Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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This report investigates the impact of potential misclassification of samples on HIV prevalence estimates for 23 surveys conducted from 2010-2014. In addition to visual inspection of laboratory results, we examined how accounting for potential misclassification of HIV status through Bayesian latent ...class models affected the prevalence estimates. Two types of Bayesian models were specified: a model that only uses the individual dichotomous test results and a continuous model that uses the quantitative information of the EIA (i.e., the signal-to-cutoff values). Overall, we found that adjusted prevalence estimates matched the surveys’ original results, with overlapping uncertainty intervals. This suggested that misclassification of HIV status should not affect the prevalence estimates in most surveys. However, our analyses suggested that two surveys may be problematic. The prevalence could have been overestimated in the Uganda AIDS Indicator Survey 2011 and the Zambia Demographic and Health Survey 2013-14, although the magnitude of overestimation remains difficult to ascertain. Interpreting results from the Uganda survey is difficult because of the lack of internal quality control and potential violation of the multivariate normality assumption of the continuous Bayesian latent class model. In conclusion, despite the limitations of our latent class models, our analyses suggest that prevalence estimates from most of the surveys reviewed are not affected by sample misclassification.
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Update - 27 June 2018
During the reporting week, the monsoon rains brought 252 mm of rainfall compared to 95 mm during the previous week. The downpour caused 65% of the week’s weather-related incidents (i.e. landslides, wind-storms and floods). Three rain gauges were installed in Chakmarkul (...near Camp 21), Camp 16 and Kutupalong, complementing existing rain gauges in Cox’s Bazar and Teknaf, as well as the Meteorological Station installed by Samaritan Purse in Camp 12. This network of rain gauges provides localized rainfall data at regular intervals throughout the day, which will allow the humanitarian community to better monitor, anticipate and respond to developments within the camps. Relocation of families at risk of landslides and flooding continued; a total of some 200 families have already moved to Camp 20 Extension and more than 100 families to Camp Extension 4. Repair of access roads, culverts, bridges and infrastructure is ongoing with continued attention to preparing for further heavy rains.
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COVID-19 outbreaks in long-term care (LTC) facilities can have devastating effects on the health and well-being of residents, as they are vulnerable to serious infection due to their age and possible underlying medical conditions. Strengthening infection prevention and control (IPC) prac...tice is crucial to prevent spread of COVID-19. This preparedness checklist consists of several elements that are crucial for preparing LTCF for COVID-19. It can be used by facility administrators, IPC focal points or staff, internal or external professionals.
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This country profile presents a summary and analysis of Argentina's status with yellow fever. It is part of a series of profiles on this topic, each focusing on a different country in the Region of the Americas. Argentina's geographical location presents a wide territorial extension throughout diffe...rent latitudes, which determines a wide climatic variety, maintaining the conditions for the enzootic transmission of the yellow fever virus in jungle areas of the northeast of the country bordering Brazil and Paraguay. After controlling the major urban epidemics that hit the port city of Buenos Aires in the 20th century, Argentina maintains foci of enzootic activity in the northeast and isolated human cases for jungle acquisition. The increases in viral activity usually occur in a regional context of epizootics that affect southern Brazil and eastern Paraguay. Argentina has not presented autochthonous cases since 2008. Outbreaks have been sporadic with long intervals without evidence of viral activity.
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Yemen’s war has become one of the world’s worst humanitarian catastrophes . In September 2014, the Ansarallah (Houthi) movement allied with former President Ali Abdullah Saleh to seize control over the capital city Sana’a and renegotiate Yemen’s fragile power-sharing agreement, and then seve...ral months later pursued President Abed Rabbo Mansour Hadi south to Aden . In March 2015, Saudi Arabia and the United Arab Emirates launched a military intervention, ostensibly to restore Hadi to power . More than 1,000 days later, that war has settled into a brutal stalemate . Officially, the Houthis remain in control of Sana’a and much of the north, while the Saudi-UAE coalition controls much of the south . A comprehensive Saudi-UAE blockade and air campaign has caused incipient famine conditions, the spread of communicable diseases such as cholera and diphtheria, and a wave of internal displacement .
