Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Men lag behind women regarding use of HIV services and represent the majority of individuals living with uncontrolled HIV, advanced HIV, and who experience HIV-related mortality. Men (15+) globally are less likely than women (15+) to know their HIV status (83% for men vs 91% for women), be on antire...troviral treatment (ART) (72% for men vs 83% for women) and reach viral suppression (67% for men vs 78% for women).
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This concept note describes the methods used to assess the prevalence of any HIVDR and HIVDR by PMTCT exposure among children less than 18 months of age using remnant dried blood spot specimens from early infant diagnosis over a 12-month period
Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal care (“same-day” initiation...). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133
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On 3 October 2016, Category 4 Hurricane Matthew cut a path of destruction across the Republic of Haiti. Its devastating winds and heavy rainfall caused widespread damage in the southwest of the country. The most affected departments are Grande-Anse, Sud, Sud-Est and Nippes. The death toll in the cou...ntry is rising to at least 473 and cholera is spreading.
A Flash Appeal was launched on 10 October to provide immediate support to 750 000 affected people for the next three months. Within this framework, the Food and Agriculture Organization of the United Nations (FAO) requires USD 9 million to provide immediate crop, livestock and fisheries support to 300 000 hurricane-affected people.
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BMJ Open2018;8:e020423. doi:10.1136/bmjopen-2017-02042
EC has been increasingly used in the evaluation of maternal and child health programmes.12–15 For instance, Nesbitt et al compared crude coverage and EC of pregnant women with facility-based obstetric services in Ghana and estimated that alth...ough 68% of the women studied had service access only 18% received high-quality care provided by a skilled birth attendant.16 Similarly, by comparing EC of young children receiving Strengths and limitation of this study. Using multiple data sources (direct observation, vignettes, facility inventories) this study comprehensively assessed under 5-year-old child service
performance of first-line health facilities. We conducted this study in around 500 primary-level health facilities and within 7000 households
across six regions in Burkina Faso.
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This report provides an overview of the main findings of the 2019–2020 harmonised AMR monitoring in the main food-producing animal populations monitored, in carcase/meat samples and in humans. Where available, monitoring data obtained from pigs, calves, broilers, laying hens and turkeys, as well a...s from carcase/meat samples and humans were combined and compared at the EU level, with particular emphasis on multidrug resistance, complete susceptibility and combined resistance patterns to critically important antimicrobials, as well as Salmonella and E. coli isolates possessing ESBL-/AmpC-/carbapenemase phenotypes.
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Physical distancing measures are important to reduce COVID-19 transmission. However, when stringently applied, they can result in negative health and socio-economic impacts. This report draws on a rapid review of available literature, case studies from across Africa and expert knowledge to make reco...mmendations on adapting classic physical distancing measures to the contextual realities in Africa and on mitigating potential negative impacts.
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The CBDRR Manual is a practical ‘how-to’ guide on community-based disaster risk reduction for government and non-government agencies in Lao PDR. It is a commonly agreed document to be referred to by agencies working on CBDRR in Lao PDR. It provides guidance and support for systematic implementat...ion of CBDRR programs by explaining each of the steps as well as tools used.
The manual will also support the Government of Lao PDR (GoL) to monitor CBDRR activities, oversee progress of activities implemented by different actors and locations, provide necessary support on CBDRR technical knowledge as well as provide a reference point for replication of initiatives for local government and implementing agencies.
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Working Document, September 2017
Arq Neuropsiquiatr 2011;69(2-B):342-348
Accessed: 02.05.2020
These consolidated guidelines provide recommendations for comprehensive prevention and case management strategies in Kenya
Scope of the Guidelines: Infection prevention and control Patient triage Emergency Medical Services Case management Laboratory testing algorithm
Target... Audience: Health care workers taking care of patients suspected or confirmed to have COVID-19
These guidelines combine both preventive and clinical management of the disease in Kenyan context. The protocol borrows various international recommendations including the World Health Organization, from experience of other countries such as China that has struggled with the outbreak for a longer time and from principles of virology and infectious disease management.
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