Dexametasona para tratamento de pacientes com COVID-19
Uso de doxiciclina para prevenção e tratamento de pacientes com Covid-19
Semana Epidemiológica 45 • 7/11 a 13/11/2021
Methodology for evaluating national national arboviral disease prevention and and control of arboviral diseases in the Americas
Health and Human Rights Series. 6 Tobacco: a rights-based approach.
Guidelines for the Vaccination Scheme against
COVID 19: Booster Dose Health Personnel
Vaccination against COVID-19 in Indigenous peoples and nationalities,
Afro-Ecuadorian and Montubio peoples and nationalities of Ecuador
Operational Guidelines
The number of COVID-19 cases is on the rise again, with South Africa nearing half of all confirmed cases in the WHO African Region. Threats of new variants loom and low vaccination coverage raises questions on the future of the response to COVID-19. Prevention remains the key strategy in most sub-Sa...haran countries. Five National Centres (NCs) from the African Health Observatory Platform on Health Systems and Policies (AHOP), based in Ethiopia, Kenya, Nigeria, Rwanda and Senegal, reflect on lessons to be learnt from their containment responses in the initial phases. They construct timelines to highlight the policies and challenges associated with introducing a range of public health containment measures and
discuss the extent to which these measures continue to be valuable given the ever-changing nature of the pandemic.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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Natural immunity against COVID-19
Scientific report 10 May 2021
Definition and categorization of the time of vertical transmission of SARS-CoV-2
Scientific report 8 February 2021
Guidance for clinical case management of thrombosis syndrome with thrombocytopenia (TTS) following vaccination to prevent coronavirus disease (COVID-19)
Interim guidance 19 July 2021
Considerations on the implementation and adjustment of
public health and social measures in the context of
COVID-19
Interim guidance 14 June 2021
Interim recommendations for the use of ChAdOx1-S [recombinant] COVID-19 vaccine (AstraZeneca COVID-19 AZD1222 Vaxzevria™, SII COVISHIELD™ vaccine) - Last updated 30 July 2021
Community health worker teams are potential game-changers in ensuring access to care in vulnerable communities. Who are they? What do they actually do? Can they help South Africa realize universal health coverage? As the proactive arm of the health services, community health workers teams provide ho...usehold and community education, early screening, tracing and referrals for a range of health and social services. There is little local or global evidence on the household services provided by such teams, beyond specific disease-oriented activities such as for HIV and TB. This paper seeks to address this gap.
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Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with HIV/AIDS, tuberculosis and now ...COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
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Resumo: o que é esta orientação dinâmica?
Pergunta clínica: qual é o papel dos medicamentos na prevenção da COVID-19?
Público-alvo: o público-alvo são os médicos e os tomadores de decisão na área da saúde.
Prática atual: o uso atual de medicamentos para prevenção da COVID-19 é ...variável, refletindo uma incerteza em grande escala. Numerosos estudos clínicos randomizados de muitos medicamentos estão em andamento para orientar melhor a prática. Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS contém novas
informações e uma recomendação sobre a hidroxicloroquina. (1) Segue-se a publicação de seis estudos sintetizados em uma meta-análise dinâmica de rede (NMA).
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Se sabe desde hace tiempo que las mujeres con el VIH presentan un mayor riesgo de desarrollar cáncer cervicouterino; sin embargo, existen pocos datos e información sobre esta afección en la Región de las Américas. Este estudio, realizado entre el 2019 y el 2020, intenta brindar información y d...atos que puedan acelerar la aplicación de políticas de salud que atiendan la particular situación de las mujeres con el VIH respecto al cáncer cervicouterino.
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