INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti...on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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The compendium provides guidance on low-cost handwashing facilities that can be widely used in low and middle-income countries. We hope that this can be shared extensively as governments and agencies tackle the crisis in low and middle-income countries where handwashing facilities are urgently neede...d in households, communities, schools and healthcare facilities.
The compendium includes information and further reading on: handwashing facilities – including facilities that are accessible for all, environmental cues to reinforce handwashing behaviours, physical distancing hygiene promotion.
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The purpose of the Participant’s Workbook is to develop the skills and knowledge of personnel involved in wheelchair service delivery. The Participant’s Workbook contains exercises which will help to test and develop participants’ knowledge and skills. The Participant’s Workbook contains mat...erial from lectures, slide presentations and the reference manual; it is intended that the participants will keep their copy of the workbook for future reference, if needed.
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Chapter 10 of Pediatric Surgery: This chapter provides an overview of some of the challenges when providing anaesthesia care for children in Africa. The chapter reviews
the cardiac, respiratory, and renal differences of children in comparison to adults. Additionally, it addresses preoperative asses...sment, including guidelines for nothing by mouth (NPO, or nil per os), general and regional anaesthesia, intraoperative monitoring, airway management, and postoperative care
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A paper presented at the 10th International Congress on Infectious Disease, Singapore
This version of Field Trials of Health Interventions includes seven new chapters on conducting systematic literature reviews, trial
governance, preliminary studies and pilot testing, budgeting and accounting, intervention costing and economic analysis, and Phase IV studies. Before new interventions... are released into disease control programmes, it is essential that they are carefully evaluated in ‘field trials’. These may be complex and expensive undertakings, requiring the follow-up of hundreds, or thousands, of individuals, often for long periods. This manual was designed to provide guidance on the practical issues in great detail
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Actualización de las orientaciones provisionales 7 de junio de 2016
The WHO Global strategy on human resources for health: workforce 2030 encourages development partners and global health initiatives to leverage their support to health systems in countries to sustainably strengthen the health workforce. To assess the impact of these investments, a methodology was de...veloped and pilot tested by WHO.
The impact assessment tool (consisting of an MS Excel calculator with two subsets) supports users to:
• assess and quantify the health impact of HRH investments made in the context of HIV, tuberculosis (TB) and malaria programmes through their modelled effect on health service coverage of these three diseases; and
• provide aggregate indicative estimates of the range of health workers required to attain high coverage of selected health services.
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Injury to the skin and underlying tissues from acute exposure to
a large external dose of radiation is referred to as cutaneous
radiation injury (CRI). Acute radiation syndrome (ARS) 1 will
usually be accompanied by some skin damage; however, CRI
can ...occur without symptoms of ARS. This is especially true with
acute exposures to beta radiation or low-energy x-rays, because
beta radiation and low-energy x-rays are less penetrating and less
likely to damage internal organs than gamma radiation is. CRI can
occur with radiation doses as low as 2 Gray (Gy) or 200 rads 2 and
the severity of CRI symptoms will increase with increasing doses.
Most cases of CRI have occurred when people inadvertently came
in contact with unsecured radiation sources from food irradiators,
radiotherapy equipment, or well depth gauges. In addition, cases of
CRI have occurred in people who were overexposed to x-radiation
from fluoroscopy units.
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Since December 2016, the El Niño Southern Oscillation (ENSO) has affected Peru, causing heavy rainfall, floods, landslides, hail and electric storms. Although the impact has been particularly serious in the northern coastal regions, levels of affectation are reported in all 24 of the country’s de...partments.
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A manual for health managers