Chromoblastomycosis (CMB) is a chronic fungal infection of the skin and the subcutaneous tissue caused by a transcutaneous traumatic inoculation of a specific group of dematiaceous fungi occurring mainly in tropical and subtropical zones worldwide. If not diagnosed at early stages, patients with CBM... require long term therapy with systemic antifungals, sometimes associated with physical methods. Unlike other neglected endemic mycoses, comparative clinical trials have not been performed for this disease. Nowadays, therapy is based on a few open trials and on expert opinion. Itraconazole either as monotherapy or associated with other drugs, or with physical methods, is widely used. Recently, photodynamic therapy has been successfully employed in combination with antifungals in patients presenting with CBM. In the present revision the most used therapeutic options against CBM are reviewed as well as the several factors that may have impact on the patient's outcome.
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As countries aim to progress towards the Sustainable Development Goals (SDGs) and achieving universal health coverage, health inequities driven by racial discrimination and intersecting factors remain pervasive. Inequities experienced by indigenous peoples as well as people of African descent, Roma ...and other ethnic minorities are of concern globally; they are unjust, preventable and remediable.
Health systems themselves are important determinants of health and health equity. They can perpetuate health inequities by reflecting structural racism and discriminatory practices of wider society. For instance, systemic racism, implicit bias, misinformed clinical practice, or discrimination by health professionals contributes to health inequities. However, health systems can also be a leading force for tackling the inequities faced by populations experiencing racial discrimination.
Primary health care (PHC) is the essential strategy for reorientating health systems and societies to become healthier, equitable, effective and sustainable. In 2018, on the 40th anniversary of the Declaration of Alma-Ata, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF) renewed the emphasis on PHC with their strategy,
WHO outlines 14 strategic and operational levers for policy-makers to strengthen PHC. Within each lever, there are multiple potential entry points for targeted actions to address racial discrimination, foster intercultural care, and reduce health inequities experienced by indigenous peoples as well as people of African descent, Roma and other ethnic minorities.
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La néphrologie pédiatrique (NP) a connu ces dernières années des progrès impressionnants en matière de soins. Cependant, le plus grand défi dans notre continent africain est de fournir aux enfants atteints de maladie rénale l’accès à une prise en
charge spécialisée par des néphrologu...es pédiatriques ayant une bonne formation, ainsi que la possibilité d’avoir un accès abordable aux techniques modernes, aux médicaments efficaces et à des stratégies de prévention. En Afrique, le développement de la NP a été très lent et sans collaboration réelle entre les pays concernés, ce qui a renforcé ma conviction sur la nécessité d’amener les néphrologues pédiatres africains à œuvrer ensemble, par le biais d’un ouvrage commun, à mettre en lumière les données spécifiques de notre continent dans ce domaine.
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Ces recommandations ont été élaborées dans le cadre de la mission de l’Organisation mondiale de la Santé de fournir des orientations normatives à ses États-membres. L’objectif de ce document est de formuler des recommandations fondées sur des données factuelles afin de faciliter l’acc...ès universel aux interventions essentielles et efficaces en matière santé maternelle et néonatale, grâce à l’optimisation des rôles du personnel de santé.
Ces recommandations s’adressent aux décideurs de la santé, aux responsables et autres acteurs aux niveaux international, national et régional. En fournissant ces recommandations générales à l’échelle internationale, l’Organisation mondiale de la Santé part du principe que les pays les adapteront et qu’ils les mettront en œuvre en tenant compte du système politique et des systèmes de santé déjà en place.
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These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor treatment in people living with HIV; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living w...ith HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
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This document was designed to inform educators, amongst others, about enhancing the pre-service curriculum with mental health Gap Action Programme Intervention Guide (mhGAP-IG) materials, which can provide future professionals with the theoretical and clinical knowledge they need to provide mental h...ealth in non-specialized health care settings.
