BMJ 2020; 370 doi: https://doi.org/10.1136/bmj.m3379
Rapid Recommendation and visual graph. This is the fifth version (update 4) of the living guideline (BMJ 2020;370:m3379). When citing this article, please consider adding the update number and date of access for clarity. The publication of the RE...COVERY and REMAP-CAP randomised controlled trials triggered this guideline update, resulting in a strong recommendation for interleukin-6 (IL-6) receptor blockers (tocilizumab or sarilumab) in patients with severe or critical covid-19.
Prior recommendations: (a) A recommendation not to use ivermectin in patients with covid-19, regardless of disease severity, except in the context of a clinical trial; (b) a strong recommendation against the use of hydroxychloroquine in patients with covid-19, regardless of disease severity; (c) a strong recommendation against the use of lopinavir-ritonavir in patients with covid-19, regardless of disease severity; (d) a strong recommendation for systemic corticosteroids in patients with severe and critical covid-19; (e) a conditional recommendation against systemic corticosteroids in patients with non-severe covid-19; and (f) a conditional recommendation against remdesivir in hospitalised patients with covid-19.
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Recently, a renewed interest in large-scale community health worker (CHW) programs has been seen globally. This renewal provides an opportune moment to take stock of issues and challenges such programs face and what can be done to make them as effective as possible. With this in mind, this manual is... intended to be used a practical guide for policymakers and program
managers wishing to develop or strengthen a CHW program, drawing lessons from other countries that have implemented CHW programs at-scale. Throughout, we discuss major policy and programmatic issues that decision-makers and planners need to consider when designing, implementing, scaling up or strengthening a national-level CHW program. We offer an overview
of specific challenges CHW programs face, country lessons, tools, and other resources that may be helpful, while incorporating relevant programmatic examples as much as possible.
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What are the FP and CAC competencies?
Through the clear articulation of the family planning and comprehensive abortion care (FP and CAC) competencies for the primary health care workforce, the aim is to advance improvements in FP and CAC service delivery by aligning health worker education approach...es with population health needs and health system demands.
This document, which describes these competencies in detail, is intended to:
be a foundational tool to be adopted and adapted by educators and regulators for FP and CAC providers (students) with a pre-service training pathway of at least 12 months;
describe competencies that are relevant to current and future health practice;
enable widespread use of the competencies not only for curriculum development for pre-service education, but also for in-service education, regulation, qualifications, quality assurance, personal development, performance evaluation, recruitment, management and career progression;
focus on the core functions of FP and CAC providers within broader efforts towards achieving universal health coverage
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The Humanitarian Pandemic Preparedness (H2P) Initiative and its many partners have developed ready-to-use training curricula for district- and community-level leaders, and community volunteers and workers in order to minimize morbidity and mortality in the event of an influenza pandemic. The time t...o put these tools into action is now.
The curriculum has separate tracks for district/community leaders and for first responders (community volunteers and workers) at the community level.
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The objective of this concept note and the framework it outlines is the elimination of a group of CDs and the negative health effects they generate, which together create a tangible burden on affected individuals, their families and communities, and on health care systems throughout the Region. Thou...gh there is no unified consensus on the best measures to use for the public’s health and a nation’s epidemiologic situation, it is common for the disease burden to be measured by disease rates (incidence, prevalence, etc.), disease-specific death rates, comparative morbidity and mortality rates, geographic distribution, and disability-adjusted life years (DALYs). The current epidemiological situation, including data on disease rates or geographic distribution for the diseases in Table 1, is discussed below in Section 4. Hotez et al. (2008) were the first to review and compare the burden of DALYs in Latin America and the Caribbean—for NTDs, HIV/AIDS, malaria, and TB—as it existed about 10 years ago. Though the regional burden of TB, malaria, and neglected infectious diseases (NIDs) is somewhat less than it was 10 years ago, work (and schooling) continue to be lost to illness and premature death or disability, and the need for stepping up disease elimination efforts is evident in all communities living in vulnerable conditions....
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The annual Joint Meeting of the Food and Agriculture Organization of the United Nations (FAO) Panel of Experts on Pesticide Residues in Food and the Environment and the World Health Organization (WHO) Core Assessment Group on Pesticide Residues (JMPR) was held in Rome, Italy, from 13 to 22 September.... The FAO panel of experts had met in preparatory sessions from 8 to 12 September. The Meeting was held in pursuance of recommendations made by previous Meetings and accepted by the governing bodies of FAO and WHO that studies should be undertaken jointly by experts to evaluate possible hazards to humans arising from the occurrence of pesticide residues in foods. During the meeting the FAO Panel of Experts was responsible for reviewing pesticide use patterns (use of good agricultural practices), data on the chemistry and composition of the pesticides and methods of analysis for pesticide residues and for estimating the maximum residue levels that might occur as a result of the use of the pesticides according to good agricultural use practices. The WHO Core Assessment Group was responsible for reviewing toxicological and related data and for estimating, where possible and appropriate, acceptable daily intakes (ADIs) and acute reference doses (ARfDs) of the pesticides for humans. This report contains information on ADIs, ARfDs, maximum residue levels, and general principles for the evaluation of pesticides. The recommendations of the Joint Meeting, including further research and information, are proposed for use by Member governments of the respective agencies and other interested parties.
