptions and rebounds in services and responses, mitigation strategies, and bottlenecks to the implementation of COVID-19 essential tools. During November–December 2021 the third round of the survey was launched, in which 223 countries, territories, and areas were invited to respond to a standardized web-based survey. This report presents the results of the third round of the survey for the countries in the Region of the Americas. It also includes an assessment of trends over time in the continuation of essential health services, where feasible. To ensure coherence and harmonization, this report adopts the structure and content of the WHO global report on the results of the third round of the survey.


Asunto(s)
COVID-19 , Vacunas contra la COVID-19 , COVID-19 , Servicios de Salud , Inmunización , Américas
7.
Washington, D.C.; OPS; 2022-06-29.
en Español | PAHO-IRIS | ID: phr-56127

RESUMEN

Las enfermedades cardiovasculares (ECV) son la principal causa de carga de enfermedad a nivel mundial. Según las estimaciones de la carga mundial de enfermedad del 2017, hubo 14 millones de casos nuevos de ECV, 80 millones de personas con esta afección y casi 1 millón de muertes atribuidas a las ECV en la Región de las Américas. La hipertensión es el principal factor de riesgo de ECV, causante de la mitad de los casos, y tiene una prevalencia alta: afecta a 1 de cada 4 adultos, incluido 40% de los mayores de 25 años. Para detectar adecuadamente la hipertensión, es fundamental que la medición de la presión arterial sea exacta, y su medición incorrecta tiene consecuencias importantes en las políticas para abordar la hipertensión, así como en la seguridad de los pacientes y la calidad de la atención que se les brinda. El Cuarto Foro Global sobre Dispositivos Médicos de la Organización Mundial de la Salud identificó varios problemas críticos relacionados con los dispositivos médicos, entre los cuales figuraban recomendaciones para aumentar la regulación de los dispositivos médicos en los países de ingresos bajos y medianos, así como la elaboración de especificaciones técnicas para optimizar la compra de dispositivos médicos prioritarios. La resolución WHA67.20 de la Asamblea Mundial de la Salud (Fortalecimiento del sistema de reglamentación de los productos médicos) enfatiza la importancia de regular los dispositivos médicos para mejorar los resultados de salud pública y aumentar el acceso a productos médicos seguros, efectivos y de calidad. Esta publicación ayudará a los gobiernos a cumplir esas recomendaciones mediante una herramienta práctica dirigida a mejorar los marcos regulatorios nacionales con el fin de aumentar la exactitud de los dispositivos de medición de presión arterial (DMPA). Además, también contribuirá a que en la atención primaria de salud se empleen de forma exclusiva DMPA automáticos validados para el 2025. Asimismo, puede orientar el desarrollo de mecanismos de compra que garanticen la disponibilidad exclusiva de DMPA en los centros de atención primaria. En concreto, se exponen brevemente los antecedentes de la importancia de utilizar DMPA validados y se destacan algunos elementos clave de las regulaciones relacionadas con la aprobación anterior a la comercialización para promover los DMPA exactos.


Asunto(s)
Enfermedades no Transmisibles , Enfermedades Cardiovasculares , Presión Arterial , Monitores de Presión Sanguínea , Hipertensión , Cardiopatías , Mortalidad , Corazón
8.
Washington, D.C.; PAHO; 2022-06-23.
en Inglés, Español | PAHO-IRIS | ID: phr-56126

RESUMEN

[WEEKLY SUMMARY]. North America: Influenza and SARS-CoV-2 activity remained at low levels. In Mexico, influenza positivity with influenza A(H3N2) viruses predominating increased, and SARS-CoV-2 positivity continues to increase. In the United States, influenza activity decreased overall, with influenza A(H3N2) viruses predominating and SARS-CoV-2 activity increasing. Caribbean: Influenza activity remained at low levels with predominating influenza A(H3N2). SARI activity associated with SARS-CoV-2 activity increased slightly in Haiti. Central America: Influenza and SARS-CoV-2 activity remained low but increased. In Guatemala, ILI activity was at high levels and associated with co-circulation of influenza, SARS-CoV-2, and RSV. In Nicaragua, influenza A(H3N2) activity continues to increase. Andean: Influenza activity remained low with A(H3N2) predominance, and SARS-CoV-2 activity declined in most countries. In Bolivia, SARI activity continue elevated and is associated with the co-circulation of influenza, SARS-CoV-2, and RSV. Brazil and Southern Cone: Influenza with A(H3N2) predominance remained low but continued to increase, and SARS‑ CoV-2 activity remained low but increased slightly. In Chile, influenza and RSV activity continues to increase. In Uruguay, SARI activity was at moderate levels and associated with increased detections of influenza A(H3N2).


