WHO directory
Contact information for regional and field offices.
WHO European Regional Office
Major Publications
World Health Report
The World Health Report 2000 Health Systems: Improving Performance is an expert analysis of the increasingly important influence of health systems in the daily lives of people worldwide.
Previous World Health Reports
Fifty
facts from the World Health Report 1998
Global health situation and trends 1955-2025 - Population: 1. The global population was 2.8 billion in 1955 and is 5.8 billion now. It will increase by nearly 80 million
people a year to reach about 8 billion by the year 2025.
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WHO Report on Infectious Diseases
Illness and death from infectious diseases can be, in most cases, avoided at an affordable
cost. Those who have received this report have a unique responsibility, as they are leaders in society who can make a substantial contribution to the prevention and control of infectious diseases.
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url: http://www.who.int/infectious-disease-report/index-rpt99.html
Health and Environment in Sustainable Development:
This is an executive summary of the WHO report Health and Environment in Sustainable Development: Five Years after the Earth Summit. The summary contains extracts from the report, selected figures and tables, and the conclusions in full. To promote ease of reference, section headings and numbers of figures and tables have been maintained as used in the report. Bibliographic references have been excluded, however.
The report is a contribution by WHO to the five-year follow-up to the Earth Summit. This anniversary has provided an opportunity to assess the impact made by environmental health activities at local, national and global level during this period. The book brings together systematically quantitative data on health-and-environment linkages at the global level, with examples from regions and countries. Such linkages have already been described in the 1972 WHO report Health hazards of the human environment and in the
1992 WHO report Our planet, our health, but new information and new ways of considering health and environment issues have since emerged and form the basis of this report.
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url: http://www.who.int/environmental_information/Information_resources/htmdocs/execsum.htm
Dr. Gro Harlem Brundtland, Director-General, World Health Organization -
Speeches
Health for the 21st Century
Breaking the Poverty Cycle:
Investing in Early Childhood
Weather, Climate and Health
Science and Health: WHO's
Perspective
Epidemic of Tuberculosis – A Global Threat
How
far have we come and where should we be going?
Global
Trends in Child Health
Other WHO reports
Documentation Centres
World Health Assembly Documentation
Documentation related to the World Health Assembly. Available in multiple
languages.
About WHO
The World Health Organization
Headquarters Office in Geneva (HQ)
Avenue Appia 20
1211 Geneva 27
Switzerland
Telephone: (+00 41 22) 791 21 11
Facsimile (fax): (+00 41 22) 791 3111
Telex: 415 416
Telegraph: UNISANTE GENEVA
Internet email
Regional and Other Offices
About WHO: Diarrhoeal
Diseases
About WHO: Diarrhoeal
Diseases
Annually, at least 1 500 million episodes of diarrhoea occur in
children under the age of five. An estimated 4 million children die each year
as a result. Diarrhoea removes essential body fluids and vital nutrients,
producing dehydration and Malnutrition.
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url: http://www.who.int/aboutwho/en/preventing/diarrhoeal.htm
About WHO : Integrated Management of Childhood Illness
Every year some 12 million children die before they reach their fifth birthday, many of them during the first year of life. Seven in every ten of these child deaths are due to diarrhoea, pneumonia, measles, malaria or malnutrition
- and often to a combination of these conditions. At least three out of four children taken to health facilities for care are suffering from one of these five conditions.
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url: http://www.who.int/aboutwho/en/preventing/integratedm.htm
About WHO: Preventing and
Controlling Specific Health Problems
Vaccine-preventable diseases, Tropical
diseases, Malaria, Tuberculosis, Diarrhoeal diseases, Acute respiratory infections,
Integrated management of childhood illness, HIV/AIDS, Sexually transmitted
diseases, New and emerging infectious diseases, heart disease, mental
health
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url: http://www.who.int/aboutwho/en/preventing/preventing.htm
About WHO: Food
Safety
Food safety Hundreds of millions of people suffer from communicable diseases
caused by contaminated food (including drinking water), which can be a major
vehicle for cholera and other forms of epidemic diarrhoeal diseases, resulting
in some 3 million deaths each year. Up to 70% of diarrhoea episodes in infants
may be food borne in origin.
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url: http://www.who.int/aboutwho/en/promoting/food.htm
About WHO: Monitoring the Environment
Access to safe drinking-water is essential for health and well-being. Since the end of the International Drinking Water Supply and Sanitation Decade (1981-1990), progress and investments in reaching the rural and periurban poor have been lagging. Over 1 000 million people do not have even minimal facilities for sanitary excreta disposal. More than 2.5 million infants and young children die each year from diarrhoeal diseases related to unsafe and poor sanitation, while approximately 1 500 million people are infected by intestinal worms resulting from
faecal-oral contamination.
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url: http://www.who.int/aboutwho/en/promoting/monitor.htm
Integrated Management of Childhood Illness (IMCI)
Integrated Management of the Sick Child
While a great deal has been learned from disease-specific control programmes during the past 15 years, the challenge remained of how to combine the lessons learned into a single method for more efficient and effective management of childhood illness. WHO and UNICEF responded by jointly developing an approach referred to as integrated management of the sick child.
