• provide scientific information on the safety, efficacy, and quality control/ quality assurance of widely used medicinal plants, in order to facilitate their appropriate use in Member States;
• provide models to assist Member States in developing their own mono- graphs or formularies for these... or other herbal medicines; and
• facilitate information exchange among Member States.
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The booklet starts with a general overview of how illicit drugs and the environment are linked within the bigger picture of the Sustainable Development Goals, climate change and environmental sustainability. It highlights direct and indirect linkages and gives examples of the significant local and i...ndividual-level impact that drugs can have on the environment. This is followed by a more in-depth overview of the latest scientific evidence for plant-based drugs and for synthetic drugs. For plant-based drugs, for example, this includes an analysis of the relationship between illicit crop cultivation and deforestation. For synthetic drugs, it includes an analysis of waste composition, volumes, and dumping and discharge, as well as the relation with wastewater treatment.
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This document focuses on making recommendations for the diagnosis and treatment of Chagas disease, an infection caused by Trypanosoma cruzi, the protozoan agent of a systemic parasitic disease. Methodology: These clinical practice guidelines were prepared following the WHO handbook for guideline dev...elopment (5). A multidisciplinary development group was formed, comprised of thematic experts, epidemiologists, methodologists, and users. Since there were no existing guidelines that could be adapted, the guidelines were developed from scratch.
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Constituting the second part of the World Drug Report 2022, the present booklet contains an overview of the global demand for and supply of drugs.
The first chapter of the booklet begins with the latest estimates of the number of people who use drugs, the distribution of those users by type of drug...s, age and sex, and recent trends in the use of drugs. The chapter also reviews the impact of the coronavirus disease (COVID-19) pandemic on drug use patterns and service provision. Other issues examined in the chapter are the health consequences of drug use, including the number of people in treatment for drug use disorders and the extent of drug injecting and of HIV and hepatitis C among people who inject drugs. The chapter concludes with a review of the extent to which strategies, policies and interventions are in place to respond to the drug use problem.
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Constituting the fourth part of the World Drug Report 2022, this booklet focuses on the market dynamics of various stimulants – cocaine, amphetamines and “ecstasy” – and of NPS.
The first chapter contains an analysis of the global market for cocaine, starting with a review of cocaine supply..., including trends in the cultivation of coca bush and in the manufacture of and trafficking in cocaine at the global level and in the various regions. An analysis of different eradication strategies is included, as well as of the role of women in the cocaine supply chain. The chapter also presents the latest estimates of and trends in cocaine use, including a brief introduction to the various cocaine consumer products. Finally, it reviews the trends in the use of cocaine and the impact of the coronavirus disease (COVID-19) pandemic in different regions
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Recognition, Assessment and Treatment
National Clinical Guideline Number 159
Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i...n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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These WHO interim recommendations on the use of the Astra Zeneca – Oxford University AZD1222 vaccine against Covid-19 were developed on the basis of advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) and the evidence summary included in the background document referenc...ed below.
This document has been updated: Version 15 March 2022.
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These WHO interim recommendations for use of the Sinovac-CoronaVac were developed on the basis of advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) and the evidence summary included in the background document and annexes referenced below.
This document has been updat...ed: version 15 March 2022.
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orientaciones provisionales, primera publicación: 24 de mayo de 2021, actualización: 21 de octubre de 2021, actualización: 15 de marzo de 2022
The report reveals that good IPC programmes can reduce health care infections by 70 %. oday, out of every 100 patients in acute-care hospitals, seven patients in high-income countries and 15 patients in low- and middle-income countries will acquire at least one health care-associated infection (HAI)... during their hospital stay. On average, 1 in every 10 affected patients will die from their HAI.
People in intensive care and newborns are particularly at risk. And the report reveals that approximately one in four hospital-treated sepsis cases and almost half of all cases of sepsis with organ dysfunction treated in adult intensive-care units are health care-associated.