[RESUMEN SEMANAL]. América del Norte: la actividad de influenza y SARS-CoV-2 se mantuvo en niveles bajos. En México, aumentó la positividad de influenza con predominio de virus de influenza A (H3N2) y la positividad de SARS-CoV-2 continúa aumentando. En los Estados Unidos, la actividad de la influenza disminuyó en general, predominando los virus de la influenza A(H3N2) y aumentando la actividad del SARS-CoV-2. Caribe: la actividad de la influenza permaneció en niveles bajos con predominio de influenza A(H3N2). La actividad de la IRAG asociada con la actividad del SARS-CoV-2 aumentó ligeramente en Haití. América Central: la actividad de la influenza y del SARS-CoV-2 se mantuvo baja pero aumentó. En Guatemala, la actividad de la ETI estuvo en niveles altos y se asoció con la circulación concurrente de influenza, SARS-CoV-2 y VRS. En Nicaragua continúa aumentando la actividad de influenza A(H3N2). Andina: la actividad de la influenza se mantuvo baja con predominio de A(H3N2), y la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En Bolivia, la actividad de la IRAG continúa elevada y está asociada a la circulación concurrente de influenza, SARS-CoV-2 y VRS. Brasil y Cono Sur: la influenza con predominio A(H3N2) se mantuvo baja pero siguió en aumento, y la actividad del SARS-CoV-2 se mantuvo baja pero aumentó levemente. En Chile, la actividad de la influenza y del VRS continúa aumentando. En Uruguay, la actividad de la IRAG estuvo en niveles moderados y se asoció con mayores detecciones de influenza A(H3N2); la actividad de la IRAG estuvo en niveles moderados y se asoció con mayores detecciones de influenza A(H3N2).


Asunto(s)
Gripe Humana , COVID-19 , SARS-CoV-2 , Betacoronavirus , Reglamento Sanitario Internacional , Américas , Región del Caribe , Gripe Humana , Reglamento Sanitario Internacional , Américas , Región del Caribe
9.
Washington, D.C.; PAHO; 2022-06-15.
en Inglés, Español | PAHO-IRIS | ID: phr-56125

RESUMEN

[WEEKLY SUMMARY]. North America: Influenza and SARS-CoV-2 activity remained at low levels. In Canada, influenza activity with influenza A(H3N2) viruses predominating declined slightly this week. In Mexico, influenza positivity with influenza A(H3N2) viruses predominating increased somewhat. In the United States, influenza activity decreased overall, with influenza A(H3N2) viruses predominating and SARS-CoV-2 activity increasing. Caribbean: Influenza activity remained at low levels with predominating influenza A(H3N2). SARS-CoV-2 activity increased slightly in the Dominican Republic and Saint Lucia. Central America: Influenza and SARS-CoV-2 activity remained low. In Costa Rica and Panama, SARS-CoV-2 activity and percent positivity increased compared to the previous week. In Guatemala, ILI activity was at high levels and associated with co-circulation of influenza, SARS-CoV-2, and RSV. Andean: Influenza activity remained low with A(H3N2) predominance, and SARS-CoV-2 activity declined in most countries. In Bolivia, SARI activity was elevated and associated with co-circulation of influenza, SARS-CoV-2, and RSV. Brazil and Southern Cone: Influenza with A(H3N2) predominance remained low but continued to increase, and SARS‑ CoV-2 activity remained low but increased slightly. In Chile, influenza and RSV activity continues to increase. In Paraguay, SARI activity continues elevated and is associated with the co-circulation of influenza SARS-CoV-2 and RSV. In Uruguay, SARI activity was at moderate levels and associated with increased detections of influenza A(H3N2). Global: Influenza activity continued to decrease, following a peak in March 2022. In some areas, increasing activity has been reported in the temperate southern hemisphere. In the temperate zones of the southern hemisphere, overall influenza activity increased slightly in recent weeks. Detections of influenza A and respiratory syncytial virus (RSV) have risen sharply in some regions of Australia. Influenza detections continued to increase in South Africa though the detections rate was low. In tropical Africa, influenza activity remained low, with influenza A(H3N2) predominant. In Southern and South-East Asia, influenza virus detections were at low levels overall. In Europe, overall influenza activity continues to decline, with influenza A(H3N2) predominant among the subtyped viruses. In Central Asia, no influenza detections were reported. In Northern Africa, Tunisia reported a single influenza B detection. In East Asia, influenza activity of predominantly influenza A(H3N2) increased in the southern provinces of China. Respiratory illness indicators remained elevated in Mongolia, though influenza detections were low. In Western Asia, increased influenza detections were reported in Qatar, with influenza A(H3N2) most frequently detected. Overall COVID-19 positivity from sentinel surveillance increased during the reporting period to approximately 30.0%. The highest increases were observed in the Americas and the Western Pacific regions, where positivity was around 20.0% and 30.0%, respectively. In the other Regions, positivity was around or below 10.0%. Activity from non-sentinel sites was varied, with overall positivity around 15.0%.


