The objective of the study was the validation and implementation of GeneXpert MTB/RIF for routine use in the rapid detection of tuberculosis and sensitivity to rifampicin in clinical samples; for this, 1592 respiratory samples were collected and analyzed in the laboratory of Instituto Nacional de In...vestigación en Salud Pública Guayaquil. The analysis of the results of GeneXpert in comparison with smear microscopy showed an initial sensitivity of 99.8% and specificity of 93.2%; The analysis of discrepancies using the results of the culture as a reference method showed that the GeneXpert results considered false negatives turned out to be true negatives, the same happens with the false positives that correspond to true positives. Recalculated the sensitivity and specificity of the GeneXpert was 99.8% and 100% correspondingly. The comparison with the drugs susceptibility test showed a sensitivity of 91.4% and a specificity of 95.5% for the GeneXpert MTB/RIF system. It is concluded that the implementation of the GeneXpert system allows solution to certain problems associated with the application of conventional diagnostic methodologies, decreasing the waiting times, and increasing the sensitivity and specificity in the diagnosis of drug-resistant tuberculosis, thus generating a valuable opportunity for early diagnosis.
more
Emerging evidence and experience to inform risk management in a warming world
BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
more
A WHO-ITU Standard.
Nearly 50% of people aged 12-35 years – or 1.1 billion young people – are at risk of hearing loss due to prolonged and excessive exposure to loud sounds, including music they listen to through personal audio devices. Ahead of World Hearing Day (3 March), the World Health Org...anization (WHO) and the International Telecommunication Union (ITU) have issued a new international standard for the manufacture and use of these devices, which include smartphones and audio players, to make them safer for listening
more
In recognition of the growing problem of antimicrobial resistance (AMR), its increasing threat to human, animal and plant health, and the need for a One Health approach to address this issue, the 39th Session of the Codex Alimentarius Commission (CAC) agreed it was important for the food safety comm...unity to play its part and re-established the ad hoc Codex Intergovernmental Task Force on Antimicrobial Resistance (TFAMR) ). The objectives of the Task Force were
to revise the current Codex Code of Practice to Minimise and Contain Antimicrobial Resistance and to develop new guidance on surveillance programmes relevant to foodborne AMR.
more
Immer wieder hören wir – in der inzwischen jahrzehntelangen
Lobbyarbeit der BAG – aus der Politik die Bitte, das Problem
der medizinischen Unterversorgung von Menschen ohne Papiere
zu „bebildern“: Wer sind diese Menschen? Wo liegen die Probleme in der gesundheitlichen Versorgung? Vor ...welchen praktischen Problemen, d.h. Sachzwängen, bürokratischen und rechtlichen Hürden stehen die Helfenden in den Anlaufstellen, die dort Hilfe leisten, wo der Zugang zum Gesundheitssystem versperrt ist? Die hier geschilderten Fälle aus der medizinischen Praxis sollen das humanitäre Problem besser nachvollziehbar machen.
more
Urge una respuesta regional ante una crisis migratoria sin precedentes
This scoping study done in Myanmar offers the chance for FoodSTART+ to explore prospects for future partnerships in another important country of the region. The study was done from October 2016 to February 2017 and included visits to selected major potato and cassava production areas to meet with re...spective stakeholders and market actors.
Although root and tuber crop (RTC) production in Myanmar has gradually increased since the late 1990s, they still lag behind the other major crops like rice. No RTCs are included in the country’s list of primary important crops even though potatoes are regularly consumed in daily meals while other common RTCs like cassava, elephant foot yam and sweetpotato are consumed occasionally. RTCs primarily contribute to food security and livelihoods through the income generated from their sale, whether fresh or processed, rather than directly through consumption.
more
Interim practical manual supporting implementation of the WHO guidelines on core components of infection prevention and control programmes
La tuberculosis (TB) continúa siendo un problema mundial de salud pública de grave magnitud, clasificándose como la segunda causa de muerte por enfermedad infecciosa, pese a los aportes logrados en el control las cifras no son alentadoras, de acuerdo con la Organización Mundial de la Salud (OMS)..., en el 2017, se presentaron 10,0 millones de personas que padecieron tuberculosis, estos casos se presentaron en 5,8 millones de hombres, 3,2 millones de mujeres y 1,0 millón de niños
more
The health system in Venezuela: a patient without medication?
Cad. Saúde Pública 34 (3) 05 Mar 2018 • https://doi.org/10.1590/0102-311X00058517
Informe mundial sobre las drogas
Rapport mondial sur les drogues 2018
El documento La carga de los trastornos mentales en la Región de las Américas, 2018 tiene como propósito mejorar la evaluación de las necesidades en materia de salud mental en la Región de las Américas al presentar un panorama actualizado y matizado de: a) la discapacidad debida a los trastorn...os mentales, por consumo de sustancias y trastornos neurológicos específicos, más la autoagresión (TMNS), tanto sola como en combinación con la mortalidad prematura; b) el desequilibrio entre el gasto en salud mental y la carga de enfermedad relacionada; y c) la asignación inadecuada de los exiguos gastos en salud mental por parte de los países de la Región
more