Bulletin of the World Health Organization最新文献

{"title":"Bundibugyo virus disease and the unfinished countermeasure agenda.","authors":"Nicola Abrescia, Antonio Capponi, Adelaide Maddaloni, Gabriella Molinaro, Maurizio D'Abbraccio","doi":"10.2471/BLT.26.296654","DOIUrl":"https://doi.org/10.2471/BLT.26.296654","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 10","pages":"658-658A"},"PeriodicalIF":6.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13628175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Laboratory tools from the Fleming Fund antimicrobial resistance surveillance programme.","authors":"Cyril Buhler, Ben Amos, N Claire Gordon, Joanna McKenzie, Sriram Raghu, Natalie Moyen, Emmanuel Azore, Stanley Fenwick, Manisha Bista, Winfred Amia, Areeya Disratthakit, Sheilla Onasanya, Deborah Nanjebe, Heidi Hopkins, Mathias Besong, Antoinette B Ngandijo, Manish Pathak, Toby Leslie","doi":"10.2471/BLT.25.294565","DOIUrl":"10.2471/BLT.25.294565","url":null,"abstract":"<p><strong>Problem: </strong>Current laboratory assessment tools aimed at improving bacteriology and testing for antimicrobial resistance focus on quality of laboratory services. No guidance exists for establishing bacteriology services necessary for diagnosis and surveillance of antimicrobial resistance in low- and middle-income countries.</p><p><strong>Approach: </strong>Comprehensive laboratory needs assessment tools and procurement catalogues were developed, piloted and used by the Fleming Fund programme. These tools were designed to support the strengthening of bacteriology testing capacity within national antimicrobial resistance surveillance systems receiving Fleming Fund support.</p><p><strong>Setting: </strong>The tools were used in reference laboratories and surveillance sites for antimicrobial resistance in 24 countries in the African, South-East Asia and Western Pacific regions, comprising 341 clinical, veterinary, aquaculture, food safety and environmental laboratories.</p><p><strong>Relevant changes: </strong>The needs assessment tool provides a structured framework for laboratory renovation and installation of bacteriology testing equipment. The procurement catalogues list reagents and consumables for antimicrobial resistance surveillance of priority pathogens in humans in the World Health Organization Global Antimicrobial Resistance and Use Surveillance System and selected bacteria in terrestrial and aquatic food-producing animals. Combined with training and capacity-building initiatives supported through other Fleming Fund investments, these efforts have substantially enhanced diagnostic capacity for bacterial infections and antimicrobial resistance surveillance in the laboratories.</p><p><strong>Lessons learnt: </strong>These tools were instrumental in identifying gaps to enhance bacteriology laboratory capacity and capabilities and became an essential resource for procurement, tracking supplies and asset management. The tools are adaptable and can strengthen laboratory capacity in settings and health programmes beyond bacteriology and antimicrobial resistance surveillance.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"640-645"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of paediatric schistosomiasis prevention with praziquantel, Madagascar.","authors":"Valentina Marchese, Diavolana Koecher Andrianarimanana, Sonya Ratefiarisoa, Ariane Guth, Myriam Lassmann, Fiona Franz, Aaron Remkes, Jana Christina Hey, Lara Schramke, André Brito, Tahinamandranto Rasamoelina, Pia Rausche, Olivette Totofotsy, Alexina Olivasoa Zafinimampera, Tiana Randrianarisoa, Haingoniavo Garcia Rambeloson, Elveric Fesia Ratiaharison, Amadou Garba, Irina Kislaya, Clara Fabienne Rasoamanamihaja, Jürgen May, Rivo Andry Rakotoarivelo, Daniela Fusco","doi":"10.2471/BLT.25.295521","DOIUrl":"10.2471/BLT.25.295521","url":null,"abstract":"<p><strong>Objective: </strong>To assess the feasibility of fixed-dose, praziquantel preventive chemotherapy against schistosomiasis in young children in rural Madagascar, focusing on treatment uptake and sustainability.</p><p><strong>Methods: </strong>We used the Consolidated Framework for Implementation Research to guide the study. Between November 2022 and December 2023, children aged 9 to 24 months at various venues were offered 300 mg of praziquantel as a crushed half tablet mixed with water and sugar. We conducted a cross-sectional survey among caregivers to assess treatment uptake and acceptability, children's compliance with drug administration, anxiety about adverse events, and praziquantel's tolerability and safety. Factors associated with uptake and acceptability were identified using Poisson regression.</p><p><strong>Findings: </strong>The study analysis included 5142 child-caregiver pairs. The praziquantel uptake rate was 86.2% (95% confidence interval, CI: 85.3-87.1) and 80.2% (95% CI: 79.1-81.3) of caregivers regarded repeated preventive chemotherapy acceptable. Clear anxiety, and uncertainty, about adverse events were the most significant factors associated with refusal of both initial and repeated treatment. No children experienced serious adverse events or choking. Of the 4434 children who received praziquantel, 152 (3.4%) swallowed a partial dose, whereas 2467 (55.6%) cried and 1833 (41.3%) initially resisted treatment, but ultimately received it.