[RESUMEN SEMANAL]. América del Norte: la actividad de la influenza y del SARS-CoV-2 se mantuvo en niveles bajos. En Canadá, la actividad de la influenza, con predominio de los virus de la influenza A(H3N2), disminuyó levemente esta semana. En México, la positividad de influenza, con predominio de virus de influenza A(H3N2), aumentó un poco. En los Estados Unidos, la actividad de la influenza disminuyó en general, predominando los virus de la influenza A(H3N2) y aumentando la actividad del SARS-CoV-2. Caribe: la actividad de la influenza permaneció en niveles bajos con predominio de influenza A(H3N2). La actividad del SARS-CoV-2 aumentó levemente en República Dominicana y Santa Lucía. América Central: la actividad de la influenza y del SARS-CoV-2 se mantuvo baja. En Costa Rica y Panamá, la actividad del SARS-CoV-2 y el porcentaje de positividad aumentaron en comparación con la semana anterior. En Guatemala, la actividad de la ETI estuvo en niveles altos y se asoció con la circulación concurrente de influenza, SARS-CoV-2 y VRS. Andina: la actividad de la influenza se mantuvo baja con predominio de A(H3N2), mientras que la actividad del SARS-CoV-2 disminuyó en la mayoría de los países. En Bolivia, la actividad de la IRAG estuvo elevada y se asoció con la circulación concurrente de influenza, SARS-CoV-2 y VRS. Brasil y Cono Sur: la actividad de la influenza se mantuvo baja con predominio A(H3N2) pero siguió en aumento, y la actividad del SARS-CoV-2 se mantuvo baja pero aumentó levemente. En Chile, la actividad de la influenza y del VRS continúa en aumento. En Paraguay, la actividad de la IRAG continúa elevada y está asociada con la circulación concurrente de influenza SARS-CoV-2 y VRS. En Uruguay, la actividad de la IRAG estuvo en niveles moderados y se asoció con mayores detecciones de influenza A(H3N2). Global: la actividad de la influenza continuó disminuyendo, después de un pico en marzo de 2022. En las zonas templadas del hemisferio sur, en general la actividad de la influenza aumentó levemente en las últimas semanas. Las detecciones de influenza A y del virus respiratorio sincitial (VRS) han aumentado considerablemente en algunas regiones de Australia. Las detecciones de influenza continuaron aumentando en Sudáfrica, aunque la tasa de detecciones fue baja. En África tropical, la actividad de la influenza permaneció baja, con predominio de influenza A(H3N2). En el sur y sudeste de Asia, las detecciones del virus de la influenza se mantuvieron en niveles bajos en general. En Europa, la actividad de la influenza sigue disminuyendo; influenza A(H3N2) predominó en las muestras a las que se les determinó el subtipo. En Asia Central, no se informaron detecciones de influenza. En el norte de África, Túnez notificó una sola detección de influenza B. En el este de Asia, la actividad de influenza, predominantemente A(H3N2), aumentó en las provincias del sur de China. Los indicadores de las enfermedades respiratorias se mantuvieron elevados en Mongolia, aunque las detecciones de influenza fueron bajas. En Asia occidental, se notificó un aumento de las detecciones de influenza en Qatar, detectándose con mayor frecuencia influenza A(H3N2). En general, durante el período del informe, en la vigilancia centinela la positividad de la COVID-19 aumentó a aproximadamente el 30%. Los mayores aumentos se observaron en las regiones de las Américas y del Pacífico Occidental, donde la positividad estuvo alrededor del 20,0 % y del 30,0 %, respectivamente. En las demás Regiones, la positividad estuvo alrededor o por debajo del 10,0 %. La actividad de los sitios no centinela fue variada, con una positividad general alrededor del 15,0 %.


