Nosocomial or health-facility-acquired infections are a serious issue, representing one of the most significant causes of morbidity and mortality in healthcare systems and consuming many scarce resources, especially in developing countries. Although much has been done, particularly in the hospital s...etting, to reduce the risk of these infections, the problem persists and demands innovative and cost-efficient solutions.
Although the care provided in most primary health care facilities is predominantly ambulatory with few or no inpatient beds, infection prevention is still important to minimize or eliminate the risks of facility-acquired infections and assure quality patient care.
Health facilities and hospitals should have written infection control procedures and guidelines in place and should also be monitoring that these procedures are adhered to in both inpatient and ambulatory care settings.
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Guidance has been updated on a number of chemicals: asbestos, bentazone, chromium, iodine, manganese, microcystins, nickel, silver, tetrachloroethene and trichloroethene. Guidance has also been added for chemicals not previously assessed in the Guidelines: anatoxin-a and analogues, cylindrospermopsi...ns and saxitoxins. The new guidance on organotins has replaced the prior guidance focused on dialkyltins. With these updates, the guideline values for tetrachloroethene and trichloroethene have been revised while new guideline values for cylindrospermopsins, manganese, microcystins, and saxitoxins have been established .
Updated information on cyanobacteria has been included, introducing an alert level framework for early-warning and to guide short-term management responses. Guidance has also been updated in the sections on adequacy of water supply, climate change, emergencies, food production and processing, and radiological aspects, particularly on managing radionuclides when exceeding WHO screening values and guidance levels.
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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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Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approximately twice as high as high-resource settings (15 o...ut of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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In the kingdom of Bahrain, the national antibiotic committee will set the framework for the national response to AMR, especially bacterial resistance to antibiotics. It will be aligned with the World Health Organization’s (WHO) Global Action Plan on Antimicrobial Resistance, and with standards and... guidelines from the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (OIE).
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The Libyan national action plan has been aligned with WHO five objectives. Analysis of the current situation and addressing the gaps and the needs to reach the main goal “one health” approach involves several national sectors and actors, including human and veterinary health, agriculture and foo...d and drug control center and environmental agencies. Therefore, a large committee of all stakeholders was formed with four technical subcommittees were established to addresses every aspect to contain antimicrobial resistance in the country.
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25 August 2021. The earthquake on August 14, 2021 was almost as strong as the severe quake in 2010, which killed about 300,000 people. The current number of victims is more than 2,200 people, and more than 12,000 people have been injured. More than 52,000 houses were destroyed and more than 77,000 ...damaged. Thousands of families were affected! The magnitude 7.2 earthquake struck southwest Haiti at 8:30 a.m. local time at a depth of about 10 km. The epicentre was measured about 12 km northeast of Saint-Louis-du-Sud, about 125 km west of the capital Port-auPrince. The situation on the ground remains chaotic and the extent of the disaster cannot yet be predicted. In addition, heavy rainfall and the unstable security situation are complicating relief efforts. What is needed most now is food and drinking water, tents and primary health care. MEDBOX has already created the Natural Hazard Toolbox after the severe earthquake in 2010 and has collected many essential materials on health care, shelter & reconstruction after an earthquake in English, French and Kreyol there. In this issue brief, we provide a quick
overview of the most important information.
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The purpose of this publication is to to provide a practical, stepwise approach to the implementation of the national action plans on AMR within the human health sector; and to provide a process and collation of existing WHO tools to prioritize, cost, implement, monitor and evaluate national action ...plan activities. The target audience of the publication are national/subnational stakeholders working on AMR within the human health sector. This includes national health authorities, national multi-sectoral coordination groups, senior technical experts and policymakers involved in implementing AMR activities at all levels of the health system, and implementation partners to accelerate sustainable implementation and monitoring and evaluation of national action plans on AMR.
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Key messages
● Pre-crisis Infant and Young Child Feeding (IYCF) Practices:
The Code has not been adequately implemented and enforced in Ukraine.
