The internationally recognized criteria for diagnosis of neurocysticercosis include a requirement for neuroimaging techniques, such as computerized tomography (CT) and/or magnetic resonance imaging (MRI), ideally supported by serology. These facilities are not available in all settings, especially i...n rural areas of low-income countries, making it difficult to identify and treat patients. Additionally, there is controversy about the role, type and duration of anthelmintic, antiinflammatory and antiepileptic drug (AED) treatments for different forms of neurocysticercosis.
These guidelines were developed to assist health-care providers in appropriate, evidence-based management of parenchymal neurocysticercosis. The guidelines do not address other forms of neurocysticercosis and do not include management of extraparenchymal disease (including cysticerci in the cerebral ventricles or subarachnoid space). The aim of the guidance is to improve decision-making to ensure appropriate patient care and to avoid misdiagnoses and inappropriate treatment of patients with neurocysticercosis.
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There are many calls for improved integration between
primary care and public health, but also sizeable obstacles to achieving
this, such as differences in the ways the two sectors are organised and
financed, as well as differences in education, culture and approach.
This article, based on a new... Observatory policy brief, describes the
types of interventions that come into consideration, the principles
that should be followed, and the factors that can facilitate successful
collaboration. While there is no universal template that can be followed
by all countries, improved integration promises to yield substantial
benefits to patients and wider populations.
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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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Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the na...tional demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
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The EAPC White Paper addresses the issue of spiritual care education for all palliative care
professionals. It is to guide health care professionals involved in teaching or training of palliative care and spiritual care; stakeholders, leaders and decision makers responsible for training and educati...on; as well as national and local curricula development groups.
The EAPC white paper points out the importance of spiritual care as an integral part of palliative care and suggests incorporating it accordingly into educational activities and training models in palliative care. The revised spiritual care education competencies for all palliative care providers are accompanied by the best practice models and research evidence, at the same time being sensitive towards different develop-ment stages of the palliative care services across the European region.
Conclusions: Better education can help the healthcare practitioner to avoid being distracted by their own fears, prejudices, and restraints and attend to the patient and his/her family. This EAPC white paper encourages and facilitates high quality, multi-disciplinary, academically and financially accessible spiritual care education to all
palliative care staff.
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L'anthrax est une maladie bactérienne, causée par Bacillus anthracis, qui peut se transmettre des animaux
herbivores à l'homme par contact étroit, en mangeant de la viande d'animaux infectés, ou par contamination
environnementale. L'anthrax peut être une maladie grave nécessitant un diagnos...tic et un traitement précoces
pour éviter une issue fatale, un handicap ou une charge financière pour les patients et leurs familles. e. La
maladie affecte également le bien-être de l'homme lorsque le bétail constitue son moyen de subsistance et
un élément important de la pratique agricole. La prévention est un mayen efficace de lutte contre la maladie.
Ces observations fournissent des données sur la survenue des cas d’anthrax dans les communes de Alafia
et Douekiré dans la région de Tombouctou ; les caractéristiques des populations et la description de la zone
en appliquant une approche One Health et la vaccination du cheptel. L’objectif était de Vacciner au moins
80% du cheptel identifié des communes de Alafia dans le cercle de Tombouctou, et de Douekiré dans le
cercle Goundam contre le charbon bactéridien afin de prévenir une épizootie de pathologie infectieuse
zoonotique.
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The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys...tems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
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Chronic obstructive pulmonary disease (COPD) is a complex disease that requires differential diagnosis and proper classification to identify appropriate therapy. Nonpharmacologic therapy and preventative measures should be utilized to prevent worsening of disease, symptoms, and complications. The Gl...obal Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines classify a patient’s COPD and provide recommendations for first-line treatment. The 2021 update included information regarding the use of e-cigarettes as nicotine replacement, triple therapy, and how the SARS-CoV-2 virus impacted patients with COPD. This article will focus on the diagnosis, classification, and treatment of COPD, as well as recently updated information regarding the use of e-cigarettes and the impact of COVID-19.
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Evidence shows that FGM can cause several physical, mental and sexual health complications in girls and women, and in newborns. Health-care providers play an important role in supporting girls and women living with FGM, and improving their health and well-being. They are in a unique position to infl...uence and change the attitudes of their patients about FGM.
WHO is committed to scaling up the health-sector response to address FGM prevention and care. One aspect is to strengthen the quality of FGM prevention and care services by building the capacity of health-care providers. Several guidance materials have been produced to target health-care providers. These include FGM content for training curricula, clinical guidelines and a clinical handbook.
This training manual complements previous publications by building person-centred communication skills specifically for FGM prevention.
