The WHO Cholera Vaccine Position Paper (August 2017) highlights the importance of oral cholera vaccines (OCVs) as a key tool in outbreak response and prevention, alongside water, sanitation, and hygiene (WASH) measures. It recommends OCVs for high-risk populations, endemic areas, and humanitarian cr...ises, emphasizing their effectiveness in reducing cases and mortality. The paper discusses two types of OCVs (Dukoral®, Shanchol™, Euvichol®) and supports the WHO-managed vaccine stockpile for rapid deployment in cholera-prone regions.
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Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving ...how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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COVID-19 disproportionately affects the poor and vulnerable. Community health workers are poised to play a pivotal role in fighting the pandemic, especially in countries with less resilient health systems. Drawing from practitioner expertise across four WHO regions, this article outlines the targete...d actions needed at different stages of the pandemic to achieve the following goals: (1) PROTECT healthcare workers, (2) INTERRUPT the virus, (3) MAINTAIN existing healthcare services while surging their capacity, and (4) SHIELD the most vulnerable from socioeconomic shocks. While decisive action must be taken now to blunt the impact of the pandemic in countries likely to be hit the hardest, many of the investments in the supply chain, compensation, dedicated supervision, continuous training and performance management necessary for rapid community response in a pandemic are the same as those required to achieve universal healthcare and prevent the next epidemic.
BMJ Global Health2020;5:e002550. doi:10.1136/bmjgh-2020-002550
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Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201...6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC release...d the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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Technical report
This manual aims to provide information about the methods for investigating outbreaks of hepatitis E, and measures for their prevention and control. In addition, the manual gives information about the causative agent – known as the hepatitis E virus (HEV) – its epidemiology..., clinical manifestations of the disease and diagnosis.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing common medical conditions at the primary healthcare level. This document includes treatment protocols ...for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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Cardiovascular diseases (CVDs) are a growing public health problem in Ghana and other African countries. Strokes and other CVDs have become a leading cause of death due to increasing risk factors such as hypertension. According to the Global Burden of Disease study (GBD), ischaemic heart disease was... the fourth leading cause of death in Ghana in 2016. The prevalence of hyper-
tension, a major risk factor for CVDs, is increasing rapidly and ranges from 19% to 48%, according to the Ghana Health Service Annual Report, 2017, due to rising life expectancy and the increasing prevalence of contributing factors such as overweight/obesity. Early diagnosis and adequate management of the risk factors can reduce the fatal consequences of CVDs.
At the heart of improving risk assessment and management of CVDs are nationally approved guidelines, which facilitate standardisation of care approaches.
These guidelines developed by experts from all levels of health care and stakeholders capture all recommended approaches and necessary information for clinicians and other healthcare workers on CVDs. They also serve as a practical guide for assessing and managing the most important CVDs prevalent in Ghana and can be used at all levels of care namely health facilities without a doctor; with a general practitioner and with a physician specialist.
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Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi...on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
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Leishmaniose cutanée : un important problèmede santé
La leishmaniose cutanée est une maladie potentiellement grave et défigurante. Les personnes atteintes de leishmaniose cutanée ont une ou plusieurs lésions durables sur la peau, le plus souvent sans fièvre ni symptômes généraux. L'impac...t de la leishmaniose cutanée sur la propagation de la pauvreté est important, car le traitement est coûteux et donc inabordable ou implique une grande perte d’argent.
Le coût du traitement et de la mise en œuvre de stratégies de prévention nécessite un investissement considérable de ressources financières et humaines. La leishmaniose cutanée est un problème de santé publique majeur dans la Région de l'OMS pour la Méditerranée orientale. Des nouveaux cas apparaissent dans des zones précédemment indemnes de la maladie. Plus de 100 000 nouveaux cas de leishmaniose cutanée sont notifiés chaque année à l'OMS par les pays de la Région, mais les estimations relatives à l'incidence réelle sont de trois à cinq fois plus élevées car de nombreux patients ne consultent jamais un médecin ou un professionnel de santé et les cas ayant reçu un diagnostic de leishmaniose cutanée ne sont pas toujours notifiés aux autorités sanitaires.
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Leptospirosis is a zoonotic disease with epidemic potential, especially after a heavy rainfall,
caused by a bacterium called Leptospira. Leptospira interrogans is pathogenic to humans and
animals, with more than 200 serologic variants or serovars. Humans usually acquire
leptospirosis through dire...ct contact with the urine of infected animals or a urine-contaminated
environment. Human-to-human transmission occurs only very rarely. Leptospirosis may present
with a wide variety of clinical manifestations, from a mild illness that may progress to a serious
and sometimes fatal disease. Its symptoms may mimic many diseases, such as influenza,
dengue and other viral haemorrhagic diseases; making the correct diagnosis (clinical and
laboratory) at the onset of symptoms is important to prevent severe cases and save lives,
primarily in outbreak situations.
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Rabies is a fatal viral zoonosis and serious public health problem.1 All mammals are believed to be susceptible to the disease, and for the purposes of this document, use of the term animal refers to mammals. The disease is an acute, progressive encephalitis caused by viruses in the genus Lyssavirus....
