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1
Tuberculosis (TB) is, and should be, a curable disease; however, each year significant numbers of patients acquire or develop drug-resistant TB, which has a much lower cure rate. Patients with
...
drug-resistant TB have a high prevalence of symptoms; hence, staff caring for these patients should have some familiarity with palliative care, so that general palliative care principles are available to all patients. The timely identification, and addressing, of adverse events occurring during the treatment course is considered as general palliative care for those receiving curative treatment. This publication summarizes the general palliative care approach, which is recommended for use in settings and services that occasionally treat palliative care patients, but do not provide palliative care as the main focus of their work. The review focuses on 18 high TB priority countries of the WHO European Region.
more
Global Tuberculosis Report 2022 Factsheet
recommended
The World Health Organization Global TB Report provides a comprehensive and up-to-date assessment of the TB epidemic, and progress in the response, at global, regional and country levels.
The 202
...
2 edition features data on disease trends and the response to the epidemic from 215 countries and areas, including all 194 World Health Organization (WHO) Member States. It provides a comprehensive and up-to-date assessment of the TB epidemic, progress in the response at global, regional and country levels, as well as on the impact of the COVID-19 pandemic on TB services.
TB remains one of the top infectious killers in the world. This year’s report presents data on an increase in the number of people falling ill with TB and drug resistant TB for the first time in many years. Increases were also reported on the number of TB deaths, highlighting the severe impact of the COVID-19 pandemic and other crises on the TB response that has reversed years of progress. It also presents the status of progress towards targets set at the first-ever United Nations General Assembly high-level meeting on TB in 2018 as well as the targets of the WHO End TB Strategy and the Sustainable Development Goals.
more
Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis
S. Mokitimi; M. Schneider; P. J. de Vries
International Journal of Mental Health Systems; BioMed Central
(2018)
CC
Mental health problems represent the greatest global burden of disease among children and adolescents. There is, however, lack of policy development and implementation for child and adolescent menta
...
l health (CAMH), particularly in low- and middle-income countries (LMICs) where children and adolescents represent up to 50% of populations. South Africa, an upper-middle income country is often regarded as advanced in health and social policy-making and implementation in comparison to other LMICs. It is, however, not clear whether this is the case for CAMH.
more
This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This
...
is followed by key figures for the region, the role of WHO in country support and, recognizing the importance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
more
Screening programmes for tuberculosis (TB) among immigrants rarely consider the heterogeneity of
risk related to migrants’ country of origin. We assess the performance of a large screening programme in asylum seekers by analysing (i) the differen
...
ce in yield and numbers needed to screen (NNS) by country and WHO-reported TB burden, (ii) the possible impact of screening thresholds on sensitivity, and (iii) the value of WHO-estimated TB burden to improve the prediction accuracy of screening yield.
more
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.
more
Tuberculosis (TB) is the leading cause of death from a single infectious agent even if is largely curable and
preventable. In 2019 an estimated 2.9 million of the 10 million people who fell ill with
...
TB were not
diagnosed or reported to the World Health Organization1. The Political Declaration adopted by the United
Nations General Assembly in September 2018 commits, amongst others, to diagnosing and treating 40
million people with TB. In order to achieve these ambitious targets, there is an urgent need to deploy
strategies to improve diagnosis and initiation of care for people with TB. One of them is systematic
screening for TB disease, which is included in the End TB Strategy as a central component of its first pillar
to ensure early diagnosis for all with TB.
more
Low- and middle-income countries (LMICs) experience a high disease burden for epilepsy, a chronic neurological condition.The authors evaluate the cost-effectiveness of community health workers (CHWs
...
) to improve adherence to medication for epilepsy in South Africa. They found that utilizing CHWs to improve medication adherence was cost-effective.
more
The mandate of the National Tuberculosis Control Programme is to provide leadership and stewardship to accelerate intense and coordinated efforts to reduce the adult TB burden of 290 per 100,000 pop
...
ulation recently established in the 2013 National TB Prevalence Survey. Other key challenges are low TB case notification, unacceptably high TB death rates, low antiretroviral therapy (ART) coverage among TB/HIV patients and low drug-resistant notification and treatment.
more
Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium
...
term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
more
Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and
...
one in 20 school-aged children have severe asthma symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
more
Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this
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disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relative to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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Journal of Clinical TB and other Mycobacterial Diseases
uberculosis (TB) in the gastrointestinal tract or peritoneum is an uncommon condition in clinical practice. Its rarity, combined with its non
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specific presentations, makes this kind of extrapulmonary tuberculosis difficult to diagnose as it can mimic other inflammatory or malignant conditions. Delays in treatment and frequent misdiagnosis can lead to hazardous complications. In countries like Ecuador where the disease is endemic, TB should always be considered in the differential diagnosis of a patients who present with nonspecific abdominal symptoms. In these scenarios, laparoscopy can be an invaluable tool when used with sufficiently high clinical awareness and adequate training.
Case presentation
We present the case of a 37-year-old female patient from Ecuador with a 1-year history of abdominal pain, nausea, intermittent vomits, night sweats, and weight loss. After clinical evaluation and a laparoscopic intervention, abdominal TB was detected and promptly treated. Antituberculosis chemotherapy was initiated, and the patient successfully reco
High clinical awareness is imperative when approaching abdominal TB due to its wide spectrum of clinical symptoms and its rarity. Early detection and prompt treatment are critical to minimize the possibility of hazardous complications.
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Guideline: Nutritional care and support for patients with tuberculosis
Maria del Carmen Casanovas, Knut Lönnroth, Luz Maria De-Regil et al
World Health Organization
(2013)
C_WHO
Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with
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TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and that undernutrition at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
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he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing
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TB patients. When appropriately implemented, the activity is cost effective, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
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Guidelines for Diagnosing and Managing Disseminated Histoplasmosis among People Living with HIV
recommended
Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in c
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ertain countries of Asia and Africa. It often affects people with impaired immunity, including people living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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Maldives has made significant strides in the area of infectious disease prevention and control. This is exemplified by elimination of malaria from Maldives in 2015 and successes in TB control. In ad
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dition, Maldives is a front runner in infectious disease prevention through successful water, sanitation, hygiene and vaccination campaigns and coverage. However, given the limited evidence that exists with respect to the occurrence of resistant organisms in the nation, it is hard to estimate the exact antimicrobial resistance (AMR) scenario. Also, it becomes difficult to compare the current situation with other countries in the region. Moreover, limited evidence exists on the trends of use of antimicrobial agents (AMA) in Maldives. Although, recent prescription audits have indicated overuse of antibiotics, especially for common conditions such as flu, cough and fever.
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The WHO Global tuberculosis report 2024 provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regio
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nal and country levels. This is done in the context of global TB commitments, strategies and targets.
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Global tuberculosis report 2025
recommended
The WHO Global tuberculosis report 2025 provides a comprehensive and up-to-date assessment of the TB epidemic and of progress in prevention, diagnosis and treatment of the disease, at global, region
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al and country levels. This is done in the context of global TB commitments, strategies and targets.
The 2025 edition of the report is, as usual, based primarily on data gathered by WHO from national ministries of health in annual rounds of data collection. In 2025, 184 countries and areas with more than 99% of the world’s population and TB cases reported data.
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Primary Care 101
recommended
Symptom-based integrated approach to the adult in primary care.
Primary Care 101 is a comprehensive clinical practice guideline that aims to equip nurses and other clinicians to diagnose and manage common adult conditions at primary level.
Tb; HI
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V; Asthma/COPD; cardiovascular disease; diabetes; Mental health conditions; Epilepsy; Musculoskeletal disorders; Women’s health
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