Prevention of nosocominal transmission of tuberculosis - overview of several national guidelines
Hyg Med 31. Jahrgang 2016 - Heft 3
Empfehlungen des Robert Koch-Instituts für Alten- und Pflegeeinrichtungen und Einrichtungen für Menschen mit Beeinträchtigungen und Behinderungen und für den öffentlichen Gesundheitsdienst
Stand 7.4.2021
Jährlicher Bericht des Deutschen Forums für Kriminalprävention (DFK) mit einem Beitrag zum Gewaltschutz in Flüchtlingsunterkünften
Prevention recommendations at home. PREVENT dengue, chikungunya and Zika by eliminating mosquito breeding sites and protecting yourself from mosquito bites.
In 2019, following a request from the Codex Committee on Food Hygiene (CCFH), the Codex Alimentarius Committee (CAC) approved new work at its 42nd Session on the development of guidelines for the control of Shiga toxin-producing Escherichia coli (STEC) in leafy vegetables and in sprouts.
The obje...ctive of the report was to evaluate commodity-specific interventions used at all stages of fresh fruit and vegetable production from primary production to post-harvest activities, transportation, point of sale and consumer use. Emphasis was placed on the identification and evaluation of interventions used throughout the world to reduce microbiological hazards of fresh fruits and vegetables that contribute to the risk of foodborne illnesses, taking into consideration their effectiveness, practicality and suitability.
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Two decades of epidemiological research shows that silent cerebrovascular disease is common and is associated with future risk for stroke and dementia. It is the most common incidental finding on brain scans. To summarize evidence on the diagnosis and management of silent cerebrovascular disease to ...prevent stroke, the Stroke Council of the American Heart Association convened a writing committee to evaluate existing evidence, to discuss clinical considerations, and to offer suggestions for future research on stroke prevention in patients with 3 cardinal manifestations of silent cerebrovascular disease: silent brain infarcts, magnetic resonance imaging white matter hyperintensities of presumed vascular origin, and cerebral microbleeds. The writing committee found strong evidence that silent cerebrovascular disease is a common problem of aging and that silent brain infarcts and white matter hyperintensities are associated with future symptomatic stroke risk independently of other vascular risk factors. In patients with cerebral microbleeds, there was evidence of a modestly increased risk of symptomatic intracranial hemorrhage in patients treated with thrombolysis for acute ischemic stroke but little prospective evidence on the risk of symptomatic hemorrhage in patients on anticoagulation. There were no randomized controlled trials targeted specifically to participants with silent cerebrovascular disease to prevent stroke. Primary stroke prevention is indicated in patients with silent brain infarcts, white matter hyperintensities, or microbleeds. Adoption of standard terms and definitions for silent cerebrovascular disease, as provided by prior American Heart Association/American Stroke Association statements and by a consensus group, may facilitate diagnosis and communication of findings from radiologists to clinicians.
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Prevention of stroke and transient ischemic attack includes both conventional approaches to vascular risk factor management (blood pressure lowering, cholesterol reduction with statins, smoking cessation and antiplatelet therapy)
and more specific interventions, such as carotid revascularization or... anticoagulation for atrial fibrillation. The objective of this review is to discuss effective interventions for optimal primary and secondary stroke prevention.
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Background
Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease.
Main text
While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc...ular disease risk factors, management strategies and service delivery, in diverse settings and diverse populations, are equally critical to improving outcomes in low- and middle-income countries. Focusing on examples drawn from four cardiovascular diseases — coronary artery disease, stroke, diabetes and kidney disease — we argue that ethnicity, culture and context matter in determining the risk factors for disease as well as the comparative effectiveness of medications and other interventions, particularly diet and lifestyle interventions.
Conclusion
We believe that a host of cohort studies and randomized control trials currently being conducted or planned in low- and middle-income countries, focusing on previously understudied race/ethnic groups, have the potential to increase knowledge about the cause(s) and management of cardiovascular diseases across the world.
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Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab...ility and mortality at much lower costs and significantly reduces the need for secondary and tertiary care. Estimates suggest that almost 52% of all conditions can be managed at the
primary care level.
In order to ensure comprehensive primary health care, close to where people live, Sub- Centres should be strengthened as Health and Wellness Centres (H&WC), staffed by appropriately trained primary health care team. The Medical officer of the Primary Health Centre would oversee the functioning of the SC/HWC that falls in that area.
Services include those that (i) can be delivered at the level of the household and outreach sites in the community by suitably trained frontline workers, (ii) those that are delivered by a team headed by a mid-level health provider, at the level of the Sub-Centre/Health and Wellness Centre and (iii) the referral support and continuity of care within the district health system in rural and urban areas. The package of services is in Box. States would need to either phase in these services or add on additional services based on state specific and local context.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health co...nsequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.
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The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate management of diabetes into primary health care. It will serve as basis for development of simple algor...ithms for use by health care staff in primary care in low-resource settings, to reduce the risk of acute and chronic complications of diabetes. The guideline was developed by a group of external and WHO experts, following the WHO process of guideline development. GRADE methodology was used to assess the quality of evidence and decide the strength of the recommendations.
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People with diabetes mellitus are at an increased risk for foot ulcerations as a result of poorly controlled blood glucose which may lead to gangrene. These patients are at a high risk for lower limb amputations, higher healthcare costs, and lower quality of life. This course aims to cover the preve...ntion of foot ulcers in persons with diabetes, classification of diabetic foot ulcers, diagnosis and treatment of foot infection in people with diabetes and interventions to enhance healing of foot ulcers.
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At the end of 2023, WHO convened our first-ever annual WHO Stakeholder Review Conference for Prevention and Response to Sexual Misconduct. Aimed at joint learning and frank discussion on challenges faced in the achieving zero tolerance for all forms of sexual misconduct by aid workers, the Conferenc...e brought together Member States, Civil Society Organizations, United Nations Agencies and Programmes, academia and media joined by WHO personnel. A set of recommendations to support all agencies are documented in the Conference Report. In addition, WHO’s Director-General hosted a social engagement segment on the evening of Day 1 to further underscore the centrality of a victim and survivor-centred approach, to celebrate progress however small, and to reaffirm commitment and renew energy for the journey ahead. The Conference took place on 30 November and 1 December 2023 in Geneva, Switzerland
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im...munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im...munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance
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The prevalance of asthma an allergy, defined as immunologically mediated hypersensitivity, is increasing. It is estimated that over 20% of the world population suffers from IgE-mediated allergic disease, such as allergic asthma, allergic rhinitis and allergic conjunctivitis, atopic eczema/atopic der...matitis, and anaphylaxis. Asthma, which in more than 50% of adults and in at least 80% of affected children is allergic, occurs in around 5-15% in the paediatric population. Asthma it estimated by the World Health Organization (WHO) to affect about 150 million people worldwide, placing an enormous strain on health resources in many countries, and is a major cause of hospitalizations for chronic diseases in children in the western wolrd.
Information may be derived from areas where a rapid increase in disease has occured, to from the basis for prevention strategies in areas where the prevalence of these diseases is still low. Where current expert opinion is still divided, where future research is required, or studies have provided negative results, the available information may prevent the implementation of unnecessary, restrictive, and costly avoidance strategies.
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Prevention Guidelines on Marburg virus disease