Over the past 50 years, dengue has spread from nine to over a hundred countries, making it the most rapidly spreading vector-borne disease. Yet, dengue continues to have a low profile among policy-makers and donors and does not receive the media attention it deserves. While there is no vaccine or cu...re for dengue, it can be managed and prevented. We need a renewed commitment to integrated programming that includes improved management and diagnosis, increased awareness and community participation in controlling the vector and enhanced environmental sanitation
more
. Interim Guidelines. This interim guideline lays out some basic principles of optimal nutritional care for adults and paediatric patients during treatment and convalescence in Ebola treatment units, community care centres or to other centres where Ebola patients are receiving care and support. It h...ighlights the key clinical problems in patients affected by Ebola virus disease (EVD) that may interfere with their nutritional status and overall clinical support in the context of the current Ebola crisis, and summarizes their nutritional needs. It does not provide specific advice on fluid management in cases of vomiting, diarrhoea and dehydration or parenteral nutrition
more
Chapter 1 provides new data on the latest developments in the global treatment effort, highlighting positive trends as well as aspects that require improvement. Chapter 2 summarizes the impact of the scale-up in reducing AIDS-related mortality and new HIV infections. Chapter 3 examines the sequence ...of steps in the continuum of care from HIV diagnosis to successful provision of ART services and outlines key supportive innovations. Chapter 4 discusses the implications and anticipated impact of the new "Consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection
more
Medicines and Allied Substances [No. 3 of 2013 47 | An Act to continue the existence of the Pharmaceutical Regulatory Authority and re-name it as the Zambia Medicines Regulatory Authority; provide for the functions and powers of the Authority; provide for the registration and regulation of pharmacie...s, health shops and agro-veterinary shops; provide for the registration and regulation of medicines and allied substances; provide for the regulation of the manufacture, importation, exportation, possession, storage, distribution, supply, promotion, advertising, sale and use of medicines and allied substances; provide for the regulation and control of clinical trials; repeal and replace the Pharmaceutical Act, 2004; and provide for matters connected with, or incidental to, the foregoing.
more
USAID funded/ Primary Health Care Project in Iraq (PHCPI) in cooperation with Iraqi Ministry of Health (MOH) aims to promote Primary Health Care (PHC) services provided by Primary Health Care Clinics (PHCCs) in Iraq in order to achieve the development goal in enhancing the PHC provision system throu...gh achieving the following results: First: Enhancing management and operations systems, which support clinical care. Second: Improving the quality of the delivered PHC according to quality standards. Third: Enhancing and expanding local community participation and partnership in PHC. Maintaining the medical & service devices in the hospitals and health clinics besides making them function according to the adapted standard specifications, lead to providing most efficient medical services for people and accomplish the purposes for which they were invented. Maintenance and repair of facilities and infrastructure, and keeping them safe and clean are also of the important approaches for the results referred to in (first) and (second) above. This can be achieved through enhancing and developing facilities, and medical & service devices management. This guideline seeks to develop work mechanism for engineers, technicians and the PHCCs’ facilities and medical & service equipment maintenance workers; clarify the concept of maintenance, its importance and classifications in health area, its planning and implementation, the tasks and duties of other directorates and departments of the Ministry in relation to all kinds of maintenance. Add to that preparing documents and forms, which are used in documenting and monitoring the steps required to be accomplished in the maintenance of PHCCs’ facilities and medical & service equipment, for the equipment to perform the best possible services for people and get their satisfaction.
more
La enfermedad de Chagas (ECha), resultado de la infección por el Trypanosoma cruzi, afecta varias poblaciones de las
zonas rurales de Suramérica y América Central. En los últimos años la enfermedad ha cobrado importancia epidemiológica no sólo porque se ha incrementado la detección de caso...s, sino por la presencia, en la infección crónica, de cardiopatía, patología de considerable gravedad clínica y cuya aparición aumenta el riesgo de incapacidad y reducción de la expectativa de vida.
more
Policy Research Working Paper 6100 | Impact Evaluation Series No. 60 | This study examines the effect of performance incentives for health care providers to provide more and higher quality care in Rwanda on child health outcomes. The authors find that the incentives had a large and significant effec...t on the weight-for-age of children 0–11 months and on the height-for-age of children 24–49 months. They attribute this improvement to increases in the use and quality of prenatal and postnatal care. Consistent with theory, They find larger effects of incentives on services where monetary rewards and the marginal return to effort are higher. The also find that incentives reduced the gap between provider knowledge and practice of appropriate clinical procedures by 20 percent, implying a large gain in efficiency. Finally, they find evidence of a strong complementarity between performance incentives and provider skill .
more
"Achieving, maintaining and improving accuracy, timeliness and reliability are major challenges for health laboratories. Countries worldwide committed themselves to build national capacities for the detection of, and response to, public health events of international concern when they decided to eng...age in the International Health Regulations implementation process. Only sound management of quality in health laboratories will enable countries to produce test results that the international community will trust in cases of international emergency. This handbook is intended to provide a comprehensive reference on Laboratory Quality Management System for all stakeholders in health laboratory processes, from management, to administration, to bench-work laboratorians. This handbook covers topics that are essential for quality management of a public health or clinical laboratory. They are based on both ISO 15189 and CLSI GP26-A3 documents"--Page 7.
more
In the area of nutrition and HIV, children deserve special attention because of their additional needs to ensure growth and development and their dependency on adults for adequate care. It was therefore proposed to first develop guidelines for children and thereafter consider a similar approach for... other specific groups.
