Global and Humanitarian Medicine
Updated WHO Guidelines | COVID-19 boosters no longer routinely recommended for low-risk groups
30 Mar, 2023 | 14:33h | UTCSummary: The WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) has revised its COVID-19 vaccination roadmap in light of the Omicron variant and widespread population immunity. The revised roadmap prioritizes protecting those at the highest risk of severe disease and death while maintaining resilient health systems. It introduces cost-effectiveness considerations for vaccinating lower-risk individuals, such as healthy children and adolescents, and presents revised booster dose recommendations.
Priority groups are categorized as high, medium, and low, based on factors like risk of severe disease and death. People in the high-priority group, consisting of older adults, individuals with significant comorbidities or immunocompromising conditions, pregnant persons, and frontline health workers, are advised to receive additional boosters 6 or 12 months after the last dose. The medium priority group, which includes healthy adults without comorbidities and children with comorbidities, is recommended to receive primary series and first booster doses. However, SAGE no longer routinely recommends additional boosters for this group due to limited public health gains.
For the low-priority group, encompassing healthy children and adolescents, vaccination decisions should take into account factors such as disease prevalence and cost-effectiveness. It is important to note that the public health benefits of vaccinating healthy children and adolescents are considerably lower compared to established essential vaccines for children, like rotavirus, measles, and pneumococcal conjugate vaccines.
News Release: SAGE updates COVID-19 vaccination guidance – World Health Organization
Commentaries:
No More COVID-19 Boosters for Healthy People, WHO Experts Recommend – Health Policy Watch
WHO vaccine advisers update COVID vaccine recommendations – CIDRAP
M-A | The efficacy of Kangaroo-Mother care to the clinical outcomes of LBW and premature infants
21 Mar, 2023 | 13:35h | UTCSummary: Kangaroo-Mother Care (KMC) is a method that involves skin-to-skin contact between the mother and newborn, frequent exclusive or almost exclusive breastfeeding, and early discharge. KMC is an alternative to traditional care interventions for low birthweight (LBW) infants, and the World Health Organization has recommended its use for LBW infants for over a decade.
The authors conducted a meta-analysis including 17 randomized clinical trials involving 17,668 participants. They found that KMC can significantly reduce neonatal mortality, lower hypothermia and sepsis rates, and reduce the duration of hospital stay. The authors suggest that KMC should be promoted, popularized, and standardized in clinical practice.
Related:
Kangaroo mother care to reduce morbidity and mortality in low birthweight infants – Cochrane Library
Analysis | Networks of care to strengthen primary healthcare in resource constrained settings
21 Mar, 2023 | 13:08h | UTCNetworks of care to strengthen primary healthcare in resource constrained settings – The BMJ
Burden, trends, and inequalities of heart failure globally, 1990 to 2019
14 Mar, 2023 | 13:35h | UTC
Evidence for harmful cardiovascular effects of ambient ozone: Insights from a multi-city time-series study in China
14 Mar, 2023 | 13:32h | UTCOzone pollution and hospital admissions for cardiovascular events – European Heart Journal
News Release: Ozone pollution is linked with increased hospitalizations for cardiovascular disease – European Society of Cardiology
The global burden of metabolic disease: data from 2000 to 2019
13 Mar, 2023 | 14:39h | UTCThe global burden of metabolic disease: Data from 2000 to 2019 – Cell Metabolism (free for a limited period)
New WHO guidelines to boost the use of life-saving safety restraints in vehicles
10 Mar, 2023 | 14:40h | UTCNews Release: New global guidelines to boost the use of life-saving safety restraints in vehicles – World Health Organization
WHO urges countries to implement comprehensive sodium reduction policies to combat cardiovascular disease
10 Mar, 2023 | 14:43h | UTCSummary:
A new report from the World Health Organization (WHO) has shown that the world needs to catch up to achieve its global target of reducing sodium intake by 30% by 2025. The report highlights that only 5% of WHO member states have mandatory and comprehensive sodium reduction policies.
Sodium, found in table salt and other condiments, increases the risk of heart disease, stroke, and premature death when eaten in excess. Implementing highly cost-effective sodium reduction policies could save an estimated seven million lives globally by 2030.
WHO suggests a number of policies, such as reducing the amount of sodium in food products, introducing front-of-pack labeling, launching mass media campaigns, and enforcing public policies related to food service and sales.
The report urges member states to implement sodium intake reduction policies without delay, and calls on food manufacturers to set ambitious targets for sodium reduction in their products.
Article: WHO global report on sodium intake reduction – World Health Organization
News Release: Massive efforts needed to reduce salt intake and protect lives – World Health Organization
Related:
Adding salt to foods and hazard of premature mortality – European Heart Journal
New WHO benchmarks help countries reduce salt intake and save lives – World Health Organization
WHO global sodium benchmarks for different food categories – World Health Organization
Commentary on Twitter
Eating too much salt is one of the top risk factors for heart disease, stroke, and death.
