The COVID-19 pandemic has put significant pressure on health systems all around the world. The drastic measures established to contain its spread are creating serious impediments to economic activity (including agrifood systems) and, consequently, to livelihoods and food security and nutrition.
Lymphatic filariasis: managing morbidity and preventing disability: an aide-mémoire for national programme managers, second edition: web annex A: protocol for evaluating minimum package of care of morbidity management and disability prevention for lymphoedema management in designated health facilit...ies.
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This manual provides a framework for morbidity management and disability prevention of patients affected by NIDs and gives specific guidance for the proper care of patients suffering from chronic conditions caused by lymphatic filariasis, leprosy, trachoma, and Chagas disease. It is intended to be u...sed mainly by health care workers at the primary health care level, but health workers at more complex and specialized levels may also find it useful.
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Manuel destiné au personnel de santé. Le présent manuel est un guide spécialisé sur les techniques et les méthodes de laboratoire à utiliser pour le diagnostic de l’ulcère de Buruli, une maladie provoquée par Mycobacterium ulcerans. Destiné aux techniciens et aux scientifi ques de labora...toire travaillant sur cette maladie, le présent manuel décrit les méthodes exactes à mettre en oeuvre pour réaliser un certain nombre de tests diagnostiques. Les procédures recommandées, utilisables dans l’ensemble du système de santé, sont adaptées aux services périphériques, des districts et centraux et ce, conformément aux ressources, compétences et matériel variables que l’on trouve classiquement dans les pays où l’ulcère de Buruli est endémique.
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A manual for health care providers.
This manual provides expert guidance on the laboratory techniques and procedures used in the diagnosis of Buruli ulcer, a disease caused by Mycobacterium ulcerans. Aimed at laboratory technicians and scientists working on this disease, the manual details the exac...t procedures to follow when performing a range of diagnostic tests. Recommended procedures, intended for use throughout the health system, are presented at levels appropriate for peripheral, district and central services and in accordance with the varying resources, skills and equipment typically found in countries where Buruli ulcer is endemic.
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Current Tropical Medicine Reports (2018) 5:247–256 https://doi.org/10.1007/s40475-018-0166-2 .Purpose of the Review Buruli ulcer (BU) is a necrotizing and disabling cutaneous disease caused by Mycobacterium ulcerans, one of the skin-related neglected tropical diseases (skin NTDs). This article aim...s to review the current knowledge of this disease and challenges ahead.
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The World Health Organization (WHO) convened a meeting of the Technical Advisory Group on Buruli ulcer at its headquarters in Geneva, Switzerland on 25 to 27 March 2019
Au total, 18 laboratoires de 13 pays ont participé aux quatre cycles d'AQE : 10 laboratoires de huit pays africains endémiques, dont quatre ont participé aux quatre cycles et trois à trois cycles. Les résultats globaux ont montré que la performance médiane de ces laboratoires s'est amélioré...e au cours des quatre cycles. Cependant, la proportion de laboratoires rapportant des cas faussement positifs reste élevée et indique un problème de spécificité probablement dû à une contamination. La proportion de laboratoires rapportant à la fois des résultats faussement positifs et faussement négatifs soulève la question de la qualité des données rapportées par l'OMS en Afrique ainsi que des résultats des études menées dans ces différents laboratoires dans divers pays.
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A total of 18 laboratories from 13 countries participated in the four rounds of EQA: 10 laboratories from eight African endemic countries, four of which participated in all four rounds and three in three rounds. The overall results showed that the median performance of these laboratories improved ov...er the four rounds. However, the proportion of laboratories reporting false–positive cases remains high and indicates a problem of specificity probably due to contamination. The proportion of laboratories reporting both false–positive and false–negative results raises the issue of the quality of the data reported by WHO in Africa as well as the results of the studies carried out in these different laboratories in various countries.
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The meeting was held from 26 to 27 March 2018 to review and discuss the following topics:
Advances and challenges in the use of fTLC, and new approaches to detecting mycolactone using monoclonal antibodies (mAbs).
The status of development of rapid diagnostic tests (RDTs) targeting the M...UL_3720 protein.
The role of PCR as a reference test, and hurdles in providing a confirmatory diagnosis and in establishing a quality assurance programme.
New molecular tools with potential for implementation at a level lower than in the national or regional reference laboratory, such as loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA).
The need to harmonize and standardize methods for collection and preparation of specimens, so samples can be referred for diagnosis and stored for evaluation of new diagnostic tests in optimal conditions.
Barriers to accessing early diagnosis and treatment, including coordination at the programme level, and lack of adequate diagnostic tools.
Defining target product profiles (TPPs) to guide the development of new diagnostic tools that can be applied at different levels of the health system. Participants agreed that two TPPs would be developed to address the current gaps: (i) a rapid test for BU diagnosis at the primary health-care level; and (ii) a test for diagnosis of BU that can also assist in treatment monitoring and differential diagnosis at the district hospital or reference centre.
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PLoS Negl Trop Dis 5(6): e1187. doi:10.1371/journal.pntd.0001187. Buruli ulcer (BU), caused by Mycobacterium ulcerans infection, is a debilitating disease of the skin and underlying tissue which starts as a painless nodule, oedema or plaque and could develop into painful and massive ulcers if left u...ntreated. Using a combination of quantitative and qualitative methods, the study assessed the effectiveness of the BUPaT programme to improve early detection and management of BU in an endemic area in Ghana.
