These guidelines group all recommendations on TB care and support in one document and are complemented by an operational handbook. The guidelines are to be used primarily by national TB programmes, or their equivalents in Ministries of Health, stakeholders and technical organizations working on... TB care in the public and private sectors and in the community.
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This document is an output of a WHO cross-programme initiative aiming to improve the prevention, diagnosis and management of anaemia and thereby accelerate reduction in its prevalence. It comes at an important time, midway through the era of the Sustainable Development Goals, when progress in reduci...ng anaemia has stagnated. This framework is based on the core principles of primary health care: meeting people’s health needs through comprehensive promotive, protective, curative, and rehabilitative care along the life course; systematically addressing the broader determinants of health; and empowering individuals, families, and communities to optimize their health
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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The National Tuberculosis Programme (NTP) of Rwanda (known as TB & ORD Division/IHDPC/RBC) is preparing to write their next National Strategic Plan and for this reason Rwanda was selected as a country to received technical assistance (TA) to conduct an assessment of their surveillance system using t...he surveillance checklist as input for the new strategy. This TA was provided under the USAID TBCARE I Core project on Monitoring and Evaluation, Operational Research and Surveillance (C7.08) developed a surveillance checklist with the objectives to assess a national surveillance system’s ability to accurately measure TB cases and deaths and to identify gaps in national surveillance systems that need to be addressed in order to improve TB surveillance.
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This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita...ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
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This comprehensive book has established itself as the most useful text for the medical practitioner in poor-resource settings who is obliged to manage surgical cases. It is particularly adapted for those whose surgical experience is basic or minimal. Importantly, it has extensive advice about pitfal...ls to avoid, and what to do if things go wrong. It is written in simple style, particularly for those whose mother tongue is not English. It is not a text which discusses the latest up-to-date technology, but it is not out-of-date being a synthesis of the best advice from a myriad of surgeons practicing for many years in low- and middle-income countries.
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The information contained in this document, be it guidelines, recommendations, diagnostic algorithms or treatment regimens, are offered in this document in the public interest. To the best of the knowledge of the guideline writing team, the information contained in these guidelines is correct. Imple...mentation of any aspect of these guidelines remains the responsibility of the implementing agency in so far as public health liability resides, or the responsibility of the individual clinician in the case of diagnosis or treatment.
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In fragile, conflict-affected and vulnerable settings, delivery of quality health services faces significant challenges, including disruption of a routine health service organization and delivery systems, increased health needs, complex and unpredictable resourcing issues, and vulnerability to multi...ple public health crises. Despite the difficulty of addressing quality in such settings, the necessity for action is acute, given the significant health needs of the populations in these environments and the increasing numbers of people for whom such settings are home.
This manual has been developed to provide a starting point for multi-actor efforts and actions to address quality of care in the most challenging settings. This includes practical approaches to action planning and implementation of a contextualised set of quality interventions.
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There is a substantial and ever-increasing unmet need for rehabilitation worldwide, which is particularly profound in low- and middle
-income countries. The availability of accessible and affordable rehabilitation is necessary for many people with health conditions to remain as independent as possi...ble, to participate in education, to be economically productive, and fulfil meaningful life roles.
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Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discrimination, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of ind...ividuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
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Outstanding child and adolescent TB priorities include the need to: find the missing children with active TB and link them to TB care; prevent TB in children who are in contact with infectious TB cases (through implementation of active contact investigation and provision of preventive treatment); an...d advance integration within general child health services, including maternal and child health/ reproductive, maternal, newborn, child and adolescent health, HIV, nutrition and other programmes.
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The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guidelines and policies regarding optimal packages of care... for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
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Exposure to air pollution causes 7 million deaths worldwide every year and costs an estimated US$ 5.11 trillion in welfare losses globally. In the 15 countries that emit the most greenhouse gas emissions, the health impacts of air pollution are estimated to cost more than 4% of their GDP. Actions to... meet the Paris goals would cost around 1% of global GDP. The report provides recommendations for governments on how to maximize the health benefits of tackling climate change and avoid the worst health impacts of this global challenge.
It describes how countries around the world are now taking action to protect lives from the impacts of climate change – but that the scale of support remains woefully inadequate, particularly for the small island developing states, and least developed countries. Only approximately 0.5% of multilateral climate funds dispersed for climate change adaptation have been allocated to health projects
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