Over a period of two decades, under-5 mortality rate in Bangladesh has declined by 66% from 133 per 1000 live births in 1993-94 to 45 per 1000 live births in 2017-18. The country reached the MDG-4 goal in the reduction of child mortality on time. However, the comparison of neonatal and under-5 morta...lity rates in Bangladesh over the same years reveals that the reduction in the neonatal mortality rate was much slower than the child mortality rate. This led to a rise in the proportion of neonatal deaths in overall under-five deaths from 40% in 1993-1994 to 67% percent in 2017-2018. More than 75% of neonatal deaths occur within the first 7 days. To achieve SDG target 3.2, Bangladesh has to further reduce under-5 mortality rate by 44% and newborn deaths by 60%. Infection is the leading cause of preventable deaths among the neonates and the young infants and the standard recommendations for treating severe bacterial infections in infants under 2 months of age include hospitalization and 7-10 days of parenteral therapy.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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EID Journal , Volume 27, no.12 , Dec. 2021. Early Release
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections may be underestimated because of limited access to testing. We measured SARS-CoV-2 seroprevalence in South Africa every 2 months during July 2020–March 2021 in randoml...y selected household cohorts in 2 communities. We compared seroprevalence to reported laboratory-confirmed infections, hospitalizations, and deaths to calculate infection–case, infection–hospitalization, and infection–fatality ratios in 2 waves of infection. Post–second wave seroprevalence ranged from 18% in the rural community children <5 years of age, to 59% in urban community adults 35–59 years of age. The second wave saw a shift in age distribution of case-patients in the urban community (from persons 35–59 years of age to persons at the extremes of age), higher attack rates in the rural community, and a higher infection–fatality ratio in the urban community. Approximately 95% of SARS-CoV-2 infections were not reported to national surveillance.
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21 July 2022. The Rapid Core CRF is designed to collect data obtained through examination, interview and review of
hospital or clinic notes of patients with suspected, probable, or confirmed monkeypox infection. Data
may be collected prospectively or retrospectively. The data collection period is ...defined as the period
from hospital admission or first clinic visit to discharge from care, transfer, death, or continued
hospitalization without possibility of continued data collection.
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Over 90% of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) and asthma occurs in low-income and middle-income countries (LMICs) due to well documented factors including decreased access to screening, trained health professionals, and therapies for disease manageme...nt. Inhaler therapy (eg, aerosolised medications by inhalation, nebulisation, or propellant) is the mainstay of treatment for COPD and asthma. Adherence to maintenance medications for COPD and asthma results in improved lung function and quality of life, as well as decreased hospitalisation and mortality. WHO have included short-acting beta-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids on the essential medications list, with a target goal of achieving 80% availability of these medications in public and private facilities. However, despite these efforts, accessibility, and affordability of medications for COPD and asthma remains scarce.
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Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious diseases is greater and exacerbated by limited access to, and availability and affordability of, antimicrobials required to treat infect...ions caused by AMR organisms. With drugs not listed on the essential drugs list (EDL), problems of increased morbidity, costs of extended hospitalisation and mortality are extremely serious. The problem of susceptibility to and spread of infections caused by multidrug-resistant (MDR) infectious agents is fuelled by factors such as limited access to clean water and sanitation to ensure personal hygiene, malnutrition, and the HIV/TB epidemic.
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La sécurité des patients est un principe fondamental des soins de santé. Plusieurs pays à revenu élevé ont publié des études montrant que les soins de santé causent des préjudices à un grand nombre de patients, et que ces préjudices peuvent entraîner des séquelles durables, des durées... d’hospitalisation plus longues, voire la mort
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Le paludisme, appelé également malaria, ou « Mal‘aria », ce qui signifie « mauvais air
», est une maladie qui menace 3 milliards de personnes dans 99 pays dans le monde.1
Les personnes les plus vulnérables sont les jeunes enfants et les femmes enceintes,
car c’est parmi cette populatio...n que le risque de décès est le plus élevé.2
Au Bénin, le paludisme représente environ 41% des motifs de recours aux soins et
première cause de consultation, d’hospitalisation et de décès parmi la population en 2012
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Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa...ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources... and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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22 Dec 2021: El oxígeno está incluido dentro de la lista de medicamentos esenciales de la OMS y es utilizado para atender pacientes en todos los niveles de las redes integradas de servicios de salud. Dado que la eficacia del uso de oxígeno ya está probada en el tratamiento de pacientes con afecc...iones respiratorias provocadas por la COVID-19, existe una gran oportunidad para mejorar la efectividad promoviendo su uso de una manera racional, sostenible y segura.