</p><p><strong>Conclusion: </strong>Fixed-dose praziquantel preventive chemotherapy using a crushed half tablet with water and sugar was feasible in preschool-aged children and was potentially sustainable. This approach has a strong potential for scaling up in areas where schistosomiasis is highly endemic.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"601-612"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early insights from the Healthy Life Trajectories Initiative.","authors":"Michelle Pentecost","doi":"10.2471/BLT.26.295804","DOIUrl":"10.2471/BLT.26.295804","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"649-650"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527687/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Public health round-up.","authors":"","doi":"10.2471/BLT.26.010926","DOIUrl":"https://doi.org/10.2471/BLT.26.010926","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"587-588"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Revision process for the <i>International statistical classification of diseases and related health problems</i>.","authors":"Jonathan Ml White, Maaya Kita, Eva Krpelanova, Carine Alsokhn, Maria L Costa, Willem Fibbe, Wolfgang Gaebel, Geoffrey M Reed, Dilani Samarawickrema Lokuhetty, Anthony Woolf, Kameshwar Prasad, Meng Zhang, Rolf-Detlef Treede, Christopher G Chute, Robert Jakob","doi":"10.2471/BLT.25.294650","DOIUrl":"10.2471/BLT.25.294650","url":null,"abstract":"<p><p>The <i>International classification of diseases and related health problems</i>, <i>11th revision</i> (ICD-11) includes an organized system of linked biomedical concepts and hierarchical coding tables called linearizations, of which the most important is the ICD-11 for Mortality and Morbidity Statistics. A publicly accessible web-based platform supports the dynamic maintenance of ICD-11 content, including proposals for modifications, based on scientific evidence and clinical relevance. This paper describes how proposals submitted through the platform are reviewed by the ICD-11 Medical and Scientific Advisory Committee. We analysed World Health Organization data on proposals to modify ICD-11 entities submitted between 2021 and 2025, according to proposal source, subject area, proposal type, time to decision and outcome. The advisory committee reviewed 256 proposals concerning 92% (24/26) of ICD-11 chapters. Proposals were submitted by international bodies, individual practitioners, patient advocacy groups and scholarly societies, with similar acceptance rates across groups. The most common proposal type was the addition of an entry, which had an acceptance rate 65% (81/125); followed by the deletion of an obsolete entity, which had an acceptance rate of 77% (44/57). The mean time to decision was 13.8 months. Overall, 69% (176/256) of proposals were recommended for adoption. These findings indicate that the advisory committee's review process is functioning adequately, with reasonable acceptance rates following scientific scrutiny. Outreach should be considered to encourage submissions in chapters with few updates between 2021 and 2025. Turnaround time may improve with the expansion of the advisory committee's membership and clearer guidance on proposal quality.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"622-630"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531092/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sales of antimicrobials for veterinary use, Bangladesh, 2023.","authors":"Sm Sabrina Yesmin, Delfy Góchez, Tanvir Ahmed, Mohammad Nayeem Golder, Pondpan Suwanthada, Niels Frederik Fabricius, Mahbub Hossain, Atm Golam Kibria Khan, Romel Mullick, Md Shariful Islam, Umme Habiba, Aninda Rahman, Md Ashraf Hossain, Md Shameem Haidar","doi":"10.2471/BLT.25.294366","DOIUrl":"10.2471/BLT.25.294366","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the volume and patterns of antimicrobial sale for food-producing animals in Bangladesh and to provide evidence to support national policy decisions.</p><p><strong>Methods: </strong>We used the World Organisation for Animal Health tool (animal antimicrobial use calculation module) for data collection and calculation of quantities of antimicrobials used in animals. We collected data on the overall amount of antimicrobials sold for use in food-producing animals, disaggregated by antimicrobial class, active molecule and route of administration.</p><p><strong>Findings: </strong>In 2023, 475 750 kg of antimicrobials were sold for use in animals across 301 products and 38 molecules. Oral administration accounted for 95.91% (456 301/475 750) of total antimicrobials sold. Tetracyclines were the most sold antimicrobial class, accounting for 32.22% (153 274/475 750) of antimicrobials sold for use in food-producing animals. The second most-sold class was aminoglycosides at 19.77% (94 044/475 750) of total sales. As regards to active molecules, chlortetracycline, neomycin, ceftriaxone, oxytetracycline, metronidazole, sulfamethoxazole, ciprofloxacin and enrofloxacin accounted for 79.34% (377 438/475 749) of the total national antimicrobial sale. Just over one fifth of the antimicrobials sold belong to classes considered to be highest priority critically important antimicrobials for humans (according to the World Health Organization's list). These classes were third- and fourth-generation cephalosporins, fluoroquinolones, other quinolones and polymyxins.