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This publication provides recommendations for the management of critically ill adult patients with COVID-19 being treated in intensive care units (ICUs) in the Americas. These clinical practice guidelines provide evidence-informed recommendations fo
...
r identifying markers and mortality risk factors in critically ill patients, as well as infection control, sample collection, supportive care (respiratory and hemodynamic), pharmacological treatment, early rehabilitation, diagnostic imaging use, prevention of complications, and discharge requirements. The recommendations are for all health care staff caring for patients in emergency departments and ICUs. These guidelines are also intended for use by decisionmakers and government entities involved in the management of patients with COVID-19 in ICUs in the Region of the Americas.
more
The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approa
...
ches to improve mortality and the associated huge quality-adjusted life years lost to it once diagnosed. A possible venue to lower the incidence is to assess the safety and efficacy of various diabetes prevention strategies. Diet and exercise have a well-developed role in the prevention of weight gain and, ultimately, diabetes mellitus type II in high-risk individuals. However, high-risk individuals can also benefit from adjunct pharmacotherapy. In light of this information, we decided to conduct a systematic review of randomized controlled trials. This article summarizes the evidence in the literature on the pharmacological prevention of diabetes in high-risk individuals.
more
The decontamination of instruments and medical devices plays a very important role in the prevention of health care-associated infections (HAIs). I
...
ndeed, improper decontamination of surgical instruments, endoscopic devices, respiratory care devices and reusable haemodialysis devices still occurs in many settings, leading to HAIs. This course is based on the WHO manual on decontamination and reprocessing of medical devices for health care facilities, as well as in collaboration with the US CDC.
more
The aim of this course is to improve the prevention, detection, treatment and cure of sexually transmitted infections (STIs) and other reproductive
...
tract infections (RTIs) in settings serving pregnant women and their families.
more
This guide is intended for shelter operators, planners, and staff, as well as emergency managers, public health professionals, and radiation protection professionals who participate in shelter plann
...
ing and could be called upon to support shelter operations. This guide provides information on the incident-specific considerations that shelter operators will
need to take into account in a radiation emergency. Shelter operations include other mass care and emergency assistance activities that are required to support a sheltered population, such as feeding, providing essential supplies, and assisting with reunification of family and friends. Guidance to support such activities can be found in other planning resources. The information in this guide is intended to complement, not supplant, existing shelter protocols and responsibilities.
more
Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approxim
...
ately twice as high as high-resource settings (15 out of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
more
July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations
...
and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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In: Antenatal Care, Maternal Care, Under 5 Clinics, Family Planning Clinics and HIV Exposed Child Follow Up.
This 5th Edition of the Malawi Guidel
...
ines for Clinical Management of HIV in Children and Adults is implemented from January 2022. It replaces all previous editions of the Malawi Antiretroviral therapy (ART) and Prevention of Mother to Child Transmission (PMTCT) guidelines.This document is written for medical doctors, clinical officers, medical assistants, nurses, midwives, laboratorians, health surveillance assistants (HSAs) and medical records clerks who are working in public and private sector health facilities in Malawi. It is designed to be a practical guide for implementation of integrated HIV Services
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This is a case-ascertained prospective investigation of all identified health care contacts working in a health care facility in which a laboratory confirmed 2019-nCoV infected patient (see 2.2 Stud
...
y population) receives care. Note that this study can be done in health care facilities at all 3 levels of a health system – not just in hospitals. It is intended to provide epidemiological and serologic information which will inform the identification of risk factors 2019-nCoV infection among health care workers.
There are three primary objectives of this investigation among health care workers in a health care setting where a 2019-nCoV infected patient is being cared for:
To better understand the extent of human-to-human transmission among health care workers, by estimating the secondary infection rate1 for health care worker contacts at an individual level.
To characterize the range of clinical presentation of infection and the risk factors for infection among health care workers.
To evaluate effectiveness of infection prevention and control measures among health care workers
To evaluate effectiveness of infection prevention and control programmes at health facility and national level
more
Supplement to: Guidance on vaccination and prevention of vaccine-preventable disease outbreaks for countries hosting refugees from Ukraine, April 2022 update
This document provides: • information
...
on how to obtain vaccination documentation remotely (intended for refugees from Ukraine and internally displaced persons (IDPs) in Ukraine who lack documentation of vaccination status for themselves or their children); • information on the types of vaccination documentation issued in Ukraine, and English translations of standard documents (intended for health care providers in refugee-host countries to facilitate assessment of vaccination status of refugees).
