Este documento apresenta uma orientação provisória sobre a gestão do fornecimento de sangue em resposta à pandemia da doença causada pelo novo coronavírus (COVID-19). É dirigido a serviços de hemoterapia, autoridades nacionais de saúde, e outros responsáveis pelo fornecimento de sangue e ...hemoderivados e pela integração do sistema de bancos de sangue com o sistema de saúde pública. A OMS continuará atualizando este documento conforme forem disponibilizadas novas informações.
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COVID-19 e oxigênio: Os dados da China sugerem que embora a maioria das pessoas com COVID-19 tenham doença leve (40%) ou moderada (40%), cerca de 15% apresentam doença grave que requer oxigenoterapia, e 5% ficam em estado crítico e precisam de tratamento em uma unidade de terapia intensiva. Alé...m disso, a maioria dos pacientes críticos com COVID-19 precisará de ventilação mecânica.2,3 Por esses motivos, as unidades de saúde que tratam da COVID-19 devem estar equipadas com oxímetros de pulso, sistemas de oxigênio em funcionamento, incluindo interfaces de administração de oxigênio de uso único. A oxigenoterapia é recomendada para todos os pacientes graves e críticos com COVID-19, em doses baixas, variando de 1-2 L/min em crianças e começando com 5 L/min em adultos com cânula nasal, fluxos moderados para o uso em máscara de Venturi (6-10 L/min); ou fluxos mais altos (10-15 L/min) com o uso de uma máscara com bolsa reservatório. Além disso, o oxigênio pode ser administrado em fluxos mais altos e em concentrações maiores, usando uma cânula nasal de alto fluxo (CNAF)
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Esta é a primeira edição da orientação sobre estratégias de prevenção e controle de infecções (PCI) que devem ser aplicadas quando houver suspeita de COVID-19. Ela foi adaptada do documento da OMS sobre prevenção e controle de infecções durante prestação de cuidados de saúde para ca...sos prováveis ou confirmados de infecção da síndrome respiratória do Oriente Médio (MERS-CoV)1, com base no conhecimento atual da situação e experiência com a síndrome respiratória aguda grave (SARS) e MERS2. A OMS atualizará estas recomendações à medida que novas informações forem surgindo. Esta orientação é dirigida a trabalhadores da saúde, administradores em saúde e equipes de PCI nas unidades de saúde, mas também é relevante para os níveis nacionais, estaduais e municipais.
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O protocolo a seguir foi desenvolvido para investigar o alcance da infecção, conforme determinado pela soropositividade da população geral, em qualquer país com casos confirmados de infecção pelo COVID-19. Os países talvez tenham que adaptar alguns aspectos deste protocolo para os respectivo...s sistemas de saúde pública, bem como sistemas laboratoriais e clínicos, de acordo com a capacidade, disponibilidade de recursos e adequação cultural. No entanto, usando-se um protocolo padronizado, tal como o descrito abaixo, dados de exposição epidemiológica e amostras biológicas podem sercoletados de forma sistemática, e rapidamente compartilhados em um formato que facilite sua agregação, tabulação e análise em diferentes cenários globais, para estimar prontamente a gravidade as taxas de ataque da infecção pelo vírus COVID-19, bem como embasar respostas de saúde públicae decisões relativas a políticas públicas. Isso é particularmente importante no contexto de um novo patógeno respiratório, como o COVID-19.
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Organizing and Delivering High Quality Care for Chronic Noncommunicable Diseases in the Americas
важные шаги по возобновлению работы школ
In many humanitarian emergencies, there is a serious lack of access to even the most basic materials needed for managing the blood in addition to a lack of appropriate sanitation facilities (including water), which are critical for addressing menstrual hygiene. Privacy in emergencies is often scarc...e, and even if toilets are available they often lack locks, functioning doors, lighting and separation between genders. These barriers are often intensified by cultural beliefs and taboos surrounding menstruation which can restrict the movements and behaviors of girls and women
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Pneumonia kills more children than any other illness – more than AIDS, malaria and measles combined. Over 2 million children die from pneumonia each year, accounting for almost 1 in 5 under five deaths worldwide. Yet, little attention is paid to this disease. This joint UNICEF/WHO report examines ...the epidemiological evidence on the burden and distribution of pneumonia and assesses current levels of treatment and prevention. It is a call to action to reduce pneumonia mortality, a key step towards the achievement of the millennium development goal on child mortality.
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1.1 Why this course is needed
The first few hours and days of a newborn baby’s life are a critical window for establishing breastfeeding and for providing mothers with the support they need to breastfeed successfully. Since 1991, the Baby-friendly Hospital Initiative (BFHI) has helped to motivate... facilities providing maternity and newborn baby services worldwide to better support breastfeeding. It has been adopted by many countries and organizations. The BFHI aims to provide a health-care environment that supports mothers to acquire the skills necessary to exclusively breastfeed for six months, and to continue breastfeeding for two years or beyond.
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Petersen et al. Int J Ment Health Syst (2016) 10:30 DOI 10.1186/s13033-016-0060-z
The far-reaching impacts of the COVID-19 pandemic underscore the critical need for evidence-informed, transparent and inclusive decision-making. Policy-makers have grappled with complex choices amidst uncertainty. They have constantly reassessed response measures while navigating their economic impl...ications and unintended consequences on societal well-being. Effective communication of the basis for these decisions has also posed a challenge, requiring transparency and public trust.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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Mohamed et al. BMC Public Health 2018, 18(Suppl 3):1215
https://doi.org/10.1186/s12889-018-6053-xpre-
Tanzania is prone to refugee influxes, often of long duration. Despite facing its own economic challenges, for decades Tanzania has welcomed thousands of refugees fleeing conflicts in neighboring countries of Great Lakes Region. The counties geographic proximity to the strifetorn Congo Basin is resp...onsible in part for the ease access of displaced populations. As well Tanzania was an early signatory in the region to international agreements on the rights and welfare of refugee and asylum seekers As of December, 2018, Tanzania host some 284,300 camp-based refugees, 77% of who are children and woman, in Nduta, Nyarugusu and Mtendeli Refugee Camps in Kigoma region in Northwest Tanzania. About 74% are from Burundi, and the remaining 26% are primarily from Democratic republic of Congo.
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