WHO’s first global report on sodium intake reduction shows only 5% of WHO Member States are protected by mandatory and comprehensive sodium reduction policies?https://t.co/hiocdiXUiy pic.twitter.com/NXSv0oe7fn
— World Health Organization (WHO) (@WHO) March 9, 2023
Report | Economic impact of overweight and obesity to surpass $4 trillion by 2035
6 Mar, 2023 | 14:32h | UTCSummary:
A recent report from the World Obesity Federation has issued a warning that the number of people worldwide suffering from overweight or obesity could increase significantly by 2035, surpassing the 50% mark. The report, called the World Obesity Atlas 2023, also highlights the significant economic impact of this trend, estimating that the cost of overweight and obesity could reach $4.32tn annually by 2035, equivalent to almost 3% of the global GDP.
The report also identifies two groups that are particularly at risk: children and individuals from lower-income countries. Childhood obesity is a growing concern, as the report predicts it could double by 2035. Additionally, lower-income countries face a rapid increase in obesity prevalence, with nine out of 10 countries with the greatest expected increases in obesity coming from low or lower-middle income countries.
Report: World Obesity Atlas 2023
News release: Economic impact of overweight and obesity to surpass $4 trillion by 2035
Commentary: Report: Obesity could cost the world over $4 trillion a year by 2035 – STAT
Related:
Report: Tenfold increase in childhood and adolescent obesity in four decades
Global cost of obesity-related illness to hit $1.2tn a year from 2025
The Lancet Series: The Double Burden of Malnutrition
Cluster RCT | Effectiveness of a non-physician community health-care provider-led intensive BP intervention vs. usual care on CVD
6 Mar, 2023 | 14:20h | UTCSummary:
The study evaluated the effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention on cardiovascular disease compared to usual care. The trial randomly assigned 326 villages to the intervention or usual care, and recruited individuals aged at least 40 years with hypertension. Trained non-physician community health-care providers initiated and titrated antihypertensive medications according to a simple stepped-care protocol and delivered health coaching for patients in the intervention group during the 36-month follow-up.
The study found that the intervention effectively reduced the risk of cardiovascular disease and all-cause death. There was a significant reduction in systolic blood pressure (23.1 mm Hg) and diastolic blood pressure (9.9 mm Hg) in the intervention group compared to the usual care group, with an increased risk of hypotension in the intervention group.
Article: Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial – The Lancet (link to abstract – $ for full-text)
Related:
Cohort Study: Impact of Community Based Screening for Hypertension in Older Adults
Randomized Trial: Community-Based Interventions to Improve Cardiovascular Risk in High-Risk Patients
Cluster-Randomized Trial of Blood-Pressure Reduction in Black Barbershops
Estimates and projections of the global economic cost of 29 cancers in 204 countries and territories from 2020 to 2050
3 Mar, 2023 | 14:09h | UTCSummary: The study aimed to estimate the global economic cost and distribution of 29 cancers in 204 countries and territories from 2020 to 2050. The study’s findings suggest that the global economic cost of cancers from 2020 to 2050 is estimated at $25.2 trillion. The five cancers with the highest financial costs are tracheal, bronchus, and lung cancer; colon and rectum cancer; breast cancer; liver cancer; and leukemia. China and the US face the highest economic costs, and the financial and health burdens are distributed unequally across countries, world regions, and country income groups.
News Release: The price of cancer – International Institute for Applied Systems Analysis
Commentary on Twitter
The estimated global economic cost of cancers in 2020–2050 is $25.2 trillion, or $2,857 per capita. Global efforts to curb the health and economic burden of cancers are urgently warranted. https://t.co/xAMOGX3Dtl
— JAMA Oncology (@JAMAOnc) February 23, 2023
Mean systolic blood pressure above the control threshold in people with treated uncontrolled hypertension in 55 countries
2 Mar, 2023 | 12:48h | UTC
WHO Report | A woman dies every two minutes due to pregnancy or childbirth
28 Feb, 2023 | 14:04h | UTCSummary: This new report by United Nations agencies shows that a woman dies every two minutes due to pregnancy or childbirth. The report covers maternal deaths from 2000 to 2020 and reveals that maternal deaths either increased or stagnated in nearly all regions of the world, with some regions experiencing major setbacks. The poorest parts of the world and countries affected by conflict continue to have the highest rates of maternal deaths. Severe bleeding, high blood pressure, pregnancy-related infections, complications from unsafe abortion, and underlying conditions aggravated by pregnancy are the leading causes of maternal deaths, which are largely preventable and treatable with access to high-quality healthcare. The COVID-19 pandemic may have further held back progress on maternal health. The report calls for urgent action to ensure every woman and girl has access to critical health services before, during, and after childbirth, so they can fully exercise their reproductive rights.
