INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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INTRODUCTION: Health service use among the public can decline during outbreaks and had been predicted among low and middle-income countries during the COVID-19 pandemic. In March 2020, the government of the Democratic Republic of the Congo (DRC) started implementing public health measures across Kin...shasa, including strict lock-down measures in the Gombe health zone.
METHODS: Using monthly time series data from the DRC Health Management Information System (January 2018 to December 2020) and interrupted time series with mixed effects segmented Poisson regression models, we evaluated the impact of the pandemic on the use of essential health services (outpatient visits, maternal health, vaccinations, visits for common infectious diseases and non-communicable diseases) during the first wave of the pandemic in Kinshasa. Analyses were stratified by age, sex, health facility and lockdown policy (i.e, Gombe vs other health zones).
RESULTS: Health service use dropped rapidly following the start of the pandemic and ranged from 16% for visits for hypertension to 39% for visits for diabetes. However, reductions were highly concentrated in Gombe (81% decline in outpatient visits) relative to other health zones. When the lock-down was lifted, total visits and visits for infectious diseases and non-communicable diseases increased approximately twofold. Hospitals were more affected than health centres. Overall, the use of maternal health services and vaccinations was not significantly affected.
CONCLUSION: The COVID-19 pandemic resulted in important reductions in health service utilizsation in Kinshasa, particularly Gombe. Lifting of lock-down led to a rebound in the level of health service use but it remained lower than pre-pandemic levels.
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Technical specifications for selection of essential in vitro diagnostic tests for SARS-COV-2, 14 June 2021
Guidance for clinical case management of thrombosis syndrome with thrombocytopenia (TTS) following vaccination to prevent coronavirus disease (COVID-19)
Interim guidance 19 July 2021
Manual for Death Surveillance in the Context of Pediatric Multisystemic Inflammatory Syndrome (SIM-P) Associated with Covid-19. Publication updated on 24/09/2021
E-book Project Reab Post-Covid
O projeto Reab pós-Covid-19 foi elaborado em parceria entre Ministério da Saúde, Conselho Nacional de Secretários de Saúde (CONASS), Conselho Nacional de Secretarias Municipais de Saúde (Conasems) e o SírioLibanês. Uma das ações desenvolvidas foi a elaboraç...ão do material apresentado a seguir. Por meio dele buscamos facilitar a difusão do conhecimento sobre o tema e o que há de oficial no Brasil sobre o assunto de maneira prática, objetiva e compatível com a realidade do SUS.
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Mortality due to enteric infections is projected to increase because of global warming; however, the different temperature sensitivities of major enteric pathogens have not yet been considered in projections on a global scale. We aimed to project global temperature-attributable enteric infection mor...tality under various future scenarios of sociodemographic development and climate change.
The Lancet Planetary Health Volume 5, ISSUE 7, e436-e445, July 01, 2021
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This article was published on December 10, 2020, and updated on December 16, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2034577
The well-being of children in sub-Saharan Africa is under siege from all directions since the advent of the COVID-19 pandemic. The region is now suffering its first-ever economic recession, pushing about 50 million people into extreme poverty, a majority of whom are children.
Introdução: A pandemia pela COVID-19 é menos incidente na população pediátrica quando comparada à adulta, sendo apenas 2% dos casos abaixo dos 20 anos. Recentemente, a infecção pelo SARS-CoV-2 em crianças e adolescentes está sendo associada a Síndrome Inflamatória Multissistêmica Pedi...trica (SIM-P), doença de Kawasaki-like. Objetivo: Relatar a ocorrência de uma das apresentações clínicas da COVID-19 na infância, a SIM-P, ressaltando suas manifestações clínicas, laboratoriais e manejo clínico.
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With this quick reference guide, providers can easily recognize diseases and side effects related to climate change, implement appropriate management and provide guidance to exposed populations, provide up-to-date information on the relationship between the adverse effects of certain drugs and the w...orsening of climate-sensitive health conditions, and determine the possible consequences of climate change for health services. This book addresses key meteorological risks, as well as the health conditions which they may influence, grouped by specific clinical areas.
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7. Rev Panam Salud Publica. 2020;44:e13
Haiti faces a double burden of disease. Infectious diseases continue to be an issue, while non-communicable diseases have become a significant burden of disease. More attention must also be focused on the increase in worrying public health issues such as road... injuries, exposure to forces of nature and HIV/AIDS in specific age groups. To address the burden of disease, sustained actions are needed to promote better health in Haiti and countries with similar challenges.
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Estas Pranchas para o diagnóstico microscópico da malária servem como guia para laboratoristas e técnicos de campo responsáveis por diagnóstico microscópico da malária pelo método de Giemsa. Também devem ser úteis para professores e alunos de disciplinas correlatas. As pranchas mostram fo...tomicrografias coloridas de lâminas de sangue (esfregaços e gotas espessas), coradas, e texto explicativo sobre as quatro espécies de parasitos causadores da malária humana e sua morfologia. São fornecidas descrições completas de cada espécie, bem como instruções sobre o preparo de lâminas e esfregaços, o uso de soluções tampão, o método de coloração Giemsa, o exame das lâminas e procedimentos para estimar a densidade parasitária. Nada será adicionado sobre knowlesi e simium? Acho importante até para que as pessoas saibam com o que se parecem. Também são descritos outros elementos celulares observados no sangue, bem como vários contaminantes comuns que podem ser confundidos com parasitos da malária.
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Este manual (Parte I dos módulos de capacitação em Bases do diagnóstico microscópico da malária) ajudará os participantes durante seu treinamento em diagnóstico microscópico da malária humana. O manual foi concebido como base para um treinamento formal de quatro a cinco semanas de duraçã...o e destina-se a alunos com conhecimentos rudimentares de ciência. Ao concluir a capacitação, o aluno será responsável pelo diagnóstico de malária com lâminas de sangue de casos suspeitos na sua comunidade. Desse modo, decisões importantes referentes ao tratamento dependem da sua competência em garantir o diagnóstico de malária sem supervisão.
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Best practice for hand hygiene requires the availability of clean water, soap, and single use disposable towels or alcohol based hand sanitiser with a concentration of 70%. Availability of these resources is not always assured. When resources for hand hygiene are not available other materials need t...o be considered to prevent transmission of infection. This document provides community guidance on evidence-based alternative hand hygiene strategies in the absence of clean running water, soap or alcohol-based hand rub.
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This third edition of the landscape analysis provides regional and country-specific data. This report illustrates the complexities in surveillance of influenza and other respiratory viruses and highlights differences in the countries’ preparedness capacities through charts, infographics, tables, a...nd brief narratives.
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The package provides practical, concise yet crucial information about the impact of COVID-19 on daily teaching practices as well as tips and suggestions to improve safety, well-being and learning, with students in face-to-face or remote settings.
The package speaks directly to the teachers. It ca...n be adapted to their context and can be completed at the teachers’ own pace. It includes quizzes and a self-evaluation and planning tool to help teachers reflect on what they learned and what they still need to learn, encouraging them to keep learning!
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