On October 6, 11 cases of Cholera were confirmed positive in one neighbourhood of the capital Sana’a. No confirmed cases have been reported in other locations in Yemen. UNICEF, together with WHO and Health authorities, have initiated a rapid response setting up a treatment centre as well as dispat...ching an investigation team to the affected neighbourhood. The source of infection was identified as water and commercial food contamination.
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Manual on Hospital Infection Control Guidelines prepared by the Indian Council of Medical Research Antimicrobial Stewardship Program. The document covers the basic principles of infection control, role of heath care workers, bio-waste management and elaborates on the steps to be followed for setting... up of an effective infection control in hospitals.
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The National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025, presents
coordinated, strategic actions that the United States Government will take in the next five years to improve the health and wellbeing of all Americans by changing the course of antibiotic resistance.
T...his Plan is based on the U.S. Government’s 2014 National Strategy for CARB, and builds on the first National Action Plan released in 2015 by expanding evidence-based activities that have already been shown to reduce antibiotic resistance, such as optimizing the use of antibiotics in human and animal health settings.
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Nosocomial infections, or hospital-acquired infec-tions (HAI), are among the most significant causesof morbidity and mortality in healthcare settingsthroughout the world.Prevention of HAIs iscentral to providing high quality and safe health-care, even in settings with limited resources.Transmi...ssion of infectious agents between patientsby health workers and irrational use of antibioticsare two important preventable factors involved inmany HAIs.
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Antibiotics and other antimicrobial agents are invaluable life savers, particularly in resource-limited countries where infectious diseases are abundant. Both uncomplicated and severe infections are potentially curable as long as the aetiological agents are susceptible to the ...antimicrobial drugs. The rapid rate with which antimicrobial agents are becoming ineffective due to resistance acquired as a result of unchecked overuse and misuse threatens to undo the benefit of controlling infections. The evidence for resistant microorganisms, many times to more than a single antimicrobial agent, has been observed globally. In Tanzania, there is evidence in the form of few scattered studies conducted in different parts of the country in a multitude of settings including health care facilities, the community, domesticated animals and wild animals
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This course will offer a practical approach to prescribing antibiotic therapy and development of antimicrobial stewardship across all specialties and settings. Antibiotics are among the most frequently prescribed classes of drugs and it is estimated that approximately 50% of antibiotic use, in both... the outpatient and inpatient settings, is inappropriate. At the same time, in contrast to any other class of drugs, every antibiotic use has a potential public health consequence – inappropriate use may not harm only the individual patient, but contributes to societal harm by exerting an unnecessary selective pressure that may lead to antibiotic resistance among bacteria. This video based course will introduce learners to the basic principles of appropriate antibiotic use, demonstrate how to apply these principles to the management of common infections, and outline how to develop and maintain an antimicrobial stewardship program.
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The Knowledge Translation Unit is a group within the University of Cape Town’s Lung Institute and Department of Medicine who has worked on primary care programmes to strengthen provision of evidence-informed care in low-resources settings in South Africa, Ethiopia, Nigeria and Brazil for two decad...es. See here for more information. We are working around the clock to help health workers in these and similar settings to manage the COVID-19 pandemic. These can be accessed below. We are also working to expand these to support primary healthcare workers, patients and households. You can also access our free online training.
For purposes of assisting communities during the COVID-19 pandemic, we are making our COVID-19 and related materials freely available for others to use subject to some simple conditions.
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While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.... In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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The purpose of this document is to provide ministries (e.g. Ministry of Health (MOH), Ministry of Water (MOW)), sub-national public health authorities, and implementing partners with a practical framework of action to both prepare for and mitigate community transmission of COVID-19. The document doe...s not address how to implement the included actions. Parts of this document are relevant for all environments, but the focus is placed on lower-resource settings
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This programmatic brief explores how to expand HIV and STI prevention and contraceptive method options in contraceptive services and, thus, to reduce HIV and STI incidence among adolescent girls and women. It focuses on settings with extremely high HIV prevalence and incidence. This brief complement...s existing guidance on HIV prevention and sexual and reproductive health and rights (SRHR), amplifies calls for action and outlines more comprehensive approaches to integration of SRHR and HIV services. It also emphasizes the importance of SRHR for women living with HIV. It aligns with updated WHO recommendations for contraceptive eligibility for women at high risk of HIV and other HIV guidance for adolescent girls and young women.
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16 Dec. 2020
This document provides guidance to Ministries of Health (MOHs), laboratory personnel and implementing partners in African Union Member States on the application of rapid antigen tests to COVID-19 testing. The guidance serves as reference for policymakers, laboratory leads, implementing... partners, and experts on use case scenarios and associated testing algorithms for COVID-19 antigen tests. It recommends the use of antigen tests to increase access to testing and enable timely results for persons with or without symptoms in specific settings. The document will be reviewed and updated as more evidence becomes available regarding the use of rapid antigen tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from global studies and evaluation efforts.
