MSF International AIDS Working Group
Maternal and child malnutrition is a significant public health problem in South Sudan. Among children aged 6-59 months, 31% are stunted, 28% are underweight, and nearly 23% are acutely malnourished of which 13% are estimated to suffer from moderate acute malnutrition and 10% from severe acute malnut...rition.
Overall, South Sudan’s nutrition situation is worrisome, with GAM persistently above the emergency threshold in the Greater Upper Nile, Northern Bahr el Ghazal and Warrap states. Though data on micronutrient deficiencies is scanty, Vitamin A Supplementation (VAS) among children 6-59 months stood at only 2.6% in 2010, showing low uptake (SHHS, 2010). This is against a backdrop of high morbidity levels and a negligible proportion of children 6 to 23 months receiving at least the recommended minimum acceptable diet. In order to ensure optimal child growth, it is essential to ensure good nutrition and basic health care from pregnancy through two years of age (the first 1000 days).
more
These guidelines aim to guide all health care providers in Myanmar, accommodating the situation of different settings in the context of progressive decentralization of HIV services. Notable changes from the previous edition include:
• diagnosis of HIV
• update on the initiation of ART<...br>
• new ARV drugs and regimens
• new recommendation on infant prophylaxis
• PrEP and PEP updates
• updates on co-infections and comorbidities management
It should be noted that these guidelines are meant for the operational level and are adapted and adopted in line with existing Myanmar context.
more
The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guidelines and policies regarding optimal packages of care... for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
more
This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent ...class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
more
Updates for the integrated management of childhood illness (IMCI) - Guideline.
As part of its response to the global epidemic of obesity, WHO has issued guidelines to support primary healthcare workers identify and manage children who are overweight or obese. Specifically, all infants and children ...aged less than 5 years presenting to primary health-care facilities should have both weight and height measured in order to determine their weight-for-height and their nutritional status according to WHO child growth standards. Comparing a child's weight with norms for its length/height is an effective way to assess for both wasting and overweight
more
BMC Family Practice (2017) 18:56 DOI 10.1186/s12875-017-0628
Internationally, there is a growing concern over antimicro-bial resistance (AMR) which is currently estimated to ac-count for more than 700,000 deaths per year worldwide. If no appropriate measures are taken to halt its pro-gress, AMR will cost approximately 10 million lives andabout US$100 trillion... per year by 2050. In contrast tosome other health issues, AMR is a problem that con-cerns every country irrespective of its level of incomeand development as resistant pathogens do not respect borders.Despite the threat presented by AMR, the 2014 WorldHealth Organization (WHO) and the recent O’Neill re-port describe significant gaps in surveillance, standardmethodologies and data sharing. The 2014 WHOreport identified Africa and South East Asia as the regions without established AMR surveillance systems.
Tadesseet al. BMC Infectious Diseases (2017) 17:616 DOI 10.1186/s12879-017-2713-1
more
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
more
2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and th...ey have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
more
Published: March 28, 2017https://doi.org/10.1371/journal.pmed.1002271
PLoS Med 14(3): e1002271. https://doi.org/10.1371/journal.pmed.1002271
Vol. 2: Clinicians' Guide
Clinicians’ Guide is designed to assist busy medical practitioners in the field with patient management by providing current, essential, practical guidance and background, packaged into a single resource
WHO/UNAIDS 2017 | Statement
This concept note describes the methods used to assess the prevalence of any HIVDR and HIVDR by PMTCT exposure among children less than 18 months of age using remnant dried blood spot specimens from early infant diagnosis over a 12-month period
La prise en charge de la tuberculose représente un véritable défi en milieu carcéral et l’organisation de la continuité des soins à la sortie un enjeu majeur. Comme tout être humain, les détenus ont le droit de jouir du meilleur état de santé physique et mental possible. Ce droit est gar...anti par l’article 25 de la Déclaration universelle des droits de l’homme adoptée par l’Organisation des Nations Unies, et par l’article 12 du Pacte international relatif aux droits économiques, sociaux et culturels. Ce travail fait un état des lieux sur la prise en charge de la tuberculose en milieu carcéral au Sénégal, depuis les stratégies de dépistage jusqu’à la continuité des soins après la sortie de prison.
more