more
Evolution of Ebola Virus Disease from Exotic Infection to Global Health Priority, Liberia
M. Allison Arwady, Luke Bawo, Jennifer C. Hunter et al
Centers for Disease Control and Prevention CDC
(2015)
Emerg Infect Dis. April 2015
Read online at: http://wwwnc.cdc.gov/eid/article/21/4/14-1940_article
Over the span of a few weeks during July and August 2014, events in West Africa changed perceptions of Ebola virus disease (EVD) from an exotic trop
...
ical disease to a priority for global health security. We describe observations during that time of a field team from the Centers for Disease Control and Prevention and personnel of the Liberian Ministry of Health and Social Welfare. The authors outline the early epidemiology of EVD within Liberia, including the practical limitations on surveillance and the effect on the country’s health care system, such as infections among health care workers
more
Following a radiation incident such as an improvised nuclear device (IND) detonation, state and local response authorities will need to establish one or more population monitoring and decontaminatio
...
n facilities to assess
people for radioactive exposure, contamination, and the need for
decontamination or other medical follow-up. These facilities are known as community reception centers (CRCs). The basic services offered at a CRC include the following: screening people for radioactive contamination, assisting people with washing or decontamination, registering people for subsequent follow-up, and prioritizing people for further care. This guide
describes the function of each station of a CRC and provides a question bank and other information to guide data collection at each station. A question bank format was chosen to provide the user the ability to tai
lor the data collection tool to fit a particular incident and/or locality.
The CRC data collection tool is designed for CRC staff to fill out the information collected from the individual being assessed.
more
This manual aims to provide an overview of this subject to health care professionals, paramedics and other voluntary services involved in health care
...
promotion
more
This document updates the 2014 Core Elements for Hospital Antibiotic Stewardship Programs and incorporates new evidence and lessons learned from experience with the Core Elements. The Core Elements
...
are applicable in all hospitals, regardless of size. There are suggestions specific to small and critical access hospitals in Implementation of Antibiotic Stewardship Core Elements at Small and Critical Access Hospitals (12).There is no single template for a program to optimize antibiotic prescribing in hospitals. Implementation of antibiotic stewardship programs requires flexibility due to the complexity of medical decision-making surrounding antibiotic use and the variability in the size and types of care among U.S. hospitals. In some sections, CDC has identified priorities for implementation, based on the experiences of successful stewardship programs and published data. The Core Elements are intended to be an adaptable framework that hospitals can use to guide efforts to improve antibiotic prescribing. The assessment tool that accompanies this document can help hospitals identify gaps to address.
more
Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health
...
and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance while maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
more
Diabetes in pregnancy
National Institute for Health and Care Excellence (NICE)
National Institute for Health and Care Excellence (NICE)
(2016)
CC2
The document "Diabetes in Pregnancy" by NICE (National Institute for Health and Care Excellence) outlines quality standards for managing diabetes in women during pregnancy, with a focus on five key
...
areas. First, it emphasizes the importance of preconception planning for women of childbearing age with diabetes. These women should receive guidance on optimizing their health before pregnancy, including achieving target HbA1c levels and taking high-dose folic acid to minimize risks. Second, joint diabetes and antenatal care is recommended for pregnant women with pre-existing diabetes, who should be seen early in pregnancy (ideally by 10 weeks gestation) by a combined diabetes and antenatal team to ensure optimal care throughout their pregnancy.
The third focus area is continuous glucose monitoring (CGM), which should be offered to pregnant women with type 1 diabetes. This includes either real-time CGM or flash monitoring to help improve blood glucose control and reduce complications during pregnancy. Fourth, postnatal testing and referral are essential for women diagnosed with gestational diabetes, who should receive glucose testing after birth to detect any persistent diabetes. Those eligible are referred to the National Diabetes Prevention Programme to lower their risk of developing type 2 diabetes. Lastly, the document recommends annual HbA1c testing for women with a history of gestational diabetes to monitor for type 2 diabetes development.
These standards aim to improve pregnancy outcomes for women with diabetes by providing individualized, accessible, and culturally appropriate care.
more
This brief from Audere and AVAC explains how artificial intelligence (AI) can support the HIV field by expanding reach, enhancing prevention, and i
...
mproving care.
more
Community use of face masks
recommended
Update 1 October 2020.
This document provides guidance to Member States on the effective use of face masks/coverings in the community by individuals without COVID-19 symptoms in order to reduce potential transmission of SARS-CoV-2.a It also provides advice on the use of masks during home
...
care for patients with COVID-19.
more
This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and
...
care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
more
Adolescents and young adults aged 10-24 remain underserved in the global response against HIV. Combination prevention, treatment and
...
care programmes use a mix of evidence-based interventions to meet the current HIV prevention needs of adolescents and young adults. However, there needs to be a focus on priority interventions that are evidence-based, practical, contextual and sustainable. This document highlights interventions and recommendations that have passed through the evidence-based lens of the WHO.
more