Lignes directrices provisoires, 13 août 2020
L’OMS a établi cette brève note d’information pour répondre au besoin de recommandations sur la prestation sûre de soins à domicile aux patients présumés atteints de l’infection par le nouveau coronavirus (2019-nCoV) présentant des symptô...mes bénins, et sur les mesures de santé publique liées à la prise en charge des contacts asymptomatiques.
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Orientations provisoires
6 avril 2020
Le présent document résume les recommandations de l’OMS sur l’utilisation rationnelle de l’équipement de protection individuelle (EPI) dans les établissements de santé et lors des soins à domicile, ainsi que lors de la manipulation des cargaison...s; il évalue également les perturbations qui touchent actuellement la chaîne d’approvisionnement mondiale et les éléments à considérer pour la prise de décisions en cas de grave pénurie d’EPI.
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Orientação provisória 17 de março de 2020
Esta orientação rápida destina-se a profissionais de saúde pública e de prevenção e controle de infecção (PCI), gestores e profissionais de saúde, ao abordar questões relacionadas ao atendimento domiciliar de pacientes com suspeita de infecç...ão pelo nCoV que apresentem sintomas leves e o tratamento de contatos assintomáticos.
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Orientação provisória, 6 de abril de 2020
Este documento resume as recomendações da OMS para o uso racional de equipamentos de proteção individual (EPIs) em unidades de saúde e na assistência domiciliar, bem como no manuseio de cargas; avalia também a situação atual da cadeia de abastec...imento global e as considerações para tomada de decisão durante desabastecimentos graves de EPIs.Este documento não inclui recomendações para membros da comunidade em geral. Clique aqui para mais informações sobre recomendações da OMS para uso de máscara na comunidade em geral.Nesse contexto, EPIs incluem luvas, máscaras faciais cirúrgicas/de uso médico - aqui denominadas “máscaras cirúrgicas”, óculos de proteção, protetor facial do tipo face shield, e aventais, bem como itens para procedimentos específicos - respiradores com máscara facial de filtração (padrão N95 ou PFF2 ou PFF3 ou equivalente) - aqui denominados “respiradores” - e capotes
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Esta é a primeira edição da orientação sobre estratégias de prevenção e controle de infecções (PCI) que devem ser aplicadas quando houver suspeita de COVID-19. Ela foi adaptada do documento da OMS sobre prevenção e controle de infecções durante prestação de cuidados de saúde para ca...sos prováveis ou confirmados de infecção da síndrome respiratória do Oriente Médio (MERS-CoV)1, com base no conhecimento atual da situação e experiência com a síndrome respiratória aguda grave (SARS) e MERS2. A OMS atualizará estas recomendações à medida que novas informações forem surgindo. Esta orientação é dirigida a trabalhadores da saúde, administradores em saúde e equipes de PCI nas unidades de saúde, mas também é relevante para os níveis nacionais, estaduais e municipais.
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This document updates the earlier version published in April 2020. In recent weeks, information on the potential use of chloroquine or hydroxychloroquine for the treatment of people with COVID-19 has been disseminated in academic journals and public media. Although there are now ongoing clinical tri...als testing the efficacy and safety of several medicines for COVID-19, as of the date of this document, there is a lack of quality evidence to demonstrate chloroquine and/or hydroxychloroquine are effective in the treatment of COVID-19. Evidence is recently emerging via small studies with sub-optimal methodologies that are conflicting.
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Med Princ Pract 2021;30:17–28
An overview of ethics and clinical ethics is presented in this review. The 4 main ethical principles, that is beneficence, nonmaleficence, autonomy, and justice, are defined and explained. Informed consent, truth-telling, and confidentiality spring from the ...principle of autonomy, and each of them is discussed. In patient care situations, not infrequently, there are conflicts between ethical principles (especially between beneficence and autonomy). A four-pronged systematic approach to ethical problem-solving and several illustrative cases of conflicts are presented. Comments following the cases highlight the ethical principles involved and clarify the resolution of these conflicts. A model for patient care, with caring as its central element, that integrates ethical aspects
(intertwined with professionalism) with clinical and technical expertise desired of a physician is illustrated
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WHO’s antiretroviral treatment (ART) clinic-based acquired drug resistance survey method yields robust estimates of HIV viral suppression and acquired HIV drug resistance in adults, children and adolescents taking both dolutegravir and non-dolutegravir based regimens.
Results are used to inform A...RT programme decision making regarding optimal ART regimens and support evaluation of programme quality with respect to maximizing viral load suppression and minimizing emergence of resistance in people taking ART.
