Executantes: profissionais das equipes que atuam na Atenção Primária à Saúde (APS) e Vigilância em Saúde. Resultado esperado: padronizar as ações para a detecção precoce de pessoas caracterizadas como casos suspeitos de infecção pelo novo coronavírus (2019-nCoV); realizar manejo inicia...l; acionar transporte e encaminhar casos suspeitos para a unidade de referência de forma oportuna e segura; registrar informações clínicas, histórico de viagem internacional ou contato com caso suspeito ou confirmado; investigar e registrar dados de contatos próximos; realizar a notificação imediata; adotar medidas para evitar casos graves e óbitos; e orientar a população sobre medidas de prevenção.
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El 31 de diciembrede 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo co...ronavirus que ha sido denominado SARS-CoV-2. Al igual que otros de la familia de los coronavirus, este virus causa diversas manifestaciones clínicas englobadas bajoel término COVID-19, que incluyen cuadros respiratorios que varían desde el resfriado común hastacuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multi-orgánico. La mayoría de los casos de COVID-19 notificados hasta el momento debutan con cuadros leves.Un punto de detección importante de casos de COVID-19es la urgencia hospitalaria. El triaje tiene como objetivo identificar y priorizar al paciente más grave. Al tratarse deuna enfermedad transmisiblese debenextremar las medidas deprecaución.
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Há três objetivos preliminares desse estudo de transmissão doméstica: 1. Para compreender melhor a extensão da transmissão doméstica estimando a taxa de infecção secundária1 para contatos domésticos em uma maneira individual, e fatores associados com qualquer variação no risco secundár...io da infecção. 2. Para caraterizar casos secundários incluindo a escala da apresentação clínica, fatores de risco para a infecção, a extensão e a fração de infecções assintomáticas. 3. Para caraterizar a resposta sorológica que segue a infecção confirmada pelo 2019-nCoV (altamente incentivado, mas opcional dependendo da capacidade e dos recursos do laboratório).
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2ª edição atualizada.
O Manual de Recomendações apresenta as diretrizes nacionais para o controle da doença, que incluem procedimentos clínicos padronizados, procedimentos laboratoriais, sistema de vigilância, ações de biossegurança e organização de serviços. Apesar de conter as reco...mendações clínicas no que diz respeito à padronização de ações de busca de casos e tratamento, o manual está destinado às ações voltadas para a saúde pública e não pretende ser um guia clínico sobre a doença. Dessa forma, não substitui livros, textos e publicações acadêmicas que identifiquem boas práticas clínicas sobre a abordagem do sintomático respiratório e do paciente com tuberculose nos seus variados aspectos e especificidades.
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MEDICINA (Buenos Aires) 2020; Vol. 80 (Supl. VI): 100-10;
La tuberculosis es una enfermedad infecciosa crónica endémica en la República Argentina causada por Mycobacterium tuberculosis, cuya localización más frecuente es la pulmonar. Suele afectar grupos poblacionales carenciados y tiene gran... repercusión sobre la salud pública. COVID-19 es una infección viral aguda caus 101-ada por SARS-CoV-2 que tiene típico compromiso respiratorio y, en ocasiones, puede presentar similitudes clínicas y radiológicas con la tuberculosis pulmonar. Ambas entidades pueden tener desenlace fatal si no son diagnosticadas y tratadas a tiempo. Presentamos una serie de casos en los que se diagnosticó tuberculosis pulmonar y COVID-19 en forma simultánea.
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All health workers require knowledge and skills to care for patients safely and protect themselves from undue harm. This course was developed due to the enormous emphasis placed on need for safe provision of oxygen to patients with COVID-19, but can be used for conditions beyond COVID-19. This cours...e teaches how to choose the right equipment for your facility, how to set up new respiratory equipment, how to clinically use respiratory equipment, how to maintain equipment, including troubleshooting, repairs and infection prevention and control, and how to decommission equipment.
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Medicina (B. Aires) vol.80 supl.6 Ciudad Autónoma de Buenos Aires dic. 2020
La tuberculosis es una enfermedad infecciosa crónica endémica en la República Argentina causada
por Mycobacterium tuberculosis, cuya localización más frecuente es la pulmonar. Suele afectar
grupos poblacionales car...enciados y tiene gran repercusión sobre la salud pública. COVID-19 es una infección
viral aguda caus 101-ada por SARS-CoV-2 que tiene típico compromiso respiratorio y, en ocasiones, puede pre-
sentar similitudes clínicas y radiológicas con la tuberculosis pulmonar. Ambas entidades pueden tener desenlace
fatal si no son diagnosticadas y tratadas a tiempo.
