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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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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Antimicrobial resistance (AMR) is a global human, animal, plant and environment health threat that needs to be addressed by every country. The impacts of AMR are wide-ranging in terms of human health, animal health, food security and safety, environmental effects on ecosystems and biodiversity, and ...socioeconomic development. Just like the climate crisis, AMR poses a significant threat to the delivery of the 2030 Agenda for Sustainable Development. The response to the AMR crisis has been spearheaded through the global action plan on antimicrobial resistance (GAP-AMR), developed by the World Health Organization (WHO) in 2015, in close collaboration with the Food and Agriculture Organization of the United Nations (FAO) and the World Organisation for Animal Health (WOAH), and formally endorsed by the three organizations’ governing bodies and by the Political Declaration of the high-level meeting of the United Nations General Assembly on AMR in 2016. In 2022, the three organizations officially became the Quadripartite by welcoming the United Nations Environment Programme (UNEP) into the alliance “to accelerate coordination strategy on human, animal and ecosystem health”.
The aim of the GAP-AMR is to ensure the continuity of successful treatment with effective and safe medicines.
Its strategic objectives include:
• improving the awareness and understanding of AMR;
• strengthening the knowledge and evidence base through surveillance and research;
• reducing the incidence of infection through effective sanitation, hygiene and infection prevention measures; optimizing the use of antimicrobial medicines in human and animal health; and
• developing the economic case for sustainable investment that takes account of the needs of all countries and increasing investment in new medicines, diagnostic tools, vaccines and other interventions.
With the adoption of the GAP-AMR, countries agreed to develop national action plans (NAPs) aligned with the GAP-AMR to mainstream AMR interventions nationally. Individually, the Quadripartite took action to advance AMR interventions in their respective sectors. FAO adopted a resolution on AMR recognizing that it poses an increasingly serious threat to public health and sustainable food production, and developed an AMR action plan to support the resolution’s implementation. For its part, WOAH developed a strategy on AMR aligned with the GAP-AMR, acknowledging the importance of a One Health approach to AMR. Similarly, more recently, UNEP’s governing body, the United Nations Environment Assembly, recognized that AMR is a current and increasing threat and a challenge to global health, food security and the sustainable development of all countries, and welcomed the GAP-AMR and the NAPs developed in accordance with its five overarching strategic objectives
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Demographic and socioeconomic data Progress towards HIV testing and treatment cascade targets by 2025 (2023) Health sector cascade (2023) Estimated number of people newly infected with HIV
Cervical cancer is a disease of the female reproductive tract caused primarily by oncogenic types of human papillomavirus
(HPV). In 2020, it was the fourth most common cancer among women worldwide, with an estimated 604 000 new cases and 342 000 deaths
Considerando los cambios estratégicos en el abordaje de la salud pública y de la atención primaria de la salud, la prevención y el control de la tuberculosis en Ecuador genera un cambio en la parte organizacional y en la prestación de servicios con enfoque en grupos vulnerables y/o con factores... de riesgo acorde a los ciclos de vida. Esta documento contempla una orientación apoyada en evidencia científica y otras recomendaciones en la práctica médica, basadas en el buen juicio clínico de quien la emplea como referencia, en las necesidades del afectado y en los recursos disponibles al momento de la atención, dando prioridad a la prevención, diagnóstico, tratamiento y control de la TB.
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El presente compendio normativo agrupa las principales normas que enmarcan las intervenciones del sector salud y establecen los mecanismos y procedimientos referidos a la coordinación entre el sector público y privado vinculados a la prevención y control de la tuberculosis, orientados a garantiza...r los derechos y deberes fundamentales de las personas afectadas por la tuberculosis.
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Edición General: Dirección Nacional de Normatización - MSP
Este manual ha sido desarrollado por profesionales de las instituciones del Sistema Nacional de Salud (SNS)
y especialistas expertos en la materia, bajo la coordinación de la Dirección Nacional de Normatización del
Ministerio de S...alud Pública (MSP) y la colaboración de la Organización Panamericana de la Salud (OPS).
