Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytolo...gy, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a ‘screen-and-treat’ approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. This guideline provides recommendations for strategies for a screen-and-treat programme
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Brief instructions for the diagnostic of specimens coming from suspected plague cases and exposed contacts, including recommendations for diagnostic confirmation
Versão 2. Última atualização 10 Março 2016
O protocolo contém orientações sobre definição de casos suspeitos, como identificação de alterações do Sistema Nervoso Central (SNC) durante a gestação, critérios para confirmação ou descarte de casos, sistema de notificação e investig...ação laboratorial. Além disso, há orientações sobre como deve ser feita a investigação epidemiológica dos casos suspeitos e sobre o monitoramento e análise de dados.
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The major areas of focus for the plan will be:
- Social mobilization and community empowerment (health promotion & education for disease prevention);
- Promotion of access to safe water, good sanitation and hygiene;
- Surveillance and laboratory confirmation of outbreaks;
- Prom...pt case management and infection control;
- Complementary use of oral cholera vaccine (OCV) for cholera endemic communities; and
- Coordination and stewardship between and for all actors.
- Monitoring, supervision, evaluation and operation research to ensure continued improvement in service delivery.
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30 April 2020
| COVID-19: Essential health services
Countries who have no testing capacity can send their samples to the WHO appointed 2019-nCoV referral laboratories for testing. National 2019-nCoV laboratories with limited experience are encouraged to send the first five positives and the first ten negative 2019-nCoV samples to their referral labor...atories for confirmation.
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El 31 de diciembrede 2019 las Autoridades de la República Popular China, comunicaron a la OMS varios casos de neumonía de etiología desconocida en Wuhan, una ciudad situada en la provincia china de Hubei. Una semana más tarde confirmaron que se trataba de un nuevo co...ronavirus que ha sido denominado SARS-CoV-2. Al igual que otros de la familia de los coronavirus, este virus causa diversas manifestaciones clínicas englobadas bajoel término COVID-19, que incluyen cuadros respiratorios que varían desde el resfriado común hastacuadros de neumonía grave con síndrome de distrés respiratorio, shock séptico y fallo multi-orgánico. La mayoría de los casos de COVID-19 notificados hasta el momento debutan con cuadros leves.Un punto de detección importante de casos de COVID-19es la urgencia hospitalaria. El triaje tiene como objetivo identificar y priorizar al paciente más grave. Al tratarse deuna enfermedad transmisiblese debenextremar las medidas deprecaución.
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Las prácticas de prevención y control de infecciones necesitan implementarse para garantizar la seguridad de los trabajadores de salud y pacientes en establecimientos de salud, es fundamental prevenir la contaminación cruzada y contener la propagación del COVID 19. • Al día de esta publicaci...n, están recomendadas las siguientes precauciones para el cuidado del paciente con sospecha o confirmación de COVID-19‡: o Para cualquier caso sospechoso o confirmado de COVID-19: precauciones estándares + contacto + precauciones en la transmisión por gotitas o Para cualquier caso sospechoso o confirmado de COVID-19 y procedimientos generadores de aerosoles: precauciones estándares + contacto + transmisión aérea (aerosoles o núcleo de gotitas)
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Este documento é uma atualização das Orientações provisórias da OPAS para o gerenciamento de casos de COVID-19 nos serviços de saúde. A lista de dispositivos médicos prioritários no contexto do vírus COVID-19 fornece descrições técnicas e especificações para o manejo de pacientes com... suspeita e/ou confirmação de infecção por COVID-19 nos diferentes níveis de complexidade do tratamento e para as fases de atendimento. Esclarecemos que a lista incluída neste documento deve ser adaptada ao contexto de cada país da região, de acordo com as necessidades e capacidades de seus sistemas de saúde.