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El presente protocolo es una actualización del emitido el 24 de abril 2020 y contiene las
siguientes modificaciones:
• Definición de caso: Las definiciones de caso sospechoso y confirmado son dinámicas y secundarias a la situación epidemiológica vigente. En este contexto el Ministerio de
...
Salud de Nación ha modificado el criterio de caso sospechoso y de caso confirmado en pediatría. El Ministerio de Salud de Provincia de Buenos Aires acepta y adhiere a estos cambios.
• Manifestaciones clínicas: Se agregan manifestaciones clínicas en pediatría en base a la evidencia disponible y según la actualización realizada por el Ministerio de Salud de
Nación.
• Criterio de Alta: Los criterios de alta para el manejo de casos son dinámicos y se
adecúan conforme con las actualizaciones de la evidencia disponible y las recomendaciones de la Organización Mundial de la Salud. En este marco, el Ministerio de Salud de Nación ha modificado el criterio de alta del aislamiento para un caso
confirmado de COVID-19 el 24 de junio. El Ministerio de Salud de Provincia de Buenos
Aires acepta y se adhiere a este cambio.
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La Profilaxis Post-Exposición para el VIH (PEP) constituye una herramienta de prevención que consiste en el uso de medicamentos antiretrovirales para reducir el riesgo de infección luego de situaciones de potencial exposición del virus. Su incorporación está recomendada por la Organización Mu...ndial de la Salud en el marco de una estrategia de Prevención Combinada1,2. Cuando se inicia dentro de las 72 horas del episodio de potencial exposición al VIH, la PEP reduce en forma significativa el riesgo de transmisión, por lo que su uso se indica en exposiciones ocupacionales y no ocupacionales esporádicas. En la actualidad, una combinación de 3 drogas antirretrovirales durante 28 días es el esquema estándar empleado como PEP2.
A través de la Dirección de Sida, ETS, Hepatitis y TBC, se distribuye la medicación
necesaria para que la PEP esté disponible en efectores del sistema público de salud cuando está clínicamente indicada.
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La presente publicación tiene como objetivo facilitar herramientas para garantizar el abordaje integral del suicidio en la adolescencia, partiendo de la comprensión de que esta problemática trasciende las fronteras de la Salud Mental: requiere de una articulación basada en los principios de inte...rdisciplina, intersectorialidad y corresponsabilidad del conjunto de las políticas públicas destinadas a esta población.
Por ello, el material incluye herramientas para el proceso de atención clínica y, al mismo tiempo, prioriza el abordaje integral y comunitario. En este sentido, se propone como un insumo tanto para las acciones quedesarrollan los equipos de salud de atención primaria como también para la articulación y el trabajo en red con todos los efectores del Sistema de Promoción y Protección Integral de Derechos de Niñas, Niños y Adolescentes.
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O Ministério da Saúde (MS), por meio da Coordenação-Geral do Programa Nacional de Imunizações (CGPNI) e da Coordenação-Geral de Informações e Análises Epidemiológicas (CGIAE) da Secretaria de Vigilância em Saúde (SVS) publica o Protocolo de Vigilância do Óbito no Contexto da síndrom...e inflamatória multissistêmica pediátrica (SIM-P) associada à covid-19.
A SIM-P é uma nova apresentação clínica potencialmente grave em crianças e adolescentes associada à infecção pelo vírus SARS-CoV-2, que já foi descrita em diversos países, inclusive no Brasil.
Até a semana epidemiológica 27 de 2021 (SE 27) que vai até 10 de julho de 2021, foram notificados 1.105 casos confirmados de SIM-P no território nacional e registrados 69 óbitos (letalidade de 6,2%).
Os dados registrados no Brasil demonstram uma letalidade maior por SIM-P quando comparados a países desenvolvidos. Neste contexto, o objetivo deste Manual é fornecer às equipes de vigilância epidemiológica munici pais, estaduais e distrital subsídios para implantação da vigilância do óbito relacionado à doença, além de investigar quais fatores estão relacionados ao óbito em decorrência da SIM-P no país.
