Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los... años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
more
Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based
primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a
broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for
high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to
enhance their programmatic activities.
Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno
District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data
was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively
selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose.
Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in
the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive
patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal-
lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and
workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi-
tive work environment through supportive relationships between CHWs and supervisors enables the CHWs.
Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec-
tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance,
manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha-
sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The
engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided
to the patients and communities, along with building supportive systems to recognize the work done by CHWs for
the primary health care systems.
more
Rapport sur les populations clés.
WHO TRS N°1012.
Key updates include: (i) surveillance strategies, including cross-sectoral linking of systems and suitable diagnostics; (ii) the latest recommendations on human and animal immunization; (iii) palliative care in lowresource settings; (iv) risk assessment to guide management of bite... victims; and (v) a proposed process for validation and verification of countries reaching zero human deaths from rabies.
more
L'eau potable et les services d'assainissement et d'hygiène (WASH) sont essentiels à la prévention des 17 maladies tropicales négligées (MTN) pour lesquelles une intensification de la lutte ou l'élimination sont prévues à l'horizon 2020.
La fourniture d’eau potable et de services d’...assainissement et d’hygiène est l’une des cinq interventions clés inscrite dans la feuille de route mondiale contre les MTN. Pourtant, à ce jour, la composante WASH de la stratégie n’a reçu que peu d’attention et le potentiel lié à la mise en commun des efforts WASH et MTN reste largement inexploité.
Des efforts ciblés sur la composante WASH sont nécessaires de toute urgence pour atteindre les cibles de la feuille de route mondiale contre les MTN.
more
The scope of this PPC document is to serve as a guide to address the unmet public health need for a PPE system that protects the HW-F in tropical climate
s while caring for patients and providing heavy duty essential health services.
The characteristics described in this guidance are targeted fo...r PPE used in
health clinics, hospitals and communities in low resource settings where there is lack of advanced environmental controls and equipment. The purpose is to ensure harmonization in PPE design and its use to avoid confusion and exacerbating the risk of infections in HW-F. The principles of this PPC document can also be considered in risk reduction strategies
in other healthcare settings.
more
Antibiotic resistant bacteria are spreading at an alarming rate and some bacterial infections may once again be untreatable. Antibiotic resistance (ABR), conservatively calculated, causes more than 500 000 deaths every year. This number is projected to rise dramatically if radical actions are not ta...ken. Lack of effective antibiotics, diagnostics and vaccines threatens the health of millions and hampers fulfilment of several of the Sustainable Devel- opment Goals. Access to effective antibiotics should be part of every adult and child’s right to health.
more
This chapter discusses the antibacterial treatment of leprosy infections. Antibiotic treatment is
a key component of leprosy treatment, as it is vital to prevent the progression of the infection.
Treatment with rifampin and other antibiotics is highly effective and cures 98% of patients with
the ...leprosy infection. Furthermore, the relapse rate is very low, at about 1% over 5–10 years.
There is little M. leprae drug resistance in leprosy and few reports of multi-drug resistance (1, 2, 3,
4, 5, 6, 7, 8). An antibiotic treatment may take months or years to produce clinical improvement,
especially in patients with an initial high bacterial index (BI).
more
Infect Dis Poverty (2021) 10:15.
Real-time polymerase chain reaction (PCR) is a sensitive and specific method for diagnosing schistoso-
miasis. However, this method should be performed in a laboratory, usually located distant from the sample collection
site. Therefore, it is important to have fas...t sampling preservation methods, which allow simple transport prior to DNA
extraction and amplification. The aim of this study was to verify if blood samples applied to filter paper are suitable for
analysis of Schistosoma mansoni DNA by real-time PCR.
more
This report makes the case for a major new initiative—to rapidly recruit, train and deploy 2 million community health workers in Africa. Drawing on a vast body of evidence and substantial regional experience, the report shows how community health workers save lives and improve quality of life and ...how investments in community health workers effectively harness the demographic dividend, reduce gender inequality and accelerate economic growth and development. Indeed, the benefits of community health workers stretch from one end of the Agenda for Sustainable Development to the other.
more
L’évaluation externe de la qualité (EEQ) est une composante importante des systèmes qualité des services de transfusion sanguine. L’EEQ est l’évaluation externe de la qualité générale des résultats obtenus par un laboratoire dans l’analyse d’échantillons de contrôle dont le cont...enu est connu, mais n’a pas été dévoilé, et la comparaison de ces résultats avec ceux qu’ont obtenus d’autres laboratoires qui ont analysé les mêmes échantillons. Dans les laboratoires qui pratiquent le dépistage des infections transmissibles par transfusion (ITT) dans les dons de sang, la participation à l’EEQ aide à surveiller et améliorer la qualité des résultats. Les informations issues de l’EEQ permettent d’améliorer continuellement la qualité en mettant en évidence les erreurs d’un laboratoire et d’appliquer des mesures pour éviter qu’elles se reproduisent. L’EEQ joue ainsi un rôle essentiel dans l’amélioration de la sécurité transfusionnelle.
more
Health needs of displaced Syrians in refugee hosting countries have become increasingly complex in light of the protracted Syrian conflict. The primary aim of this study was to identify the primary health needs of displaced Syrians in Iraq, Jordan, Lebanon, Turkey, and Syria.
Для создания этого отчета MSF исследовала программы и практику лечения лекарственно-чувствительного и лекарственно-устойчивого туберкулеза в восьмистранах с высо...ким бременем туберкулеза, обладающих различным набором эпидемиологических, экономических, географических и демографических характеристик (Бразилия, Зимбабве, Индия, Кения, Мьянма, Российская Федерация, Узбекистан, ЮАР). Мы исследовали ключевые показатели диагностики, лечения и доступности основных препаратов, поставок лекарственныхсредств и финансирования .
more
This paper is motivated by the global spread of the coronavirus referred to as COVID-19 and its efect on Sub-Saharan African (SSA) economies. The International Monetary Fund (IMF) has alluded to the COVID-19 not only afecting the global health but also trade and tourism, commodity prices, and fnanci...al conditions that calls for an additional policy response to support demand and ensure an adequate supply of credit
more
Cancer is an emerging public health problem in sub-Saharan Africa due to population growth, ageing and westernisation of lifestyles. In this piece, we use data from Mozambique over a 50-year period to illustrate cancer epidemiological trends in low-income and middle-income countries to hypothesise ...potential circumstances and factors that could explain changes in cancer burden and to discuss surveillance weaknesses and potential improvements. This epidemiological transition deserves increasing policy attention.
more
Ces lignes directrices provisoires présentent quelques principes de base en matière de prise en charge nutritionnelle adaptée aux patients adultes et pédiatriques pendant leur traitement et leur convalescence dans les unités de traitement Ebola, dans les centres de soins communautaires et autre...s centres dans lesquels des patients Ebola reçoivent des soins et un soutien.
more
The aim of this document is to provide interim guidance for interventions to reduce the risk of maternal Zika virus infection and to manage potential complications during pregnancy. This guidance is based on the best available research evidence and covers areas prioritized by an international, multi...disciplinary group of health care professionals and other stakeholders. Specifically, it presents guidance for preventing Zika virus infection;antenatal care and management of women with infection; and care during pregnancy for all pregnant women living in affected areas, with the aim of optimizing health outcomes for mothers and newborns.
more