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url: http://www.who.int/inf-fs/en/fact096.html
Reducing mortality from major killers of children
Each year, more than eleven million children die from the effects of disease and inadequate nutrition. In some countries, more than one in five children die before they reach their fifth birthday, and many of those who do survive are unable to grow and develop to their full potential.
Seven out of 10 of childhood deaths in developing countries can be attributed to just five main causes, or often to a combination of them: pneumonia, diarrhoea, measles, malaria and malnutrition. Around the world, three out of every four children seen by health services are suffering from at least one of these conditions.
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url: http://www.who.int/inf-fs/en/fact178.html
Child Health Division
WHO
Child Health and Development
Integrated Management of Childhood Illness, Acute Respiratory Infections, Diarrhoeal Diseases Cholera Documents, FAQ's, Links, Search, CHD IntraNet
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url: http://www.who.int/chd/
Links to Child Health Resources
Division of Child Health and Development (CHD) World
Health Organization
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url: http://www.who.int/chd/links/linkmenu.htm
Division of Diarrhoeal and Acute Respiratory Disease
Control
Diarrhoea and acute respiratory infections each kill more children under 5 than any other disease. The
World Health Organization (WHO) estimates that in 1990 diarrhoea caused 3.2 million deaths in this age
group and acute respiratory infections (ARI) a further 4.3 million deaths.
These 7.5 million deaths accounted for over half of all deaths among children under 5.
Some of the ARI-related deaths were due to the respiratory manifestations of two diseases preventable by
immunization: measles and whooping cough, but the vast majority were due to pneumonia. Half of the
diarrhoea deaths were due to dehydration. Almost all of the deaths could have been prevented with simple,
cheap treatment.
Each year children under 5 throughout the world suffer over 1.3 billion episodes of diarrhoea and 40 million
episodes of pneumonia. For those who survive, these illnesses are major factors in their poor nutritional
state.
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url: http://www.who.int/chd/publications/cdd/pofact77.htm
CHD
programme report 1996
This interim report covers 1996, the first year of the current biennium. A more complete report of the
Division's activities will be prepared at the end of the biennium. The report describes the activities of the
WHO Headquarters' Division of Child Health and Development (CHD) and of its counterparts in the WHO
regional offices and in countries.
Introduction
I. Technical Support to Countries
II. Health Systems Practices and Programme Managemant Methods
III. Family and Community Practices
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url: http://www.who.int/chd/report/intro.htm
Oral Rehydration
Rice-based
ORS
Oral rehydration therapy (ORT) using the WHO/UNICEF glucose-based Oral Rehydration Salts (ORS)
solution is the preferred method for treating most children with dehydration due to diarrhoea (except those
with severe dehydration); it has been used successfully in millions of cases worldwide. In many countries
glucose-ORS solution is also recommended for home treatment of children with diarrhoea after they have
been seen at a health facility, even when there are no signs of dehydration. Glucose-ORS solution works
because glucose is rapidly absorbed by most patients with diarrhoea, and this causes salt and water also to
be absorbed, thus replacing the faecal losses.
Although glucose-ORS solution efficiently replaces faecal losses of water and salts, it has one important
shortcoming: it does not reduce stool volume during diarrhoea or shorten the duration of the illness, which
are the results that mothers and many health workers seek. If an ORS formulation could be developed that
had the positive features of the standard glucose-ORS, including low cost safety, and stability during
prolonged storage, but also appreciably reduced the rate of stool loss during illness and/or the duration of
diarrhoea, it could have considerable advantages over glucose-ORS. Most importantly, it could be promoted
as having a true antidiarrhoeal effect, which should lead to increased acceptance and use of ORS by both
health workers and mothers, and perhaps also to a reduction in the use of ineffective
"antidiarrhoeal" drugs
and inappropriate antibiotics. This would represent a major advance in efforts to control diarrhoeal
morbidity and mortality through appropriate case management.
Clinical trials of rice-based ORS: Recent studies suggest that an ORS with these advantages may be possible. The first evidence came from
clinical trials in Bangladesh and India, which showed that dehydrated diarrhoea patients given an ORS
solution containing 50 grams of cooked rice powder in place of the usual 20 grams of glucose were
satisfactorily rehydrated and had an appreciably reduced rate of stool output during treatment as compared
with patients given glucose-ORS solution.
No. 7, August 1990
url: http://www.who.int/chd/publications/newslet/update/updt-07.htm
Education and Training - Manuals and Guidelines
Diarrhoea
Management Training Course
- Introduction
Guidelines for Conducting Clinical Training
Courses at Health Centres and Small Hospitals
Diarrhoeal diseases are a leading cause of childhood mortality and morbidity in the developing world. These
deaths are caused by dehydration, dysentery, and persistent diarrhoea. Dehydration from acute diarrhoea
of all etiologies and in all age groups can be treated safely and effectively by the simple method of oral
rehydration therapy (ORT).