Asunto(s)
Gripe Humana , SARS-CoV-2 , COVID-19 , Betacoronavirus , Reglamento Sanitario Internacional , Américas , Región del Caribe , Gripe Humana , Reglamento Sanitario Internacional , Américas , Región del Caribe
10.
Washington, D.C.; OPS; 2022-06-28.
en Español | PAHO-IRIS | ID: phr-56124

RESUMEN

Los riesgos para la salud pública relacionados con emergencias y desastres derivan de la interacción de amenazas biológicas, tecnológicas, sociales o naturales con las comunidades. Si estos riesgos no se manejan con eficacia, pueden tener importantes consecuencias a corto y a largo plazo en los planos individual, comunitario, municipal, nacional y mundial. La Herramienta Estratégica para la Evaluación de Riesgos (STAR) ofrece un conjunto integral de herramientas fáciles de usar y un método para que los gobiernos nacionales y subnacionales puedan hacer rápidamente una evaluación estratégica de los riesgos para la salud pública, basada en la evidencia, a fin de planificar y priorizar las actividades de preparación para emergencias de salud y gestión del riesgo de desastres.


Asunto(s)
Urgencias Médicas , Medición de Riesgo , Administración de Desastres , Emergencias en Desastres , Defensa Civil
11.
Washington, D.C.; PAHO; 2022-06-27.
No convencional en Inglés | PAHO-IRIS | ID: phr-56123

RESUMEN

The 2030 Agenda for Sustainable Development (2030 Agenda) established in 2015 sets guiding principles to “achieve a better and more sustainable future for all.” The Sustainable Development Goals (SDGs) included in the 2030 Agenda make explicit what this means by specifying relevant statistical indicators and setting clearly defined targets in them to be achieved by 2030. Given the emphasis on the collection and availability of SDG-related data, it is possible to track universal progress towards the SDG targets. One of the SDGs, SDG 3, includes targets to improve health and well-being. In general, SDG health-related indicators measure health outcomes and coverage at the country level by employing averages. However, given the nature of the data, inequalities in health outcomes and the access to health services tend to be masked. Since it is important to strive for gains in health and well-being to be equitably distributed among individuals regardless of their wealth, educational attainment, and other factors relating to their social background, it is essential to first identify and quantify existing social inequalities in health. To this end, this publication provides an overview of social inequalities in several indicators related to the health of women, children, and adolescents in a region deemed as one with high levels of inequality: the Latin America and the Caribbean (LAC) region. In order for it to serve as a baseline for the 2030 Agenda, emphasis is placed on examining these inequalities around year 2014. The analysis suggests that reducing within-country disparities is a priority, as widespread social inequalities in health are identified among LAC countries.


Asunto(s)
Salud del Niño , Salud Materna , Salud de la Mujer , Salud del Adolescente , Desarrollo Sostenible , Factores Socioeconómicos , Américas , Región del Caribe
12.
Washington, D.C.; OPS; 2022-06-28.
en Español | PAHO-IRIS | ID: phr-56121

RESUMEN

Las leishmaniasis son enfermedades infecciosas desatendidas de gran importancia en la Región de las Américas debido a su morbilidad, mortalidad y amplia distribución geográfica. De las tres formas clínicas principales, la cutánea es la más común y la visceral es la forma más grave, ya que puede causar la muerte de hasta 90% de las personas que no reciban tratamiento. En el 2013, la Organización Panamericana de la Salud (OPS) elaboró recomendaciones para el tratamiento de las leishmaniasis en la Región de las Américas utilizando la metodología de clasificación de la valoración, la elaboración y la evaluación de las recomendaciones (GRADE, por su sigla en inglés). No obstante, dada la evidencia acumulada desde entonces, se hizo necesario revisar esas recomendaciones. En esta segunda edición se presentan las recomendaciones actualizadas sobre el tratamiento de las leishmaniasis, y se detallan los esquemas y los criterios de indicación del tratamiento en el contexto regional. Estas directrices presentan modificaciones sustanciales con respecto a la primera edición. En el caso de la leishmaniasis cutánea, se ha eliminado el ketoconazol de las opciones terapéuticas, el número de especies de Leishmania para las que hay evidencia sólida de la eficacia de la miltefosina ha aumentado de dos a cuatro y la recomendación de administrar antimoniales intralesionales ahora es fuerte. Con respecto a la leishmaniasis mucosa, se incluye una recomendación fuerte sobre el uso de antimoniales pentavalentes con o sin pentoxifilina oral. Por lo que respecta a la leishmaniasis visceral, la recomendación fuerte sobre el uso de antimoniales pentavalentes y desoxicolato de anfotericina B ahora es condicional. También hay evidencia contundente en contra del uso de miltefosina en pacientes con leishmaniasis causada por Leishmania infantum. Otros cambios importantes son el desglose de las recomendaciones según si se trata de pacientes adultos o pediátricos, la inclusión de las especies de Leishmania y, en el caso de los pacientes inmunocomprometidos, la introducción de una recomendación fuerte contra el uso de antimoniales pentavalentes.


