The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp...ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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Summary of current WHO recommendations and guidance on programmatic approaches
This manual is designed primarily to assist managers of national malaria programmes and national reference laboratory responsible for quality assurance of malaria microscopy control. The information is also applicable to non-governmental organizations and funding agencies investing in quality manage...ment systems for malaria microscopy.
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The recommendations in these guidelines promote the use of simple, non-invasive diagnostic tests to assess the stage of liver disease and eligibility for treatment; prioritize treatment for those with most advanced liver disease and at greatest risk of mortality; and recommend the preferred use of n...ucleos(t)ide analogues with a high barrier to drug resistance (tenofovir and entecavir, and entecavir in children aged 2–11 years) for first- and second-line treatment. Recommendations for the treatment of HBV/HIV-coinfected persons are based on the WHO 2013 Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection, which will be updated in 2015.
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Advising principles. The purpose of this document is to support competent authorities in charge of IHR implementation to improve national capacities for the prevention, detection and control of events, by strengthening communications and coordination between points of entry and the national health s...urveillance system
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Skin and mucosal conditions are extremely common in all children and adults in particular in HIV-infected adults and children and are one of the commonest daily management problems faced by health care workers caring for patients with HIV infection
Q3: Can febrile seizures (simple or complex) be managed at first or second level care by non-specialist health care providers in low and middle income country settings? What is the role of diagnostic tests in the management of febrile seizures by non-specialists in low and middle income settings? Fo...r prophylaxis to prevent recurrence of simple or complex febrile seizures, which of the pharmacological interventions when compared with placebo/comparator produce benefit/harm in specified outcomes?
- continuous anticonvulsant therapy - intermittent anticonvulsant therapy - intermittent antipyretic treatment
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Neurology Asia 2008; 13 : 41 – 48
Improving the management of childhood tuberculosis within national tuberculosis programmes: research priorities based on a literature review
WHO/HTM/TB/2007.381, 07.02