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Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and
...
recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP), which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes. more
The WHO Model List of Essential Medicines and Model List of Essential Medicines for Children are updated and published every two years, intended as a guide for countries or regional authorities to a
...
dopt or adapt in accordance with local priorities and treatment guidelines for the development and updating of national essential medicines lists. Selection of a limited number of essential medicines as essential, taking into consideration national disease burden and clinical need can lead to improved access through streamlined procurement and distribution of quality-assured medicines, support more rational or appropriate prescribing and use and lower costs for both health care systems and for patients.
more
Integrated management of childhood illness. The last update was in the IMCI chart booklet in 2014, but since then there have been significant updates on the management of sick young infant (SYI) aged up to 2 months. This 2019 update of the sick young infant section Management of the sick young infan
...
t age up to 2 months: IMCI chart booklet. supersedes the 2014 IMCI chart booklet. The new updates reflect the recent guidelines on Managing possible serious bacterial infection (PSBI) in young infants when referral is not feasible published in 2015. It includes assessment, classification and referral of SYI with PSBI; and outpatient treatment of SYI with local infection or fast breathing (pneumonia) in infants 7-59 days old. Other updates include: a new section on how to reassess, classify and treat SYI with PSBI when referral is not feasible in outpatient health facilities by IMNCI trained health workers; changes in assessment and management of young infants for HIV infection; and identification of infants less than 7 days of who need Kangaroo Care.
more
J Fungi (Basel) . 2019 Aug 16;5(3):75. doi: 10.3390/jof5030075 . Namibia is a sub-Saharan country with one of the highest HIV infection rates in the world. Although care
...
and support services are available that cater for opportunistic infections related to HIV, the main focus is narrow and predominantly aimed at tuberculosis. We aimed to estimate the burden of serious fungal infections in Namibia, currently unknown, based on the size of the population at risk and available epidemiological data. Data were obtained from the World Health Organization (WHO), Joint United Nations Programme on HIV/AIDS (UNAIDS), and published reports.
more
Language influences the way we think, how we perceive reality, and how we behave. With respect to HIV, language can embody stigma and discriminatio
...
n, which impacts access to testing, acquisition of HIV, and engagement with treatment. Language plays a role in supporting respect and empowerment of individuals, as communities shape how they are referred to and the labels they wish to use. Consideration and use of appropriate language can strengthen the global response to the HIV pandemic by diminishing stigma and discrimination and increasing support and understanding for individuals and communities living with HIV. Comments and suggestions for modifications should be sent to
more
The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
...
3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
more
The "Integrated Management of Malaria Training – Health Worker’s Manual" is a practical guide developed by Uganda’s Ministry of Health to train healthcare workers at all levels in the effective diagnosis, treatment, prevention,
...
and management of malaria. It aligns with national malaria treatment guidelines and aims to improve the quality of care and reduce malaria-related illness and death. The manual covers key topics such as clinical assessment of fever, use of rapid diagnostic tests (RDTs), case management of uncomplicated and severe malaria, malaria in pregnancy, co-infections like HIV, as well as community engagement and proper documentation. It includes structured training sessions, case studies, and job aids designed to strengthen the skills of health workers in both public and private sectors, and to ensure standardized, evidence-based malaria care across the country.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
...
sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
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 treatment 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.
more
Program Considerations
Community health workers, recipients’ experiences and constraints to care in South Africa – a pathway to trust
Nonhlanhla Nxumalo, Jane Goudge & Lenore Manderson
AIDS Care Psychological and Socio-medical Aspects of AIDSHIV
(2016)
CC
This document provides an overview of key considerations for the provision of the HIV continuum of care in the context of displaced people from Ukraine in the EU/EEA. This document has two aims: fir
...
stly, to outline what is known of the Ukrainian HIV epidemic, and secondly, to use the HIV continuum of care as a framework to set out suggestions based on published evidence and expert opinion on the management of the HIV continuum of care, with special consideration for people living with HIV from Ukraine. The document will also address the needs of those at risk of acquiring HIV. The main findings of this document were presented during an ECDC webinar, ‘Key considerations on the continuum of HIV care for refugees from Ukraine,’ hosted on 19 May 2022.
more
Disclosure of HIV Status Toolkit for Pediatric and Adolescent Populations
N. Rakhmanina; J. Kose; K. Wallner; et al.
Elizabeth Glaser Pediatric New Horizons (Advancing Pediatric HIV Care) ; Johnson & Johnson; AIDS Foundation (Until no child has AIDS); Children & Aids
(2019)
C2
Accessed: 26.10.2019
This clinical job aid addresses the importance of maternal health and antiretroviral therapy adherence, as well as care and testing for the
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HIV-exposed infant until the infant’s final HIV diagnosis after the end of breastfeeding.
more
National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
Division of Tuberculosis Elimination.
