Desde hace muchas décadas, los microbios, en particular las bacterias, se han vuelto cada vez más resistentes a diversos antimicrobianos. El aval de la Asamblea Mundial de la Salud al Plan de Acción Mundial sobre la resistencia a los antimicrobianos, en mayo de 2015, y la Declaración política d...e la reunión de alto nivel de la Asamblea General sobre la resistencia a los antimicrobianos, en septiembre de 2016, reconocen que la resistencia a los antimicrobianos es una amenaza para la salud pública mundial. Estas iniciativas políticas reconocen el uso excesivo e inapropiado de los antimicrobianos como el principal factor que favorece dicha resistencia, así
como la necesidad de optimizar el uso de estos medicamentos.
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Las directrices actualizadas del mhGAP, la retroalimentación de
información y la evaluación de la versión 1.0 de la GI-mhGAP
por los usuarios han permitido la revisión y elaboración de esta
versión actualizada de la guía. En el año 2015, se llevó a cabo y
se publicó una actualización... completa de las directrices mhGAP
conforme a la metodología de la OMS para la formulación de
directrices, que incluyó el proceso de análisis de datos científicos
y la síntesis y formulación de recomendaciones mediante la
participación de un grupo de expertos internacionales e
instituciones con experiencia apropiada: médicos clínicos,
investigadores, directores de programa, formuladores de
políticas y usuarios de los servicios. Se pueden encontrar detalles
de los métodos y las recomendaciones actualizadas en el centro
de datos de investigación del mhGAP: http://www.who.int/
mental_health/mhgap/evidence/es/.
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Paraguay muestra avances en el compromiso asumido, de avanzar hacia la Salud Uni¬versal. La experiencia ha demostrado que el proceso puede acelerarse cuando existe un fuerte involucramiento social. En este marco se realizó un llamado a los líderes del MSPYBS, la sociedad civil y público en gener...al para lograr un sólido compromiso con las acciones que nos permitan avan¬zar hacia la salud para todos y todas en ámbitos específicos. El propósito fue el de abrir un espacio de diálogo que genere propuestas concretas para sentar las bases de un sistema de Salud Universal. En este marco se realizó un llamado a los líderes del MSPYBS, la sociedad civil y público en general para lograr un sólido compromiso con las acciones que nos permitan avan¬zar hacia la salud para todos y todas en ámbitos específicos. El propósito fue el de abrir un espacio de diálogo que genere propuestas concretas para sentar las bases de un sistema de Salud Universal.
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El uso de los antimicrobianos en seres humanos es imprescindible para combatir a los microorganismos causantes de distintas enfermedades, no obstante, el uso y abuso de estos productos farmacéuticos ha propiciado un aumento en la resistencia, desarrollo y propagación de microorganismos multirresis...tentes. Consecuentemente, esto ha ocasionado una amenaza para la salud pública y un impacto en las Infecciones Asociadas a la Atención en Salud (IAAS). Las IAAS producen un aumento en la mortalidad, morbilidad, estancia hospitalaria, discapacidades en los pacientes, gastos en los servicios de salud, entre otros. Las IAAS son causadas por microorganismos tales como bacterias, virus, hongos, parásitos o priones y pueden afectar tanto a los pacientes como al personal sanitario du- rante la atención de la salud
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El Plan Nacional para enfrentar la resistencia a los antimicrobianos 2017 – 2021, representa la respuesta del país ante la amenaza creciente de la resistencia antimicrobiana y el incremento en el uso de los antimicrobianos, es un instrumento que busca integrar una respuesta multisectorial y multi...disciplinaria bajo el enfoque de “Una Salud”. Este enfoque reconoce la necesidad de actuar
conjuntamente todos los sectores partícipes en la generación y solución de este problema de salud pública.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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This document presents the World Health Organization Operational framework for building climate resilient and low carbon health systems*. ***The framework's goal is to increase the climate resilience of health systems to protect and improve the health of communities in an unstable and changing clima...te, while optimizing the use of resources and implementing strategies to reduce GHG emissions. It aims to contribute to the design of transformative health systems that can provide safe and quality care in a changing climate.
