News Flash 550: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

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News Flash 550

Weekly Snapshot of Public Health Challenges

 

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IPS – COP28 2023

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News Flash 549: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Elviscot ship wreck, Elba island, Italy

News Flash 549

Weekly Snapshot of Public Health Challenges

 

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Rapid Diagnosis of Dengue: a Crucial Tool in Global Healthcare   by Nicolas Castillo

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Phasing down or phasing up? Top fossil fuel producers plan even more extraction despite climate promises Production Gap Report 2023 

Africa: Plastic Pollution Crisis Deepens Despite Global Efforts

 

 

 

 

 

 

 

 

 

Rapid Diagnosis of Dengue: a Crucial Tool in Global Healthcare

This article explores the fundamental importance of implementing rapid tests in the diagnosis of dengue, emphasizing their essential role in early detection and efficient management of this mosquito-transmitted disease. These tests, based on the detection of viral antigens or specific antibodies, not only provide results in record time but also constitute a significant contribution to global healthcare.

Rapid tests offer an immediate response, allowing timely medical intervention that can make a difference in the clinical course of the patient. Their ability to identify the virus in the early stages of infection is crucial, not only for individualized care but also for mitigating the spread of dengue at the community level. Moreover, by distinguishing between virus serotypes, these tests provide a more precise perspective for the application of therapeutic and preventive strategies. The accessibility and simplicity of rapid tests become key elements for their positive impact, especially in resource-limited settings. The swift availability of results not only accelerates clinical decision-making but also facilitates the collection of crucial epidemiological data. This information contributes to the strategic planning of public health authorities, enabling a coordinated and efficient response to dengue outbreaks and epidemics.

The widespread adoption of rapid tests in dengue diagnosis emerges as a fundamental pillar in global healthcare. Their ability to provide rapid and accurate results, their role in early detection, and their contribution to efficient management make these tests an invaluable tool in the fight against this prevalent disease, redefining how we approach the diagnosis and treatment of dengue on a global scale

By Nicolás Castillo

Biochemical. Private Laboratory Santa Clara de Saguier Sanatorium, Santa Fe, Argentina  

Rapid Diagnosis of Dengue

a Crucial Tool in Global Healthcare

 

Introduction

Dengue, a mosquito-borne viral disease transmitted by Aedes mosquitoes, has become a growing concern for global health due to its significant impact in various regions worldwide. The complexity of the infection, ranging from mild to potentially life-threatening cases, underscores the critical importance of effective detection and management strategies. Swift identification of the virus stands as an essential pillar for the efficient management of individual cases and the prevention of epidemic spread.

In this context, rapid tests have emerged as fundamental tools in the diagnosis of dengue, offering innovative and efficient solutions to address the clinical challenges associated with this disease.

These tests, based on the detection of viral antigens or specific antibodies, not only provide rapid results but also play a crucial role in enabling timely medical interventions. This immediate responsiveness translates into improved disease management, minimizing morbidity, and contributing to the prevention of severe complications.

As the burden of dengue continues to be a public health concern, research and the implementation of advanced diagnostic tools become imperative. Rapid tests, by offering a unique combination of speed and accuracy, position themselves as essential components in a comprehensive strategy to address dengue.

Development

The constant evolution in the fields of medicine and technology has led to an ongoing reevaluation of diagnostic methods for infectious diseases such as dengue. Particularly, the introduction of rapid tests has marked a paradigm shift in how we approach the identification and management of this mosquito-borne viral disease.

Rapid tests for dengue are based on the detection of viral antigens or specific antibodies in the patient’s sample. Unlike conventional methods such as serology and polymerase chain reaction (PCR), these tests offer a crucial advantage in terms of agility and simplicity. The immunochromatographic response allows for results in a matter of minutes, facilitating timely medical intervention.

The sensitivity and specificity of rapid tests are determining factors in their effectiveness. Numerous clinical studies have demonstrated their ability to detect the dengue virus in the early stages of infection, even before evident clinical symptoms appear. Early identification of cases benefits not only the individual patient but also holds significant implications for the community and epidemiological management of the disease.

The distinction between virus serotypes is crucial, as certain serotypes can trigger more severe forms of the disease. Rapid tests, by providing information about the specific serotype present in the sample, enable a more precise adaptation of treatment and control strategies. This capability to distinguish between different serotypes represents a significant advancement in tailoring medical care for patients affected by dengue.

