This course will equip clinicians who frequently prescribe antimicrobials with knowledge and tools to improve their use of these essential medications in daily clinical practice. Through case based examples, the course will highlight how antimicrobial stewardship principles can be applied to common ...clinical scenarios. We will first review foundational clinical knowledge necessary to use antimicrobials wisely. Then, we will illustrate how clinicians can incorporate this knowledge into the management of patients with common infections through adherence to the five core competencies of appropriate antimicrobial prescribing. This course will provide a framework for approaching each clinical encounter from the perspective of combating antimicrobial resistance.
The course is available in English, French, Italian, Russiand and Spanish
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The Rethabile positive parenting activity is being run by 4Children Lesotho with caregivers and teens ages 9 to 24 for the purpose of reducing harsh parenting practices (i.e., violence) and improving positive parenting practices. By promoting adult–child communication around topics such as HIV a...nd AIDS prevention, and exploring models of family-focused violence prevention and support, the program facilitates disclosure of HIV status, promotes greater treatment seeking and adherence, and helps to reduce HIV stigma.lesoth
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The third edition, released in 2018, has grown to include a total of 18 chapters, contributed by 20 experts and authors from many countries. The goal remains the same: to educate primary care providers on the best practices in TB diagnosis, treatment and follow-up. All articles are richly illustrate...d, and most include quizzes and CME questions for self learning. The 3rd edition includes new chapters on MDR-TB, adverse effects of TB drugs, adherence monitoring strategies, and nutritional support. There is also content on how to manage children with TB, care for patients co-infected with TB and HIV, how to read and interpret chest x-rays, and how to avoid common pitfalls in TB management.
To download book chapters or the whole book go to the website: http://www.letstalktb.org/download/
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Version 1.1 July 2016
The purpose of this document is to describe standard operating procedures for viral load monitoring, including the schedule for viral load testing when used for routine monitoring of children, adolescents and adults on ART; interpretation of results; patient management; an...d specimen collection, preparation and transport. This template document to be adapted for use in various contexts and is one component of a viral load monitoring toolkit, to be used in conjunction with ICAP’s Viral Load Monitoring Flipchart and Enhanced Adherence Treatment Plan.
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These National Operational Guidelines for Viral Load Testing detail how routine viral load testing will be implemented at the facility level in India. They include frequency and interpretation of monitoring, sample collections, storage and transportation, receipt of results, adherence counseling, an...d reporting requirements. Roles and responsibilities are outlined as well as turnaround time requirements.
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The 2007 Rwanda Service Provision Assessment (RSPA) was a national representative survey conducted in 538 health facilities throughout Rwanda. The survey covered hospitals, health centers, dispensaries and
health posts, including all public facilities such as government and government-assisted heal...th facilities. The 2007 RSPA used interviews with health service providers and clients and observations of provider client consultations to obtain information on the capacity of facilities to provide quality services and the existence of functioning systems to support quality services. The areas addressed were the overall facility
infrastructure, maternal and child health, reproductive health, tuberculosis, malaria services; and services for sexually transmitted infections and HIV/AIDS. The objective was to assess the strengths and
weaknesses of the infrastructure and systems supporting these services, and to assess the adherence to standards in the delivery of services.
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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Module 1
Clinical
July 2017
Module 1: Clinical. This module is for clinicians, including physicians, nurses and clinical officers. It gives an overview of how to provide PrEP safely and effectively, including: screening for substantial risk of HIV; performing appropriate testing before initi...ating someone on PrEP and while the person is taking PrEP; and how to follow up PrEP users and offer counselling on issues such as adherence.
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Module 6
Pharmacists
July 2017
Module 6: Pharmacists. This module is for pharmacists and people working in pharmacies. It provides information on the medicines used in PrEP, including on storage conditions. It gives suggestions for how pharmacists and pharmacy staff can monitor PrEP adherence... and support PrEP users to take their medication regularly.
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The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR-TB. The WHO Operational Handbook on Tuberculosis, ...Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The document provides information on different aspects of care and support for TB patients. In particular, the handbook provides practical guidance on the implementation of the interventions that enable treatment adherence such as social support, treatment administration options, digital adherence technologies. The practical guidance also includes models of care for all TB patients, models of care for children and adolescents, integrated care for TB, HIV and comorbidities, engagement of private sector, managing of TB in health emergencies. This new practical handbook also includes two important chapters on health education and counselling, and palliative care for patients with TB.
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Lessons from three African Countries.
Achieving Health for All, and in particular universal health coverage (UHC), will not happen without fully functioning basic water, sanitation and hygiene (WASH) services in all health care facilities. Such services are needed to provide quality care, ensure ad...herence to infection prevention and control (IPC) norms and standards and guarantee that facilities are able to provide environments that respect the dignity and human rights of all care seekers, especially mothers, newborns and children. WHO undertook a series of national situational analyses in three countries (Ghana, Ethiopia and Rwanda) to understand current barriers to change, accountability structures and measures to strengthen WASH in health care facilities and more broadly, the quality of health service delivery.
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WHO and Psyon Games have joined forces to launch a new tower defense game called the Antidote COVID-19 to turn complex, scientific information into a fun learning experience. During the course of the game, players will learn about their immune system, pathogens, vaccines and how to protect themselve...s from COVID-19.