2 Rabies virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are maintained in wild mammalian reservoir populations such as raccoons, skunks, foxes, and bats. Although the United States has been declared free from transmission of canine rabies virus variants, there is always a risk of reintroduction of these variants.The rabies virus is usually transmitted from animal to animal through bites. The incubation period is
highly variable. In domestic animals, it is generally 3 to 12 weeks, but can range from several days to months, exceeding 6 months.8 Rabies is communicable during the period of salivary shedding of rabies virus. Experimental and historic evidence documents that dogs, cats, and ferrets shed the virus for a few days prior to the onset of clinical signs and during illness. Clinical signs of rabies are variable and include inappetance, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs.
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Le cancer du sein est le cancer le plus courant dans le monde et la première cause de mortalité imputable cette maladie chez les femmes. Il touche de façon disproportionnée les pays à revenu faible et intermédiaire. L’Initiative mondiale contre le cancer du sein met tout en œuvre pour faire... reculer la mortalité due à cette maladie de 2,5 pour cent par an, ce qui, en vingt ans, pourrait sauver 2,5 millions de vies. Cet ensemble de mesures techniques fondamentales a pour objet de définir les grandes lignes d’une voie qui mènerait à des améliorations progressives et pérennes, adaptées aux besoins spécifiques des pays et reposant sur trois stratégies et objectifs clés : promotion de la santé à l’appui d’une détection précoce, diagnostic en temps voulu et prise en charge globale du cancer du sein. Le présent document propose un cadre commun associant les décideurs politiques, les parties prenantes, le milieu hospitalier, les gestionnaires de programmes et la société civile à une démarche systématique fondée sur des données probantes susceptible de faciliter le renforcement des systèmes de santé et de diminuer les inégalités touchant à la santé des femmes tout au long de leur vie.
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L'OMS a développé une définition de cas clinique de l'état post COVID-19 par la méthodologie Delphi qui comprend 12 domaines, disponible pour une utilisation dans tous les contextes. Cette première version a été élaborée par des patients, des chercheurs et d'autres personnes, représentant... toutes les Régions de l'OMS, étant entendu que la définition peut changer à mesure que de nouvelles preuves apparaissent et que notre compréhension des conséquences de la COVID-19 continue d'évoluer.
L'état post COVID-19 survient chez les personnes ayant des antécédents d'infection probable ou confirmée par le CoV-2 du SRAS, généralement 3 mois après l'apparition de symptômes qui durent au moins 2 mois et ne peuvent être expliqués par un autre diagnostic. Les symptômes courants comprennent la fatigue, l'essoufflement, le dysfonctionnement cognitif mais aussi d'autres et ont généralement un impact sur le fonctionnement quotidien. Les symptômes peuvent être d'apparition récente après le rétablissement initial d'un épisode aigu de COVID-19 ou persister depuis la maladie initiale. Les symptômes peuvent également fluctuer ou rechuter au fil du temps.
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On 25 August, UN agencies and partners launched a US$187.3 million Flash Appeal to reach 500,000 of the most vulnerable people affected by the 14 August earthquake.
Around 650,000 people are in need of emergency humanitarian assistance in the three most affected departments – Grand’Anse, Nipp...es and Sud – where 634,000 were already in need of multisectoral assistance before the quake.
Based on lessons learned from past emergencies, humanitarian actors are aiming to capitalize on local and national level expertise, capacities and knowledge to promote a rapid and effective response tailored to the expressed needs of affected people.
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Module appartenant à la série d’évaluations des capacités des services de santé dans le cadre de la pandémie de COVID-19: orientations provisoires, 12 mai 2021. L'outil d'évaluation de la continuité des services de santé essentiels : Facility Assessment Tool peut être utilisé par les pa...ys pour évaluer rapidement la capacité des établissements de santé à maintenir la prestation des services de santé essentiels pendant la pandémie de COVID-19. Il peut aider à alerter les autorités et les autres parties prenantes sur les points où la prestation et l'utilisation des services peuvent nécessiter des modifications et/ou des investissements. Cet outil d'évaluation couvre les aspects suivants des services de santé essentiels :
le personnel de santé (effectifs, absences, infections au COVID-19, gestion du personnel de santé, formation et soutien) ;
gestion financière et obstacles ;
prestation et utilisation des services (fermetures d'établissements, changements dans la prestation des services, campagnes de communication communautaires, changements dans l'utilisation des services et stratégies de rattrapage) ;
capacités en matière de prévention des infections (protocoles, mesures de sécurité, directives et disponibilité d'équipements de protection individuelle (EPI) pour le personnel) ;
la disponibilité des thérapeutiques, des diagnostics et des fournitures, et la disponibilité des vaccins ; et
la fourniture de services de soins primaires COVID-19.
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This document aims to provide guidance to healthcare facilities and healthcare providers in the European Union/European Economic Area (EU/EEA) and the United Kingdom (UK) on preparedness and infection prevention and control (IPC) measures for the management of possible and confirmed cases of COVID-1...9 in healthcare settings, including long-term care facilities (LTCFs). In addition, this document addresses the management of clinical diagnostic specimens at laboratories in the EU/EEA. This is the sixth update of the ECDC guidance on ‘Infection prevention and control and preparedness for COVID-19 in healthcare settings’, and replaces the document dated 6 October 2020.
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It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi-sectoral technical working groups on testing, case management, risk communication and community engag...ement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
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