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  1. 1

    Smallpox: post-eradication vigilance continues.

    WHO CHRONICLE. 1982; 36(3):87-91.

    This article summarizes the major findings and recommendations of the Committee on Orthopoxvirus Infections, established by the World Health Assembly to advise on posteradication policy. Although smallpox has been eradicated, there remains a need for the monitoring of vaccination practices, investigation of rumored smallpox cases, verification of virus and vaccine storage conditions, and surveillance of the other orthopoxviruses, including monkeypox. Routine vaccination for smallpox has been officially discontinued in 150 of the 158 Member States and Associate Members of the World Health Organization (WHO); Egypt and Kuwait continue to immunize, while the present status of vaccination remains unknown in 6 other countries. WHO is taking further steps to encourage all countries to cease this practice and is contracting laboratories that continue to produce smallpox vaccine to request that they cease commercial vaccine distribution. Since 1979, 124 rumors of smallpox cases from 55 countries have been investigated, most of which were misdiagnosed cases of chickenpox, measles, and other skin diseases; none has been smallpox. At present, variola virus is being stored in 4 laboratories, 3 of which are WHO collaborating centers. WHO will continue to inspect these laboratories to ensure that requirements for containment are being met. Programs for the surveillance of human monkeypox in west and central Africa are being initiated, although present data indicate that this disease is not of public health importance. The total number of known cases of human monkeypox since 1970 stands at 63. Important studies for the postsmallpox surveillance program include the development of simple and reliable screening tests for orthopoxvirus antibody and of reliable tests for antibody specific to monkeypoxvirus. Plans are underway to publish a book dealing with all aspects of the smallpox eradication campaign.
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  2. 2

    Tuberculosis and HIV: a framework to address TB / HIV co-infection in the Western Pacific Region.

    World Health Organization [WHO]. Regional Office for the Western Pacific

    Manila, Philippines, WHO, Regional Office for the Western Pacific, 2004. 44 p.

    This framework, which draws on the Global strategic framework to reduce the burden of TB/HIV and on the Guidelines for phased implementation of collaborative TB and HIV activities, was developed based on the following two premises. First, the National TB Programme (NTP) needs to address the impact of HIV, i.e. higher caseload of TB and increasing drug-resistant TB, and to mobilize resources related to TB/HIV activities. Second, the National AIDS Programme (NAP) needs to prolong the life and reduce the suffering of PHA through better management of TB, and to mobilize resources for TB/HIV. The Regional framework is built on the strengths of the individual National TB and AIDS Programmes, and identifies areas in which both programmes complement each other in addressing TB/HIV. This approach is considered useful, not only for countries with a relatively high prevalence of HIV, such as Cambodia, but also for most of countries in the Region that are faced with a relatively low prevalence of HIV. The scope of the Regional framework comprises interventions against tuberculosis (intensified case- finding and cure and tuberculosis preventive treatment) and interventions against HIV (and therefore indirectly against tuberculosis), e.g. comprehensive prevention, care and support, including condoms, sexually transmitted infection (STI) treatment, safe injecting drug use (IDU) and antiretroviral (ARV) treatment. Key components of the Regional framework are: surveillance; diagnosis and referral, including voluntary counselling and testing (VCT) for HIV; interventions; and, areas of collaboration. The framework outlines the roles of the individual TB and HIV/AIDS programmes (i.e. “who does what”) and provides examples of how to operationalize the different components. (excerpt)
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  3. 3
    Peer Reviewed

    Neuropsychiatric aspects of HIV-1 infection.


    A consultation on the neuropsychiatric aspects of HIV-1 infection was held at the World Health Organization (WHO) headquarters January 11-13, 1990. Of topics discussed, participants concluded that a group of conditions characterized by cognitive and motor impairment can be described. New terminology was suggested accordingly. Participants found that otherwise health HIV-1 seropositive patients were no more likely than HIV-1 seronegative patients to manifest clinically significant cognitive impairment. The serological screening of asymptomatic patients for HIV-1 in attempts to protect public safety was therefore deemed unnecessary. Hallucinations and delusions being not infrequent in AIDS and ARC patients, they may be indicative of cognitive impairment or later accompanied by symptoms pointing to diagnosis of delirium or dementia. Acute psychotic disorders outside of evidence of cognitive impairment may result as anomalies described within the text. Depressive syndrome may result outside of severe depressive episode or major depression due to recent diagnosis as HIV-1 positive and/or as the first stage of HIV-1 dementia. DIstinguishing between ARC and the above-mentioned states as the cause of this syndrome may be difficult. Consultation participants cited stress associated with HIV-1 infection or disease to be conditioned by several factors. Finally, neuropsychiatric disorders due to HIV-1 opportunistic processes were discussed. Country-level recommendations included preparing health workers for a wide range of neuropsychiatric conditions in the HIV-1 positive patient, and notifying then that otherwise healthy HIV-1 positive patients may not show clinically significant signs of cognitive impairment. Recommendations followed in urging health services to prepare for a large burden of neuropsychiatric illness in AIDS and ARC patients; governments should support services and train health workers accordingly. Pre- and post-serological testing counseling was stressed, with facility for and understanding of the special needs of HIV-1 positive patients' families and involved health staff. Research on the neurological and mental health needs of patients should be given high priority with attention given to the immediate policy and care implications. Final qualification of the difficulty involved in generalizing research findings to apply across sociocultural and geographical contexts was provided with mention in the text of a WHO multicenter study addressing this concern in its pilot phase at the time of publication. Neurological tests were designed for use in this study to be culturally nonspecific.
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