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Each year 1–2 million people are diagnosed with a tropical disease called leishmaniasis, which is caused by single-celled parasites. People are infected when they are bitten by sandflies carrying the parasite, and often develop skin lesions around the bite site. Though mild cases may recover on th...eir own or with treatment, sometimes the parasites multiply and spread elsewhere causing further skin lesions and facial disfigurement. Furthermore, the parasites can also infect internal organs such as the spleen and the liver, which without treatment can be fatal.
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The International Rescue Committee (IRC) is a leading humanitarian agency dedicated to helping people whose lives have been shattered by conflict and disaster to survive, recover, and gain control of their future. Health comprises nearly half of IRC’s program portfolio globally and encompasses thr...ee sectors: 1) Primary Health (including child health, sexual and reproductive health and rights, and mental health); 2) Nutrition; and 3) Environmental Health. IRC health programming across its portfolio, in terms of the size and breadth, responds to significant needs in crisis affected settings, improving health and wellbeing while reducing causes of ill-health.
This five-year Health Strategy sharpens our focus on where we can have the most impact. It guides our efforts in planning, technical assistance, business development, advocacy, and internal and external collaboration. Through this strategy, we will invest and grow in areas that will help us achieve high impact at scale for our clients. For the next five years these priorities will include: Nutrition; Immunization: Infectious Disease Prevention and Control; Last Mile Delivery of Primary Health Care: Clean Water.
Our strategy aligns with Strategy 100 (S100) and Strategy Action Plans (SAPs). It lays out how IRC, through health, nutrition, and Environmental Health (EH) programming, will advance the IRC’s S100 ambitions, respond to global trends, and capitalize on our value add. The strategy will be complemented by delivery plans that detail investments, actions, and roles and responsibilities to advance our priorities. At the end of FY24, we will take stock of the implementation of the strategy, measure progress towards achieving our goals, and review if it continues to be fit for purpose.
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Technical Note on Antimicrobial Resistance
This document reflects UNICEF’s response to the growing global threat of AMR to child survival, growth and development. It identifies UNICEF’s AMR-specific and AMR-sensitive actions in reducing infections, promoting access to and optimal use of antimic...robials, and increasing AMR awareness and understanding. Of particular relevance to this group, UNICEF country offices are directed to provide technical support for development and implementation of national AMR action plans, linking them as appropriate to maternal, newborn and child health programmes and ensuring these are prioritized in both surveillance and policy changes. The guidance note on AMR is intended to inform UNICEF’s AMR-related internal initiatives, programming and activities, as well as external engagements with governments and other stakeholders.
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The road map 2030 was developed by WHO through an extensive global consultation, with indicators set for measuring progress against targets and milestones. This compendium of indicators provides a comprehensive and standardized listing of recommended indicators, including the 70 core indicators pres...ented in the M&E framework. These indicators will also support reporting on strategies described in other road map companion documents to guide action against neglected tropical diseases include the sustainability framework, the global strategy on water, sanitation and hygiene, the One Health approach and the strategic framework for integrated control and elimination of skin-related neglected tropical diseases.
The purpose of this compendium is to guide monitoring and evaluation of programmes and thereby to improve their quality and effectiveness in alignment with the road map goals. It provides a standardized listing of the most widely used indicators relevant to countries, with uniformity in defining indicators to allow comparisons over time and among different programmes. Detailed metadata are provided for each of these indicators to facilitate validity, internal consistency, standardized measurement, estimation methods and comparability of data across countries.
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The Global Antibiotic Resistance Partnership (GARP)-Mozambique team, in partnership with the Center for Disease Dynamics, Economics & Policy (CDDEP), has produced this report as part of a solid com-mitment to develop actionable policy proposals to tackle antibiotic resistance and improve appropriate... antibiotic access. It is the result of a thorough review of published and unpublished data on antibiotic resistance and a long internal consultation effort that engaged academic scientists, health professionals and other stakeholders within Mozambique.
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he central Sahel region—Burkina Faso, Mali and Niger—is facing a severe humanitarian and protection crisis.
Massive displacement, most of it driven by intense and largely indiscriminate violence perpetrated by a range of armed actors against civilian populations, is taking place across the regi...on. While internal displacement is on the rise substantial numbers of refugees have fled to neighboring countries, and the situation risks spilling over into the coastal countries of Benin, Côte d'Ivoire, Ghana, and Togo.