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El oxígeno está incluido dentro de la lista de medicamentos esenciales de la OMS y es utilizado para atender pacientes en todos los niveles de las redes integradas de servicios de salud. Dado que la eficacia del uso de oxígeno ya está probada en el tratamiento de pacientes con afecciones respira...torias provocadas por la COVID-19, existe una gran oportunidad para mejorar la efectividad promoviendo su uso de una manera racional, sostenible y segura.
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Good primary care may lead to fewer avoidable hospitalizations, but unsafe primary care can cause avoidable illness and injury, leading to unnecessary hospitalizations, and in some cases, disability and even death.Implementing system changes and practices are crucial to improve safety at all levels ...of health care. Recognizing the paucity of accessible information on primary care, World Health Organization (WHO) set up a Safer Primary Care Expert Working Group. The Working Group reviewed the literature, prioritized areas in need of further research and compiled a set of nine monographs which cover selected priority technical topics. WHO is publishing this technical series to make the work of these distinguished experts available to everyone with an interest in Safer Primary Care.The aim of this technical series is to provide a compendium of information on key issues that can impact safety in the provision of primary health care.
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Avec l’augmentation soudaine du nombre d’hospitalisations causées par la pandémie de COVID-19 en Amérique latine et dans les Caraïbes, et étant donné la rareté des ressources humaines et matérielles telles que les équipements médicaux et les gaz médicaux, il est devenu nécessaire de ...repenser les modèles de soins dans la Région dans le but d’optimiser l’utilisation de ce qui est disponible et de s’assurer qu’un plus grand nombre de patients recevront l’oxygène dont ils ont besoin en quantité et en qualité. L’oxygène est inclus dans la liste des médicaments essentiels de l’Organisation mondiale de la Santé et sert à soigner les patients à tous les niveaux des réseaux de services de santé intégrés. L’efficacité de l’utilisation de l’oxygène est démontrée dans le traitement de patients atteints de maladies respiratoires causées par la COVID-19, et cette efficacité pourra être grandement améliorée si on encourage le recours rationnel, durable et sûr à cette pratique.
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Em vista do aumento repentino do número de hospitalizações causadas pela pandemia de COVID-19 na América Latina e no Caribe, bem como da escassez de recursos humanos e materiais, como equipes médicas e gases medicinais, é necessário reformular os modelos de atenção na Região de modo a otim...izar o que já está disponível e garantir que mais pacientes recebam oxigênio na quantidade necessária e com a qualidade adequada O oxigênio consta na lista de medicamentos essenciais da Organização Mundial da Saúde sendo usado na atenção a pacientes em todos os níveis das redes integradas de serviços de saúde. Considerando que já está comprovada a eficácia do uso de oxigênio no tratamento de pacientes com afecções respiratórias causadas pela COVID-19, há uma grande oportunidade de melhorar a efetividade caso se promova seu uso racional, sustentável e seguro.
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This booklet provides policymakers, planners, and other interested parties with insight into the current state of the Rwandan health sector. These statistics provide a basis for policies, strategies, and planned interventions to ensure they are responsive to the needs of the health sector and, cruci...ally, are focused on addressing current priorities that aim to improve the health of the Rwandan population.
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The World Health Organization (WHO) recognizes the challenges countries face for maintaining their COVID-19 response while addressing competing public health challenges, conflicts, climate change and economic crises.
It remains critical for national programmes to continue to offer testing for COVI...D-19 in line with three main objectives: reduce morbidity and mortality through linkage to prompt care and treatment, reduce onward transmission and track the evolution of the epidemic and the virus
itself.
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The below guidance has been designed to ensure the care of children affected by COVID-19 due to either the child or caregiver requiring medical care in the home, community or health facility, it serves to
Vacunación Antigripal 2022 - Guía rapida