Bulletin of the World Health Organization最新文献

Objective: To assess the effectiveness of mental health and psychosocial support interventions for addressing post-traumatic stress symptoms in children and adolescents in humanitarian settings, with separate analyses of targeted and universal interventions.

Methods: We systematically searched MEDLINE, Web of Science, PTSDpubs and PsycInfo databases for relevant randomized controlled trials that involved individuals aged 18 years or younger in humanitarian settings and compared psychological interventions with passive controls. Random-effects meta-analyses were performed separately for interventions targeted to specific symptoms and for more general universal interventions. The review was registered on PROSPERO (CRD42023434878).

Findings: The meta-analysis included 16 trials of targeted interventions (n = 2356) and 11 of universal interventions (n = 3378) that met inclusion criteria. Children and adolescents who received targeted interventions reported significantly fewer post-traumatic stress symptoms after the intervention than controls. These positive effects were sustained at follow-up. Benefits were also observed for depressive symptoms. In addition, universal interventions were associated with significantly fewer post-traumatic stress symptoms. Moderator analyses showed that outcomes were not significantly influenced by country income level, the use of lay or professional therapists, or whether trauma was caused by human-made or natural disasters. However, considerable heterogeneity and a high risk of bias were noted across studies.

Conclusion: Both targeted and universal mental health and psychosocial support interventions were associated with fewer post-traumatic stress symptoms among children and adolescents in humanitarian settings compared with passive controls. As interventions delivered by non-specialists were also successful, task-sharing could be considered where resources are scarce.

Objective: To describe a multi-agency public response to an outbreak of avian influenza virus in poultry farms in Victoria, Australia, in 2024.

Methods: After detecting an outbreak of high-pathogenicity avian influenza at a poultry farm and notifying the Victorian health department, Agriculture Victoria identified a further seven infected premises through tracing and surveillance activities. Testing at the Australian Centre for Disease Preparedness identified high-pathogenicity H7N3 at seven premises in the Golden Plains Shire, and high-pathogenicity H7N9 at a property in the Terang region in the Corangamite Shire. The Victorian health department established a multi-agency incident management team, and we defined, identified and managed contacts and suspected cases. Public health actions included influenza vaccination, antiviral prophylaxis, active surveillance of high-risk contacts, and supporting infection prevention and control measures.

Findings: We identified a total of 212 (165 high- and 47 low-risk) unique human contacts with residence locations spread across 25 local government areas. We identified 20 suspected cases from six of the eight infected premises, all of whom tested negative for influenza A. Of the 172 unique high-risk contacts and suspected cases, local health services and clinics reported that 19.2% (33) received antiviral medication and 27.3% (47) received the seasonal influenza vaccine.

Conclusion: Our rapid, coordinated, multi-agency response was a success; however, governments, agricultural industries and health workers must strengthen preparedness and response strategies across national, state, regional and local levels to improve surveillance, foster collaboration and address gaps in preventive health care.

Objective: To understand and simulate international spread of the disease mpox, considering variations in sexual activity levels and international travel among men who have sex with men.

Methods: We developed a mathematical model that considers differing sexual networks and the volume of international travel among men who have sex with men, calibrated to disease incidence data in Japan. We then used our model to simulate the potential international spread of mpox across 42 countries and territories on the Asian continent, assuming Japan as the origin of spread.

Findings: Our simulations identified countries and territories at a high risk of mpox introduction, many being low- and middle-income countries and territories in the Western Pacific and South-East Asia regions. We found that the simulated risk of importation gradually shifted over time from the Western Pacific to the South-East Asia region, and later to the Eastern Mediterranean and European regions. This simulated pattern broadly aligns with actual mpox spread patterns observed between 2023 and 2024.

Conclusion: Our multicountry model for mpox outbreaks can help project the possible trajectory of mpox spread across countries and territories on the Asian continent. Our findings warrant global efforts to contain mpox outbreaks, particularly support for low- and middle-income countries and territories which are at higher risk of introduction, so that the risk of continued spread across the Asian continent and beyond is reduced.