This context is exacerbated by the COVID-19 pandemic, which is already affecting areas hosting refugees and IDPs
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Injury to the skin and underlying tissues from acute exposure to
a large external dose of radiation is referred to as cutaneous
radiation injury (CRI). Acute radiation syndrome (ARS) 1 will
usually be accompanied by some skin damage; however, CRI
can ...occur without symptoms of ARS. This is especially true with
acute exposures to beta radiation or low-energy x-rays, because
beta radiation and low-energy x-rays are less penetrating and less
likely to damage internal organs than gamma radiation is. CRI can
occur with radiation doses as low as 2 Gray (Gy) or 200 rads 2 and
the severity of CRI symptoms will increase with increasing doses.
Most cases of CRI have occurred when people inadvertently came
in contact with unsecured radiation sources from food irradiators,
radiotherapy equipment, or well depth gauges. In addition, cases of
CRI have occurred in people who were overexposed to x-radiation
from fluoroscopy units.
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An 82 percent funding gap is putting the lives of 2.5 million people in north-west Syria at risk this winter.
The first cholera case in north-west Syria was confirmed on 19 September. See below for the latest updates.
On 17 September, at least six airstrikes were reported in Idleb, 10 ...km away from the road used by the 7th cross-line convoy. One man was injured.
On 27 September, an airstrike reportedly hit in the vicinity of five IDP camps in Idleb, near the Bab AlHawa border crossing, injuring a woman, child and seven men.
HNAP recorded 19,545 new internal displacements in north-west Syria in September – the highest record so far in 2022 - largely driven by the deteriorating economy.
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A multidisciplinary and multisectoral collaboration, through a One Health approach is required to effectively prepare for, detect, assess, and respond to emerging and endemic zoonotic diseases. However, external and internal health system evaluations continue to identify major gaps in capacity ... to implement multisectoral and multidisciplinary collaboration within and between many countries, and countries are asking for support from the Tripartite to fill these gaps. This guide is the response to those requests.
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The changes occurring in Myanmar highlight the need to have a robust DRR network that can support the Government as well as the communities in their efforts to build a resilient Myanmar. To this end, the DRR WG devised and facilitated a multi-stakeholder process aiming to develop its Strategic Frame...work 2013-2018. This document is the outcome of a series of internal workshops and external consultations, in particular with the relevant departments of the Government of Myanmar. This Strategic Framework will guide the collective efforts of the DRR WG over the next five years.
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Leishmaniasis is a parasitic disease that is found in parts of the tropics, subtropics, and southern Europe. Leishmaniasis is caused by infection with Leishmania parasites, which are spread by the bite of infected sand flies. There are several different forms of leishmaniasis in people. The most com...mon forms are cutaneous leishmaniasis, which causes skin sores, and visceral leishmaniasis, which affects several internal organs (usually spleen, liver, and bone marrow).
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Primary Post-partum Haemorrhage (PPH) is one of the major causes of maternal death in the developing world.
This animation is aimed at women and TBAs. It teaches how to prevent and manage PPH in settings where it would take the woman more than 4 hours to reach skilled obstetric care. It demonstra...tes the use of Misoprostol as well as internal bimanual compression.
This film is aimed at training Traditional Birth Attendants and community health workers in the management of PPH when delivery is not in a health centre and the nearest referral centre and access to skilled care is more than 3 hours away. this films should be used with caution and always taught by a health worker due to invasive procedures within the film.
This animation has no voice-over.
http://medicalaidfilms.org/our-films/somali-films/?v=28630558
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This is a series of videos about Buruli ulcer disease from Kwame Nkrumah University of Science and Technology. These videos were created Richard Phillips, Stephen Sarfo, Emmanuel Adu, Veronica Owusu-Afriyie, and Cary Engleberg (University of Michigan). The complete learning module is available throu...gh the African Health OER Network at: http://open.umich.edu/education/med/oernetwork/med/internal/buruli-ulcer/2009.
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Detonation of a nuclear weapon or activation of a radiological dispersal device could cause radioactively contaminated decedents. These guidelines are designed to address both of these scenarios. They could also be applicable in other instances where decedents’ bodies are contaminated with radioa...ctive material (e.g. reactor accidents, transportation accidents involving radioactive material, or
the discharge of a decedent from a hospital after injection or implantation of a radiopharmaceutical). These guidelines suggest ways for medical examiners, coroners, and morticians to deal with loose surface contamination, internal contamination, or shrapnel on or in decedents’ bodies.
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