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The 2019 ANA’s Principles for Nurse Staffing, Third Edition, identifies major elements needed to achieve appropriate nurse staffing, which enhances the delivery of safe, quality health care. These principles are grounded in the substantive and growing body of evidence that demonstrates the link be...tween appropriate nurse staffing and better patient outcomes and apply to all types of nurse staffing at every practice level in any healthcare delivery setting. Focused on addressing the complexities of appropriate nurse staffing decisions, the principles and supporting material in this publication will guide nurses and other decision-makers in identifying and developing processes and policies needed to improve nurse staffing.
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Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal...ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
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Antibiotics are among the most frequently prescribed classes of drugs and it is estimated that approximately 50% of antibiotic use, in both the outpatient and inpatient settings, is inappropriate. At the same time, in contrast to any other class of drugs, every antibiotic use has a potential public ...health consequence – inappropriate use may not harm only the individual patient, but contributes to societal harm by exerting an unnecessary selective pressure that may lead to antibiotic resistance among bacteria. This video based course will introduce learners to the basic principles of appropriate antibiotic use, demonstrate how to apply these principles to the management of common infections, and outline how to develop and maintain an antimicrobial stewardship program. We will offer a number of illustrative cases, recognizable to the practicing physician in his or her practice to engage learners in the thought processes that lead to optimal decision making, improved outcomes of individual patients, and harm reduction vis-a-vis the bacterial ecology.
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The arrival and rapid spread of the mosquito-borne viral disease Chikungunya across the Americas is one of the most significant public health developments of recent years, preceding and mirroring the subsequent spread of Zika. Globalization in trade and travel can lead to the importation of these vi...ruses, but climatic conditions strongly affect the efficiency of transmission in local settings. In order to direct preparedness for future outbreaks, it is necessary to anticipate global regions that could become suitable for Chikungunya transmission. Here, we present global correlative niche models for autochthonous Chikungunya transmission. These models were used as the basis for projections under the representative concentration pathway (RCP) 4.5 and 8.5 climate change scenarios. In a further step, hazard maps, which account for population densities, were produced. The baseline models successfully delineate current areas of active Chikungunya transmission. Projections under the RCP 4.5 and 8.5 scenarios suggest the likelihood of expansion of transmission-suitable areas in many parts of the world, including China, sub-Saharan Africa, South America, the United States and continental Europe. The models presented here can be used to inform public health preparedness planning in a highly interconnected world.
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Most neglected tropical diseases (NTDs) occur in remote areas of low- and middle-income countries, where health systems are often poorly developed. Therefore, these neglected patients generally lack access to quality preventive, diagnostic, and therapeutic care [1]. The difficulty to access NTD-ende...mic areas, challenging logistics, and the lack of skilled human resources in these areas are also major obstacles to conduct clinical research. We had to face these when conducting a good clinical practice/good clinical laboratory practice (GCP/GCLP)-compliant clinical study in eastern Sudan, a well-known endemic area for visceral leishmaniasis and other NTDs. We share here the challenges related to study preparation and implementation of this GCP/GCLP study that investigated the causes of persistent fever in a rural hospital located in Gedaref State in eastern Sudan. We think this type of paper may be of interest for researchers planning to conduct a clinical trial in a resource-limited setting as well as for funders of such research.
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In October 2022, President Biden signed the Global Malnutrition Prevention and Treatment Act (GMPTA) into law, which directs USAID to prevent and treat malnutrition globally. The GMPTA further codifies USAID’s leadership on nutrition, with a focus on evidence-based interventions across health syst...ems and food systems, in both development and humanitarian settings.
Realizing the potential of good nutrition to save lives and ensure a brighter future for generations to come is central to U.S. Government priorities. For over 60 years, USAID has been a leader in the fight to end global malnutrition. Nutrition affects every aspect of human development: from the ability to fight disease, to children’s performance in school, to a nation’s health and economic advancement. There is overwhelming evidence of the power of good nutrition but, due to challenges in accessing safe, nutritious foods and health and sanitation services, many people in low- and middle-income countries remain undernourished.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Tanzania, like other developing countries, is facing a higher burden of cardiovascular diseases (CVDs). The country is experiencing rapid growth of modifiable and intermediate risk factors that accelerate CVD mortality and morbidity rates. In rural and urban settings, cardiovascular risk factors suc...h as tobacco use, excessive alcohol consumption, unhealthy diet, hypertension, diabetes, hyperlipidemia, overweight, and obesity, are documented to be higher in this review. Increased urbanization, lifestyle changes, lack of awareness and rural to urban movement have been found to increase CVD risk factors in Tanzania. Despite the identification of modifiable risk factors for CVDs, there is still limited information on physical inactivity and eating habits among Tanzanian population that needs to be addressed. Conclusively, primary prevention, improved healthcare system, which include affordable health services, availability of trained health care providers, improved screening and diagnostic equipment, adequate guidelines, and essential drugs for CVDs are the key actions that need to be implemented for cost effective control and management of CVDs. Effective policy for control and management of CVDs should also properly be employed to ensure fruitful implementation of different interventions.
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Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue.
The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases.
This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field.
It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure.
Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness.
The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms).
Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected.
To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions.
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