HIV & AIDS Treatment in Practice No. 198
Biology, Diagnosis and Treatment, Epidemiology and Prevention
In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable quality from public and private providers who are not engaged by the NTP. The quality of care provided i...n these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
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Q3: Are pharmacotherapies safe and effective for the treatment of psychostimulant dependence (maintenance or relapse prevention) in non-specialized settings?
Suicides take a high toll. Over 800 000 people die by suicide every year and it is the second leading cause of
death in 15-29-year-olds. Most suicides occur in low- and middle-income countries where resources
and services, if they do exist, are often scarce and limited for early identification, tr...eatment and support of
people in need. These striking facts and the lack of implemented timely interventions make suicide a serious
global public health problem that needs to be tackled urgently.
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Operational Guidelines for the national and district health workers & planners.
These new approaches include use of selective chemotherapy, Rapid Diagnostic Tests (RDTs), Zinc for treatment of cholera in children and complementary use of OCV
Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i...n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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Is your child’s ear hurting? It could be an ear infection. Children are more likely than adults to get ear infections. Talk to your child’s doctor about the best treatment. Some ear infections, such as middle ear infections, need antibiotic treatment, but many can get better on their own without... antibiotics.
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The World Health Organization (WHO) recommends the use of insecticide-treated nets (ITNs) and intermittent preventive treatment in pregnancy (IPTp) as a cost-effective intervention for the prevention of malaria during pregnancy in endemic areas. This study was conducted to investigate: (1) the exten...t of use of both IPTp and ITNs, and (2) conduct multinomial regression to identify factors affecting the optimal usage of IPTp and ITNs among women with a recent pregnancy in Senegal.
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The product of all this work is the Standard Treatment Guideline and Essential Medicines List of Common Medical Conditions in the Kingdom of Swaziland. These systematically developed statements are designed to assist practitioners in making decisions about appropriate treatment for specific clinical... conditions. They are meant to reflect expert consensus based on a review of current and published scientific evidence of acceptable approaches to diagnosis, man-agement, or prevention of specific conditions.It is enlightening to note that section A of the document contains the STG, and effort has been made to have the conditions commonly encountered in Swaziland classified according to systems. Written in simple, clear language, each section consists of a short definition followed by common symptoms and signs of the disease or condition and then management (pharmacological and nonpharmacological)
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Web annex 6: Injectable prostaglandins versus
placebo or no treatment
Evidence to Decision Framework
Web annex 5: Oxytocin and ergometrine versus placebo or no treatment
Evidence to decision framework
Web annex 2: Carbetocin versus placebo or no treatment
Evidence to decision framework
very woman has the right to the highest attainable standard of health, which includes the right to dignified, respectful health care.
Many women experience disrespectful and abusive treatment during childbirth in facilities worldwide. Such treatment not only violates the rights of women to respectf...ul care, but can also threaten their rights to life, health, bodily integrity, and freedom from discrimination. This statement calls for greater action, dialogue, research and advocacy on this important public health and human rights issue
Available in different langugages
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Cryptococcal disease, particularly cryptococcal meningitis is a significant cause of morbidity and mortality among people living with HIV with advanced HIV disease. It is estimated that it is responsible for nearly 19% of AIDS-related mortality, second only to tuberculosis. Rapid screening, diagnosi...s and linking to appropriate treatment are critical actions national programs must take to reduce the burden of disease.
WHO in 2022 introduced updated guidelines for diagnosing, preventing, and managing cryptococcal disease among adults, adolescents and children living with HIV. This policy brief provides a summary of the key recommendations, clinical considerations, and also stresses the importance of ensuring access to life-saving antifungals. There is an urgent need for countries to scale-up management for not just cryptococcal meningitis, but address cryptococcal disease in the context of a package of care for advanced HIV disease as recommended by WHO.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is atherosclerosis, which develops over many years and is usually advanced by the time symptoms occur, genera...lly in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing common medical conditions at the primary healthcare level. This document includes treatment protocols ...for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
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People with diabetes mellitus are at an increased risk for foot ulcerations as a result of poorly controlled blood glucose which may lead to gangrene. These patients are at a high risk for lower limb amputations, higher healthcare costs, and lower quality of life. This course aims to cover the preve...ntion of foot ulcers in persons with diabetes, classification of diabetic foot ulcers, diagnosis and treatment of foot infection in people with diabetes and interventions to enhance healing of foot ulcers.
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These training materials apply to all healthcare facilities that are not designated MVD treatment facilities.
HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes and pu...blic health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
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