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Este documento presenta una actualización de las recomendaciones interinas de la Organización Panamericana de la Salud para la gestión de los casos de COVID-19 en los servicios de salud. La lista de dispositivos médicos prioritarios en el contexto de la COVID-19 proporciona normas mínimas, desc...ripciones técnicas y especificaciones para el manejo de pacientes con sospecha o confirmación de infección por coronavirus en los distintos niveles del entramado asistencial y puntualmente para todas las etapas de atención.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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Esta quarta edição do manual se baseia no esquema de avaliação de risco apresentado na terceira edição. Uma avaliação completa, baseada em evidências e transparente dos riscos permite que as medidas de segurança sejam equilibradas com o risco real de trabalhar com agentes biológicos, caso... a caso. Isso permitirá que os países implementem políticas e práticas de biossegurança e biosseguridade laboratoriais economicamente viáveis e sustentáveis que sejam relevantes para suas circunstâncias e prioridades individuais.A necessidade de atualizar as diretrizes de biossegurança de laboratórios internacionais faz parte de uma iniciativa mais ampla para globalizar a biossegurança e enfatizar os princípios e as abordagens que são acessíveis a países que tenham ampla gama de recursos financeiros, técnicos e regulatórios. A OMS revisou o Regulamento Sanitário Internacional em 2005 “para ajudar a comunidade internacional a prevenir e a responder aos riscos agudos de saúde pública que tenham o potencial de cruzar fronteiras e ameaçar pessoas em todo o mundo”. Esses regulamentos exigem que todos os 196 estados-membros da OMS estejam bem preparados para surtos em potencial e novas doenças; isso inclui o diagnóstico precoce e a confirmação laboratorial para facilitar a prevenção e o controle de infecções.
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Any individual that meets the suspected case definition of monkeypox should be offered testing in appropriately equipped laboratories by staff trained in the relevant technical and safety procedures. Confirmation of monkeypox virus infection is based on nucleic acid amplification testing (NAAT), usi...ng real-time or conventional polymerase chain reaction (PCR), for detection of unique sequences of viral DNA. PCR can be used alone, or in combination with sequencing. The recommended specimen type for laboratory confirmation of monkeypox is skin lesion material, including swabs of lesion surface and/or exudate, roofs from more than one lesion, or lesion crusts.
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MEDBOX Issue Brief no. 24 (Sept.2022)
On 20 September 2022, Uganda health authorities declared an outbreak of Ebola disease, caused by Sudan virus,
following laboratory confirmation of a patient from a village in Madudu sub-county, Mubende district, central
Uganda.
Therefore the MEDBOX Team cre...ated this issue brief to give a quick overview of the most important documents and training material.
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Buruli ulcer is caused by infection with Mycobacterium ulcerans. The disease is reported in more than 33 countries worldwide, but only about half of these countries regularly report data to WHO; most cases are reported from subregions of West and Central Africa. The mode of transmission is not known....
About half of those affected are children aged under 15 years; there is no gender difference. Diagnosis is based mainly on clinical and epidemiological characteristics. Of the four methods used for laboratory confirmation (microscopy, polymerase chain reaction (PCR), histopathology and culture), PCR is the most rapid and widely used. Other rapid methods for detection of mycolactone in lesions from suspected cases, such as fluorescent thin-layer chromatography, are under evaluation in four countries in Africa.
Research to develop point-of-care tests is in progress. Treatment of Buruli ulcer comprises 8 weeks of combined antibiotics (rifampicin and clarithromycin). Complementary therapies such as wound care, skin graft and prevention of disability are needed in some cases to ensure full recovery.
The target set by the World Health Organization (WHO) for control of Buruli ulcer is for countries to achieve a rate of case confirmation by PCR of at least 70%. All endemic countries have at least one PCR facility to support confirmation of cases. However, most countries in the WHO African Region have not been able to reach the target, and the rate of case confirmation has been declining
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L’ulcère de Buruli, une infection causée par Mycobacterium ulcerans, touche plus de 33 pays dans le monde, mais un peu moins de la moitié seulement de ces pays communiquent régulièrement des données sur la maladie à l’OMS. La plupart des cas notifiés se trouvent dans les sous-régions d...Afrique occi-
dentale et centrale. Le mode de transmission de l’ulcère de Buruli n’est pas connu. Environ la moitié des personnes touchées sont des enfants de moins de 15 ans et les deux sexes sont concernés à parts égales.