Asunto(s)
Leishmaniasis , Leishmaniasis Visceral , Leishmaniasis Mucocutánea , Leishmaniasis Cutánea , Enfermedades Desatendidas , Enfermedades Transmisibles , Américas
13.
Washington, D.C.; PAHO; 2022-06-28.
en Inglés | PAHO-IRIS | ID: phr-56120

RESUMEN

Leishmaniases are neglected infectious diseases of great importance in the Americas because of their morbidity, mortality, and wide geographical distribution. Out of the three main clinical forms of leishmaniasis, cutaneous leishmaniasis is the most common and the visceral form is the most severe, causing death in up to 90% of untreated people. In 2013, the Pan American Health Organization (PAHO) developed recommendations for the treatment of leishmaniases in the Americas using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology. However, given the new evidence that has accumulated since that time, there was a need to revise those recommendations. This second edition presents updated therapeutic recommendations for leishmaniases, detailing the treatment indications, criteria and schemes in the regional context. These guidelines include several notable changes from the first edition. For cutaneous leishmaniasis, ketoconazole has been removed from the list of treatment options; the number of Leishmania species for which there is strong evidence for the efficacy of miltefosine has increased from two to four; and the recommendation for intralesional antimonials is now strong. For mucosal leishmaniasis there is now a strong recommendation for use of pentavalent antimonials with or without oral pentoxifylline. For visceral leishmaniasis, the strong recommendations for use of pentavalent antimonials and amphotericin B deoxycholate are now conditional. For miltefosine, there is strong evidence against its usage in patients with leishmaniasis caused by Leishmania infantum. Further important changes include the division of recommendations by adult and pediatric populations, the addition of Leishmania species, and for immunocompromised patients, a strong recommendation against the use of pentavalent antimonials.


Asunto(s)
Leishmaniasis , Leishmaniasis Visceral , Leishmaniasis Mucocutánea , Leishmaniasis Cutánea , Enfermedades Desatendidas , Enfermedades Transmisibles , Américas
14.
Washington, D.C.; PAHO; 2022-06-04.
en Inglés | PAHO-IRIS | ID: phr-56119

RESUMEN

Following an outbreak of a novel Coronavirus (COVID-19) in Wuhan City, Hubei Province of China, rapid community, regional and international spread occurred with exponential growth in cases and deaths. On 30 January 2020, the Director-General (DG) of the WHO declared the COVID-19 outbreak a public health emergency of international concern (PHEIC) under the International Health Regulations (IHR) (2005). The first case in the Americas was confirmed in the USA on 20 January 2020, followed by Brazil on 26 February 2020. Since then, COVID-19 has spread to all 56 countries and territories in the Americas. SITUATION IN NUMBERS IN THE AMERICAS as of 3 June 2022: 157,660,472 Total REPORTED cases; 2,746,686 Total REPORTED deaths; 1,871,173,262 Vaccine doses administered.


Asunto(s)
COVID-19 , Coronavirus , Infecciones por Coronavirus , Betacoronavirus , Análisis de la Situación , Urgencias Médicas , Américas , Región del Caribe
15.
Washington, D.C.; OPS; 2022-06-22. (OPS/FPL/IM/22-0018).
en Francés | PAHO-IRIS | ID: phr-56117