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Climate change triggers mounting food insecurity, poverty and displacement in Africa
Human use of land has been transforming Earth's ecology for millennia. From hunting and foraging to burning the land to farming to industrial agriculture, increasingly intensive human use of land has reshaped global patterns of biodiversity, ecosystems, landscapes, and climate. This review examines ...recent evidence from archaeology, paleoecology, environmental history, and model-based reconstructions that reveal a planet largely transformed by land use over more than 10,000 years. Although land use has always sustained human societies, its ecological consequences are diverse and sometimes opposing, both degrading and enriching soils, shrinking wild habitats and shaping novel ones, causing extinctions of some species while propagating and domesticating others, and both emitting and absorbing the greenhouse gases that cause global climate change. By transforming Earth's ecology, land use has literally paved the way for the Anthropocene.
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Background: Healthcare workers’ mental health was affected by SARS-CoV-2 pandemic.
Aim: To evaluate healthcare workers’ mental health and its associated factors during the pandemic in Chile. Material and Methods: An online self-reported questionnaire was designed including the Goldberg Healt...h Questionnaire, the Patient Health
Questionnaire, (PHQ-9), and the Columbia-Suicide Severity Rating Scale among other questions. It was sent to 28,038 healthcare workers.
Results: The questionnaire was answered by 1,934 participants, with a median age of 38 years (74% women). Seventy five percent were professionals, and 48% worked at a hospital. Fifty nine percent of respondents had a risk of having a mental health disorder, and 73% had depressive symptoms. Significant associations were found with sex, workplace, and some of the relevant experiences during the pandemic. Fifty one
percent reported the need for mental health support, and 38% of them received it.
Conclusions: There is a high percentage of health workers with symptoms of psychological distress, depression, and suicidal ideas. The gender approach is essential to understand the important differences found. Many health workers who required mental health care did not seek or received it.
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La pratique infirmière avancée (PIA), telle qu’évoquée dans le présent document, se réfère aux services et
aux interventions de santé renforcés et étendus, assurés par des infirmières qui, grâce à des compétences avancées, influent sur les résultats des soins de santé cliniques ...et dispensent des services de santé directs à la personne, aux familles et aux collectivités (CNA, 2019; Hamric et Tracy, 2019). Une infirmière de pratique avancée (IPA) a acquis, grâce à une formation complémentaire, une base de connaissances spécialisées, des capacités perfectionnées en matière de prise de décision et des compétences cliniques pour une pratique infirmière plus étendue, dont les caractéristiques dépendent du contexte dans lequel elle est accréditée
à exercer ses fonctions (CII, 2008a). L’infirmière clinicienne spécialisée (ICS) et l’infirmière praticienne (IP)
sont les deux catégories d’IPA les plus généralement
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Schistosomiasis is widely recognized as a disease that is socially determined. An understanding of the social and behavioural factors linked to disease transmission and control should play a vital role in designing policies and strategies for schistosomiasis prevention and control. To this must be a...dded the awareness that schistosomiasis is also a disease of poverty. It still survives in poverty-stricken, remote areas where there is little or no safe water or sanitation, and health care is scarce or non-existent. For a variety of complex reasons, many of which are addressed in this book, the disease is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural China. This concern for human behaviour in an environment of poverty echoes the concerns of the new research priority for “diseases of poverty” identified by the Special Programme for Research & Training in Tropical Diseases.
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The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly re...placing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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Schistosomiasis is widely recognized as a disease that is socially determined. An
understanding of the social and behavioural factors linked to disease transmission and
control should play a vital role in designing policies and strategies for schistosomiasis
prevention and control. To this must b...e added the awareness that schistosomiasis is
also a disease of poverty. It still survives in poverty-stricken, remote areas where there
is little or no safe water or sanitation, and health care is scarce or non-existent. For
a variety of complex reasons, many of which are addressed in this book, the disease
is particularly prevalent in sub-Saharan Africa, and persists in certain areas of rural
China. This concern for human behaviour in an environment of poverty echoes the
concerns of the new research priority for “diseases of poverty” identified by the
Special Programme for Research & Training in Tropical Diseases.
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Chagas disease is currently endemic and also predicted to be at increased transmission risk under future climate change scenarios. Similarly, an expansion of areas in the United States at increased risk for Chagas disease transmission is also expected over the next several decades under climate chan...ge scenarios. Of particular interest is the predicted northern shift of triatomine species to central regions of the United States with historically unsuitable climates for T. cruzi vectors. The weight of evidence regarding the influences climate change may pose on T. cruzi vector species distributions demonstrates the sensitivity of Chagas disease transmission to future climate variability. In order to advance forecasts for the impact climate change may have on Chagas disease transmission in the Americas, it is imperative to
further develop, utilize, and perhaps combine predictive species distribution modeling approaches that integrate accurate, long term data on climate variables, vector species distributions, Chagas disease incidence, as well as other socio-ecological variables.
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