Multiple Indicator Cluster Survey (MCIS) data from 2012: Child ever breastfed (95.4%); early initiation of breastfeeding (EIBF) within 1... hr of birth (65.7%); children under 6 months exclusively breastfed (EBF)(19.7%); continued breastfeeding at 1 (37.9%) and 2 years of age (22%); children under 6 months predominantly breastfed (51.6%); children 0-23 months bottle fed (66.6%); introduction of solid, semi-solid or soft foods for children 6-8 months (43.2%).
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Addressing gaps and improving health system performance is simply not enough to prepare a health system to tackle the effects of the climate crisis. Climate change’s impact on the health and well-being of people globally is reaching catastrophic levels. As the earth continues to warm, tens of mill...ions of people are at increased risk from rapid and unpredictable spread of infectious diseases, heatwaves, water and food insecurity and scarcity, air pollution, poverty and homelessness. Health services are often regarded as a first line defense in preventing adverse health outcomes, especially from those caused by climate impacts
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In collaboration with partners, the government of Ethiopia has successfully developed 10 years Hand Hygiene for All (HH4A) costed national roadmap- a country-wide approach to achieving sustainable and universal hand hygiene. On the occasion of the 2022 Global Hand Washing Day event ( Ethiopia is cel...ebrating the event for one month with different sessions), the national HH4A road map launched on the 4th of Nov 2022 in a high-level advocacy event in the presence of higher officials and partners. Action is set mainly on the need for a joint effort to mobilize resources for implementation, monitoring and documenting of lessons and best practices.
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Over 6 million people worldwide are infected with Trypanosoma cruzi, the protozoan that causes Chagas disease
(CD). T. cruzi is transmitted by triatomine insects, congenitally, through uncontrolled blood donations and organ transplants,
and via consumption of food or drink contaminated by triatomi...nes.
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WHO needs US$2.54 billion to provide life-saving assistance to millions of people around the world facing health emergencies. WHO’s Health Emergency Appeal is a consolidation of WHO’s priorities and financial requirements for 2023 to carry out health interventions in emergency and humanitarian r...esponses. The number of people in need of humanitarian relief has increased by almost a quarter compared to 2022, to a record 339 million. WHO is responding to an unprecedented number of intersecting health emergencies: climate change-related disasters such as flooding in Pakistan and food insecurity across the Sahel in the greater Horn of Africa; the war in Ukraine; and the health impact of conflict in Yemen, Afghanistan, Syria and north eastern Ethiopia – all of these emergencies overlapping with the health system disruptions caused by the COVID-19 pandemic and outbreaks of measles, cholera, and other killers. Contributions to the appeal can be fully flexible, flexible across a region, or flexible within a country appeal.
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This document focuses on the management of patients affected by gambiense HAT and
constitutes an update to the WHO therapeutic guidance issued in 2013. The main changes in recommendations concern the criteria and methods for deciding the treatment among the new set of therapeutic options and the pa...rticular conditions that apply to treatment with fexinidazole, as outlined below. Because HAT is a serious, life-threatening disease and because the efficacy of fexinidazole depends on swallowing the medicine after an appropriate intake of food as well as on completing the full 10-day
treatment schedule, the recommendations regarding fexinidazole administration are considered key elements that must be carefully followed. When the conditions listed in these guidelines are not met for any individual patient, the alternative available treatments should be prescribed.
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This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita...ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
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Leishmaniases are a group of diseases of zoonotic importance caused by over 20 species of protozoa of the genus Leishmania, in which domestic dogs are considered to be the main reservoir for the disease. However, the involvement of other vertebrates as reservoirs for these parasites has also been in...vestigated. Therefore, the objective of the present study was to carry out a systematic review with meta-analysis on occurrences of leishmaniasis in equids. The case reports described animals with cutaneous symptoms of leishmaniasis (papules, nodules, ulcers or crusts) that regressed spontaneously, located mainly on the head and limbs, from which three species of protozoa were identified in the lesions: Leishmania braziliensis, Leishmania infantum and Leishmania siamensis. In turn, the meta-analysis showed a combined prevalence of 25%, although with high heterogeneity among the studies, which was attributed to the use of different methods for diagnosing the disease. Leishmaniasis in equids is a benign disease but it should be included in the differential diagnosis of cutaneous diseases among these species. Seroepidemiological studies are important in investigating and monitoring suspected exposure of these hosts to the parasite, especially in endemic areas. However, there is also a need to standardize diagnostic methods.