</p><p><strong>Conclusion: </strong>Our findings highlight antimicrobial overuse and misuse in food-producing animals in Bangladesh and the need for policy interventions to combat antimicrobial resistance. Our report provides baseline data to support Bangladesh's <i>National action plan on antimicrobial resistance</i> and enable evidence-based policy development and strengthening of antimicrobial stewardship in the veterinary sector.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"613-621"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527688/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational heat protection policies.","authors":"Xin Zhou, Shi Huang, Xinman Hu, Weiyi Xu, Yidu Zheng, Hongyuan Li, Haitao Zhao, Xuemei Zhang, Zhen Pu, Ruixiang Li","doi":"10.2471/BLT.26.295639","DOIUrl":"10.2471/BLT.26.295639","url":null,"abstract":"","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"646-648"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Market landscape of penicillin for syphilis and rheumatic heart disease, WHO South-East Asia Region.","authors":"Gereltuya Dorj, Uhjin Kim, Po-Lin Chan, Pradeep Joshi, Abhishek Royal, Karina Razali","doi":"10.2471/BLT.25.295053","DOIUrl":"10.2471/BLT.25.295053","url":null,"abstract":"<p><strong>Objective: </strong>To assess the market landscape of penicillin formulations used for the treatment of syphilis and rheumatic heart disease in the World Health Organization South-East Asia Region.</p><p><strong>Methods: </strong>We analysed market data for five essential penicillin formulations across nine countries in the South-East Asia Region using a survey form to collect data on product registration, inclusion in national essential medicines lists, procurement, availability, pricing and demand forecasting.</p><p><strong>Findings: </strong>Substantial disparities exist in registration status, procurement and pricing across the region. The price of benzathine benzylpenicillin 1.2 million international units (IU) in Timor-Leste was over 23 times higher than in Bangladesh (3.45 United States dollars, US$, versus US$ 0.15), while the price for 2.4 million IU varied by up to 55-fold across the region. Several countries reported supply issues, including shortages of benzathine benzylpenicillin in India, Maldives, Myanmar, Thailand and Timor-Leste; aqueous benzylpenicillin in Sri Lanka during the 2022 economic crisis; and supply disruptions of phenoxymethylpenicillin 250 mg in Maldives and Sri Lanka. Morbidity-based estimates indicated annual regional demand of 171 966 061 vials of benzathine benzylpenicillin 2.4 million IU and 923 053 121 tablets of phenoxymethylpenicillin 250 mg, with corresponding costs of US$ 62 127 441 and US$ 48 005 181, respectively. India has the highest demand of these two formulations.</p><p><strong>Conclusion: </strong>Differences in registration, procurement, pricing and forecasting undermine reliable access to penicillin products in the South-East Asia Region. Stronger regional collaboration, improved forecasting, harmonized regulatory approaches and pooled procurement strategies are needed to secure equitable and sustainable access.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"589-600"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527684/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of maternal mortality, United Republic of Tanzania.","authors":"Ahmad Mohamed Makuwani, Sophia Kagoye, Honorati Masanja, Habib Rutakyamirwa Ismail, Rose Mpembeni, Josephine Shabani, Secilia Kapalata Ng'weshemi, Golden Masika, Leonard Katalambula, Ties Boerma, Claudia Hanson","doi":"10.2471/BLT.25.295623","DOIUrl":"10.2471/BLT.25.295623","url":null,"abstract":"<p><p>Maternal mortality, defined as the death of a woman during pregnancy or shortly after childbirth, is a key target of the sustainable development goals. Yet, in many low- and middle-income countries, accurate measurement of maternal mortality remains a major challenge. Reliable death registration systems are often incomplete or absent, making it difficult to calculate the maternal mortality ratio. However, opportunities exist to improve measurement. In about two thirds of low- and middle-income countries, more than 80% of births now occur in health facilities. This shift means that health facilities can serve as a valuable source of data not only for local quality improvement but also for informing population mortality estimates. However, this requires high-quality data. To improve the quality of facility-based data, we propose four simple quality metrics: (i) plausibility of reported national and subnational levels and patterns; (ii) the ratio of reported stillbirths to maternal deaths; (iii) the distribution of causes of death; and (iv) the share of deaths among women aged 35 years and older. Using data from the United Republic of Tanzania as an example, we show how these metrics can be applied to assess the completeness and internal consistency of routine health data systems. Our example aims to encourage quality assessment of facility-based data in other countries, alongside: (i) individual death reporting using standardized classification of causes of death; (ii) centralized data quality assessment based on the proposed metrics; and (iii) regular national on-site assessment of the completeness and accuracy of maternal and perinatal death reporting.</p>","PeriodicalId":9465,"journal":{"name":"Bulletin of the World Health Organization","volume":"104 9","pages":"631-639A"},"PeriodicalIF":6.9,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527681/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}