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url: http://www.who.int/chd/publications/cdd/dmtc/dmtcintr.htm
Diarrhoea
Management Training Course
- Chapter 1: Training Objectives
Exactly what the training includes, how it is done, and
how long it takes will differ from one facility to another. These things will
depend on the number and type of participants and the resources and
capabilities
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url: http://www.who.int/chd/publications/cdd/dmtc/dmtc1.htm
Diarrhoea
Management Training Course
- Chapter 2: Handling Administrative Arrangements
Careful administrative planning is essential for the training to be successful. The planning steps are listed
below. One or two instructors may do all of these steps, but it is advisable that the team of instructors
and staff participate. Suggestions for each of these steps are provided in greater detail in this chapter.
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url: http://www.who.int/chd/publications/cdd/dmtc/dmtc2.htm
Clinical
Skills: A Self-Instructional Course
The Clinical Skills training course is designed to teach health workers to assess and treat cases of diarrhoea
properly and to educate families about prevention and home treatment of diarrhoea.
Primarily self-instructional, Clinical Skills is the first course designed especially for health workers who may
be unable to attend a training course away from their worksites, but who have the important responsibility
of treating diarrhoea.
url: http://www.who.int/chd/publications/newslet/update/updt-19.htm
Medical Education: Teaching Medical Students
about Diarrhoeal Diseases
Strengthening the Teaching of Diarrhoeal Diseases in
Medical Schools -
"Readings on Diarrhoea" is intended for medical students, especially
during their clinical training in pediatrics. It will also be useful for
physicians participating in training courses on the management of diarrhoea
in children. The materials in this book are compatible with other WHO
publications on the management and prevention of diarrhoea. Units that
concern the management of children with diarrhoea are based on the WHO
treatment chart "Management of the Patient with Diarrhoea" (1990).
Portions of that chart are reproduced at appropriate places in this text.
There are eight units to the training program:
The epidemiology and etiology of diarrhoea
Pathophysiology of diarrhoea
Assessing the diarrhoea patient
Treatment of diarrhoea at home
Treatment of
dehydrated patients
Dysentery, persistent
diarrhoea and diarrhoea associated with other diseases
Diarrhoea and
Nutrition
Prevention of
Diarrhoea
url:
http://www.who.int/child-adolescent-health/New_Publications/CHILD_HEALTH/Meded
Topics in International Health
Produced by the Wellcome Trust for use as an educational resource in tropical
and international health. The series is divided into numerous CDs, each focusing
on a specific disease or group of diseases.
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url: http://www.who.int/hlt/otherdata/English/topics.htm
Strengthening the
Teaching of Diarrhoeal Diseases in Basic Training Programmes
Manual for Instructors of Nurses and Other Health Workers
Advising
Mothers on Management of Diarrhoea in the Home:
Instructions for Facilitators.
This guide teaches a process and skills which will help the health worker to advise mothers on home case management correctly
and effectively. The process will help the health worker to communicate all the essential information to the
mother in a structured manner, and in a reasonable amount of time. It will also help the health worker to
limit the amount of information to give, and it should make it easier for mothers to remember the advice.
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url: http://www.who.int/chd/publications/cdd/advising/adv_mom2.htm
Diarrhoea Case Management
The Treatment of
Diarrhoea: A Manual for Physicians
and Other Senior Health Workers
Diarrhoeal diseases are a leading cause of childhood morbidity and mortality in developing countries, and an
important cause of malnutrition. On average, children below 3 years of age in developing countries
experience three episodes of diarrhoea each year. In 1993 an estimated 3.2 million children below 5 years
died from diarrhoea. Eight out of 10 of these deaths occur in the first two years of life. In many countries
diarrhoea, including cholera, is also an important cause of morbidity among older children and adults.
- Introduction,
- Essential concepts concerning diarrhoea,
- Assessment of the child with diarrhoea,
- Management of acute diarrhoea without blood,
- Management of suspected cholera,
- Management of acute bloody diarrhoea (dysentery),
- Management of persistent diarrhoea,
- Management of diarrhoea with severe malnutrition,
- Other problems associated with diarrhoea,
- Antimicrobials and drugs,
- Prevention of diarrhoea,
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How
Research Findings Have Improved Diarrhoea Case Management
1. Practical application of research, 2. Treatment advice
for diarrhoea - WHO's Division of Diarrhoeal and Acute Respiratory Disease Control (CDR), among its many activities,
supports research into ways of preventing and treating diarrhoeal diseases. The research is coordinated by
CDR's Programme for Diarrhoeal Disease Control (CDD). Over the years this research has evaluated a
number of new or improved approaches to the control of diarrhoeal diseases.
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url: http://www.who.int/chd/publications/newslet/update/updt-20.htm
Improving the
Practices of Pharmacists and Licensed Drug Sellers
1. Pharmacists as health care workers, 2. Successful training methods, 3. What field tests show
- The importance of the private sector - If diarrhoea in children is to be managed correctly, there is need to look beyond public sector health
facilities. Good management has to be promoted in the home, and there is also a need to improve the
practices of all providers of care, particularly in the private sector.
