The Lancet. Published Online December 22, 2016 http://dx.doi.org/10.1016/S0140-6736(16)32621-6. Open Access
PLOS ONE | https://doi.org/10.1371/journal.pone.0192068 March 9, 2018
the Lancet : Published Online July 31, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61117-5
Clúster de Educación
30 de marzo de 2020
Le Burkina Faso traverse des flambées épidémiques complexes sans précédent de la poliomyélite et du virus Corona qui affectent gravement le pays.
Avec de multiples maladies endémiques et d'autres flambées signalées telles que la rougeole, la méningite, le virus Corona, découvert pour l...a première fois en Chine début décembre 2019, a gravement affecté la population du Burkina Faso et son système de santé. Comme c'est le cas pour plusieurs pays Il s'agit de la première histoire de l'épidémie de corona virus dans le Pays, et qui est l'un des pays à avoir enregistré de nombreux cas avec un taux de mortalité élevé. La particularité est le mélange de crise humanitaire et la pandémie COVID-19 marqué par une transmission interhumaine active et étendue dans différentes régions du pays.
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The Lancet Vol.400 (2022) p.17-67-1776. Published:October 31, 2022DOI:https://doi.org/10.1016/S0140-6736(22)01884-0.
Surgical site infection (SSI) is the most common complication of surgery around the world: ChEETAh trial finds routinely changing gloves and instruments for wound closure could preve...nt as many as one in eight SSIs in abdominal surgery
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Soil-transmitted helminths (STH) affect 1.45 billion people worldwide, and high intensity infections are associated with anemia, undernutrition and impaired cognition, particularly among children. Mathematical models suggest it may be possible to interrupt the transmission of STH in a community by e...xpanding mass drug administration (MDA) from targeted high-risk groups (primarily school-aged children and women of child-bearing age) to all community members with high coverage. The DeWorm3 Project will test the feasibility of this approach to interrupting the transmission of STH using a series of cluster randomized trials in Benin, India and Malawi. Each study area (population 80,000) will be divided into 40 clusters and randomized to community-wide or standard-of-care targeted MDA for three years. Two years following the final round of MDA, prevalence of STH will be compared between arms and transmission interruption assessed in each cluster. The DeWorm3 trials will provide stakeholders with information regarding the potential to switch from STH control to a more ambitious and sustainable strategy.
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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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Despite recent global declines, under-five mortality remains high in many of the poorest countries. Barriers to timely
quality care, including user fees, distance to facilities and the availability of trained health workers and medical supplies,
hinder progress in further reducing morbidity and m...ortality
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