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This paper, originally presented as a Sussex Development Lecture, asks how the Ebola crisis might offer a lens to reflect on interlaced challenges around curbing inequalities, accelerating sustainability, and building inclusive, secure societies, and why these matter so much. And it discusses why ad...dressing these interactions must become central to a renewed vision of development for all
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Atherosclerotic lower-extremity peripheral artery disease (PAD) is increasingly recognized as an important cause of cardiovascular morbidity and mortality that affects more than 230 million people worldwide. Traditional cardiovascular risk factors, including advanced age, smoking, and diabetes, are ...strongly linked to an increase risk of PAD. Although PAD has been historically underappreciated compared to coronary artery disease and stroke, greater attention on PAD in recent years has led to important new epidemiologic insights in the areas of thrombosis, inflammation, dyslipidemia, and microvascular disease. In addition, the concept of polyvascular disease, or clinically-evident atherosclerosis in multiple arterial beds, is increasingly identified as a particularly malignant cardiovascular disease worthy of special clinical attention and further study. It is noteworthy that PAD may increase the risk of adverse outcomes in similar or even greater magnitude than coronary disease or stroke. In this review, we highlight important new advances in the epidemiology of PAD with a particular focus on polyvascular disease, emerging biomarkers, and differential risk pathways for PAD compared to other atherosclerotic diseases.
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The Government of Malawi, in fulfilling its primary role of protecting the lives of its vulnerable citizens during disasters and reducing their exposure to risk through preparedness, led the development of a National Coronavirus Disease (COVID-19) Preparedness and Response Plan.
Chapter 5: A Community Guide to Environmental Health
The National Tuberculosis Programme (NTP) of Rwanda (known as TB & ORD Division/IHDPC/RBC) is preparing to write their next National Strategic Plan and for this reason Rwanda was selected as a country to received technical assistance (TA) to conduct an assessment of their surveillance system using t...he surveillance checklist as input for the new strategy. This TA was provided under the USAID TBCARE I Core project on Monitoring and Evaluation, Operational Research and Surveillance (C7.08) developed a surveillance checklist with the objectives to assess a national surveillance system’s ability to accurately measure TB cases and deaths and to identify gaps in national surveillance systems that need to be addressed in order to improve TB surveillance.
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This six-day training is intended for case managers/community health volunteers/field supervisors who help households affected by HIV in India.
Unchecked inequality and failure to protect the rights of poorest women could undermine peace and world’s development goals, new UNFPA report warns:
- Only about half of the world’s women hold paid jobs
- Globally, women earn 77 per cent of what men get
- Three in five women worldwide lack m...aternity leave, many pay "motherhood penalty"
The report is also available in French: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_FR_swop_Etat_de_la_population_mondiale.pdf; in Spanish: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_ES_SWOP_Estado_de_la_Poblacion_Mundial.pdf; in Russian: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_RU_SWOP_NARODONASELENIE_MIRA_V_2017_GODU.pdf and in Arabic: https://www.unfpa.org/sites/default/files/sowp/downloads/UNFPA_PUB_2017_AR_SWOP_Hl_skn_llm_.pdf
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Thirty years ago, the United Nations General Assembly adopted the Convention on the Rights of the Child at a moment of rapid global change marked by the end of apartheid, the fall of the Berlin Wall and the birth of the World Wide Web. These developments and more brought momentous and lasting evolut...ion, as well as a sense of renewal and hope for future generations. In a reflection of that hopeful spirit, the Convention has since become the most widely ratified human rights treaty in history.
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The information contained in this document, be it guidelines, recommendations, diagnostic algorithms or treatment regimens, are offered in this document in the public interest. To the best of the knowledge of the guideline writing team, the information contained in these guidelines is correct. Imple...mentation of any aspect of these guidelines remains the responsibility of the implementing agency in so far as public health liability resides, or the responsibility of the individual clinician in the case of diagnosis or treatment.
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This report sets out the compelling case for repurposing harmful agricultural producer support to reverse this situation, by optimizing the use of scarce public resources, strengthening economic recovery from the COVID-19 pandemic, and ultimately driving a food systems transformation that can suppor...t global sustainable development commitments.
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A handbook for building skills, Updated 2013