News Release: A woman dies every two minutes due to pregnancy or childbirth: UN agencies – World Health Organization
Commentaries:
Ambitious goal to slash maternal deaths in jeopardy – Nature
U.N.: Progress on reducing global maternal mortality has stalled since 2015 – STAT
Eight Hundred Women Die Every Day During Pregnancy or Childbirth – Health Policy Watch
WHO Report | Global trends in the 2022-23 Mpox (Monkeypox) outbreak
23 Feb, 2023 | 13:43h | UTCSummary: The report provides an overview of the 2022-23 monkeypox (mpox) outbreak worldwide as reported to WHO as of February 18, 2023. The report focuses on laboratory-confirmed cases and mentions that 86,019 cases and 1,389 probable cases, including 96 deaths, have been reported to WHO from 110 Member States across all 6 WHO regions, including some countries without previously documented mpox transmission. The outbreak primarily affects men who have sex with men, and no signal suggests sustained transmission beyond these networks. The WHO Director-General has determined that this outbreak continues to constitute a public health emergency of international concern and issued revised temporary recommendations in relation to the outbreak.
Report: 2022-23 Mpox (Monkeypox) Outbreak: Global Trends – World Health Organization
Commentary on Twitter
With over 86,000 total cases & 96 related deaths, #mpox outbreak has slowed down but is still ongoing in several countries.
Maintained surveillance & enhanced access to diagnostics, vaccines and treatments are key to stop the disease transmission globally https://t.co/mLHsVoWKBY pic.twitter.com/PcLFQjjrz7
— World Health Organization (WHO) (@WHO) February 21, 2023
M-A | Global and regional prevalence of multimorbidity in the adult population in community settings
22 Feb, 2023 | 12:47h | UTCSummary: The article presents a systematic review and meta-analysis of surveys that estimate the prevalence of multimorbidity among adults in community settings. The study analyzed data from 126 peer-reviewed studies, including nearly 15.4 million people from 54 countries worldwide. The overall global prevalence of multimorbidity was 37.2%, with South America having the highest prevalence, followed by North America, Europe, and Asia. The study also found that females have a higher prevalence of multimorbidity than males, and that more than half of the adult population worldwide above 60 years of age had multimorbid conditions.
Related:
Costs of multimorbidity: a systematic review and meta-analyses – BMC Medicine
Systematic review of high-cost patients’ characteristics and healthcare utilization – BMJ Open
Multimorbidity: a priority for global health research – The Academy of Medical Sciences
The global burden of multiple chronic conditions: a narrative review – Preventive Medicine Reports
Redesigning Care for High-Cost, High-Risk Patients – Harvard Business Review
Multimorbidity: clinical assessment and management – NICE Guideline
Richard Smith: The challenge of high need, high cost patients – The BMJ Blogs
Better Care for People with Complex Needs – Institute for Healthcare Improvement
Trends and predictions of malnutrition and obesity in 204 countries and territories: an analysis of the Global Burden of Disease Study 2019
22 Feb, 2023 | 12:17h | UTC
Perspective | Choosing the right path toward polio eradication
17 Feb, 2023 | 13:18h | UTCChoosing the Right Path toward Polio Eradication – New England Journal of Medicine
Hidden harms of indoor air pollution — five steps to expose them
16 Feb, 2023 | 15:13h | UTCHidden harms of indoor air pollution — five steps to expose them – Nature
Commentary on Twitter
Dirty outdoor air might grab the headlines, but learning how pollutants inside buildings form, accumulate and affect our health is equally crucial, argue Alastair Lewis, Deborah Jenkins and @CMO_England in a @Nature Comment article. https://t.co/C8MrWEwfE2
— Nature Portfolio (@NaturePortfolio) February 8, 2023
SR | The impact of interventions to prevent neonatal healthcare-associated infections in low- and middle-income countries
16 Feb, 2023 | 14:47h | UTC
SR | The impact of antimicrobial stewardship in children in low- and middle-income countries
16 Feb, 2023 | 14:46h | UTC
Eight countries eliminated a neglected tropical disease in 2022
14 Feb, 2023 | 10:45h | UTCEight countries eliminated a neglected tropical disease in 2022 – Nature
Original report: WHO Global report on neglected tropical diseases 2023
The Lancet Series | Breastfeeding 2023
13 Feb, 2023 | 12:52h | UTCHomepage: Breastfeeding 2023 – The Lancet
Editorial: Unveiling the predatory tactics of the formula milk industry
Breastfeeding: crucially important, but increasingly challenged in a market-driven world
Marketing of commercial milk formula: a system to capture parents, communities, science, and policy
Commentaries:
Expert reaction to review of formula baby milk – Science Media Centre
Systematic estimates of the global, regional and national under-5 mortality burden attributable to birth defects in 2000–2019
10 Feb, 2023 | 13:46h | UTC
Spinal cord injury: the global incidence, prevalence, and disability from the Global Burden of Disease Study 2019
9 Feb, 2023 | 13:20h | UTCCommentary: Measures needed to combat growing incidence and burden of spinal cord injury – Spinal News International
Video | Malaria — Epidemiology, treatment, and prevention
8 Feb, 2023 | 12:37h | UTCMalaria — Epidemiology, Treatment, and Prevention | NEJM