Contempla lineamientos técnicos, operacionales y administrativos, con la finalidad de garantizar la atención
integral, oportuna y de calidad a los usuarios de los establecimientos del SNS, dando prioridad a la preven-
ción, detección, diagnóstico y tratamiento para el control de la TB.
Los autores han declarado no tener conflicto de interés y han procurado ofrecer información completa y
actualizada; sin embargo, en vista de los posibles cambios en las ciencias médicas, se recomienda revisar el
prospecto de cada medicamento que se planea administrar, para cerciorarse de que no se hayan producido
cambios en las dosis sugeridas o en las contraindicaciones para su administración. Esta recomendación cobra
especial importancia en el caso de medicamentos nuevos o de uso infrecuente
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Primera Edición
Serie: Documentos Técnico normativos
Los presentes Lineamientos tecnicos del ministerio de salud de El Salvador establece las disposiciones para la prevención y control de la tuberculosis, para su aplicación por el personal del Sistema Nacional Integrado de Salud para incidir en la reducción de la morbimortalidad causada por la enfe...rmedad. Este documento tiene como enfoqe especial el tuberculosis y la diabetes. Incluye propositos de promocion de salud con la participación comunitaria para el control de la tuberculosis. Ademas propone una educacion de salud con enfasis en tuberculosis.
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La presente norma del ministerio de salud de El Salvador establece las disposiciones técnicas que regulan la promoción, prevención, detección, diagnóstico, tratamiento, control y la notifcación obligatoria de los casos de tuberculosis en todas sus formas. Esto incluyen el regulamento de digano...sis y tratamiento de differente grupos de pacientes.
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El manual está diseñado en temas sobre prevención y control de la tuberculosis y derechos humanos, así como las herramientas y técnicas necesarias para realizar las sesiones educativas con un enfoque de promoción de la salud, utilizando una metodología participativa que toma en cuenta las con...diciones de contexto como base para su formación de promotor de salud en la lucha y control de la tuberculosis.
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La estrategia nacional de participación comunitaria tiene como objetivo promover la participación activa de las organizaciones sociales y comunitarias en la prevención y control de la tuberculosis.
Pretende incorporar a las organizaciones no gubernamentales (ONG), a fin de que atiendan a los gru...pos vulnerables, movilizar a la comunidad e implementar estrategias de Información, Educación y Comunicación, con el propósito de superar la brecha de detección y tratamiento oportuno de personas con tuberculosis, tuberculosis y Virus de la Inmunodeficiencia Humana y otras comorbilidades.
Considera también el involucramiento de las municipalidades, a través de sus concejos municipales, así como el fundamentar acciones integrales con la participación activa de la sociedad civil a través de las Comisiones Municipales de Protección Civil, asegurando que esta se responsabilice y cuente con los recursos necesarios para el trabajo con poblaciones específicas.
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Este documento brinda orientaciones y directrices técnicas para mantener las acciones para la prevención y control de la tuberculosis (TB), ante la coyuntura que representa la pandemia del COVID-19 en Colombia, de conformidad con las directrices y recomendaciones emitidas por la Organización Mund...ial de la Salud (OMS), Organización Panamericana de la Salud (OPS) y demás organismos internacionales, que generan recomendaciones en la respuesta integrada a estos eventos de alto impacto para la salud pública. Estas recomendaciones están dirigidas a los diferentes agentes del sistema de salud tales como: entidades territoriales del orden departamental, municipal y distrital, empresas administradoras de planes de beneficios, prestadores de servicios de salud, trabajadores de la salud, agentes comunitarios y demás implicados en las acciones para la prevención y control de la tuberculosis y el COVID-19.
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12 countries have a high TB estimated burden with an incidence rate more than 45 per 100 000 population They represent 88 of the cases in the Region
In 2019 the TB case detection gap in the Region was 52 500 cases
Revised National Tuberculosis Control Programme