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A handy desk reference tool for primary level health workers. The Adolescent Job Aid is a handy desk reference tool for health workers (trained and registered doctors, nurses and clinical officers) who provide services to children, adolescents and adults. It aims to help these health workers respond... to their adolescent patients more effectively and with greater sensitivity. It provides precise, step-by-step guidance on how to deal with adolescents when they present with a problem or a concern about their health or development
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his document, a first of its kind, clearly sets out the standards for rehabilitation and provides guidance on building or strengthening the capacity of EMTs in this area.The importance of early rehabilitation for functional outcomes is well documented. Rehabilitation needs can pe...rsist far beyond the departure of EMTs; therefore, close, supportive collaboration must be established with local services. Emergency response presents an opportunity to rebuild devastated health systems and build local rehabilitation capacity. This document emphasizes the importance of aligning practices to the local context and maximizing opportunities for training and mentorship. The minimum standards and recommendations described will result in faster access of patients to rehabilitation services and equipment and a better transition between EMTs and local health facilities.
Available in English, German, Arabic, Chinese
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi...ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local and national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards... have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
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Procédures de gestion clinique standard.
La maladie à virus Ebola (MVE) est une maladie multisystémique potentiellement mortelle qui entraîne souvent une hypovolémie, une acidose métabolique, une hypoglycémie et une défaillance multi-viscérale. L'épidémie prolongée de MVE en Afrique de... l'Ouest en 2013-2016 a permis une évolution dans le domaine des soins telle qu'à la fin de l'épidémie, de nombreux patients ont pu recevoir des soins de support individualisés et optimisés, dont la réanimation hydro-électrolytique, le contrôle des symptômes, la surveillance biologique en laboratoire et au chevet de la glycémie et des électrolytes, la prise en charge des défaillances d’organe, ainsi que la détection et le traitement rapides des co-infections, contribuant ainsi à une réduction de la mortalité.
Toutefois, le niveau des soins varie considérablement d'un centre de traitement Ebola (CTE) à l'autre, au cours de la même épidémie, ainsi que d’une épidémie à l’autre
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources... and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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Asthma is the most common chronic illness of childhood. The prevalence is rising and the mortality and morbidity from asthma are unacceptably high in South Africa. This article emphasizes the importance to make a correct diagnosis based, most importantly, on the clinical history and supported by inv...estigations. Further, the appropriate drug and device must be chosen to achieve good asthma control. It explains that patients must be followed up regularly and their asthma control must be assessed so that the treatment can then be adjusted according to the level of control. Additionally, Asthma education and adherence are important components of management of the condition.
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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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Health workers participating in pandemic response are exposed to many different occupational risks to health and safety. These include: COVID-19 infection, illness, and transmission to others; fatigue from working longer hours and heavy workload, insufficient sleep or rest, dehydration, and inadequa...te nutrition; musculoskeletal injury from handling of patients and heavy objects, prolonged work while using personal protective equipment which can cause heat stress, skin and mucosal damage; workplace violence and stigma, and a variety of mental health problems, emotional distress and occupational burn-out.
All health workers require knowledge and skills to protect themselves and others from the occupational risks they encounter, so that they can work safely and effectively. This course consists of five sections in response to these needs: Module 1: Infectious risks to health and safety
Module 2: Physical risks to health and safety
Module 3: Psychosocial risks to health and safety
Module 4: Basic occupational health and safety in health services.
This course is also available in the following languages: македонски - Português_ Spanish
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Centre Africain de contrôle et de prévention des maladies (CDC Afrique) protocole par la surveillance renforcée du syndrome respiratoire aigu sévère (SRAS) et du syndrome grippal pour COVID-19 en Afrique
Mars 2020
Le nombre d’États membres de l’Union signalant des cas de COVID-19 est ...en augmentation et il est probable que la transmission communautaire en Afrique se produira. L’OMS a récemment modifié la définition de cas suspect de COVID-19 pour inclure des infections respiratoires aiguës sévères et conseille de tester tous les cas de syndrome respiratoire aigu sévère (SRAS).1 Cependant, de nombreux États membres n’ont pas encore commencé à mettre en œuvre ces changements, ils concentrent toujours leurs efforts
de surveillance sur les personnes ayant des antécédents de voyage vers une zone de transmission locale de COVID-19. Cela signifie que les patients présentant des symptômes similaires, mais sans aucun contact apparent, peuvent ne pas être enquêtés.
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Les conflits et les guerres ont des effets catastrophiques sur la santé et le bien-être des nations, et ils ont considérablement évolué au cours des dernières décennies. Avec la forte augmentation des crises humanitaires, y compris de la violence urbaine, de plus en plus de gens sont touchés... pendant des périodes plus longues par des interruptions des services élémentaires, devenues une triste réalité.
Les interventions sanitaires et les approches novatrices face aux défis que posent les
crises humanitaires peuvent sauver des vies et atténuer les conséquences des conflits
pour les civils.
Les équipes médicales qui interviennent lors de conflits armés et dans d’autres
environnements dangereux sont fréquemment confrontées à de graves menaces pour
leur sécurité et leur sûreté. Elles doivent surmonter ces difficultés pour avoir accès
aux patients, d’autant plus qu’elles se heurtent parfois à la réticence des populations
auprès desquelles elles interviennent et qui sont parties au conflit.
Une riposte médicale fondée sur des principes se compose d’interventions cliniques
et opérationnelles inspirées et respectueuses de normes fondamentales, qui mettent
l’accent sur la qualité, la sécurité et la protection dans l’intérêt des patients.
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