RESUMEN

Le virus de la variole du singe est un orthopoxvirus qui provoque une maladie dont les symptômes sont similaires, mais moins graves, à ceux de la variole. Alors que la variole a été éradiquée en 1980, la variole du singe continue d'être présent dans les pays d'Afrique centrale et occidentale. Deux clades distincts sont identifiés : le clade ouest-africain et le clade du bassin du Congo. La variole du singe est une zoonose. Les cas sont souvent observés en proximité des forêts tropicales humides où divers animaux sont porteurs du virus, notamment les écureuils, les rongeurs, les loirs et les singes. La plupart des infections humaines par le virus de la variole du singe dans les pays endémiques résultent d'une transmission primaire de l'animal à l'homme. La transmission interhumaine existe, la plus longue chaîne de transmission documentée étant de six générations. La transmission se fait par contact avec les fluides corporels, les lésions sur la peau ou sur les surfaces muqueuses internes, comme dans la bouche ou la gorge, les gouttelettes respiratoires et les objets contaminés. Il faut éviter tout contact étroit avec des personnes infectées ou des matériaux contaminés. Bien que la transmission d'homme à animal soit rare, elle doit être considérée comme un lien possible dans la chaîne de transmission. La variole du singe est endémique en Afrique centrale et occidentale depuis sa première détection en 1958 en la République Démocratique du Congo. Néanmoins, depuis le 13 mai 2022, cependant, plusieurs pays d'Europe ont signalé l'apparition soudaine et inattendue de la variole du singe. À ce jour, 27 pays non endémiques répartis dans quatre régions de l'OMS ont signalé des cas. Parmi ceux-ci, quatre sont des pays des Amériques. Plusieurs cas suspects dans ces pays et dans d'autres sont en cours d'investigation. Le Groupe consultatif technique (GCT) sur les maladies évitables par la vaccination s'est réuni le 31 mai 2022 afin de discuter des implications de la variole du singe dans la Région des Amériques. Le rapport résume les données épidémiologiques à ce jour, passe en revue les informations disponibles sur les vaccins contre la variole du singe, et fournit des recommandations aux États Membres des Amériques sur les stratégies pour minimiser la transmission virale et aborder les opérations de vaccination.


Asunto(s)
Virus de la Viruela del Simio , Enfermedades Prevenibles por Vacunación , Comités Consultivos , Orthopoxvirus , Enfermedades Transmisibles
16.
Washington, D.C.; OPS; 2022-06-22. (OPS/FPL/IM/22-0018).
en Español | PAHO-IRIS | ID: phr-56116

RESUMEN

El virus de la viruela símica es un Ortopoxvirus que causa una enfermedad con síntomas similares, pero menos graves, a los de la viruela. Aunque la viruela fue erradicada en 1980, la viruela símica sigue apareciendo en países de África central y occidental. Se han identificado dos clados distintos: el clado de África occidental y el clado de la cuenca del Congo. La viruela símica es una zoonosis. Los casos suelen encontrarse cerca de las selvas tropicales, donde varios animales son portadores del virus, como las ardillas, los roedores, los lirones y los monos. La mayoría de las infecciones humanas por viruela símica en los países endémicos son el resultado de una transmisión primaria de animal a humano. La transmisión de persona a persona se produce, siendo la cadena de transmisión más larga documentada de seis generaciones. La transmisión se produce a través del contacto con fluidos corporales, lesiones en la piel o en superficies mucosas internas, como en la boca o la garganta, gotas respiratorias y objetos contaminados. Debe evitarse el contacto estrecho con personas infectadas o materiales contaminados. Aunque la transmisión de persona a animal es rara, debe considerarse como un posible eslabón en la cadena de transmisión. La viruela símica ha sido endémica en África central y occidental desde su primera detección en 1958 en la República Democrática del Congo. Sin embargo, desde el 13 de mayo de 2022, múltiples países de Europa han notificado la aparición repentina e inesperada de la viruela símica. Hasta la fecha, 27 países no endémicos de cuatro regiones de la OMS han notificado casos. De ellos, cuatro son países de las Américas. Actualmente se están investigando múltiples casos sospechosos en estos y otros países. El Grupo Técnico Asesor (GTA) sobre Enfermedades Prevenibles por Vacunación de la OPS se reunió el 31 de mayo del 2022 para discutir las implicaciones de la viruela símica en la Región de las Américas. El informe los datos epidemiológicos hasta la fecha, revisa la información disponible sobre las vacunas contra la viruela símica y ofrece recomendaciones a los Estados Miembros de las Américas sobre cómo minimizar la transmisión viral y enfocar las operaciones de vacunación.


