À l’heure où des techniques innovantes de dépistage sur le lieu de soins (POC) sont mises sur le marché, le présent rapport soumet à l’attention des gouvernements un examen des principaux aspects relatifs à leur introduction et à leur extension au sein des programmes publics nationaux. L...’élargissement de la portée de cette stratégie aux réseaux nationaux de dépistage des laboratoires conventionnels contribuerait à la réalisation des objectifs d’accélération de la riposte visant à mettre fin à l’épidémie de sida d’ici à 2030.
Le dépistage sur le lieu de soins, lorsqu’il est stratégiquement mis en place et intégré dans les réseaux nationaux de dépistage, peut contribuer à promouvoir des changements et à améliorer la prestation des services cliniques et de dépistage. Le présent document s’inspire de l’expérience acquise en matière d’introduction, par le biais de financements catalysateurs, de techniques de dépistage sur le lieu de soin dans les programmes et les marchés de nombreux pays d’Afrique subsaharienne pour défendre ce point de vue.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline... is available both online and PDF.
This version of the living guideline (version 6.0) includes fifteen statements on IPC measures in health-care settings (screening and patient placement, ventilation, physical barriers, environmental cleaning, waste management, amongst others) as well as one statement on mask fit in the community context.
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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility of measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by hig...h disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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In April 2020, Gavi and COVAX joined the Access to COVID-19 Tools Accelerator (ACT-A) to provide equitable global access to COVID-19 vaccines to tackle the pandemic. In June 2020, the Gavi COVAX Advance Market Commitment (AMC) was launched to finance equitable access in 92 lower-income countries. Si...nce then, US$ 10 billion has been raised for the AMC to procure vaccines and support delivery. Despite a challenging supply situation, COVAX has now shipped one billion doses to 144 countries, including over 870 million to AMC economies.
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The ethical governance of research assumes the existence of a national entity (or subnational if applicable, according to the constitution of a country) in charge of supervising the research ethics committees (RECs) that review and monitor research with human beings. This supervision includes the ac...creditation of the RECs that authorize them to operate in the jurisdiction in question. This tool has the objective of facilitating the work of accreditation of RECs and ensuring that it is carried out in accordance with international ethical standards.
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This technical report has been developed within the framework of the WHO Global Initiative for
Childhood Cancer. Its goal is to improve the situation of children and adolescents with cancer worldwide,
giving them the best chances of survival, living a full life and, above all, enjoying quality of ...life and dying
without suffering
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Vaccines are powerful weapons in the fight against pandemic viruses as shown by responses to both the 2009 H1N1 influenza and the COVID-19 pandemics. However, planning for accessing, allocating and deploying vaccines in a pandemic situation is a complex endeavour, beset with multiple challenges at a...ll levels – local, regional and global. The World Health Organization (WHO) and its partners have prepared this revised guidance document to assist countries update their national deployment and vaccination plans (NDVPs) by leveraging global learnings from past pandemic responses, including the recent COVID-19 vaccination effort. The development and testing of a NDVP would not only advance pandemic preparedness efforts but would also have benefits in terms of increasing national capabilities to manage other health emergencies which require emergency vaccination campaigns.
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This WHO laboratory manual provides the most up to date methods and procedures for the laboratory identification of yellow fever virus infection in humans. It provides guidance on the establishment and maintenance of an effective laboratory providing routine surveillance testing for yellow fever, wh...ich operates within the WHO coordinated Global Yellow Fever Laboratory Network (GYFLaN) capable of providing confirmation of yellow fever infection reliably and timely. This second edition supersedes the first edition of the 2004 WHO manual for the monitoring of yellow fever virus infection.
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The ERF provides WHO staff with essential guidance on how the Organization manages the assessment, grading and response to public health events and emergencies with health consequences, in support of Member States and affected communities. The ERF adopts an all-hazards approach and it is therefore a...pplicable in all acute public health events and emergencies.
This version (2024) of the WHO ERF has been developed following extensive consultation across the three levels of the Organization and response experiences over the last five years of emergency response. Key areas have been updated to improve the accountability, predictability, timeliness and effectiveness of WHO’s response to emergencies.
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Anaemia is a serious global public health problem that particularly affects young children, menstruating adolescent girls and women, and pregnant and postpartum women. It is a condition in which the number of red blood cells or the haemoglobin concentration within them is lower than normal, affectin...g the blood’s ability to carry oxygen to the body’s tissues.
To reliably monitor the prevalence of anaemia at a population level, it is vital to measure the haemoglobin concentration in an accurate and precise way. In large-scale surveys, however, haemoglobin is most commonly measured using single-drop capillary blood specimens in point-of-care devices. Emerging evidence suggests that the use of single-drop capillary blood can introduce random and/or systematic errors, which may lead to inaccurate estimates, complicating effective anaemia programming.
