Version 1.1. The WHO protocol has been adapted to resource-limited settings and builds on existing methodologies from the European Centre for Disease Prevention and Control (ECDC), the Global PPS project from University of Antwerp, the US Centers for Disease Control and Prevention (CDC), and the Med...icines Utilisation Research in Africa (MURIA).
Point Prevalence Surveys collects information on prescribing practices of antibiotics and other information relevant to treatment and management of infectious diseases in hospitalized patients, and complements surveillance of antimicrobial consumption.
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[Preface]. For more than forty years Primary Health Care (PHC) has been recognized as the cornerstone of an effective and responsive health system. The Alma-Ata Declaration of 1978 reaffirmed the right to the highest attainable level of health, with equity, solidarity and the right to health as its ...core values. It stressed the need for comprehensive health services, not only curative but services that addressed needs in terms of health promotion, prevention, rehabilitation and treatment of common conditions. A strong resolutive first level of care is the basis for health system development [...] The Pan American Health Organization/World Health Organization (PAHO/WHO) has supported the countries in the establishment of interprofessional PHC teams, in the transformation of health education and in building capacity in the strategic planning, and management of human resources for health. Nursing can play a critical role in advancing PHC. New profiles such as the advanced practice nurses, as discussed in this document, can be fundamental in this effort, and in particular, in health promotion, disease prevention and care, especially in rural and underserved areas.
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District hospital level Severe | Malaria is a Medical Emergency
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
Division of Tuberculosis Elimination.
The following information provides guidance to health care providers attending to the medical needs of HIV-infected adults (including pregnant women) or children displaced from disaster areas who have not yet secured HIV care in the areas where they have relocated.
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- HHS Panel on Antiretrov...iral Guidelines for Adults and Adolescents
- HHS Panel on Treatment of HIV-Infected Pregnant Women and Prevention of Perinatal Transmission
- HHS Panel on Antiretroviral Therapy and Medical Management of HIV-Infected Children
- HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults & Adolescents
- HHS Panel on Guidelines for the Prevention and Treatment of Opportunistic Infection in HIV-Infected Children
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The Global Health Network is an open source platform that provides trusted knowledge, guidance, tools and resources to support the generation of more and better health research data. During emerging outbreaks it is vital to learn as much as possible to generate evidence on best practice for preventi...on, diagnosis and treatment and to facilitate effective preparedness and response for future outbreaks.
This pop-up space for 2019 Novel Coronavirus COVID-19 (formerly 2019-nCoV) supports evidence generation by pooling protocols, tools, guidance, templates, and research standards generated by researchers and networks working on the response to this outbreak. Findings from previous outbreaks, largely obtained during MERS and SARS, are also available. This all aims to make research faster and easier and to enable standardised, quality data to be collected and prepared for sharing.
Latest updates will be provided on transmission as well as recommendations for healthcare professionals on transmission, disease management, and care.
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Expert international faculty present weekly, concise MedicalMinute updates, host biweekly Question and Answer Webinars, and author a continually updated downloadable slideset including the latest data on COVID-19 epidemiology and clinical management; specific topics include best practices and ongoin...g research in screening, prevention, diagnosis, disease management, and treatment for diverse patient populations.
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These Blended Learning Modules have been produced in collaboration with the Ethiopian Federal Ministry of Health (FMOH) and Regional Health Bureaus (RHBs) as well as a range of medical experts and health science specialists within Ethiopia. They are being used to upgrade the theoretical knowledge of... the country's 33,000 rural Health Extension Workers to that of Health Extension Practitioners and to train new entrants to the service.
The Modules are Open Educational Resources (OERs) and are free for everyone to use. You can download them as they are or adapt them to fit your specific context. The OERs cover the full range of health promotion, disease prevention, basic management and essential treatment protocols to improve and protect the health of rural communities.
