First Edition, July 2009
Trainers’ Manual
Le Ministère de la Santé (MS), dans le cadre de la démarche qualité au niveau du secteur, s’est engagé depuis quelques années dans la normalisation des activités par l’élaboration et la mise en place de documents normatifs. C’est le cas du présent document de politique, normes et proc...édures en matière de prise en charge des Personnes Vivant avec le VIH (PVVIH).
L’impact socio-économique et sanitaire du VIH/Sida fait désormais de cette affection, tant un problème de santé publique qu’un problème de développement. C’est donc pour ne pas laisser les personnes infectées en marge du développement de notre pays, que leur prise en charge a été identifiée comme domaine de prestation de service avec des directives nationales de prise en charge des PVVIH diffusées.
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The 20th century was a period of unprecedented ecological change, with dramatic reductions in natural ecosystems and biodiversity and equally dramatic increases in people and domestic animals. Never before have so many animals been kept by so many people—and never before have so many opportunities... existed for pathogens to pass from wild and domestic animals through the biophysical environment to affect people causing zoonotic diseases or zoonoses. The result has been a worldwide increase in emerging zoonotic
diseases, outbreaks of epidemic zoonoses as well as a rise in foodborne zoonoses globally, and a troubling persistence of neglected zoonotic diseases in poor countries.
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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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