The objective of the study was the validation and implementation of GeneXpert MTB/RIF for routine use in the rapid detection of tuberculosis and sensitivity to rifampicin in clinical samples; for this, 1592 respiratory samples were collected and analyzed in the laboratory of Instituto Nacional de In...vestigación en Salud Pública Guayaquil. The analysis of the results of GeneXpert in comparison with smear microscopy showed an initial sensitivity of 99.8% and specificity of 93.2%; The analysis of discrepancies using the results of the culture as a reference method showed that the GeneXpert results considered false negatives turned out to be true negatives, the same happens with the false positives that correspond to true positives. Recalculated the sensitivity and specificity of the GeneXpert was 99.8% and 100% correspondingly. The comparison with the drugs susceptibility test showed a sensitivity of 91.4% and a specificity of 95.5% for the GeneXpert MTB/RIF system. It is concluded that the implementation of the GeneXpert system allows solution to certain problems associated with the application of conventional diagnostic methodologies, decreasing the waiting times, and increasing the sensitivity and specificity in the diagnosis of drug-resistant tuberculosis, thus generating a valuable opportunity for early diagnosis.
more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
Les infections au SRAS-CoV-2 chez les enfants et les adolescents provoquent une maladie moins grave et moins de décès que chez les adultes. Bien qu'une évolution moins grave de l'infection soit un résultat positif, on s'inquiète du fait que des symptômes légers aient pu conduire à moins de t...ests, ce qui a entraîné un nombre moins important de cas identifiés de COVID-19 chez les enfants. Si les enfants présentant des symptômes légers ou inexistants transmettent la maladie, ils peuvent agir comme des vecteurs de transmission au sein de leur communauté. Il est essentiel de comprendre les symptômes, l'infectivité et les modes de transmission du SRAS-CoV-2 chez les enfants et les adolescents pour développer, adapter et améliorer les mesures de contrôle du COVID-19 à tous les âges. Ce document est un résumé des connaissances actuelles concernant l'acquisition et la transmission de l'infection par le SRAS-CoV-2 et les symptômes de la maladie COVID-19 chez les enfants et les adolescents. Il vise à éclairer les décisions, en fonction des contextes locaux, sur la meilleure façon de maintenir ouvertes les écoles, les jardins d'enfants et les crèches et sur les conseils à appliquer en matière de mixité intergénérationnelle.
more
Climate change triggers mounting food insecurity, poverty and displacement in Africa
The EAPC White Paper addresses the issue of spiritual care education for all palliative care
professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and educati...on; as well as national and local curricula development groups.
The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care. The revised spiritual care education competencies for all palliative care providers are accompanied by the best practice models and research evidence, at the same time being sensitive towards different develop-ment stages of the palliative care services across the European region.
Conclusions: Better education can help the healthcare practitioner to avoid being distracted by their own fears, prejudices, and restraints and attend to the patient and his/her family. This EAPC white paper encourages and facilitates high quality, multi-disciplinary, academically and financially accessible spiritual care education to all
palliative care staff.
more
In 2015, to advance the global and national response to antimicrobial resistance (AMR), the World Health Assembly issued resolution WHA68.7 calling for all Member States to develop AMR national action plans that address the five objectives of the World Health Organization Global Action Plan (GAP) by... May 2017. The WHO GAP provides a framework to support countries in developing their national action plans on AMR. To operationalize and accelerate implementation of national action plans on AMR, WHO has developed a costing and budgeting tool and accompanying user guide. The purpose is to support countries in costing prioritized activities of an operational plan linked to their AMR national action plan, and identify existing funding and funding gaps to promote resource mobilization and sustainable implementation. The target audience of the publication are national policy makers and designated costing coordinators for national action plans on AMR.
