The main objective of these guidelines is to provide guidance on up-to-date, uniform, evidence-informed practices for suspecting, diagnosing and managing various forms of extra-pulmonary tuberculosis (EPTB) at all levels of healthcare delivery. They can then contribute to the National Programme to i...mprove detection, care and outcomes in EPTB; to help the programme with initiation of treatment, adherence and completion whilst minimizing drug toxicity and overtreatment; and contribute to practices that minimize the development of drug resistance.
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Procédures de gestion clinique standard.
La maladie à virus Ebola (MVE) est une maladie multisystémique potentiellement mortelle qui entraîne souvent une hypovolémie, une acidose métabolique, une hypoglycémie et une défaillance multi-viscérale. L'épidémie prolongée de MVE en Afrique de... l'Ouest en 2013-2016 a permis une évolution dans le domaine des soins telle qu'à la fin de l'épidémie, de nombreux patients ont pu recevoir des soins de support individualisés et optimisés, dont la réanimation hydro-électrolytique, le contrôle des symptômes, la surveillance biologique en laboratoire et au chevet de la glycémie et des électrolytes, la prise en charge des défaillances d’organe, ainsi que la détection et le traitement rapides des co-infections, contribuant ainsi à une réduction de la mortalité.
Toutefois, le niveau des soins varie considérablement d'un centre de traitement Ebola (CTE) à l'autre, au cours de la même épidémie, ainsi que d’une épidémie à l’autre
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Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201...6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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"Le Manuel de l’OMS pour la gestion de l’aspect santé publique des accidents chimiques a pour objet de passer en revue l’ensemble des principes et des rôles qui sont ceux de la santé publique dans la gestion des accidents et des situations d’urgence d’origine chimique. Tout en apportant... ce type d’information pour chaque phase du cycle de gestion des situations d’urgence, notamment en ce qui concerne la prévention, les plans d’urgence, la préparation, la détection et l’alerte, l’intervention et le rétablissement de la situation, les auteurs admettent que la gestion des accidents et des situations d’urgence de nature chimique nécessite une approche pluridisciplinaire et plurisectorielle et que le secteur de la santé est susceptible de jouer un rôle complémentaire influent, voire le rôle de chef de file, aux différents stades du processus de gestion. Le manuel s’adresse notamment aux professionnels de la santé publique et de la protection de l’environnement ainsi qu’à tous ceux qui sont partie prenante à la gestion des accidents de nature chimique."
Also available in english and spanish
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Rapport de mission, 10-14 juillet 2017
Madagascar a conduit la mission d’évaluation externe conjointe de la mise en œuvre des capacités du Règlement Sanitaire International (2005) du 10 au 14 juillet 2017. ...
Pour disposer de capacités fonctionnelles et pérennes, le pays devra ren...forcer encore d’avantage l’ensemble des 19 domaines techniques en mettant en œuvre les recommandations ci-dessous. A cet égard, il est primordial de mettre l’accent sur : i) l’élaboration et l’application de cadres législatifs, propices à l’application du Règlement sanitaire international (2005) et à la gestion des risques de catastrophe ; ii) la coordination multisectorielle dans la mise en œuvre du Règlement sanitaire international (2005) ; iii) le renforcement des capacités du point focal RSI ainsi que sa relation avec tous les secteurs clés dans la prévention, la détection et la riposte ; iv) la rédaction et la mise en œuvre des procédures requises en tenant compte de l’approche englobant l’ensemble des menaces ; et v) l’analyse et la cartographie des risques d’épidémies et de catastrophes, en utilisant une approche multisectorielle qui permettra d’actualiser et d’établir des plans de préparation et de riposte contre les zoonoses, les maladies infectieuses émergentes et ré-émergentes et les facteurs de risque environnementaux en utilisant l’approche « Une seule santé ».
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Despite the considerable improvement in global health, millions of people still lack access to quality health services, including access to effective antimicrobial medicines, or are impoverished as a result of health spending. At the same time, antimicrobial resistance – a consequence of overuse a...nd misuse of antimicrobials – is increasingly a barrier to accessing effective care. The declining effectiveness of antibiotics is driven by multiple factors, many of which can be addressed through well functioning primary health care. However, primary health care has not always had much attention in national health sector responses to
antimicrobial resistance, which often focus on tertiary care, laboratory detection and surveillance. The three pillars of primary health care (community engagement, front-line health services including primary care and essential public health, and multisectoral action on wider health determinants) are central not just to Universal Health Coverage and the Sustainable Development Goals, but also to an effective response to antimicrobial resistance.