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a biological process related to virus and host interactions. In trying to protect the nutritional well-being or reverse the undernutrition experienced by infected children, issues of food insecurity, food quantity and quality as well as absorption and digestion of nutrients are considered. Interventions are proposed that are practical and feasible in resource-poor settings and offer a prospect for clinical improvement.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
more
Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant
tuberculosis (XDR-TB) increasingly occur in resource-constrained settings.
In the context of a national response to MDR- and XDR-TB, health workers in
TB clinics (in district hospitals and some accredited health centres) wil...l need
to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB
treatment.
Management of MDR-TB: a field guide was created to help health workers
carry out these tasks. It is a job aid that medical officers and TB nurses
are meant use frequently during the day for quick reference. This module
is closely related to other clinical guideline modules in the Integrated
Management of Adolescent and Adult Illness (IMAI) series. In particular, the
approach to chronic disease management is taken from General principles
of good chronic care in the IMAI series.
more
Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de...veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
more
El objetivo de este conjunto de herramientas técnicas básicas es delinear una trayectoria para lograr mejoras acumulativas y sostenibles adaptadas a las necesidades específicas de cada país a partir de tres estrategias y objetivos clave: la promoción de la salud para una detección precoz; el d...iagnóstico oportuno; y la gestión integral del cáncer de mama. En este documento se ofrece un marco común que vincula a los responsables de formular políticas, las partes interesadas, la comunidad de atención clínica, los gestores de programas y la sociedad civil con enfoques sistemáticos basados en la evidencia que pueden facilitar el fortalecimiento de los sistemas de salud y reducir las inequidades en la salud de las mujeres a lo largo de su ciclo vital.
more
The aim of the Annual Inspection Report is to present findings of public sector health establishments inspected by the OHSC to monitor compliance with the National Core Standards (NCS) during the 2016/2017 financial year in South Africa.
The NCS define fundamentals for quality of care based on six ...dimensions of quality: Acceptability,Safety, Reliability, Equity, Accessibility, and Efficiency.
The NCS structured assessment tools were used to collect data during inspections across the seven domains namely: Patient Rights; Patient Safety, Clinical Governance and Clinical Care; Clinical Support Services; Public Health; Leadership and Governance; Operational Management and Facilities and Infrastructure. A total of 851 routine inspections were conducted with 201 of these facilities re-inspected. Inspection data was captured on District Health Information System (DHIS) data entry forms and exported for analysis to Statistical Analysis Software (SAS) version 9.4.
more
Lymphatic filariasis (LF) is an avoidable, debilitating, disfiguring disease caused by infection with the filarial parasites Wuchereria bancrofti, Brugia malayi and B. timori. Globally, 51.4 million people are
estimated to be infected. Lymphoedema and hydrocoele are the visible, chronic clinical co...nsequences of the lymphatic vessel impairment caused by infection with these parasites. Mosquitos in the genera Culex, Anopheles, Mansonia and Aedes transmit the parasites from person to person. 2020 marked the 20th year since WHO established the Global Programme to Eliminate Lymphatic Filariasis (GPELF) which aims to stop transmission of infection with mass drug administration (MDA) and to alleviate suffering among people affected by the disease through morbidity management and disability prevention (MMDP).
more
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
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.
more
Lancet Oncol 2022; 23: e251–312Published OnlineMay 9, 2022 https://doi.org/10.1016/S1470-2045(21)00720-8
In sub-Saharan Africa (SSA), urgent action is needed to curb a growing crisis in cancer incidence and mortality.
Without rapid interventions, data estimates show a major increase in cancer mo...rtality from 520 348 in 2020 to about
1 million deaths per year by 2030. Here, we detail the state of cancer in SSA, recommend key actions on the basis of
analysis, and highlight case studies and successful models that can be emulated, adapted, or improved across the
region to reduce the growing cancer crises. Recommended actions begin with the need to develop or update national
cancer control plans in each country. Plans must include childhood cancer plans, managing comorbidities such as
HIV and malnutrition, a reliable and predictable supply of medication, and the provision of psychosocial, supportive,
and palliative care. Plans should also engage traditional, complementary, and alternative medical practices employed
by more than 80% of SSA populations and pathways to reduce missed diagnoses and late referrals. More substantial
investment is needed in developing cancer registries and cancer diagnostics for core cancer tests.
more
Case Management; Guide for Tutors