La publicación que aquí presentamos busca mostrar los resultados de la iniciativa SAIDI en los países intervenidos, para ello se entrega un perfil que muestra el panorama de la situación de la resistencia antimicrobiana, pre y post iniciativa, así como información clave de los actores que trab...ajan en el tema. Está dirigida al personal técnico y a los tomadores de decisiones, que abordan desde sus distintas perspectivas el tema del uso de antibióticos y la resistencia a los antimicrobianos.
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South Africa has faced many challenges over the past two decades, accomplishing profound positive changes in the social structure and government of the nation. This has not yet fully translated into better health for the population, however, particularly the poorest segment. In fact, the p...opulation has lost ground since the 1990s in virtually all important health indicators, leaving South Africa with a high burden of infectious disease.
August 2011, Vol. 101, No. 8 SAMJ
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Antimicrobial resistance (AMR) is an important public health concern shared by developed and developing countries. In developing countries the burden of infectious diseases is greater and exacerbated by limited access to, and availability and affordability of, antimicrobials required to treat infect...ions caused by AMR organisms. With drugs not listed on the essential drugs list (EDL), problems of increased morbidity, costs of extended hospitalisation and mortality are extremely serious. The problem of susceptibility to and spread of infections caused by multidrug-resistant (MDR) infectious agents is fuelled by factors such as limited access to clean water and sanitation to ensure personal hygiene, malnutrition, and the HIV/TB epidemic.
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Antimicrobial resistance (AMR) is described as a situation when bacteria, viruses, fungi and parasites
change over time and no longer respond to medicines, making infections harder or impossible to treat,
and increasing the risk of disease spread, severe illness and death.1 AMR in recent years has... become
a global priority in public health due to its widespread consequences and increasing occurrence from
time to time. AMR has a formidable impact where the existing antibiotics and other antimicrobial
medicines become ineffective, and infections become increasingly difficult or impossible to treat.
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The GHS Index is intended to be a key resource in the face of increasing risks of high-consequence and globally catastrophic biological events and in light of major gaps in international financing for preparedness. These risks are magnified by a rapidly changing and interconnected world; increasing ...political instability; urbanization; climate change; and rapid technology advances that make it easier, cheaper, and faster to create and engineer pathogens.
Key findings from the study of 195 countries:
• Out of a possible 100 points, the average GHS Index score across 195 countries was 40.2.
• The majority of high- and middle-income countries do not score above 50.
• Action is urgently needed to improve countries’ readiness for high-consequence infectious disease outbreaks.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de...aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline... is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
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The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly re...placing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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Participant Manual
February 2011
Edition 3.0
Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa...nded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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The new treatment recommendations that extend the 2018 treat all recommendation for adults with chronic HCV infection to include adolescents and children down to 3 years, and to align the existing recommended pangenotypic direct-acting antiviral (DAA) regimens (SOF/DCV, SOF/VEL and G/P) for adults, ...to those for adolescents and children. This alignment is expected to simplify procurement, promote access to treatment among children in low- and middle-income countries and contribute to global efforts to eliminate the disease
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These guidelines form part of efforts to institutionalize the prevention and containment of antimicrobial resistance (AMR) in healthcare facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two interr...elated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level. They aim to serve as a practical, step-by-step or ‘how-to’ guide, addressing the infection prevention and AMS components of a robust response in a hospital. They draw on
evidence from various international guidance documents and standards for interventions that have been shown to be successful in infection
prevention and AMS programmes. These interventions have been customised to the South African hospital setting based on local
experiences in the public and private health sectors. This was done through a series of workshops and requests for comment involving
country-level experts.
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As a public good, antimicrobial medicines require rational use if their effectiveness is to be preserved. However, up to 50% of antibiotic use is inappropriate, adding considerable costs to patient care, and increasing morbidity and mortality. In addition, there is compelling evidence that antimicro...bial resistance is driven by the volume of antimicrobial agents used. High rates of antimicrobial resistance to common treatments are currently reported all over the world, both in health care settings and in the community. For over two decades, the Region of the Americas has been a pioneer in confronting antimicrobial resistance from a public health perspective. However, those efforts need to be stepped up if we are to have an impact on antimicrobial resistance and want to quantify said impact.
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These guidelines form part of efforts to institutionalise the prevention and containment of antimicrobial resistance (AMR) in health care facilities in South Africa, as outlined in the Antimicrobial Resistance Strategic Framework and Implementation Plan. The focus of these guidelines is on two inte...rrelated aspects of prevention of healthcare associated infections (HAIs) and their spread; and the application of antimicrobial stewardship (AMS) practices at hospital level.
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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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Las guías para la prevención de Infecciones del Sitio Quirúrgico (ISQ) resumen las medidas basadas en la evidencia que han demostrado disminuir su incidencia y mejorar la calidad asistencial de los pacientes sometidos a cirugía. La última revisión local fue realizada en el año 2009, en el mar...co del consenso intersociedades INE - SADI - ADECI.
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UN, international agencies and experts released a groundbreaking report demanding immediate, coordinated and ambitious action to avert a potentially disastrous drug-resistance crisis.
If no action is taken - warns the UN Ad hoc Interagency Coordinating Group on Antimicrobial Resistance who release...d the report – drug-resistant diseases could cause 10 million deaths each year by 2050 and damage to the economy as catastrophic as the 2008-2009 global financial crisis. By 2030, antimicrobial resistance could force up to 24 million people into extreme poverty.
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