Este documento foi desenvolvido com a colaboração da Coordenação de Saúde da Criança e Aleitamento Materno (Cocam) do Secretaria de Atenção Primária a Saúde (SAPS)
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A varíola dos macacos é uma doença infeciosa emergente causada por um vírus transmitido aos humanos por animais infetados, na sua maioria roedores. Pode ser propagado a outras pessoas, mas a transmissão de pessoa para pessoa, isoladamente, não pode facilmente sustentar um surto. A apresentaç...o clínica é semelhante à observada no passado com a varíola, mas menos grave. A varíola foi erradicada mundialmente em 1980; no entanto, a varíola dos macacos ainda ocorre esporadicamente em partes da África Central e Ocidental, perto das florestas tropicais húmidas. Normalmente, a mortalidade nos surtos da varíola dos macacos tem sido de 1 a 10%, mas com os cuidados adequados, a maioria dos doentes recupera. Este curso fornece uma introdução geral à varíola dos macacos e destina-se aos profissionais de saúde responsáveis pela prevenção e controlo da varíola dos macacos.
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La viruela del mono es una enfermedad transmisible emergente causada por un virus que se transmite a los seres humanos a partir de animales infectados, generalmente roedores. Puede contagiarse a otras personas, pero la transmisión de persona a persona por sí sola no es capaz de mantener un brote. ...La presentación clínica es similar a la observada en el pasado con la viruela, pero menos grave. La viruela fue erradicada en el mundo en 1980; sin embargo, la viruela del mono sigue produciéndose esporádicamente en partes de África Central y Occidental, cerca de las selvas tropicales. Normalmente, la letalidad en los brotes de viruela del mono ha sido del 1 al 10%, pero con los cuidados adecuados, la mayoría de los pacientes se recupera. Este curso ofrece una introducción general a la viruela del mono y está dirigido al personal sanitario responsable de la prevención y el control de la viruela del mono.
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HIV-1 infection disproportionately affects women in sub-Saharan Africa, where areas of high HIV-1 prevalence and Schistosoma haematobium endemicity largely overlap. Female genital schistosomiasis (FGS), caused most frequently by S. haematobium egg deposition in the genital tract, has been associated... with prevalent HIV-1 infection in cross-sectional studies. The presence of S. haematobium eggs in genital tissue is also associated with vascularization and the accumulation of CD4+ lymphocytes and macrophages, making the granuloma-associated environment a potential contributor to HIV-1 vulnerability. In addition to modulation of the local cervicovaginal environment, FGS has also been associated with a higher frequency of systemic CD4 T-cells expressing the chemokine receptor CCR5. Tissue-entrapped eggs are also associated with clinically visible FGS-associated manifestations in the cervicovaginal mucosa. FGS lesions may breach the intact cervicovaginal immune barrier and are hypothesized to provide an entry point for HIV-1 infection. However, the underlying mechanism for potential HIV-1 vulnerability in FGS has not been fully characterized and requires further investigation.
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A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas' disease have now been detected in non-endemic areas, such as North America and some E...uropean countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.
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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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Pathogen genomic surveillance has become a priority for public health systems in recent years. Genomic sequencing is increasingly being used to characterize pathogens and monitor important public health priorities (e.g. poliovirus, influenza virus, Mycobacterium tuberculosis and Vibrio cholerae, ant...imicrobial resistance (AMR)). The decrease in cost and time of sequencing and the exponential development of bioinformatic pipelines have played a critical role in integrating pathogen genomics into routine public health surveillance. The coronavirus disease 2019 (COVID-19) pandemic has highlighted the role that sequencing plays in the surveillance of infectious diseases. Sequencing facilitates earlier detection, more accurate investigation of outbreaks, closer real-time monitoring of pathogen evolution and tailored development and evaluation of interventions to inform local to global public health decision-making and action. However, there remains a need to coordinate efforts, leverage and link existing surveillance and laboratory networks and capabilities, and systematically integrate genetic sequence data (GSD) with clinical and epidemiological data to strengthen its utility.
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Social inequalities are perpetuating unhealthy living and working conditions and behaviours. These causes are commonly called ‘the social determinants of health’. Achieving greater equity in health will demand that the health sector assumes a greater leadership role in addressing social inequali...ties. This requires equipping health and care workers to better understand how the social determinants of health impact patients and communities. Education of the health workforce is thus a key step to advancing action. Integration of the social determinants of health into education and training will prepare the workforce to adjust clinical practice, define appropriate public health programmes and leverage cross-sector policies and mechanisms.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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The primary objective of this curriculum is to equip health and care workers with the essential knowledge and competencies necessary for delivering safe and effective care. By doing so it aims to significantly reduce HAIs and combat antimicrobial resistance, thereby safeguarding both patient and HCW...s well-being.
This curriculum is developed to meet the needs of IPC professionals responsible for developing learning resources and overseeing training within health care organizations. Moreover, the curriculum is intended to encompass all individuals involved in health care delivery and support. This holistic approach includes a wide range of staff -ranging from clinical workers to administrative and auxiliary services, thus ensuring a broad and inclusive approach to IPC training.
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