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To enhance health co-benefits across urban policies which tackle air pollution and climate change, WHO, in cooperation with various international, national, and local partners, implemented the Urban Health Initiative (UHI) pilot project in Accra, Ghana. The Initiative prompted the health sector to u...se its influential position to demonstrate to decision-makers and the public the full range of health, environmental and economic benefits that can be achieved from implementing local emission reduction and energy access policies and strategies. Policy tracking, although not always considered, is a fundamental component of this procedure. It assesses the planning, implementation and progress of a policy to refine or adjust policies with the final objective of increasing the likelihood of the policy being successful. This report is an outcome of the last component of the UHI model process, Policy tracking and monitoring outcomes. The report proposes a framework for tracking urban health policies, with a special focus on the impacts of air quality and energy access on human health and well-being in African countries, giving some examples from the pilot project in Accra. The report also provides resources to survey air quality in cities and other tools to assess public health and the environmental impacts of urban policies and monitor or track their effects.
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Improving the survival chances and quality of life of women, newborns, and children remains an urgent global challenge. Since 2012, substantial progress has been made in reducing maternal and under-5 deaths, and a only handful of countries are on target to meet the SDG targets in 2030. Yet, 5 millio...n children still die each year under the age of 5, and nearly half of those are newborns less than a month old. Worse still, the global maternal mortality ratio is going in the wrong direction.
A Decade of Progress and Action for the Future will examine the tenacity and innovation that helped us make gains, the lessons learned through monitoring, country-led adaptation and leadership, analysis, and reflection, as well as the approaches we must take to reinvigorate the momentum and global commitment to improving maternal and child survival. Increasing coverage, strengthening the quality of care, and enhancing equity will be tantamount to our global progress.
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This document aims to assist countries to take the first step towards better considering gender and equity issues in their efforts to tackle antimicrobial resistance (AMR), to inform the implementation of strategies in national action plans and contribute to improved reach and effectiveness of AMR e...fforts in the longer term. It is part of a series of papers being developed y WHO, FAO and OIE to build a better global evidence base for implementing AMR national action plans. This version is illustrated by examples from the health sector predominantly but
will be updated with advice from the food and animal sectors in due course.
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The NDMS&IP focuses on mainstreaming disability to promote equitable access to services in the six thematic areas of health, education, livelihoods, empowerment, and social inclusion and cross-cutting issues.
The first part of the NDMS&IP outlines incongruences between national and sectoral policie...s and pieces of legislation on one hand, and practice on the other and identifies key priority areas/themes of the strategy,
medium-term outcomes and strategies for each identified priority area/ theme. This process is largely informed by key findings and recommendations from a study on the Situation of Persons with Disabilities
in Malawi (CBMM/NAD, 2011). The study provides background descriptive information on existing national and sectoral policy and legal framework, level of access by children, adult women and males with disabilities to services in the areas of education, health, livelihoods and other social services as well as of participation by persons with disabilities through self-representation in development activities at various levels. A review of relevant documents at the international level further describes the disability situation in Malawi in the global context.
The second part of the NDMS&IP consists of the operational matrix, (Annex 1), a monitoring and evaluation framework (Annex 2) and budget estimates (Annex 3). This part outlines specific actions by various actors both in the public, private and civil society sectors to prioritise disability in their routine policy, programming, resource mobilisation and allocation, monitoring, evaluation and reporting routines. The action plan lays out priority sectors and concrete actions by setting out implementation schedules, defining targets, assigning responsibility to key duty bearers and rights holders for coordination, decision-making, monitoring and reporting, mobilisation and allocation and control of resources.
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