Supplement to the 2016 consolidated Guidelines on the use of antiretroviral drugs for Treating and Preventing HIV infection
HIV Treatment
The global burden of disease due to mental disorders continues to rise, especially in low- and middle-income countries (LMIC). In addition to causing a large proportion of morbidity, mental disorders – especially severe mental disorders (SMD) – are linked with poorer health outcomes and increase...d mortality. SMD are defined as a group of conditions that include moderate to severe depression, bipolar disorder, and schizophrenia and other psychotic disorders. People with SMD have a two to three times higher average mortality compared to the general population, which translates to a 10-20 year reduction in life expectancy. While people with SMD do have higher rates of death due to unnatural causes (accidents, homicide, or suicide) than the general population, the
majority of deaths amongst people with SMD are attributable to physical health conditions, both
non-communicable and communicable.
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WHO Recommendations 2018 Update
The primary audience for these recommendations includes health professionals who are responsible for developing national and local health care guidelines and protocols (particularly those related to PPH prevention and treatment) and those involved in the provision of... care to women and their newborns during labour and childbirth, including midwives, nurses, general medical practitioners and obstetricians, as well as managers of maternal and child health programmes, and relevant staff in ministries of health and training institutions, in all settings.
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Botswana CPD.
The 6th Government of Botswana/UNFPA Country Programme (2017-2021) is focusing on a transformative development agenda that is universal, inclusive, human rights-based, integrated and anchored in the principle of equality and leaving no one behind, while reaching the furthest left beh...ind first. The country programme will contribute directly to the three outcomes of the United Nations Sustainable Development Framework (2017-2021).
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The third edition, released in 2018, has grown to include a total of 18 chapters, contributed by 20 experts and authors from many countries. The goal remains the same: to educate primary care providers on the best practices in TB diagnosis, treatment and follow-up. All articles are richly illustrate...d, and most include quizzes and CME questions for self learning. The 3rd edition includes new chapters on MDR-TB, adverse effects of TB drugs, adherence monitoring strategies, and nutritional support. There is also content on how to manage children with TB, care for patients co-infected with TB and HIV, how to read and interpret chest x-rays, and how to avoid common pitfalls in TB management.
To download book chapters or the whole book go to the website: http://www.letstalktb.org/download/
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The National Strategic Plan is based on the following guiding principles:
1) Life-course approach: adolescence is a key decade in the course of life that influences the health outcomes later in life.
2) Comprehensive approach: It recognizes the cross cutting health and development needs o...f young people such as intentional and unintentional injuries and violence, SRH, HIV/AIDS, mental health, substance use, violence, substance use and substance use disorders, infectious diseases and common conditions.
3) Equity and rights-based approach: focusing on equitable access to services to all adolescents including vulnerable groups and the recognizing the need to move from aspirations to obligations in fulflling young people rights for the highest attainable standard of health.
4) Multisectoral approach: recognizing cognizant of the fact that holistic development of young people requires multisectoral approach involving education, social welfare.
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Policy Brief.
WHO recommends that pregnant women receive testing for HIV, syphilis and hepatitis B (HBSAg) at least once during pregnancy, preferably in the first trimester.
Dual HIV/syphilis rapid diagnostic tests (RDTs) can be used as the first test for pregnant women as part of antenatal care (...ANC).
These simple tests can be used at the point-of-care and are cost-saving compared to standard testing in ANC. They enable more women to be diagnosed with HIV and syphilis so that they can access treatment and prevent transmission to their children.
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Policy brief.
Globally, one in five people with HIV are unaware of their status, despite considerable scale up of HIV testing, treatment and prevention services. Many of those unreached by HIV testing services (HTS) are from key populations, partners of people with HIV and, in Eastern and southern ...Africa, men and young people. Improving the availability, accessibility, friendliness and quality of services is important to address these testing gaps.
At the same time, tools and interventions that increase the demand for HTS are needed to reach people who are uninformed about HTS options and advances in treatment and prevention, people who are not motivated to seek HTS and those who are hesitant to test because of fear of an HIV diagnosis or other reasons.
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In 1998 the Swedish Veterinary Association decided to adopt a general policy for the use of antibiotics in animals. Since then specifi c policies for the use of antibiotics in dogs and cats have been adopted and in 2011 Guidelines for the use of Antibiotics in Production animals – Cattle and Pigs,... were accepted. By decision of the board of the Swedish Veterinary Society (SVS) these guidelines have been updated. Th e over-arching goal of SVS is to achieve a low and controlled use of antibiotics in Swedish animal production so that the fi rst-hand choices of treatment remain effi cient and that the spread of antimicrobial resistance – among animals and herds as well as in the food chain – is kept at a minimum. Keeping antimicrobial resistance in animals low is important also for human health, since we are all part of the same ecosystem. Th e authors of these guidelines hope that they may be useful for veteri-narians in clinical practice when deciding on treatments for common diseases and ailments caused by bacteria. Sometimes the decision may even be to refrain from use of antibiotics and chose other ways of improving herd health.