Moreover, the application of these tests in daily clinical practice provides a valuable tool for informed decision-making by healthcare professionals. The swift availability of results allows for the immediate implementation of preventive and therapeutic measures, reducing morbidity and mortality associated with dengue. This translates into more efficient and effective care, especially in resource-limited settings.

Nevertheless, it is crucial to address some challenges associated with the widespread implementation of rapid tests. Variability in the sensitivity of these tests in different infection stages and diverse populations can impact their performance. Additionally, proper training of healthcare personnel is essential to ensure accurate interpretation of results and their effective integration into clinical protocols.

The integration of rapid tests into clinical practice not only has implications at the individual level but also at the epidemiological level. Accurate data collection on dengue prevalence and serotype distribution facilitates a more effective response to outbreaks and epidemics. Epidemiological information derived from these tests contributes to the strategic planning of public health authorities, enabling more efficient resource allocation and a rapid response to emergency situations.

In conclusion, rapid tests have emerged as essential tools in the diagnosis of dengue, offering a unique combination of speed, effectiveness, and accessibility. Their proper implementation and continuous research in this area are crucial to maximizing their positive impact on clinical and epidemiological management of dengue. These advancements not only enhance individual patient care but also significantly contribute to mitigating the global burden of this mosquito-borne disease.

Discussion

The widespread implementation of rapid tests in dengue diagnosis presents challenges and opportunities. It is crucial to address the variability in the sensitivity of these tests, considering the dynamics of infection and the patient’s immune response. Proper training of healthcare personnel and the integration of these tests into clinical protocols are key aspects to maximize their positive impact.

Early detection of dengue not only benefits the individual patient but also contributes to the effective management of outbreaks and epidemics. The ability to identify cases quickly allows for a more efficient mobilization of resources and the implementation of vector control measures. Additionally, the collection of accurate epidemiological data facilitates informed decision-making by public health authorities.

Conclusions

In conclusion, the incorporation of rapid tests in dengue diagnosis represents a significant advancement in the fight against this disease. The speed and effectiveness of these tests have the potential to transform clinical and epidemiological management, improving outcomes for patients and the community at large. Proper implementation and ongoing research in this area are essential to maximize the benefits of these rapid diagnostics and contribute to the global reduction of the dengue burden.

References

  1. World Health Organization. Dengue: Guidelines for Diagnosis, Treatment, Prevention and Control. Geneva: World Health Organization; 2009.
  2. Guzmán MG, Kourí G. Dengue: an update. The Lancet Infectious Diseases. 2002;2(1):33-42.
  3. Peeling RW, Artsob H, Pelegrino JL, et al. Evaluation of diagnostic tests: dengue. Nature Reviews Microbiology. 2010;8(12 Suppl):S30-38.

 Additional Citations

Bhatt S, Gething PW, Brady OJ, et al. The global distribution and burden of dengue. Nature. 2013;496(7446):504-507.

Simmons CP, Farrar JJ, Nguyen V, Wills B. Dengue. The New England Journal of Medicine. 2012;366(15):1423-1432.

Wilder-Smith A, Ooi EE, Horstick O, Wills B. Dengue. The Lancet. 2019;393(10169):350-363.

 

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BY THE SAME AUTHOR ON PEAH 

Preparing for the Future: The Vitality of an Effective Testing Strategy in Future Pandemics 

 The Positive Impact of Artificial Intelligence in Future Pandemics 

The Value of Communication in a Pandemic 

Epidemiological Surveillance in Pandemics

Population Aging, a Challenge for Public Health in Latin America and the World

 

 

 

 

News Flash 548: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

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News Flash 548

Weekly Snapshot of Public Health Challenges

 

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News Flash 547: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

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News Flash 547

Weekly Snapshot of Public Health Challenges

 

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WHO, the Right to Health and the Climate Crisis – What Advice for the ICJ?

The UN Charter gives the UN General Assembly (UNGA) and the Security Council the power to request an advisory opinion from the International Court of Justice (ICJ) on any legal question. In March 2023, the ICJ received a much anticipated request from the UNGA to advise States on their legal obligations regarding climate change. The UNGA’s request covers different areas of international law, including human rights law and the right to health. 

The World Health Organization (WHO) has the opportunity to make a submission. 