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Par ailleurs l’existence d’éléments épidémiologiques en faveur d’une sous-estimation du nombre réel de cas de COVID-19 et de l’existence d’une transmission communautaire soutenue dans une zone géographique pour lesquels les deux critères ci-dessus ne sont pas observés pourra être ...prise en compte dans la décision de l’inclure dans la liste des zones d’exposition à risque (par exemple : un taux de mortalité parmi les cas confirmés beaucoup plus élevé qu’attendu ; la détection de cas exportés depuis cette zone dans plusieurs pays ; une proportion importante des cas confirmés sans historique de voyage/séjour dans une zone d’exposition à risque ni contact identifié avec un cas confirmé de COVID-19).
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On 31st December 2019, the World Health Organization (WHO) China Country Office was informed of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China. On 7th January 2020, Chinese authorities identified a new strain of Coronavirus as the causative age...nt for the disease. The virus has been renamed by WHO as SARS-CoV-2 and the disease caused by it as COVID-19. The disease since its first detection in China has now spread to over 200 countries/territories, with reports of local transmission happening in more than 160 of these countries/territories. As per WHO (as of 1st April, 2020), there has been a total of 823626 confirmed cases and 40598 deaths due to COVID-19 worldwide.
In India, as on 2nd April, 2020, 1965 confirmed cases (including 51 foreign nationals) and 50 deaths reported from 29 States/UTs. Large number of cases has been reported from Delhi, Karnataka, Kerala, Maharashtra, Rajasthan, Tamil Nadu, Telangana and Uttar Pradesh.
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This document sets out the preparedness and response plan of the Nigerian Primary Health Care System for COVID-19 Acute Respiratory Disease. It outlines the planning scenarios, key areas of work and priority activities required for the Primary Health Care Sector to quickly scale up its core capacity... to prevent, quickly detect, characterize and efficiently respond, in a coordinated manner to the COVID-19 pandemic. These include guidelines for the setup and operationalization of COVID-19 response platforms at the national and state levels, guidelines for the provision of PHC services during the pandemic to minimize transmission in PHCs as well as guidelines for preparedness and response of PHC Centres and communities for COVID-19 case detection and response.
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Under the International Health Regulations (IHR) 2005, public health authorities at international ports, airports and ground crossings are required to establish effective contingency plans and arrangements for responding to events that may constitute a public health emergency of international concer...n and to communicate with their National IHR Focal Point about relevant public health measures.
The current outbreak of novel coronavirus (COVID-19) disease has spread across borders through travelers, conveyances, which has prompted demands for the detection and management of suspected cases at points of entry (POE), including ports, airports and ground crossings, on board conveyances.
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For COVID-19, as for many infectious diseases, the true level of transmission is frequently underestimated because a substantial proportion of people with the infection are undetected either because they are asymptomatic or have only mild symptoms and thus typically fail to present at healthcare fac...ilities. There may also be neglected or under-served segments of the population who are less likely to access healthcare or testing. Under-detection of cases may be exacerbated during an epidemic, when testing capacity may be limited and restricted to people with severe cases and priority risk groups (such as frontline healthcare workers, elderly people and people with comorbidities). Cases may also be misdiagnosed and attributed to other diseases with similar clinical presentation, such as influenza.
Differences in mortality between groups of people and countries are important proxy indicators of relative risk of death that guide policy decisions regarding scarce medical resource allocation during the ongoing COVID-19 pandemic. This document is intended to help countries estimate CFR and, if possible, IFR, as appropriately and accurately as possible, while accounting for possible biases in their estimation
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27 May 2021
This is a document to support the use of pulse oximeter for assessment of suspected and confirmed cases of Covid-19 in the community.
It is a well-known fact that Covid-19 can present as “happy hypoxia” with minimum symptoms of severe respiratory distress despite significant low ox...ygen levels in the blood. The use of pulse oximeter for clinical assessment significantly augments decision making, save lives and provide high quality care. It allows for early detection of patients with hypoxia requiring either close monitoring in the community or timely referral for hospital care.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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Countries across the world are facing diverse epidemiological situations with varying response
capacities and access to life saving tools. The World Health Organization (WHO) recommends that national authorities continue to apply a risk-based approach when implementing measures related to COVID-19... and international travel while respecting the dignity, human rights and fundamental freedoms of travellers. This approach should consider the risk posed by travel for the importation and exportation of cases in the context of the evolving epidemiology, including the emergence and circulation of virus variants of concern; the expansion of the COVID-19 vaccination roll-out; and lessons learned while responding to the pandemic, including on the early detection and management of cases and the application of public health and social measures.