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This publication provides recommendations for the management of critically ill adult patients with COVID-19 being treated in intensive care units (ICUs) in the Americas. These clinical practice guidelines provide evidence-informed recommendations for identifying markers and mortality risk factors in... critically ill patients, as well as infection control, sample collection, supportive care (respiratory and hemodynamic), pharmacological treatment, early rehabilitation, diagnostic imaging use, prevention of complications, and discharge requirements. The recommendations are for all health care staff caring for patients in emergency departments and ICUs. These guidelines are also intended for use by decisionmakers and government entities involved in the management of patients with COVID-19 in ICUs in the Region of the Americas.
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Primary care represents the first level of personal health care services in the community, which ensures accessible, continual,
whole-person care for health needs throughout an individual’s lifespan. Primary care professionals work with patients and
their families to address their immediate and ...long-term health needs and not just for a set of specific diseases with an
approach that addresses the broader determinants of health and the interrelated aspects that influence people’s physical,
mental, and social well-being.
Nurses have a key role to play in primary care in expanding, connecting and coordinating care. Through their training and
work, they are well placed and have been shown to provide safe and effective care in disease prevention, diagnosis,
treatment, management and rehabilitation. The purpose of this document is to provide guidance and inspiration for
policymakers, instructors, managers and clinicians
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Cotonou Declaration oBuruli Ulcer
Cotonou, Benin, 30 March 2009
Neglected tropical diseases kill, weaken or incapacitate millions of people every year, causing permanent physical suffering, social stigmatization and reduced productive capacity. Buruli ulcer, one such disease, causes immense suffer...ing and disabilities, especially among children. Delayed schooling and loss of productivity are considerable among the affected populations. These adverse consequences tend to aggravate poverty in affected communities. Globally, the disease has been reported in 30 countries. In WHO’s African Region, Buruli ulcer has been confirmed in 12 countries and is suspected in 10 others.
Significant progress has been made in the past 10 years in knowledge of Buruli
ulcer, investments in related research, control of the disease, and improvement
of tools for case diagnosis and development of treatment protocols. Substantial achievements have been made in diagnosis, treatment, immunology and epidemiology. Despite these achievements, little is known about the exact mode of transmission of the disease, and there is no simple diagnostic test usable in the field.
The use of antibiotics has revolutionized treatment and contributed to reducing the need for surgery by half. However, efforts are still needed to develop simple diagnostic tools usable in the field as well as disability prevention methods. The Global Buruli Ulcer Initiative has adopted the strategy recommended by WHO. The strategy is based on early diagnosis of the disease and the use of antibiotics for treatment upon the onset of the first signs by improving access to screening and case management at the most peripheral level of the health system.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Peripheral artery disease (PAD) is the most underdiagnosed, underestimated and undertreated of the atherosclerotic vascular diseases despite its poor prognosis. There may be racial or contextual differences in the Asia-Pacific region as to epidemiology, availability of diagnostic and therapeutic mod...alities, and even patient treatment response. The Asian Pacific Society of Atherosclerosis and Vascular Diseases (APSAVD) thus coordinated the development of an Asia-Pacific Consensus Statement (APCS) on the Management of PAD.
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Each year, ≈795 000 individuals in the United States experience a stroke, of which 87% (690 000) are ischemic and 185 000 are recurrent.1 Approximately 240 000 individuals experience a transient ischemic attack (TIA) each year.2 The risk of recurrent stroke or TIA is high but can be mitiga...ted with appropriate secondary stroke prevention. In fact, cohort studies have shown a reduction in recurrent stroke and TIA rates in recent years as secondary stroke prevention strategies have improved.3,4 A meta-analysis of randomized controlled trials (RCTs) of secondary stroke prevention therapies published from 1960 to 2009 showed a reduction in annual stroke recurrence from 8.7% in the 1960s to 5.0% in the 2000s, with the reduction driven largely by improved blood pressure (BP) control and use of antiplatelet therapy.5 The changes may have been influenced by changes in diagnostic criteria and differing sensitivities of diagnostic tests over the years.
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r...eport was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.
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