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url: http://www.who.int/chd/publications/newslet/update/updt-18.htm
Treatment of Diarrhoeal Diseases: Information for
Pharmacists and other Drug Sellers
This guide contains information aimed at improving the practices of
drug sellers in the treatment of diarrhoea. It is divided into nine sections:
-
1.How to use this guide
-
2.Choosing a target audience
-
3.Analyzing the target audience
-
4.Factors influencing drug sellers' practices
-
5.Planning an intervention
-
6.Developing printed materials
-
7.Training staff and testing the intervention
-
8.Monitoring and evaluation
-
9.Carrying out the intervention
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url: http://www.who.int/chd/publications/cdd/pharm/intro.htm
The
Outpatient Management of Bloody Diarrhoea in Young Children
1. What causes bloody diarrhoea, 2. Practical guidelines for treatment -
About 10% of diarrhoeal episodes in children under 5 years of age have visible blood in the stool and these
cause about 15% of diarrhoea-associated deaths in this age group. Compared with watery diarrhoea,
bloody diarrhoea generally lasts longer, is associated with more complications, is more likely to adversely
affect a child's growth, and has a higher risk of death.
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url: http://www.who.int/chd/publications/newslet/update/updt-16.htm
The Management of Bloody Diarrhoea in Young Children
Bloody diarrhoea in young children is usually a sign of invasive enteric infection that carries a substantial
risk of serious morbidity and death. This is especially true in the developing countries, where the problem
occurs most frequently. Non-infectious causes account for a very small proportion of episodes of bloody
diarrhoea.
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url: http://www.who.int/chd/publications/cdd/bloody_d.htm
Disease Outbreak
1999 - Acute
Diarrhoea in Sudan
The outbreak of acute diarrhoea which began in early March is continuing. The areas of
Padak, Mading, Wanding, Lankien, Akobo
and Burmat have reported a total of 892 cases with 24 death up to 27 April 1999.
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url: http://www.who.int/emc/outbreak_news/n1999/apr/n30bapr1999.html
1999 - Diarrhoeal
Disease / Cholera in Congo
WHO has been informed of an outbreak of diarrhoeal disease in Brazzaville, Congo. Some cholera cases have now been confirmed in this outbreak and more details on the current situation will be given as soon as they are available.
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url: http://www.who.int/emc/outbreak_news/n1999/mar/n17cmar1999.html
1999 - Acute
Watery Diarrhoea in Sudan
As of 19 March, 78 deaths caused by acute watery diarrhoea had been reported. The total number of cases is unknown. Investigations are being carried out by the Ministry of Health.
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url: http://www.who.int/emc/outbreak_news/n1999/mar/n26amar1999.html
1998 - Bloody
Diarrhoea in Cameroon
Shigella dysenteriae type 1 (Sd1) has been confirmed as the organism responsible for the outbreak of bloody diarrhoea which started in Cameroon in November 1997. Since then 237 cases with 60 deaths have been reported.
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url: http://www.who.int/emc/outbreak_news/n1998/apr/n29apr1998.html
1998 -
Cholera / Diarrhoea Outbreak in Liberia
The national health authorities of Liberia have reported an outbreak of cholera/diarrhoea which started at the end of May. The areas affected by the outbreak are Nimba County and Margibi County. Up to 26 June a total of 560 cases with 12 deaths had occurred.
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url: http://www.who.int/emc/outbreak_news/n1998/aug/n03aug1998.html
1998 -
Cholera / Acute Diarrhoea in Somalia
A significant increase in the number of cases of acute diarrhoea has been reported to WHO by Médecins sans frontières (Spain), who have opened their cholera treatment centre in North Mogadishu as a result. An average of 14 cases are being admitted daily to this facility.
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url: http://www.who.int/emc/outbreak_news/n1998/dec/n18dec1998.html
1998 - Cholera-like
Diarrhoeal Disease in the Congo
Since November 1997, 445 cases of which 83 were fatal (case fatality rate 20%) have been reported in Pointe-Noire in the southern part of the country. The cases occurred between 7 November 1997 and 27 January 1998.
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url: http://www.who.int/emc/outbreak_news/n1998/feb/n3feb1998a.html
1998 - Diarrhoeal
Diseases in Bangladesh
The devastating floods which are sweeping the country began in early July this year and 52 districts out of a total of 64 with nearly 20 million people (25% of the total population) are affected. The death toll was reported as 730 up to 7 September 1998. Most of the districts currently affected are also endemic for diarrhoeal diseases and some outbreaks of acute diarrhoea have occurred. Over 185,OOO people have so far been affected and 151 have died.
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url: http://www.who.int/emc/outbreak_news/n1998/sept/n30sept1998.html
Bangladesh - Diarrhoeal
Diseases in Bangladesh
The devastating floods which are sweeping the country began in early July this year and 52 districts out of a total of 64 with nearly 20 million
people (25% of the total population) are affected. The death toll was reported as 730 up to 7 September 1998. Most of the districts currently
affected are also endemic for diarrhoeal diseases and some outbreaks of acute diarrhoea have occurred. Over 185,000 people have so far
been affected and 151 have died.
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url: http://www.who.int/eha/emergenc/bangla/021098.htm
Cases of
Acute Bloody Diarrhoea in a Rural District by Month
January 1994- April
1995 Objective: To detect outbreaks of dysentery by monitoring the incidence of
cases of acute bloody diarrhoea. Slide
7 of 32 ...