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Les pays du monde entier sont confrontés à des situations épidémiologiques diverses, et disposent de capacités de réaction différentes et d’un accès inégal aux outils permettant de sauver des vies. L’Organisation mondiale de la Santé (OMS) recommande aux autorités nationales de contin...uer à appliquer une approche fondée sur les risques lorsqu’elles mettent en œuvre des mesures relatives aux voyages internationaux dans le contexte de la COVID-19, tout en respectant la dignité, les droits humains et les libertés fondamentales des voyageurs. Cette approche doit prendre en compte le risque d’importation et d’exportation de cas posé par les voyages dans le cadre de l’évolution de la situation épidémiologique, y compris de l’émergence et de la circulation de variants préoccupants du SARS-CoV-2, du déploiement de la vaccination contre la COVID-19 et des enseignements tirés de la riposte à la pandémie, notamment en ce qui concerne la détection précoce et la prise en charge des cas, ainsi que l’application de mesures sociales et de santé publique.
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3rd edition. In 2001, Uganda adapted the Integrated Disease Surveillance and Response (IDSR) developed by World Health Organization (WHO) for member states in African region. The Ministry of Health has been implementing the IDSR strategy since then with success across the country. This strategy prov...ides the opportunity for rational use of resources and maximises investments in health surveillance systems. The 3rd edition IDSR guidelines incorporates lessons learnt from previous
epidemics, new frameworks like the Global Health Security Agenda (GHSA), One Health, Disaster Risk Management (DRM), the WHO regional strategy for health security and emergencies, and the rising non-communicable diseases, and aims to strengthen implementation of IHR (2005) core surveillance and response capacities. These guidelines have been adapted to reflect national priorities, policies and public health structures; and shall be used in conjunction with other similar
guidelines/strategies or initiatives.
Overall, the 3rd edition technical guidelines will incorporate the following:
• Strengthening Indicator Based Surveillance
• Strengthening Event Based Surveillance
• Improving community-based disease surveillance
• Improving Cross Border Surveillance and response
• Scaling up e-IDSR implementation
• Improving reporting and information sharing platforms
• Improved data sharing across sectors
• Tailoring IDSR to Emergency or Disaster contexts
The 3rd edition guidelines are intended for use as:
• A general reference for surveillance activities across all levels
• A set of definitions for thresholds that trigger some action for response
• A stand-alone reference for level-specific guidelines on surveillance and response
• A resource for developing training, supervision and evaluation of surveillance activities
• A guide for improving early detection and preparedness for outbreak response.
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The course will cover the topics related to antimicrobial resistance with basic definitions and overview on antimicrobials their use and the emergence and spread of resistance. The course will guide you through the concepts and the importance of resistance spread and dissemination and how that happ...ens. It will show you how bacteria become resistant and which mechanisms they might use for this. And as part of the course you will also receive some training in methods for antimicrobial susceptibility testing (AST) and detection of specific resistance in the microbiological laboratories with the basic methods available and with focus on the obtention of good quality results which can be interpreted and used for different purposes.
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The purpose of cancer screening tests is to detect pre-cancer or early-stage cancer in asymptomatic individuals so that timely diagnosis and early treatment can be offered, where this treatment can lead to better outcomes for some people.
The aim of a cancer screening programme is either to reduc...e mortality and morbidity in a population by early detection and early treatment of a cancer (for example, breast screening) or to reduce the incidence of a cancer by identifying and treating its precursors (such as cervical and colorectal screening).
This short guide is designed to be a quick reference that contains the important ideas about cancer screening. Readers should refer to other publications for comprehensive discussion and detailed guidance on cancer screening programmes.
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In 2009, WHO’s Second International Conference on Buruli Ulcer Control and Research resolved to strengthen the capacity of national laboratories to confirm cases of the disease, but advised that “efforts are still needed to develop simple diagnostic tools usable in the field as well as disabilit...y prevention methods”.
In 2013, WHO and the Foundation for Innovative New Diagnostics convened a meeting of Buruli ulcer experts in Geneva, Switzerland (9) at which two priority unmet needs in diagnosis were identified:
a diagnostic test for early detection of Buruli ulcer in symptomatic patients with sufficient positive predictive value to put patients on appropriate treatment; and
a screening test at the primary health care or community level for symptomatic patients with ulcer
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Policy Brief November 2021 Available in English, Spanish and Portuguese
The COVID-19 pandemic has fueled the ongoing antimicrobial resistance (AMR) global crisis due to the increase in the use of antibiotics to treat COVID-19 patients, disruptions to infection prevention and control practices in o...verwhelmed health systems, and diversion of human and financial resources away from monitoring and responding to AMR threats. Moreover, AMR is likely to have caused more COVID-19 deaths, as secondary bacterial infections can worsen the outcome of severe and critical COVID-19 illness. Therefore, it is more urgent than ever to prioritize efforts towards AMR containment and support countries to improve the detection, characterization and rapid response to emerging AMR.
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