Asunto(s)
Viruela de los Simios , Virus de la Viruela del Simio , Virus de la Viruela del Simio , Enfermedades Transmisibles , Orthopoxvirus
17.
Washington, D.C.; PAHO; 2022-06-21.
en Inglés | PAHO-IRIS | ID: phr-56113

RESUMEN

Since the onset of the pandemic in 2020 and up to June 21, 2022, a cumulative total of approximately 537 million COVID-19 cases including about 6.3 million deaths were reported from all six WHO regions. During the epidemiological week (EW) 24, cases increased in the regions of Europe (5.8%), Eastern Mediterranean (45.2%), and South-East Asia (45.8%) while they decreased in the remaining three WHO regions. COVID-19 deaths decreased in all WHO regions except for the region of South-East Asia (3.4% increase). Globally, approximately 3,369,753 new COVID-19 cases were reported in EW 24 (June 12, 2022-June 18, 2022) - a -4.3% decrease compared to EW 23 (June 05, 2022-June 11, 2022) (Figure 1). For the same period, 7,762 new COVID-19 deaths were reported globally – a - 13.6% relative decrease compared to the previous week. In the region of the Americas, 1,179,055 cases and 3,608 deaths were reported in EW 24 - an 8.2% decrease in cases and -7% decrease in deaths compared to the previous week. At the subregional level, COVID-19 cases decreased in all subregions (range: -17.2% - - 4.5%). COVID-19 Deaths increased in two subregions – Central America (20.6%) and Caribbean and Atlantic Ocean Islands (1.8%). The overall weekly case notification rate for the region of the Americas was 115.3 cases per 100,000 population during EW 24 (125.6 the previous week). Between EW 24 and 23, the 14- day COVID-19 death rate was 7.3 deaths per 1 million population (7.2 the previous two weeks). Among 32 countries/territories in the region with available data, COVID-19 hospitalizations increased in 16 countries and territories (range: 1.4% - 100%) during EW 24 compared to the previous week. Among 24 countries and territories with available data, COVID-19 ICU admissions increased in 13 countries and territories (range: 4.1% - 300%).


Asunto(s)
COVID-19 , SARS-CoV-2 , Coronavirus , Infecciones por Coronavirus , Betacoronavirus , Vacunas , Cobertura de Vacunación , Inmunización , Genómica , Urgencias Médicas , Américas , Región del Caribe
18.
Washington, D.C.; PAHO; 2022-06-14.
en Inglés | PAHO-IRIS | ID: phr-56112

RESUMEN

Since the onset of the pandemic in 2020 and up to June 14, 2022, a cumulative total of approximately 533.4 million COVID-19 cases including about 6.3 deaths were reported from all six WHO regions. During epidemiological week (EW) 23, cases increased in four WHO regions (range: 0.6 – 33.4%) while they declined in the regions of Africa (-5.7%) and Western Pacific (- 8.1%). COVID-19 deaths increased in the regions of the Americas (19.4%) and Western Pacific (16.5%) while they decreased in the remaining four WHO regions (range: -31.9 - -11.3%). Globally, approximately 3,334,244 new COVID-19 cases were reported in epidemiological week (EW) 23 (June 05, 2022-June 11, 2022) - a 2.9% increase compared to EW 22 (May 29, 2022- June 04, 2022) (Figure 1). For the same period, 8,923 new COVID-19 deaths were reported globally – a 5.5% relative increase compared the previous week. In the region of the Americas, 1,269,855 cases and 4,069 deaths were reported in EW 23 - a 12% increase in cases and 19.4% increase in deaths compared to the previous week. At the subregional level, COVID-19 cases increased in all subregions (range: 3.7 – 20.3%) with the exception of Central America (-32.3%). COVID-19 deaths increased in two subregions – North America (20%) and South America (33.6%). The overall weekly case notification rate for the region of the Americas was 125 cases per 100,000 population during EW 23 (110.5 the previous week). Between EW 23 and 22, the 14-day COVID-19 death rate was 7.3 deaths per 1 million population (7.5 the previous two weeks). Among 34 countries/territories in the region with available data, COVID-19 hospitalizations increased in 15 countries and territories (range: 2% - 100%) during EW 23 compared to the previous week. Among 26 countries/territories with available data, COVID-19 ICU admissions increased in 10 countries/territories (range: 4.2% - 400%).