more
As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness,... equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
more
La détection directe des protéines virales du SRAS-CoV-2 (antigènes) dans les écouvillons nasaux et autres sécrétions respiratoires à l'aide de tests immunologiques à flux latéral (également appelés tests de diagnostic rapide, TDR) offre une méthode plus rapide et moins coûteuse pour te...ster le SRAS-CoV-2 que la méthode de référence, les tests d'amplification des acides nucléiques (TAAN). Ces lignes directrices provisoires offrent des recommandations sur les utilisations prioritaires des tests de diagnostic rapide à détection d'antigène (TDR-Ag) dans des populations et des contextes spécifiques, notamment (i) pour la détection primaire des cas chez les personnes symptomatiques suspectées d'être infectées et les personnes asymptomatiques à haut risque de COVID-19, (ii) pour la recherche des contacts, (iii) pendant les enquêtes sur les épidémies et (iv) pour surveiller les tendances de l'incidence de la maladie dans les communautés. Les TDR-AG répondant aux exigences minimales de performance peuvent être utilisés en dehors des milieux cliniques et des laboratoires, y compris dans les communautés, par des opérateurs formés conformément aux instructions. Le guide fournit en outre des recommandations sur la mise en œuvre, la sélection des produits et le stockage
more
Multizentrische Analyse des Erkrankungsspektrums und der Versorgungsqualität anhand dezentralisierter Routinedaten des Verbunds PriCarenet
Health Equity Studies & Migration Report Series 2021-03
Ein Positionspapier des bundesweiten Netzwerks Flucht, Migration und Behinderung
Der extrem umfangreich recherchierte und lesenswerte IPPNW-Report beleuchtet die gesund-heitlichen und humanitären Folgen der deutschen Abschiebepraxis der vergangenen Jahre. Die Publikation soll zudem gezielt Wissen vermitteln, wie Gutachten besser verfasst werden kön-nen und welche Erfahrungen d...ie Ärzt*innen gesammelt haben im Zusammenhang mit Abschiebungen.
more
The United Nations Commission on Life-Saving Commodities (UNCLSC, 2012) defined 13 health products to end preventable deaths of woman and children. One of those 13 products is the neonatal resuscitator, is indispensable medical device to save newborns from asphyxia at birth. For the efficient use of... neonatal resuscitation, training of healthcare professionals using neonatal resuscitation manikins is the most effective approach. Critical lifesaving trainings calls for the need of neonatal resuscitation manikins with the right features.
The purpose of the WHO Neonatal resuscitation manikin: technical specifications is to provide a minimum standard baseline to meet the increasing demand to procure good quality, affordable, accessible, and appropriate neonatal resuscitation manikins. Towards the development of this baseline, this document includes compilation of available scientific evidence from technical literature, international publications, expert reviews, and an industry survey which was conducted by WHO medical devices team.
more
Guidelines on optimising oxygen use and ventilatory support in critically ill patients with COVID-19 (updated on 11/06/2021)
Coronavirus Clinical Management Protocol (COVID-19) in Primary Health Care (Version 7)
SBMFC Recommendations for PHC during the Pandemic of COVID-19 (edition 4)
This document answers questions and gives recommendations so that the Brazilian PHC can quickly receive the best possible scientific synthesis on the current situation of the pandemic of COVID-19
Healthy communities rely on well-functioning ecosystems. They provide clean air, fresh water, medicines and food security. They also limit disease and stabilize the climate. But biodiversity loss is happening at unprecedented rates, impacting human health worldwide, according to a new state of knowl...edge review of the Convention on Biological Diversity (CBD) and WHO.
The report synthesizes the available information on the most important inter-linkages between biodiversity, ecosystem stability, and epidemic infectious diseases such as the Ebola virus; and the connection between biodiversity, nutritional diversity and health. It also covers the potential benefits of closer partnerships between conservation and health, from improved surveillance of infectious diseases in wildlife and human populations, to promoting access to green spaces to promote physical activity and mental health. It also highlights the many areas in which further research is needed.
The Joint report hopes to provide a useful reference for the Sustainable Development Goals and post-2015 development agenda, which represents an unique opportunity to promote integrated approaches to biodiversity and health by highlighting that biodiversity contributes to human well-being, and highlighting that biodiversity needs protection for development to be sustainable.
more