In case of resistance to rifampicin, fluoroquinolones become the preferred category of second-line drugs. Unfortunately, quinolone-resistant strains of Mycobacterium leprae have also been reported in several countries, probably due to the extensive use of quinolones for treating several types of inf...ections. Clofazimine resistance is still rare but this antimicrobial cannot be given alone
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Background paper for the Oslo Summit on Education for Development
Guide de formation à l’usage des paramédicaux
Le présent guide de formation sur la prise en charge globale des personnes vivant avec le VIH est désormais à la disposition des personnels paramédicaux, des écoles et structures de formation de ces personnels dans la région africaine franco...phone. Il a été conçu par des experts africains et français rompus à la formation et engagés depuis de nombreuses années dans la lutte contre le VIH. Il a été testé, amendé et corrigé par un collège de paramédicaux. Il allie clarté, simplicité et intègre l’ensemble des standards internationaux en matière de prise en charge globale, tout en restant proche des réalités concrètes de l’exercice professionnel sur le terrain africain. Il constitue, j’en suis convaincu, un outil de grande qualité au service des professionnels de santé paramédicaux et devrait s’imposer rapidement comme un référentiel francophone incontournable pour la prise en charge globale des personnes vivant avec le VIH.
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La meningitis es una enfermedad mortal y debilitante; golpea rápidamente, conlleva graves consecuencias sanitarias, económicas y sociales, y afecta a personas de todas las edades y en todos los países del mundo. La meningitis bacteriana puede provocar epidemias, ocasionar la muerte en 24 horas y ...dejar a una de cada cinco personas afectadas, con discapacidad permanente después de la infección. Muchos casos de meningitis y defunciones conexas son prevenibles mediante vacunación, pero los progresos para derrotar a la meningitis están rezagados respecto de otras enfermedades prevenibles mediante vacunación.
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Climate change threatens to undermine the past 50 years of gains in public health. In response, theNational Health Service (NHS) in England has been working since 2008 to quantify and reduce its carbon footprint.
This Article presents the latest update to its greenhouse gas accounting, identifying ...interventions for mitigation efforts and describing an approach applicable to other health systems across the world.
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Рекомендации ВОЗ по оказанию дородовой помощи для формирования положительного опыта беременности
Mental disorders impose an enormous burden on society, accounting for almost one in three years lived with disability globally. •In addition to their health impact, mental disorders cause a significant economic burden due to lost economic output and the link between mental disorders and costly, po...tentially fatal conditions including cancer, cardiovascular disease, diabetes, HIV, and obesity.•80% of the people likely to experience an episode of a mental disorder in their lifetime come from low- and middle-income countries.• Two of the most common forms of mental disorders, anxiety and depression, are prevalent, disabling, and respond to a range of treatments that are safe and effective. Yet, owing to stigma and inadequate funding, these disorders are not being treated in most primary care and community settings.
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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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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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La réanimation a pour objectifs de prévenir et de pallier les différentes défaillances
viscérales aiguës. Elle s’adresse aux malades graves et est actuellement considérée
comme un élément normal de l’arsenal thérapeutique. Les médecins et les soignants ont
démontré l’utilité ...de la présence permanente 24 heures/24 et 7 jours/7 auprès des
malades graves d’une équipe hautement spécialisée. Ensemble, ils ont fait progresser les
techniques nécessaires à la prise en charge de ces malades : ventilation mécanique,
épuration extrarénale, surveillance et exploration cardiovasculaires... La réanimation
médicale née sur le terrain hospitalier a obtenu sa reconnaissance universitaire en 1969.
Le champ d’application de la réanimation s’étend à toute la pathologie et en particulier aux malades chirurgicaux. La distinction entre réanimation médicale et réanimation chirurgicale a été nécessaire pour une répartition raisonnable des tâches, surtout en
CHU, et aucunement en raison de connaissances pratiques et théoriques différentes. Cette distinction est obsolète, car il n’y a pas plusieurs façons de faire de la réanimation.
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In 2015, 26% of the deaths of 5.9 million children who died before reaching their fifth birthday could have been prevented
through addressing environmental risks – a shocking missed opportunity. The prenatal and early childhood period represents
a window of particular vulnerability, where enviro...nmental hazards can lead to premature birth and other complications,
and increase lifelong disease risk including for respiratory disorders, cardiovascular disease and cancers. The environment
thus represents a major factor in children’s health, as well as a major opportunity for improvement, with effects seen in every
region of the world.
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J Mov Disord > Volume 11(2); 2018 > Article
Review Article
J Mov Disord 2018; 11(2): 53-64.
Published online: May 30, 2018
DOI: https://doi.org/10.14802/jmd.17028
This brochure draws on data from more than 90 nationally representative surveys making it the most up-to-date compilation of statistics on FGM/C. Available data show that the practice of FGM/C is highly concentrated in a swath of countries from the Atlantic coast to the Horn of Africa, in areas of t...he Middle East such as Iraq and Yemen and in some countries in Asia like Indonesia. However, FGM/C is a human rights issue that affects girls and women worldwide. Evidence suggests that FGM/C exists in some places in South America such as Colombia and elsewhere in the world including in India, Malaysia, Oman, Saudi Arabia, and the United Arab Emirates.
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Manual para la primera fase de implementación
The elimination scenario planning (ESP) manual provides malaria-endemic countries with a comprehensive framework to assess different scenarios for moving towards this goal, depending on programme coverage and funding availability. It also helps countries set realistic timelines and provides essentia...l knowledge for strategic planning in the long term.
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