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url: http://www.who.int/csr/labepidemiology/surveillancesystems/en/
Epidemic Control
Mozambique - The
Fight Against Disease Increases
The next two to eight weeks are critical for Mozambique's health and aid workers fighting the threat of potential cholera and malaria epidemics, said the World Health Organization (WHO) today. The threat of a malaria epidemic in the country is increasing and will be at its most dangerous in around three to six weeks time as floodwaters gradually subside, the rains stop and warm temperatures return – ideal breeding conditions for mosquitoes.
url: http://www.who.int/inf-pr-2000/en/pr2000-16.html
Guidelines for Cholera Control
These guidelines have been prepared by the Global Task Force on Cholera Control of the World Health
Organization to help managers of national programmes for control of diarrhoeal diseases and others
responsible for implementing cholera control activities. They may also be useful to international, bilateral,
and nongovernmental agencies when deciding on appropriate assistance to countries for controlling cholera
outbreaks.
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url: http://www.who.int/chd/publications/cholera/cholguid.htm
Epidemic
Diarrhoeal Disease Preparedness and Response. Training and Practice.
Participant's Manual
Introduction, Chapter 1: Preparedness and Detection, Chapter 2: Response,
Chapter 3: Control Measures, Exercise Y: Case study (Rivas District outbreak)
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url: http://www.who.int/emc-documents/cholera/whoemcdis973c.html
Epidemic
Diarrhoeal Disease Preparedness and Response. Training and Practice.
Facilitator's Guide
Introduction, Checklist of Instructional Materials Needed at the Course, Checklist of Supplies Needed at the Course, Materials and Information to be Obtained before the Course Begins, Space Requirements Guidelines on Techniques, Detailed Guidelines, Summary of Chapter 1, Summary of Chapter 2, Summary of Chapter 3, Annexes, Annex 1: Evaluation, Annex 2: Sample draft for invitation letter, Annex 3: Suggested timetable
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url: http://www.who.int/emc-documents/cholera/whoemcdis974c.html
Review of the
Project for Improving Preparedness and Response to Cholera and Other Epidemic
Diarrhoeal Diseases in Southern Africa
In 1993 following the concern of Southern African countries over the yearly epidemics of cholera that have been occurring since the late 1980's and the spread of epidemic dysentery in the region, a sub-regional programme was initiated by WHO to help countries affected to improve their capacity to be prepared and respond to epidemic diarrhoeal diseases. The programme was funded by voluntary contributions from Switzerland, Australia, Italy and the United States. The sub-regional team worked with Ministries of Health and other involved national government sectors, international agencies, as well as with non-governmental organizations. After three years project implementation, a joint evaluation team composed of WHO Headquarters and Regional Office for Africa, plus donors, met in Harare to review the outcome of the project. The evaluation group concluded that the project was very successful and should be replicated in other regions.
Executive Summary, Background/Project Description, Purpose and Methods of the Review, Overall Achievements of the Project, Laboratory Strengthening, Analysis of the Status of the Project Implementation, Lessons Learned, Critical Activities to be Continued and Recommended Duration of Support, Replicability of Project, Recommendations
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url: http://www.who.int/emc-documents/cholera/whoemcdis975c.html
url: http://www.who.int/emc-documents/cholera/docs/whoemcdis975.html
Cholera and
Other Epidemic Diarrhoeal Diseases Control.
Technical Cards on Environmental Sanitation
Planning and management topics
- Emergency Interventions for Cholera Outbreaks
- Estimating Requirements for Water Quality Monitoring and Control
- Community Planning for Diarrhoeal Disease Control
Technology selection and construction topics
- Well Sinking in Non-Collapsing Formations
- Spring Protection
- Excreta Disposal Options
- Septic Tank Systems for Peri Urban Areas
- Ventilated Improved Pit Latrines
- Rainwater Harvesting Systems
Technology maintenance
- Afridev Handpump Maintenance
- Repair of the Model "A" Bushpump
Water quality and hygiene topics
- Household Water Treatment and Storage
- Disinfectants
- Cleaning and Disinfection of Wells
- Dosing Water with Hypochlorite Solutions
- Testing for Chlorine
- Cleaning and Disinfection of Storage Tanks, Tanker Trucks and Pipelines
- Sanitary Surveillance of Wells and Boreholes
- Sanitary Surveillance of a Distribution System
- Collection of Water Samples – Sampling
- Collecting Water Samples - Methods
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url: http://www.who.int/emc-documents/cholera/whoemcdis976c.html
Guidelines for the
Control of Epidemics Due to
Shigella Dysenteriae Type 1
Shigella dysenteriae type 1 (Sd1) is an unusually virulent enteric pathogen
that causes endemic or epidemic dysentery with high death rates. It is the
only cause of large-scale, regional outbreaks of dysentery. In recent years,
Sd1 has caused epidemic dysentery in Central America, south Asia, and central
and southern Africa. An epidemic in Central America from 1969 to 1973 was
responsible for more than 500,000 cases and 20,000 deaths. The epidemic in
central and southern Africa began in 1979 and has affected at least nine
countries. It is likely that most developing countries are at risk of epidemic
dysentery due to Sd1.
These guidelines are intended to assist national health authorities, public
health officers and health care providers in their efforts to prevent and/or
treat Sd1 disease. The text describes the epidemiology, clinical features and
management of disease caused by Sd1, and interventions that can reduce both
the incidence of Sd1 infections and mortality due to Sd1 disease.