Asunto(s)
COVID-19 , SARS-CoV-2 , Coronavirus , Infecciones por Coronavirus , Betacoronavirus , Vacunas , Cobertura de Vacunación , Inmunización , Genómica , Urgencias Médicas , Américas , Región del Caribe
19.
Washington, D.C.; PAHO; 2022-06-07.
en Inglés | PAHO-IRIS | ID: phr-56111

RESUMEN

Since the onset of the pandemic in 2020 and up to June 07, 2022, a cumulative total of approximately 530 million COVID-19 cases including about 6.3 million deaths were reported from all six WHO regions. During epidemiological week (EW) 22, cases increased in the regions of Europe (18.7%), the Americas (3.7%), and South-East Asia (1.2%) while they decreased in the remaining three WHO regions. COVID-19 deaths decreased in all WHO regions (range: -26.5 - -12.8%) except for the Western Pacific region (7.2% increase) compared to the previous week. Globally, approximately 3,113,507 new COVID-19 cases were reported in EW 22 (May 29, 2022- June 04, 2022) - a -8.2% decrease compared to EW 21 (May 22, 2022-May 28, 2022) (Figure 1). For the same period, 7,992 new COVID-19 deaths were reported globally – a -18.7% relative decrease compared to the previous week. In the region of the Americas, 1,124,932 cases and 3,304 deaths were reported in EW 22 - a 3.7% increase in cases and -21.8% decrease in deaths compared to the previous week. At the subregional level, COVID-19 cases increased in two subregions - South America (26.5%) and Central America (4.7%) while they decreased in North America (-4.4%) and the Caribbean and Atlantic Ocean Islands (-5.7%). COVID-19 deaths declined in all but one subregion - Caribbean and Atlantic Ocean Islands (11.2%) during EW 22 compared to the previous week. The overall weekly case notification rate for the region of the Americas was 110 cases per 100,000 population during EW 22 (106.1 in the previous week). Between EW 22 and 21, the 14-day COVID-19 death rate was 7.4 deaths per 1 million population (7.7 in the previous two weeks). Among 33 countries/territories in the region with available data, COVID-19 hospitalizations increased in 20 countries and territories (range: 0.3% - 100%) during EW 22 compared to the previous week. Among 28 countries and territories with available data, COVID-19 ICU admissions increased in 15 countries and territories (range: 2.2% - 200%).


Asunto(s)
COVID-19 , SARS-CoV-2 , Coronavirus , Infecciones por Coronavirus , Betacoronavirus , Vacunas , Cobertura de Vacunación , Inmunización , Genómica , Urgencias Médicas , Américas , Región del Caribe
20.
Washington, D.C.; PAHO; 2022-06-01.
en Inglés | PAHO-IRIS | ID: phr-56110

RESUMEN

Since the onset of the pandemic in 2020 and up to June 1, 2022, a cumulative total of approximately 527 million COVID-19 cases including nearly 6.3 million deaths were reported from all six WHO regions. During the epidemiological week (EW) 21, cases increased in the regions of Europe (1.4%) and the Americas (10.3%) while they decreased in the remaining four WHO regions. COVID-19 deaths increased in the regions of Africa (15.2%), the Americas (14.2%), and Western Pacific (18.3%) while they decreased in the remaining three WHO regions. Globally, approximately 3,331,171 new COVID-19 cases were reported in epidemiological week (EW) 21 (May 22, 2022-May 28, 2022) - a -11.4% decrease compared to EW 20 (May 15, 2022- May 21, 2022) (Figure 1). For the same period, 9,635 new COVID-19 deaths were reported globally – a 2 % relative decrease compared to the previous week. In the region of the Americas, 1,087,197 cases including 4,159 deaths were reported in EW 21 - a 10.3 % and 14.2 % increase in cases and deaths respectively compared to the previous week. At the subregional level, COVID-19 cases and deaths increased in all subregions (range: cases; 2.9-43.1%, deaths; 14.1-21.3% increase) with the exception of the Caribbean and Atlantic Ocean Islands, where there was a decrease in cases (8.9%) and no change in deaths (0%). The overall weekly case notification rate for the region of the Americas was 106.3 cases per 100,000 population during EW 21 (96.3 the previous week). Between EW 21 and 20, the 14-day COVID-19 death rate was 7.6 deaths per 1 million population (7.1 the previous two weeks). Among 32 countries/territories in the region with available data, COVID-19 hospitalizations increased in 11 countries/territories (range: 0.1% - 119.4%) during EW 21 compared to the previous week. Among 28 countries/territories with available data, weekly COVID-19 ICU admissions increased in 11 countries/territories (range: 2.6% - 900%).


Asunto(s)
COVID-19 , SARS-CoV-2 , Coronavirus , Infecciones por Coronavirus , Betacoronavirus , Vacunas , Cobertura de Vacunación , Inmunización , Genómica , Urgencias Médicas , Américas , Región del Caribe
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