Le diagnostic repose principalement sur l’observation des caractéristiques cliniques et épidémiologiques.
Parmi les quatre méthodes de confirmation utilisées (examen microscopique, amplification en chaîne par polymérase (PCR), histopathologie et mise en culture), la PCR est la plus rapide et la plus courament employée. D’autres méthodes rapides, comme l’utilisation de la chromatographie sur couche mince par fluorescence pour détecter la mycolactone dans les lésions des cas suspects d’ulcère de Buruli, sont actuellement à l’étude dans quatre pays d’Afrique. Des travaux de recherche sont en cours pour mettre au
point des tests utilisables sur le lieu des soins. Le traitement de l’ulcère de Buruli consiste à administrer une association d’antibiotiques (rifampicine et clarithromycine) pendant 8 semaines. Des traitements complémentaires, comme le soin des plaies, les greffes cutanées et la prévention des incapacités, sont nécessaires dans certains cas pour parvenir à une guérison complète.
La cible fixée par l’Organisation mondiale de la Santé (OMS) exigée des pays pour assurer la lutte contre l’ulcère de Buruli est la confirmation d’au moins 70 % des cas par PCR pour chaque pays. Tous les pays d’endémie disposent d’au moins un établissement doté des moyens nécessaires pour effectuer les tests de PCR pour la confirmation des cas. Cependant, la plupart des pays de la Région africaine n’ont pas réussi à atteindre la cible fixée. Un déclin du taux de confirmation a même été observé.
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Four (04) new EVD alerts were reported from Rubkona, Nimule, and juba during week 45 (ending 13 November 2022) but only one sample was collected for laboratory confirmation which tested negative. The other three were discarded as they did not meet EVD case definition.
This WHO laboratory manual provides the most up to date methods and procedures for the laboratory identification of yellow fever virus infection in humans. It provides guidance on the establishment and maintenance of an effective laboratory providing routine surveillance testing for yellow fever, wh...ich operates within the WHO coordinated Global Yellow Fever Laboratory Network (GYFLaN) capable of providing confirmation of yellow fever infection reliably and timely. This second edition supersedes the first edition of the 2004 WHO manual for the monitoring of yellow fever virus infection.
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Strict storage recommendations for insulin are difficult to follow in hot tropical regions and even more challenging in conflict and humanitarian emergency settings, adding an extra burden to the management of people with diabetes. According to pharmacopeia unopened insulin vials must be stored in a... refrigerator (2–8°C), while storage at ambient temperature (25–30°C) is usually permitted for the 4-week usage period during treatment. In the present work we address a critical question towards improving diabetes care in resource poor settings, namely whether insulin is stable and retains biological activity in tropical temperatures during a 4-week treatment period. To answer this question, temperature fluctuations were measured in Dagahaley refugee camp (Northern Kenya) using log tag recorders. Oscillating temperatures between 25 and 37°C were observed. Insulin heat stability was assessed under these specific temperatures which were precisely reproduced in the laboratory. Different commercialized formulations of insulin were quantified weekly by high performance liquid chromatography and the results showed perfect conformity to pharmacopeia guidelines, thus confirming stability over the assessment period (four weeks). Monitoring the 3D-structure of the tested insulin by circular dichroism confirmed that insulin monomer conformation did not undergo significant modifications. The measure of insulin efficiency on insulin receptor (IR) and Akt phosphorylation in hepatic cells indicated that insulin bioactivity of the samples stored at oscillating temperature during the usage period is identical to that of the samples maintained at 2–8°C. Taken together, these results indicate that insulin can be stored at such oscillating ambient temperatures for the usual four–week period of use. This enables the barrier of cold storage during use to be removed, thereby opening up the perspective for easier management of diabetes in humanitarian contexts and resource poor settings.
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