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url: http://www.who.int/chd/publications/cholera/shig4g.htm
url: http://www.who.int/emc-documents/cholera/whocdr954c.html
Cholera
Cholera -
WHO
Fact Sheet
Surveillance and Response Global incidence, epidemiology, disease
outbreaks, articles and publications, videos WHO Publications Diarrhoeal
Diseases Infectious, Emerging Diseases International Travel and Health
vaccination requirements and health advice
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url: http://www.who.int/health-topics/cholera.htm
Cholera - WHO Fact Sheet
Cholera is an acute intestinal infection caused by the bacterium Vibrio
cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given. Vomiting also occurs in most patients.
Fact Sheet N107- Revised March 2000
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url: http://www.who.int/inf-fs/en/fact107.html
Some
Frequently Asked Questions About Cholera
What is cholera? How is cholera spread? Where do outbreaks occur? Can cholera be prevented? What treatments are available? What about antibiotics and other drugs? Do vaccines confer protection?
url: http://www.who.int/emc/diseases/cholera/questionsaboutcholera.html
Management of the
Patient with Cholera
Cholera should be suspected when: - a patient older than 5 years develops severe dehydration from acute watery diarrhoea (usually with
vomiting); or - any patient above the age of 2 years has acute watery diarrhoea in an area where there is an outbreak of
cholera.
Steps in the management of suspected cholera: Step 1. Assess for dehydration, Step 2. Rehydrate the patient, and monitor frequently. Then reassess hydration
status, Step 3. Maintain hydration: replace ongoing fluid losses until diarrhoea
stops, Step 4. Give an oral antibiotic to the patient with severe
dehydration, Step 5. Feed the patient.
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url: http://www.who.int/chd/publications/cholera/cholman.htm
url: http://www.who.int/emc-documents/cholera/whocddser9115c.html
WHO
Guidance on Formulation of National Policy on the Control of Cholera
Adequate surveillance and reporting is essential for national and international efforts to control cholera. Case definitions: The primary purpose of collecting and reporting information on cases of cholera is to facilitate local and national control efforts. As cholera is notifiable under the terms of the International Health Regulations, standard definitions should be used and certain information should be included in reports from all levels of the health system.
- Surveillance and reporting
- The use of the laboratory
- Cholera Immunization
- Control of International spread of cholera
- Use of antibiotics
- Tourism in cholera-affected areas
- Water supply and sanitation
- Cholera and food: General considerations
- Cholera and International trade in food
- Health Education
url: http://www.who.int/chd/publications/cholera/cholpol.htm
Cholera: Dealing with an
Emergency
Reporting, 1. Laboratory testing of stool specimens, 2. Common sources
of infection, 3. Effective control measures, 4. Ineffective control
measures, 5. Cholera treatment
url: http://www.who.int/chd/publications/cholera/cholemer.htm
Cholera - WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases
Chapter 4 - 1. Background of disease, 2. Description of the data, 3. Trends, 4. Conclusions, 5. References & links, 6. Tables
url: http://www.who.int/emc-documents/surveillance/docs/whocdscsrisr2001.html/cholera/cholera.htm
Cholera and Epidemic Dysentery
Pointers to information about cholera and epidemic dysentery - Fact Sheets, WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases - Cholera,
Global Data, Cholera in the Disease Outbreak News, Documents and Publications,
Videos
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url: http://www.who.int/emc/diseases/cholera/
Dysentery
Dysentery -
WHO
Fact Sheet
Epidemic Dysentery, Children: Reducing Mortality, Integrated
Management of Childhood Diseases, Publications and documents on diarrhoeal
diseases, Surveillance and Response, Epidemic dysentery: global incidence,
epidemiology, disease outbreaks, articles and publications
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url: http://www.who.int/health-topics/diarrhoeal.htm
Epidemic Dysentery
Dysentery may be simply defined as diarrhoea containing blood. Although several organisms can cause dysentery, Shigella are the most important. Shigella dysenteriae type 1 (Sd1), also known as the Shiga bacillus, is the most virulent of the four serogroups of
Shigella. Sd1 is the only cause of epidemic dysentery.
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Communication
Radio Guide: A
Guide to Using Radio Spots in National CDD Programmes
The keys to effective promotion via radio are creativity and repetition. Although there are various types of
radio materials that could be used to support CDD programmes, both of these criteria are best fulfilled by
using radio spots. For these reasons, the CDD Programme and the HealthCom Project, Academy for
Educational Development, have developed a manual called Radio guide: A guide to using radio spots in
national CDD programmes.
This manual will interest national CDD programmes which actively promote home case management, which have some evidence that radio is an important channel in their country, and
which are willing to commit the necessary time and resources.
url: http://www.who.int/chd/publications/newslet/update/updt-15.htm
Using
Radio Spots to Support National CDD Programmes
The main focus of national diarrhoeal disease control (CDD) activities is to assure the correct treatment of
child diarrhoea. This involves teaching parents how to take care of their children during and after diarrhoea
episodes, including when to seek help from health professionals.