In view of the WHO’s longstanding work and advocacy on climate change as the pre-eminent public health concern of this century, it would be a lost opportunity if WHO only submits technical reports on the impact of climate change on health. More valuable would be a strong statement of the international legal arguments for State obligations to address climate change from the right to health perspective

 By David Patterson, LLM, MSc, PhD Candidate

 Groningen Centre for Health Law

Department of Transboundary Legal Studies, Faculty of Law

University of Groningen, Netherlands  

Member, Steering Committee, EUPHA law and public health section

 WHO, the Right to Health and the Climate Crisis – What Advice for the ICJ?

 

The UN Charter gives the UN General Assembly (UNGA) and the Security Council the power to request an advisory opinion from the International Court of Justice (ICJ) on any legal question. The same is true for UN specialised agencies (within the scope of their activities), including the World Health Organization (WHO). Advisory opinions are generally not binding however they carry great legal weight and moral authority.

Thirty years ago, in 1993, the World Health Assembly (WHA) asked the ICJ to advise on the legality of the use of nuclear weapons in war or other armed conflict. The WHO then made substantive legal submissions to the ICJ on the issue. This was a bold, highly political move by the WHA and the WHO, and reflected worldwide concerns about nuclear annihilation at that time.

This year the ICJ has again been called to advise on an issue affecting the very survival of humankind. In March 2023, the ICJ received a much anticipated request from the UNGA to advise States on their legal obligations regarding climate change. The UNGA’s request covers different areas of international law, including human rights law and the right to health.

All the currently submitted documentation is on the ICJ website. The UN Environment Programme (UNEP) and the World Meteorological Organization (WMO) have submitted technical reports. But these reports don’t address States’ international legal obligations. Other stakeholders, including the Organization of Petroleum Exporting Countries (OPEC), have also been accredited to make submissions. They may well argue for a narrow interpretation of States’ obligations.

In view of the WHO’s longstanding work and advocacy on climate change as the pre-eminent public health concern of this century, it would be a lost opportunity if WHO only submits technical reports on the impact of climate change on health. This information is already well-documented by Lancet Countdown and other sources. More valuable would be a strong statement of the international legal arguments for State obligations to address climate change from the right to health perspective.

The broad arguments are already well-articulated by authoritative sources. In July 2022 the UN General Assembly declared access to a clean, healthy and sustainable environment a universal human right. In August 2023 the UN Committee on the Rights of the Child (CRC) issued General Comment 26 on children’s rights and the environment, with a special focus on climate change. The CRC discussed the right to the highest attainable standard of health and noted, for example, obligations regarding national health plans, policies and strategies, and legislative, regulatory and institutional frameworks. The CRC also advised that States should immediately ‘…equitably phase out the use of coal, oil and natural gas, ensure a fair and just transition of energy sources and invest in renewable energy, energy storage and energy efficiency…’

Under international law States also have obligations to provide international assistance commensurate with their capacities, resources and influence. States in a position to do so should provide international assistance, including financial, technological, and other forms of assistance, to contribute to the realization of human rights of present and future generations. WHO should also explore these obligations in its submission to the ICJ.

The WHO Director-General, Dr Tedros Adhanom Ghebreyesus has done much to affirm the right to health under international law, including through a statement on Human Rights Day in 2017, an article in The Lancet in 2018 and at the launch of a major report on global health and the law in 2019 (his remarks in this video could not be clearer or more compelling). WHO’s Key Facts on Human Rights (10 December 2022) reiterates that ‘The right to the highest attainable standard of health’ implies a clear set of legal obligations on states to ensure appropriate conditions for the enjoyment of health for all people without discrimination.’ In February 2023, WHO reiterated the importance of rights-based approaches to the climate crisis in a submission regarding the first Global Stocktake.

The deadline for ICJ submissions is 22 January 2024. States and organizations which have made submissions may then make written comments on other statements submitted to the ICJ.

The international human rights legal framework we have today was forged in the ashes of wars in first half of the 20th century. Yet those horrors do not approach the devastation inaction today will bring current and future generations. There is now a unique opportunity for WHO to stress, at the highest international legal level, that combatting climate change for public health is not just a matter of sound policy making. States also have legal obligations to respect, protect and fulfil the right to health in the context of climate change. This includes obligations of international assistance and cooperation.

Cross-posted to the Groningen Centre for Health Law blog

 

By the same Author on PEAH

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News Flash 546: Weekly Snapshot of Public Health Challenges

News Flash Links, as part of the research project PEAH (Policies for Equitable Access to Health), aim to focus on the latest challenges by trade and governments rules to equitable access to health in resource-limited settings

Needlefish (Belone belone)

News Flash 546

Weekly Snapshot of Public Health Challenges

 

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