The game comes at a critical point of the pandemic where misinformation is hindering COVID-19 vaccine acceptance and adherence to other public health measures due to fear, mistrust and doubt. By putting players in the driver’s seat, the game urges everyone to play a role in fighting harmful misinformation online, and learning and sharing the facts from trusted sources of information.
The game starts just before the pandemic begins. The player is recruited to halt the spread of SARS-COV-2, the virus that causes COVID-19, by developing vaccines and helping the human immune system fight off the virus. Based on real events, this online adventure takes the player to the frontline of science, ultimately providing lifesaving information in the palms of their hands.
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me...thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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Buruli ulcer is a chronic, progressive skin disease caused by infection with Mycobacterium ulcerans. It is currently considered to be one of the neglected tropical diseases; less common than tuberculosis but more common than leprosy. The initial lesion is a painless subcutaneous nodule, usually less... than 5 cm diameter and adherent to skin. The nodule typically breaks down centrally after days to weeks forming an ulcer with undermined edges. Thus, the external appearance of the ulcer underestimates the true size of the affected area. The patient remains well and there is no pain unless secondary bacterial infection occurs. Other forms of M. ulcerans disease include a firm plaque lesions that behaves in the same way as the nodule or an oedematous lesion that is more aggressive and extends rapidly resulting in a very large ulcer.
Any age group can be affected by Buruli ulcer diseases, but the incidence peaks at 5 to 15 years. Ulcers are most frequently on the limbs but can be on the trunk or head, sometimes with catastrophic consequences such as loss of sight or loss of breast or genital tissue. Healing close to a joint can result in contracture, and sometimes there is so much tissue destruction on a limb that amputation is unavoidable. Occasionally osteomyelitis occurs in bone adjacent to a skin lesion but involvement of other organs is rare. Disseminated disease with HIV has been reported.
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Chagas is a complex, multidimensional phenomenon in which political, economic, environmental, biomedical, epidemiological, psychological, and sociocultural factors intersect. Nonetheless, the hegemonic conceptualisation has long envisioned Chagas as primarily a biomedical question, while ignoring or... downplaying the other dimensions, and this limited view has reinforced the disease’s long neglect. Integrating the multiple dimensions of the problem into a coherent approach adapted to field realities and needs represents an immense challenge, but the payoff is more effective and sustainable experiences, with higher social awareness, increased case detection and follow-up, improved adherence to care, and integrated participation of various actors from multiple action levels. Information, Education, and Communication (IEC) initiatives have great potential for impact in the implementation of multidimensional programs of prevention and control successfully customised to the diverse and complex contexts where Chagas disease persists.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP...C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline... is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
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Advances in the treatment of pediatric cancer have made it possible to expand initiatives beyond cure and cover aspects such as early detection, continuity of treatment and reduction in toxicity. All this has paved the way for a more comprehensive vision of patient care, which means better chances o...f healing and a fuller life - objectives of the World Initiative against Childhood Cancer. Within this comprehensive care, psychosocial care includes the social, psychological, spiritual and functional dimensions of the disease process of patients. This series includes guidelines and standards based on evidence that guarantee the quality of said care. The standards are the result of discussion and review by different professionals from Latin America and the Caribbean. Module 1 focuses on psychosocial evaluation as a strategy to support the objectives of the World Initiative against Childhood Cancer, and as a tool for health professionals to gather the necessary information to offer these patients a comprehensive approach focused on well-being, adaptation to the disease process, and adherence to treatment.
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Los avances en el tratamiento del cáncer pediátrico han permitido ampliar las iniciativas más allá de la curación y abarcar aspectos como la detección precoz, la continuidad del tratamiento y la reducción de su toxicidad. Todo ello ha abierto paso a una visión más integral del cuidado de lo...s pacientes, lo que supone mejores oportunidades de curación y una vida más plena, objetivos de la Iniciativa Mundial contra el Cáncer Infantil. Dentro de ese cuidado integral, la atención psicosocial incluye las dimensiones social, psicológica, espiritual y funcional del proceso de enfermedad de los pacientes. Esta serie recoge una serie de orientaciones y normas basadas en la evidencia que garantizan la calidad de dicha atención. Las normas son el resultado de la discusión y la revisión de distintos profesionales de América Latina y el Caribe. El módulo 1 se centra en la evaluación psicosocial como estrategia de apoyo a los objetivos de la Iniciativa Mundial contra el Cáncer Infantil y como herramienta para que los profesionales de la salud recaben la información necesaria para ofrecer a estos pacientes un abordaje integral enfocado en el bienestar, la adaptación al proceso de enfermedad y la adherencia al tratamiento.
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Advanced HIV disease (defined in persons living with HIV with a CD4 cell count of <200cells/mm3 or presenting with a WHO Stage 3/4 AIDS-defining illness) poses a challenge to many countries globally and is responsible for significant mortality and morbidity among people living with HIV. In 2017, WHO... recommended a package of care for the prevention and management of advanced HIV disease. The package was composed of screening tests, diagnostics, prophylaxis, rapid antiretroviral therarpy initiation and enhanced adherence counselling.
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