Implementation of the framework's ten components would help health organizations, authorities, and programmes to be better able to anticipate, prevent, prepare for, and manage climate-related health risks and therefore decrease the burden of associated climate-sensitive health outcomes. Implementing low carbon health practices would contribute to climate change mitigation while also improving health outcomes. Achieving these aims is an important contribution to universal health coverage (UHC), global health security, and specific targets within the Sustainable Development Goals (SDGs). The document is a useful resource for decision-makers in health systems, including public health agencies, and other specialized institutions, and for decision-makers in health-determining sectors.
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During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc...e for care of those suffering from LF, this update was both warranted and timely.
At the outset, the Committee noted that barriers continue to exist in care of patients affected by LF-associated morbidity. These barriers include lack of information for patients as well as for many healthcare providers, including general surgeons and others within health systems
This update offers a new consensus of the Committee regarding the staging of hydroceles caused by LF, also known as “filariceles”. It recommends integrating LF surgery with other efforts to strengthen surgical care by assessing health facilities for their surgical readiness using the WHO surgical assessment tool or “SAT”. It also recommends integratinghernia surgery with hydrocele surgery and integrating standards for prevention of surgical site infection (SSI).
The update revises recommendations for standard procedures and processes, offers an algorithm for diagnosis (including the use of ultrasound) and discusses postoperative care. It recommends collecting data using the staging and grading system described by Capuano and Capuano along with other metrics for public health management of LF.
A multifaceted approach has therefore been recommended to coordinate public health outreach with national surgical planning and local health systems to include supporting partners such as nongovernmental organizations. Surgical camps with mobile teams, as well as training of personnel at DCP3 “first level” or WHO Level II hospitals (depending on region and resources), have important roles for reducing LF morbidity.
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The NDMS&IP focuses on mainstreaming disability to promote equitable access to services in the six thematic areas of health, education, livelihoods, empowerment, and social inclusion and cross-cutting issues.
The first part of the NDMS&IP outlines incongruences between national and sectoral policie...s and pieces of legislation on one hand, and practice on the other and identifies key priority areas/themes of the strategy,
medium-term outcomes and strategies for each identified priority area/ theme. This process is largely informed by key findings and recommendations from a study on the Situation of Persons with Disabilities
in Malawi (CBMM/NAD, 2011). The study provides background descriptive information on existing national and sectoral policy and legal framework, level of access by children, adult women and males with disabilities to services in the areas of education, health, livelihoods and other social services as well as of participation by persons with disabilities through self-representation in development activities at various levels. A review of relevant documents at the international level further describes the disability situation in Malawi in the global context.
The second part of the NDMS&IP consists of the operational matrix, (Annex 1), a monitoring and evaluation framework (Annex 2) and budget estimates (Annex 3). This part outlines specific actions by various actors both in the public, private and civil society sectors to prioritise disability in their routine policy, programming, resource mobilisation and allocation, monitoring, evaluation and reporting routines. The action plan lays out priority sectors and concrete actions by setting out implementation schedules, defining targets, assigning responsibility to key duty bearers and rights holders for coordination, decision-making, monitoring and reporting, mobilisation and allocation and control of resources.
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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 approximately twice as high as high-resource settings (15 o...ut 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.
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The larval stage of the parasite Taenia solium can encyst in the central nervous system causing neurocysticercosis, which is the main cause of acquired epilepsy in the countries in which the parasite is endemic. Endemic areas are those with the presence (or likely presence) of the full life cycle of... Taenia solium. The parasite is most prevalent in poor and vulnerable communities in which pigs roam free, open defecation is practiced, basic sanitation is deficient, and health education is absent or limited. Several tools are available for the control of Taenia solium. Preventive chemotherapy for Taenia solium taeniasis, which is directed at the adult tapeworm, is one of them. Other tools focus on pig management, pig vaccination and treatment, sanitation and hygiene, and community education. Three potential drugs—niclosamide, praziquantel, and albendazole—have been considered for use for preventive chemotherapy in Taenia solium taeniasis control programs through mass drug administration or targeted chemotherapy. In this Guideline, we provide recommendations for preventive chemotherapy in Taenia solium-endemic areas using niclosamide, praziquantel, or albendazole, including at which dose and in which population groups.