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Cette première version des orientations evolutives relatives a la prise en charge clinique de la MVE contient quatre nouvelles recommandations concernant l’utilisation de traitements contre la MVE, y compris deux recommandations fortes en faveur de l’utilisation de thérapies à base d’antico...rps monoclonaux. Ce nouveau document est rédigé en vue d’accompagner des soins de support optimisés (oSoC) pour les procédures opérationnelles standards appliquees a la MVE (5, 6). Les orientations evolutives presentent des preuves de haute qualité concernant l’efficacite des traitements contre la MVE et les recommandations de l’OMS relatives leur utilisation.
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For patients on HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the prong for any sign of mechanical damage, confirm it fits and the filters are in place. Ensure the settings are appropriate and flow is max...imized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the device must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
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WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly re...sults from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
WHO suggests that hospitalized patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) rather than standard oxygen therapy.
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The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community engagement, disease control regulations, and multisector approaches to improve resilience, EHS quality..., and equity.
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This document, Programme and curriculum development guide, presents a systematic approach to developing programmes and curricula for implementation of the family planning (FP) and comprehensive abortion care (CAC) competencies,and the theory behind the approach. Specifically, the aim is for effectiv...e implementation of these competencies in the context of pre-service education and training, post-graduate studies and continuing professional development (CPD). This guide is designed for programme and curriculum developers who are preparing or revising formal education and training programmes and curricula for the FP and CAC workforce.
This guide proposes a new FP and CAC Educational Design Model for programme and curriculum development. This model can support competency-based education (CBE) for current and future FP and CAC services, with a pre-service training pathway of at least 12 months, and can also support in-service training. CBE provides the most effective means to orient educational programmes and curricula towards effective health services that meet population health needs, and this Educational Design Model provides a guide for linking the competencies required to provide a range of health services
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he Pan American Health Organization (PAHO) would like to thank the group that developed these guidelines for the tremendous work, quick response, and commitment they demonstrated in this process. We would like to especially recognize the following doctors: Roberto Chuit, Jaime Altcheh, Alejandro Luq...uetti, Faustino Torrico, and Juan Carlos Villar, for sharing their extensive expertise on the subject; Ariel Izcovich, Juan Criniti, Ana Marcela Torres, and Ludovic Reveiz, for methodological coordination; and Roberto Salvatella and Luis Castellanos for promoting this initiative.
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Chagas disease (CD) is caused by the parasite Trypanosoma cruzi, and it is endemic in Central, South America, Mexico and the
South of the United States. It is an important cause of early mortality and morbidity, and it is associated with poverty and stigma. A third of
the cases evolve into chronic... cardiomyopathy and gastrointestinal disease. The infection is transmitted vertically and by blood/organ
donation and can reactivate with immunosuppression. Case identification requires awareness and screening programmes targeting the
population at risk (women in reproductive age, donors, immunocompromised patients). Treatment with benznidazole or nifurtimox is most
effective in the acute phase and prevents progression to chronic phase when given to children. Treating women antenatally reduces but does
not eliminate vertical transmission. Treatment is poorly tolerated, contraindicated during pregnancy, and has little effect modifying the
disease in the chronic phase. Screening is easily performed with serology. Migration has brought the disease outside of the endemic
countries, where the transmission continues vertically and via blood and tissue/organ donations. There are more than 32 million migrants
from Latin America living in non-endemic countries. However, the infection is massively underdiagnosed in this setting due to the lack of
awareness by patients, health authorities and professionals. Blood and tissue donation screening policies have significantly reduced
transmission in endemic countries but are not universally established in the non-endemic setting. Antenatal screening is not commonly
done. Other challenges include difficulties accessing and retaining patients in the healthcare system and lack of specific funding for the
interventions. Any strategy must be accompanied by education and awareness campaigns directed to patients, professionals and policy
makers. The involvement of patients and their communities is central and key for success and must be sought early and actively. This review
proposes strategies to address challenges faced by non-endemic countries
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