This technical brief describes the current best practices for haemoglobin measurement, providing guidance to help plan or implement field surveys to assess anaemia at a population level. Continuing work to review emerging evidence is led by members of the WHO-UNICEF Technical Expert Advisory group on nutrition Monitoring (TEAM).
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One of the main aims of the WHO Global Initiative for Childhood Cancer and the CureAll Americas framework is to strengthen centers of excellence and promote the training of the health workforce, especially pediatric oncology nurses, specialized in nursing care for children and adolescents with cance...r and their families. These health personnel provide compassionate, non traumatic, complex, continuous, ethical, conscious patient- and family-centered care in order to meet the physical, emotional, psychosocial, and cultural needs of the people involved. This publication is aimed at health administration teams, hospital management teams, and professional pediatric oncology nursing groups. Its objective is to identify, systematize, and consolidate available evidence on the scope of pediatric oncology nursing practice in Latin America and the Caribbean based on core competencies, in order to incorporate them into clinical practice, teaching, and research. The preparation process included a systematic review aimed at finding the best evidence on this subject. Patient- and family centered care and the conceptual model of competencies for teenagers and young adults with cancer, developed by the Teenage Cancer Trust with the support of the Royal College of Nursing, were the theoretical foundations supporting the systematization of recommendations.
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Since 2016, the Pan American Health Organization (PAHO) has been promoting the implementation of the HEARTS Initiative in the Americas as a regional adaptation of the World Health Organization's Global HEARTS Initiative. During this time, 33 countries in the Region of the Americas have committed to ...implementing HEARTS, and PAHO has developed many technical resources to support them. Most of these resources are clinical tools for primary healthcare teams and focus on quality improvement. This compendium aims to group all these clinical tools in a single document under a simple format that facilitates their practical implementation in daily clinical practice. The reader will notice that each tool is summarized on a single page and presented in a modular format. Therefore, each tool can be used together or separately as needed. In addition, at the bottom of each tool, the reader will find the references and hyperlinks to access full texts in case deeper knowledge is required.
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Smallpox eradication was certified in 1980. Mpox has been endemic in Central and West African countries since it was first detected in 1958 . It is a zoonosis; cases are often found close to tropical rainforests where various animals carry the orthopoxvirus that causes the disease. In endemic countr...ies, most mpox infections in humans result from a primary animal-to-human transmission. Human-to-human transmission can result from close contact with respiratory secretions, skin lesions of an infected person, or recently contaminated objects. Transmission can also occur via the placenta from mother to fetus or through close contact during and after birth.
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A erradicação da varíola humana (mpox em inglês) foi certificada em 1980. A varíola símia (mpox em inglês) é endêmica nos países da África Central e Ocidental desde a sua primeira detecção, em 1958. Trata-se de uma zoonose cujos casos geralmente ocorrem perto de florestas tropicais, ond...e diversos animais são portadores do ortopoxvírus causador da doença. A maioria das infecções em seres humanos pelo vírus da varíola símia em países onde a doença é endêmica é resultado de transmissão primária de animais para humanos. A transmissão de pessoa a pessoa pode ocorrer por meio de contato próximo com secreções respiratórias ou lesões cutâneas de uma pessoa infectada ou com objetos recém-contaminados. A transmissão também pode ocorrer através da placenta da mãe para o feto ou por contato direto durante ou após o parto. Até 21 de maio de 2022, 12 países onde não há varíola símia endêmica, em 2 regiões da Organização Mundial da Saúde (OMS), haviam notificado 92 casos confirmados da doença. Até 26 de agosto de 2022, 96 países sem endemicidade, de todas as 6 regiões da OMS, haviam notificado 45.198 casos confirmados de varíola símia, incluindo 6 óbitos. No mesmo período, os países onde a doença é endêmica notificaram 350 casos confirmados e 6 óbitos. Na Região das Américas, 29 países e territórios notificaram 23.479 (48%) casos confirmados e 3 óbitos. Diversos estudos observacionais sobre as vacinas de primeira geração demonstraram que a eficácia da vacinação contra a varíola humana na prevenção da varíola símia é de aproximadamente 85%. Atualmente, as vacinas originais (de primeira geração) contra a varíola humana não estão mais disponíveis.
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El 23 de julio del 2022, el Director General de la OMS declaró el brote de viruela símica una emergencia de salud pública de importancia internacional. A raíz de esa declaración, se puso en marcha un dispositivo de respuesta coordinada con el objeto de interrumpir la transmisión y proteger a l...os grupos en situación de vulnerabilidad. En estas orientaciones se tratan diferentes aspectos relativos al uso de vacunas para respaldar las intervenciones primarias de salud púbica en la respuesta para detener la trasmisión de persona a persona. Tienen como propósito brindar información útil y accesible acerca de las vacunas contra la viruela símica a fin de facilitar el despliegue de estrategias de prevención adaptadas a la situación epidemiológica, con base en las recomendaciones de la VIII Reunión ad hoc del Grupo Técnico Asesor de la OPS sobre Enfermedades Prevenibles por Vacunación.
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