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The Ideal Clinic Realisation and Maintenance (ICRM) programme was initiated by the National Department of Health in July 2013 in order to systematically improve primary health care (PHC) facilities and the quality of care they provide. The Ideal Clinic framework/dashboard sets out the standards for ...PHC facilities to provide good-quality health services. An Ideal Clinic is defined as a clinic with good infrastructure, adequate staff, adequate medicines and supplies, good administrative processes, and sufficient adequate bulk supplies. Applicable clinical policies, protocols and guidelines are adhered to, and it harnesses partner and stakeholder support.
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The Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level provide a platform for transparency to enable equitable access to safe, effective, and affordable treatment options at hospital level taking into consideration the changing clinical needs of our population and th...e pragmatic implications of the introducing a new health technology.
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The following protocol has been designed to investigate the First Few X cases (FFX) and their close contacts. It is envisioned that the FFX 2019-nCoV investigation will be conducted across several countries or sites with geographical and demographical diversity. Using a standardized protocol such a...s the protocol provided here, epidemiological exposure data and biological samples can be systematically collected and shared rapidly in a format that can be easily aggregated, tabulated and analyzed across many different settings globally for timely estimates of 2019-nCoV infection severity and transmissibility, as well as to inform public health responses and policy decisions. This is particularly important in the context of a novel respiratory pathogen, such as 2019-nCoV
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Défis et progrès. ce rapport présente l’information la plus à jour sur l’incidence de la grossesse non planifiée et de l’avortement à Kinshasa (République démocratique du Congo). La publication du Protocole de Maputo au Journal officiel de la nation en 2018 a formalisé l’obligation... du gouvernement d’élargir l’accès à l’avortement médicalisé dans les conditions énoncées au Protocole. Néanmoins, les obstacles à la mise en œuvre continuent de rendre les services d’avortement sécurisé largement inaccessibles. En conséquence, la majorité des femmes de Kinshasa qui choisissent d’interrompre leur grossesse le font-elles dans la clandestinité — souvent dans des conditions non médicalisées potentiellement dangereuses pour leur santé.
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This document provides an overview of sexual and reproductive health and rights issues that may be important for the human rights, health and well-being of adolescents (aged 10–19 years) and the relevant World Health Organization (WHO) guidelines on how to address them in an easilyaccessible, user...-friendly format. The document serves as a gateway to the rich body of WHO guidelines, and as a handy resource to inform advocacy, policy and programme/project design and research. It aims to support the implementation of the Global Strategy for Women’s, Children’s and Adolescents’ Health 2016–2030 (1), and is aligned with the WHO Global Accelerated Action for the Health of Adolescents (AA-HA!) as well as the WHO Operational Framework on Sexual Health and Its Linkages to Reproductive Health (2,3).
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Poor quality health services are holding back progress on improving health in countries at all income levels.
Today, inaccurate diagnosis, medication errors, inappropriate or unnecessary treatment, inadequate or unsafe clinical facilities or practices, or providers who lack adequate training an...d expertise prevail in all countries.
The situation is worst in low and middle-income countries where 10 percent of hospitalized patients can expect to acquire an infection during their stay, as compared to seven percent in high income countries. This is despite hospital acquired infections being easily avoided through better hygiene, improved infection control practices and appropriate use of antimicrobials.. At the same time, one in ten patients is harmed during medical treatment in high income countries.
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These guidelines provide a recommendation on iodine thyroid blocking (ITB), via oral administration of stable iodine, as an urgent protective action in responding to a nuclear accident. This recommendation aims to support emergency planners, policy makers, public health specialists, clinicians and o...ther relevant stakeholders, in order to strengthen public health preparedness for radiation emergencies in WHO Member States as required by the International Health Regulations (IHR) and in line with the international safety standards (GSR Part 7). The scope of the guidelines is confined to public health aspects of planning and implementation of ITB before and during a radiation emergency, such as dosage and timing of ITB administration, adverse effects of stable iodine, its packaging, storage, and distribution.
These guidelines supersede the 1999 WHO Guidelines for Iodine Prophylaxis following Nuclear Accidents.