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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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Antimicrobial resistant (AMR) organisms are increasing globally, threatening to render existing treatments ineffective against many infectious diseases. In Africa, AMR has already been documented to be a problem for HIV and the pathogens that cause malaria, tuberculosis, typhoid, cholera, meningitis..., gonorrhea, and dysentery. Recognizing the urgent need for action, the World Health Assembly adopted the Global Action Plan on Antimicrobial Resistance in May 2015. In accordance with the Global Action Plan and to meet needs specific to Africa, Africa CDC will establish the Anti-Microbial Resistance Surveillance Network (AMRSNET). AMRSNET is a network of public health institutions and leaders from human and animal health sectors who will collaborate to measure, prevent, and mitigate harms from AMR organisms.
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Human rights must be at the centre of all prevention, preparedness, containment and treatment efforts from the start, in order to best protect public health and support the groups and people who are most at risk. States have an obligation to protect and guarantee everyone the right to the highest at...tainable standard of health.
All European states have committed to fulfilling the right to health and have signed international and regional human rights treaties to that purpose. In the context of the current pandemic, authorities should engage all available resources to counter the pandemic while fulfilling the right to health.
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One important application of digital health in TB patient care is the support that it can lend to medication adherence. TB programmes have already been using short message service (SMS), video-supported treatment (VOT) and event monitoring device for medication support ...(EMM)1 to help patients complete treatment and health-care workers to monitor both daily dosing and treatment continuity
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BUKO Pharma-Kampagne has investigated the causes and consequences of antibiotic resistance in India, South Africa, Tanzania and Germany. Together with our partners we collected data and did interviews with numerous stakeholders. The outcome is presented in a brochure that is now available in English...
Resistant bacteria are spreading worldwide. In collaboration with partners in India, Tanzania, South Africa and Germany, we have investigated the causes and consequences of this spread.2 This Pharma-Brief Special presents the results. It examines the risks for humans, animals and the environment. It focuses on local problems and approaches, international interactions and the re-sponsibility of doctors, farmers and consumers.
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The reports bring together the latest findings and conclusions about the state of resistance to artemisinins and artemisinin-based combination therapy (ACT), summarize WHO’s current policy and treatment recommendations, and highlight areas of concern.
High salt consumption is an important determinant of high blood pressure and reducing it would improve health outcomes by lowering cardiovascular disease and therefore death rates. Reducing salt intake has been identified as one of the most effective public health measures and is one of the leading ...targets at global, regional and national levels to reduce the burden of noncommunicable diseases. The purpose of the Dietary Salt Intake Survey in the Republic of Moldova was to establish current baseline average consumption of salt (sodium), potassium and iodine through 24-hour urinary excretion testing among a random sample of the adult population (aged 18–69 years), and to assess the knowledge, attitudes, practices and behaviour around dietary salt in order to enable more efficient planning and the implementation of an effective salt-reduction strategy in the Republic of Moldova.
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Apart from implementation of TB infection Prevention and Control measures, treatment of those with active TB of the lungs is key in preventing the spread of the TB bacilli. The Public Health Act CAP 242, section 17 classify TB as notifiable infectious disease and under section 26 as part of preventi...on and control of infectious diseases, those exposed or suffer from the notifiable infectious diseases should be isolated in designated place and detained while taking medication until in the assessment of the Medical officer of health confirm that the person is free from infection or able to be discharged without danger to public health.
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Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
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This report reviews and analyses the Affordable Medicines Programme, which was introduced in Ukraine in April 2017 to provide patients with improved access to 23 outpatient medicines for the treatment of chronic noncommunicable diseases. The evaluation combines both quantitative and qualitative anal...ysis. The findings confirm that the Programme has contributed to a significant increase in access to needed outpatient medicines in Ukraine. Further, while implementation was successful overall, uptake across regions was uneven. The report concludes by listing a number of policy options to support the sustainability and expansion of the Affordable Medicines Programme.
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Adapting community-led approaches . Three out of 10 people in urban areas do not use improved sanitation facilities, and one out of 10 people are forced to practise open defecation. Still higher proportions do not have access to safely managed sanitation facilities, where the fecal sludge
is contai...ned and either left in situ or safely emptied, transported, and delivered to a treatment plant.
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