Face-to-face communication, such as that between a health worker and a caretaker, is the most effective
way to teach parents how to treat their children during diarrhoea episodes. The
WHO/CDD document
Advising mothers on management of diarrhoea in the home teaches health workers the basic skills they
need to advise parents how to manage their child's diarrhoea. But the advice given by health workers
reaches only those people who come to health facilities, which may be only certain groups: families who live
near enough to walk to the facility, or who can afford transport, or who are already convinced that the clinic
is the best place to go for help, or those whose child is dangerously ill. In addition, a mother probably
comes to the health facility only rarely, and it may be difficult for her to remember all the information
learned at each visit.
Radio can complement face-to-face communication in national CDD programmes because it:
- Reinforces the advice that health workers are giving,
- Reaches those people who do not come to health facilities.
It can also:
- Help the CDD programme to promote behaviours that will help prevent diarrhoea
- Help inform people and raise awareness about a new idea, a new product, or a service that is available. ("When your child has diarrhoea, help him to eat and drink so he will stay strong." "ORS (oral rehydration salts) packets are now available free at district health posts.")
- Create a demand for services. ("Ask the doctor for advice on how to encourage your child to eat during diarrhoea." "Ask the nurse how to mix ORS correctly.")
- Remind people what they have already learned. ("Remember to take your child to the clinic if her diarrhoea has blood in it.")
- Motivate people, by presenting information in a compelling or entertaining way.
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Vaccine and
Immunization
Diseases
and Vaccines information - GPV, Global Programme for Vaccines and Immunization
Vaccine
research information from GPV, Global Programme for Vaccines and Immunization
...
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Vaccine
Research and Development - Diarrhoeal Diseases
Cholera, Rotavirus,
Shigella,
Enterotoxic Escherichia Coli,Thyphoid Fever
Vaccine
and Immunization information from GPV, Global Programme for Vaccines and
Immunization - Overall Objective: to obtain effective and safe vaccines against enteric diseases which: are easy to deliver, can be delivered in one (or few) doses, can be incorporated into existing schedules of vaccine delivery and are robust enough to retain their protective properties in the adverse conditions likely to be encountered in the developing world.
The spectrum of pathogens covered includes bacterial organisms such as Vibrio
cholerae, enterotoxic Escherichia coli (ETEC), Shigella dysenteriae and Shigella
flexneri, and Salmonella typhi as well as rotaviruses.
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Rotavirus
Vaccines
Potential Rotavirus Vaccines: It has been estimated that an effective rotavirus vaccine could: reduce all diarrhoeal deaths by 30% in the age group 6-24 months, and avert 500,000 - 1,000,000 deaths in children annually.
No. 5, March 1989
url: http://www.who.int/chd/publications/newslet/update/updt-05.htm
Shigella
Vaccine
and Immunization information from GPV, Global Programme for Vaccines and
Immunization
Four main species of Shigella, are able to cause diarrhoeal diseases: S.
dysenteriae, S. flexneri, S. boydii, and S. sonnei. These species are divided in serotypes on the basis of the O-specific polysaccharide of the LPS. There are 12 serotypes of S.
dysenteriae, 13 of S. flexneri, 18 of S. boydii and 1 of S. sonnei. S. flexneri is the predominant species in endemic areas, accounting for approximately 50% of culture-positive disease. S. flexneri is highly infectious by the oral route, and ingestion of as few as ten organisms can cause an infection in volunteers. Studies in animal models and epidemiological evidence in human populations indicate that Shigella infections elicit
serotype-specific immunity.
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Surveillance and Response
Disease Surveillance
and Response
The surveillance of a communicable disease is fundamental for disease prevention and control. Surveillance is defined as the "ongoing systematic collection, collation, analysis and interpretation of data; and the dissemination of information to those who need to know in order that action may be taken".
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Principles of Surveillance - Slide show
32 slides
url: http://www.who.int/emc/slideshows/Survintro/sld001.htm
EMC Document
Centre - By Titles
These documents offer an introduction to the activities and work of Communicable Disease Surveillance and Control. This department incorporates the former Division of Emerging and other Communicable Diseases Surveillance and Control and programmes from the Control of Tropical Diseases.
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EMC Document
Centre - By Publication Year
These documents offer an introduction to the activities and work of Communicable Disease Surveillance and Control. This department incorporates the former Division of Emerging and other Communicable Diseases Surveillance and Control and programmes from the Control of Tropical Diseases.
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EMC Document
Centre - By Subject
These documents offer an introduction to the activities and work of Communicable Disease Surveillance and Control. This department incorporates the former Division of Emerging and other Communicable Diseases Surveillance and Control and programmes from the Control of Tropical Diseases.
url: http://www.who.int/emc-documents/index.html
WHO Recommended Surveillance Standards. Second
Edition
This document has been produced jointly by technical clusters of WHO, as well as by
UNAIDS, in order to bring together WHO recommended standards for the surveillance of communicable diseases. It is not meant to replace existing technical guidelines or be an
exhaustive description of surveillance of all diseases. This document serves only as a guide to good practice and may help to harmonize
surveillance activities.