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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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These guidelines provide a framework for effective action to facilitate access to safe and ethical
testing services for different population groups. The implementation of the a comprehensive
approach, known as HIV Testing Services (HTS) is cardinal as an effective package of services
that diminis...hes the impact of the HIV epidemic in our country. All forms of HTS adhere to
the 5Cs: Confidentiality, Counselling, Consent, Correct results and Connection, or linkage
to care, with all based within a human right context. In addition to the 5Cs, however, the
MOHCDGEC emphasizes the use of a variety of approaches to HTS that will reduce the
number of missed opportunities. These include Provider-Initiated Testing and Counselling
testing, Couple counselling and testing, Index testing, and infant and children counselling and
testing in alignment to the revised WHO guidelines. Furthermore, these guidelines accentuate
on the continual provision of integrated HTS service at all levels of the public and private
health service delivery system.
The HTS Providers, managers and other stakeholders
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Les maladies infectieuses sont en constante mutation. De nouvelles maladies apparaissent, d’autres qui sont bien connues se propagent ou refont surface, et quelques rares fois, une maladie est éradiquée. Les maladies infectieuses telles que le VIH, la tuberculose et le choléra sont des causes c...onsidérables de morbidité et de mortalité dans plusieurs régions du monde. Le personnel de la santé joue un rôle primordial, en ce qui concerne la protection de leurs clients contre les maladies infectieuses et leurs traitements en cas d’infection. Dans le cadre de leur travail, le personnel de santé accomplisse des tâches cliniques ou autres activités susceptibles de les exposer ainsi que leurs clients aux microorganismes – orga- nismes potentiellement infectieux. Bon nombre de ces clients sont malades et, par conséquent, sont plus vulnérables aux infections ou peuvent avoir des infec-tions susceptibles d’être transmises à d’autres personnes. Par chance, l’ensemble du personnel travaillant dans les services de santé est en mesure d’exécuter des procédés simples visant à minimiser le risque – vis-à-vis d’eux-mêmes et de leurs clients – et réduire la propagation des infections. Ces pratiques peuvent être intégrées à moindre frais dans les habitudes quotidiennes au sein des établissements de santé du monde entier. Ce guide de référence est spécialement conçu pour l’emploi à tous les niveaux du système sanitaire, depuis les plus grands hôpitaux jusqu’aux plus petits dispensaires ou centres de santé, dans des établissements où les ressources sont rares.Ce guide, publié pour la première fois en 1999, a été mis à jour. Bien que la plu-part des pratiques restent inchangées, il a fait l’objet de quelques modifications significatives – par exemple, concernant les recommandations liées au lavage des mains et aux précautions standard. Toutefois, ce guide continue de présenter des recommandations pratiques en matière de procédés simples et relativement peu coûteux pouvant être exécutés partout, à l’aide des matériels de base et des équi-pements de niveau technologique moyen.
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Важкі умови життєдіяльності громадян, обтяжені веденням антитерористичної операції на Сході країни, призводять сьогодні до зростання кількості стресових та, нав...ть, по-справжньому травматичних ситуацій, погіршуючи здоров'я населення та ускладнюють політико-соціо-економічну ситуацію — сучасність називають "століттям травми". Внаслідок значних руйнувань інфраструктури на тимчасово окупованих територіях та порушення усталеної, злагодженої життєдіяльності тисячів українців, з'являються переселенці, постраждалі, збільшується кількість військових, втрачають життя та здоров'я тисячі українців.
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Towards a Healthier Botswana
Ce guide donne un aperçu complet des informations essentielles relatives à la vaccination, notamment des informations techniques sur les vaccins, un examen des meilleures pratiques de gestion des programmes de vaccination, des conseils sur la prestation des services de vaccination, le suivi et l'...valuation, la surveillance des maladies et le rôle du changement de comportement.
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This guide provides a comprehensive overview of essential information related to immunization, including technical information about vaccines, a review of immunization program management best practices, guidance on the delivery of immunization services, monitoring and evaluation, disease surveillanc...e, and the role of behavior change.
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