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The Ethiopian Hospital Services Transformation Guidelines (EHSTG) build on and expand the Ethiopian Hospital Reform Implementation Guidelines (EHRIG) and are consistent with the Health Sector Transformation Plan (HSTP). The EHSTG, which is consistent with the national focu...s on quality improvement in health care, contains a common set of guidelines to help hospital Chief Executive Officers(CEOs), managers, and clinicians (care providers) in steering the consistent implementation of these transformational systems and processes in hospitals throughout the country. The EHSTG focused on selected management and clinical functions, including new individual service specific chapters for Emergency Medical, Outpatient and Inpatient Services, Nursing and Midwifery, Maternal, Neonatal and Child Health and Teaching Hospitals’ Management. These guidelines also incorporate recent lessons from the operationalization of the EHRIG, as well as, new national initiatives such as the Guidelines for the Management of Federal Hospitals in Ethiopia, Hospital Development Army (HDA), Clean and Safe Hospital (CASH), and Auditable Pharmaceutical Transaction and Service (APTS).
II10 Pharmacy ChapterIt is expected that the guidelines will continuously evolve as new evidence emerges regarding improved hospital care and practices that are better tailored to needs and circumstances of different tiers of public hospitals. We are grateful to all partners that have participated in the production of these guidelines. Special thanks go to our colleagues at the Clinton Health Access Initiative for their substantial contributions and support throughout the development of these guidelines as well as their dedicated efforts in support of our health reform efforts in so many other capacities
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There is an urgent need for safer, simpler, more efficacious and accessible treatment regimens for all forms of TB. The development of Target Product Profiles for TB treatment regimens (referred to as Target Regimen Profiles or TRPs) seeks to guide the drug development process towards important regi...men characteristics corresponding to the needs of end-users.
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The objectives of these WHO guidelines are to provide updated evidence- based recommendations for the treatment of persons with hepatitis C infection using, where possible, all DAA-only combinations. The guidelines also provide recommendations on the preferred regimens based on a patient’s HCV gen...otype and clinical history, and assess the appropriateness of continued use of certain medicines. This document also includes existing recommendations on screening for HCV infection and care of persons infected with HCV that were first issued in 2014
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Everyday experience shows that there is a commonality between spirituality and medical practice. A text message I received from a friend recently read, "Please pray for me. I've been getting a mysterious headache for some days now. I will be seeing the doctor today." This clearly speaks of a relatio...nship: asking for prayer so as to be relieved of a "mysterious headache", yet going to see a doctor whose job is not to cure mysterious headaches. Even though both areas of human experience have their peculiar and largely unrelated methodologies, this paper argues that any extreme separation of the two is injurious to the teleology of both disciplines in relation to human well-being, which forms the core of spirituality and medicine.
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The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (“pneumonia” which is treated at home with oral amoxicillin and “severe pneumonia” which requires injectable antibiotics) and (B) oral amoxicillin replaces o...ral cotrimoxazole as first line treatment, preferably in 250mg dispersible tablet form, twice daily for five days which can be reduced to three days in low HIV settings.
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BAB training in prevention and management of postpartum hemorrhage increased knowledge and confidence among skilled and semiskilled birth attendants. Further studies are needed to determine the impact of this training on skills retention and clinical outcomes following postpartum hemorrhage, after b...roader implementation of the training program
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Objectives and scope of the document
This document was developed to provide recommended management strategies for problems and disorders that are specifically related to the occurrence of a major stressful event. The recommended strategies will form the basis of a new module to be added to the WHO ...(2010) mhGAP Intervention Guide for use in non-specialized specialized health-care settings.
The scope of the problems covered by these guidelines is:
symptoms of acute stress in the first month after a potentially traumatic event, with the following subtypes:
- symptoms of acute traumatic stress (intrusion, avoidance and hyperarousal) in the first month after a potentially traumatic event;
- symptoms of dissociative (conversion) disorders in the first month after a potentially traumatic event;
- non-organic (secondary) enuresis in the first month after a potentially traumatic event (in children);
- hyperventilation in the first month after a potentially traumatic event;
- insomnia in the first month after a potentially traumatic event;
posttraumatic stress disorder (PTSD);
bereavement in the absence of a mental disorder.
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