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L’ulcère de Buruli, une infection causée par Mycobacterium ulcerans, touche plus de 33 pays dans le monde, mais un peu moins de la moitié seulement de ces pays communiquent régulièrement des données sur la maladie à l’OMS. La plupart des cas notifiés se trouvent dans les sous-régions d...Afrique occi-
dentale et centrale. Le mode de transmission de l’ulcère de Buruli n’est pas connu. Environ la moitié des personnes touchées sont des enfants de moins de 15 ans et les deux sexes sont concernés à parts égales.
Le diagnostic repose principalement sur l’observation des caractéristiques cliniques et épidémiologiques.
Parmi les quatre méthodes de confirmation utilisées (examen microscopique, amplification en chaîne par polymérase (PCR), histopathologie et mise en culture), la PCR est la plus rapide et la plus courament employée. D’autres méthodes rapides, comme l’utilisation de la chromatographie sur couche mince par fluorescence pour détecter la mycolactone dans les lésions des cas suspects d’ulcère de Buruli, sont actuellement à l’étude dans quatre pays d’Afrique. Des travaux de recherche sont en cours pour mettre au
point des tests utilisables sur le lieu des soins. Le traitement de l’ulcère de Buruli consiste à administrer une association d’antibiotiques (rifampicine et clarithromycine) pendant 8 semaines. Des traitements complémentaires, comme le soin des plaies, les greffes cutanées et la prévention des incapacités, sont nécessaires dans certains cas pour parvenir à une guérison complète.
La cible fixée par l’Organisation mondiale de la Santé (OMS) exigée des pays pour assurer la lutte contre l’ulcère de Buruli est la confirmation d’au moins 70 % des cas par PCR pour chaque pays. Tous les pays d’endémie disposent d’au moins un établissement doté des moyens nécessaires pour effectuer les tests de PCR pour la confirmation des cas. Cependant, la plupart des pays de la Région africaine n’ont pas réussi à atteindre la cible fixée. Un déclin du taux de confirmation a même été observé.
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Buruli ulcer is caused by infection with Mycobacterium ulcerans. The disease is reported in more than 33 countries worldwide, but only about half of these countries regularly report data to WHO; most cases are reported from subregions of West and Central Africa. The mode of transmission is not known....
About half of those affected are children aged under 15 years; there is no gender difference. Diagnosis is based mainly on clinical and epidemiological characteristics. Of the four methods used for laboratory confirmation (microscopy, polymerase chain reaction (PCR), histopathology and culture), PCR is the most rapid and widely used. Other rapid methods for detection of mycolactone in lesions from suspected cases, such as fluorescent thin-layer chromatography, are under evaluation in four countries in Africa.
Research to develop point-of-care tests is in progress. Treatment of Buruli ulcer comprises 8 weeks of combined antibiotics (rifampicin and clarithromycin). Complementary therapies such as wound care, skin graft and prevention of disability are needed in some cases to ensure full recovery.
The target set by the World Health Organization (WHO) for control of Buruli ulcer is for countries to achieve a rate of case confirmation by PCR of at least 70%. All endemic countries have at least one PCR facility to support confirmation of cases. However, most countries in the WHO African Region have not been able to reach the target, and the rate of case confirmation has been declining
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Monitoring financial protection and utilization of health services in Mongolia 2009-2018 is based on national representative household socioeconomic surveys. The study finds that between 2009 and 2018, despite ambitious health reforms, the incidence of catastrophic health spending and impoverishing ...spending at the relative poverty line have increased. These increases were mainly driven by out-of-pocket spending on medicines and inpatient care. In the same period, inequity in access to and utilization of health services remained constant among population groups. Evidence suggests health financing policies need to be further strengthened to make progress towards universal health coverage. Continuous tracking of out-of-pocket payments and service utilization to inform policymaking is needed.
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Maintaining proper storage conditions for health commodities is vital to ensuring their quality. Product expiration dates are based on ideal storage conditions and protecting product quality until their expiration date is important for serving customers and conserving resources. Guidelines for the S...torage of Essential Medicines and Other Health Commodities is a practical reference for those managing or involved in setting up a storeroom or warehouse. The guide contains written directions and clear illustrations on receiving and arranging commodities; special storage conditions; tracking commodities; maintaining the quality of the products; constructing and designing a medical store; waste management; and resources. It was written to meet the needs of district-level facilities; however, the guidelines and information it contains apply to any storage facility, of any size, in any type of environment.
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The harmful use of alcohol causes approximately 3 million deaths every year and the overall burden of disease and injuries attributable to alcohol consumption remains unacceptably high. The pace of development and implementation of alcohol policies has been uneven in WHO regions, and resources and c...apacities for implementation of the WHO Global strategy to reduce the harmful use of alcohol 10 years after its endorsement do not correspond to the magnitude of the problems. On this basis, the WHO Executive Board in its decision EB146 (14) called for accelerated action to reduce the harmful use of alcohol.
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This manual is to assist health care providers and laboratory scientists to diagnose mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the clinical presentation and its diagnosis. The methods described are tailored to various levels of care and avail...able resources to improve the diagnosis and surveillance of the disease.
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