Health in All Policies (HiAP) promotes health and equity. It is based on the recognition that our greatest health challenges for example, non-communicable diseases, health inequities and inequalities, climate change, and spiraling health care costs are highly complex and often linked through the soc...ial determinants of health (SDH). In this context, promoting healthy communities, and in particular health equity across different population groups, requires that we address the social determinants of health, such as public transportation, education access, access to healthy food, economic opportunities, and more. While many public policies work to achieve this, conflicts of interest may arise. Alternatively, unintended impacts of policies are not measured and addressed. This requires innovative solutions, and structures that build channels for dialogue and decision-making that work across traditional government policy siloes. Hence, HiAP could be adopted to ensure commitment from the highest decision makers within government to address the social determinants of health.
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El Laboratorio de Micología del Centro Nacional de Salud Pública del Instituto Nacional de Salud (INS) ha elaborado el presente manual de procedimientos micológicos, a fin de actualizar y uniformizar los conocimientos referidos al diagnóstico micológico que se basa en la identificación precisa... de los agentes causales de las micosis, aislados a partir de muestras clínicas representativas, así como también en pruebas de susceptibilidad antifúngica.
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The World Health Organization (WHO)6, the Civil Society Action Committee and the Lancet Migration global collaboration are amongst many organisations that have advised governments against returning irregular migrants during the Coronavirus disease 2019 (COVID-19) pandemic. The expulsion of i...rregular migrants to under-prepared countries puts migrants and communities at risk, and is against the principles of solidarity and public health that should inspire action during these challenging times. It also puts at risk the staff who implement these policies. Detention, overcrowded conditions and lack of hygiene all render irregular migrants more vulnerable to the impact of COVID-19. Irregular laborers, agricultura land food workers, cleaners and caregivers are all essential in the response to the pandemic, there fore the temporary or longer term regularisation of migrants to facilitate their access to health, social services and employment should be considered as a humane, practical and self-interested alternative to forcible return.
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2ª edição atualizada.
O Manual de Recomendações apresenta as diretrizes nacionais para o controle da doença, que incluem procedimentos clínicos padronizados, procedimentos laboratoriais, sistema de vigilância, ações de biossegurança e organização de serviços. Apesar de conter as reco...mendações clínicas no que diz respeito à padronização de ações de busca de casos e tratamento, o manual está destinado às ações voltadas para a saúde pública e não pretende ser um guia clínico sobre a doença. Dessa forma, não substitui livros, textos e publicações acadêmicas que identifiquem boas práticas clínicas sobre a abordagem do sintomático respiratório e do paciente com tuberculose nos seus variados aspectos e especificidades.
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La presente publicación tiene como objetivo facilitar herramientas para garantizar el abordaje integral del suicidio en la adolescencia, partiendo de la comprensión de que esta problemática trasciende las fronteras de la Salud Mental: requiere de una articulación basada en los principios de inte...rdisciplina, intersectorialidad y corresponsabilidad del conjunto de las políticas públicas destinadas a esta población.
Por ello, el material incluye herramientas para el proceso de atención clínica y, al mismo tiempo, prioriza el abordaje integral y comunitario. En este sentido, se propone como un insumo tanto para las acciones quedesarrollan los equipos de salud de atención primaria como también para la articulación y el trabajo en red con todos los efectores del Sistema de Promoción y Protección Integral de Derechos de Niñas, Niños y Adolescentes.
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Há três objetivos preliminares desse estudo de transmissão doméstica: 1. Para compreender melhor a extensão da transmissão doméstica estimando a taxa de infecção secundária1 para contatos domésticos em uma maneira individual, e fatores associados com qualquer variação no risco secundár...io da infecção. 2. Para caraterizar casos secundários incluindo a escala da apresentação clínica, fatores de risco para a infecção, a extensão e a fração de infecções assintomáticas. 3. Para caraterizar a resposta sorológica que segue a infecção confirmada pelo 2019-nCoV (altamente incentivado, mas opcional dependendo da capacidade e dos recursos do laboratório).
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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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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Humanitarian crises exacerbate nutritional risks and often lead to an increase in acute malnutrition. Emergencies include both manmade (conflict) and natural disasters (floods, drought, cyclones, typhoons, earthquakes, volcanic eruptions, etc.). Complex emergencies are combinations of both manmade a...nd natural disasters, often of a protracted nature. Millions of people are affected by humanitarian crises every year. The increasing frequency and scale of emergencies requires nutrition to be addressed in all phases of a response.
Crisis situations, whether acute or protracted, impact on a range of factors that can increase the risk of undernutrition, morbidity, and mortality. They may involve: the large-scale destruction of property and infrastructure; the erosion of livelihood strategies and purchasing power; a breakdown of and reduced access to essential services, including health services, water supply, and sanitation; and the displacement of large numbers of people. Emergencies can also disrupt social systems and the quality of care/feeding practices. Household access to food may be negatively affected and people may find themselves in overcrowded settlements with their families divided. As a result, at the individual level, there is often an increased risk of deteriorating health and nutritional status, resulting in a greater likelihood of death.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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ecancer, Cardiff University and the African Palliative Care Association have developed an online course in palliative care contextualised for African healthcare professionals. The course has been created through the IAEA Programme of Action for Cancer Therapy, Virtual University of Cancer Control a...nd is available for free through ecancer as well as the VUCCnet online.
Filming and development of the modules took place in the UK and South Africa and involved input from 37 of Africa’s leading palliative care experts as well as Cardiff University’s team. Dr Fiona Rawlinson, who is a consultant in palliative medicine at the Princess of Wales Hospital, UK and the leader of Cardiff University’s team, worked closely with the African Palliative Care Association to ensure the content of the course was appropriate for the sub-Saharan cancer profile and resource setting
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Accessed July 2014
For the whole Emergency and Trauma Care Modules visit: http://www.who.int/surgery/publications/immesc_emergency_trauma_care/en/
The guide helps patients to understand their rights in relation to the care received and provides insights into the common legal and
human rights issues they may encounter, and encourages them to share these with the health care provider for support. This booklet covers key issues that you mig...ht need to understand about ethical care, human rights and legal aspects. It aims to help people with serious illness as they face these issues, and give them guidance on how they can find solutions.
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Lancet Respir Med 2020Published OnlineMarch 20, 2020https://doi.org/10.1016/S2213-2600(20)30121-1