The purpose of this manual is to be a handy reference for key elements and contact information for all communicable diseases / syndromes
associated with current WHO control programmes. It should be particularly useful at the Ministry of Health level in Member States, in
approaching integrated surveillance of communicable diseases / syndromes.
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Breastfeeding
Breast-Feeding and the
Use of Water and Teas.
Results from recent surveys indicate that the majority of neonates in Africa, Asia, and Latin America are
breast-fed. However, the same surveys show that exclusive breast-feeding, i.e., giving the infant no other
fluid or food than breast milk, is a very infrequent practice. Water and/or teas (such as camomile and fennel
infusions) are offered to young infants, frequently from the first week of life, in the belief that they will
relieve pain (e.g., from colic, earache), prevent and treat colds and constipation, soothe fretfulness, and,
especially, quench thirst.
The intake of such supplementary fluids is associated in young infants with an increased risk of disease and a shortening of the duration of breast-feeding. Moreover, several studies have
shown that these fluids are not actually needed by healthy infants during the first semester of life if they
are exclusively breast-fed.
No. 1, Aug. 1992
url: http://www.who.int/chd/publications/newslet/update/updt-09.htm
Breastfeeding
Counselling: A Training Course
Breastfeeding: Training health workers. Health workers can play a key role in the protection, promotion and support of breastfeeding. Their
presence at the time of delivery and their subsequent contacts with mothers and infants provide them with
unique opportunities to help mother and baby to establish and maintain lactation.
In the past two decades, there has been a rapid increase in our understanding, not only of the scientific
basis of lactation and suckling, but also of effective management and prevention of breast-feeding
problems, including the use of basic counselling skills. Research has shown that if health workers' attitudes
and practices are supportive, it is more likely that mothers will breastfeed successfully and for a longer
period. No. 14, Aug. 1994
url: http://www.who.int/chd/publications/newslet/update/updt-14.htm
Not
Enough Milk and Breastfeeding
WHO and UNICEF recommend that infants should be exclusively breastfed for at least the first four months
of life, and if possible for 6 months. However, worldwide, few infants are breastfed exclusively for more than
a few weeks. Even in societies where breastfeeding is still the norm, mothers often introduce
complementary foods or drinks at an early age. One of the commonest reasons that mothers all over the
world give for stopping breastfeeding or introducing complementary food early is that they think they do
not have enough milk or that the quality of milk is poor. Some mothers worry about the amount of
breastmilk they produce as early as the first days post-partum.
No. 21 Feb. 1995
url: http://www.who.int/chd/publications/newslet/update/updt-21.htm
Hepatitis B and
Breastfeeding
The question of whether breastfeeding plays a significant role in the transmission of hepatitis B has been
asked for many years. It is important given the critical role of breastfeeding and the fact that about 5% of
mothers worldwide are chronic hepatitis B virus (HBV) carriers. Examination of relevant studies indicates
that there is no evidence that breastfeeding poses any additional risk to infants of HBV carrier mothers.
The use of hepatitis B vaccine in infant immunization programmes, recommended by WHO and now
implemented in 80 countries, is a further development that will eventually eliminate risk of transmission.
This document discusses the issues relevant to breastfeeding and HBV transmission, and provides
guidance from a WHO perspective.
No. 22 Nov 1996
url: http://www.who.int/chd/publications/newslet/update/updt-22.htm
Travel
International
Travel and Health
This booklet is addressed to national health administrations responsible for providing advice on the health
hazards of international travel, and to the practising physicians, travel agencies, shipping companies, airline
operators, and other bodies who are called upon to give advice in individual cases. In addition to
summarizing the vaccination requirements of individual countries, this booklet covers certain health hazards
to which the traveller may be exposed and indicates the areas in which these hazards are most likely to
occur. This is particularly important with malaria, which has continued to cause serious problems in recent
years. It also recommends precautions that the wise traveller should take when visiting unfamiliar place
Cholera: Basic Facts for Travellers
What is cholera?, What should I do if I think I may have cholera?, Where are the outbreaks of cholera?, Do vaccinations work against cholera?, What can I do to avoid cholera?
url: http://www.who.int/emc/diseases/cholera/factstravellers.html
Cholera: Basic
Facts for Travellers
Cholera outbreaks occur every year in different parts of the world. Although potentially fatal,
cholera can be easily prevented and treated. By following some simple and sensible rules, the
traveller can avoid infection. Here are the basic facts about cholera.
url: http://www.who.int/chd/publications/cholera/chobfact.htm
WHO Publications:
Travel Medicine
A Guide on Safe Food for Travellers, International Certificates of Vaccination, International Health Regulations, International Medical Guide for Ships, International Travel and Health 2000 edition online, Ports Designated in Application of the International Health Regulations, Yellow Fever Vaccinating Centres for International Health
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url: http://www.who.int/dsa/cat98/trav8.htm
Reference
WHO: List of
Non-Governmental Organization Abbreviations
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url: http://www.who.int/ina-ngo/ngo/z-abbrev.htm
Anti-infective
Drug Resistance
WHO Global Strategy for Containment of Antimicrobial Resistance.
Despite the enormous advances in health care in the last half-century, infectious diseases still account for 25% of deaths worldwide and 45% in low-income countries. As we increasingly recognize the role of infectious agents |
