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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РУКОВОДСТВО ПО БИОЛОГИЧЕСКОЙ БЕЗОПАСНОСТИ ЛАБОРАТОРНЫХ ИССЛЕДОВАНИЙ ПРИ ТУБЕРКУЛЕЗЕ.
Examination of the business behavior of Boehringer Ingelheim, Bayer and Baxter in India
The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Health Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including... asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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The International Journal of Tuberculosis and Lung Disease 21(5) DOI: 10.5588/ijtld.16.0518
On 25 August, UN agencies and partners launched a US$187.3 million Flash Appeal to reach 500,000 of the most vulnerable people affected by the 14 August earthquake.
Around 650,000 people are in need of emergency humanitarian assistance in the three most affected departments – Grand’Anse, Nipp...es and Sud – where 634,000 were already in need of multisectoral assistance before the quake.
Based on lessons learned from past emergencies, humanitarian actors are aiming to capitalize on local and national level expertise, capacities and knowledge to promote a rapid and effective response tailored to the expressed needs of affected people.
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Clinical Infectious Diseases
1586 - 1594 • CID 2016:62 (15 June) • HIV/AIDS
La movilidad humana en Colombia incluye una combinación de migración interna e internacional, tanto de personas colombianas como originarios de otros países. Históricamente, el principal movimiento migratorio internacional en Colombia ha sido la emigración. Las razones son variad...as, muchas han estado relacionadas con el conflicto armado, la inestabilidad política y económica, unidas a la falta de oportunidades de algunos grupos de la población, lo que generó para muchas generaciones la salida del país en pro de una mejor calidad de vida. Un segundo movimiento masivo es el de las personas desplazadas internas por el conflicto armado. Más recientemente, a estos dos movimientos se ha sumado el de las personas venezolanas que ingresan a Colombia, ya sea con la intención de continuar hacia otros países de la región o para permanecer en este país. En este documento, abordamos los posibles impactos de la pandemia de COVID-19 en consideración de estas tres movilidades en Colombia.
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abridged version, March 2021
he study highlights the impacts of COVID-19 on women and men as gleaned from research conducted during 2020, as well as the Computer Assisted Telephonic Interviews (CATI) Rapid Gender Assessments (RGAs) executed by UN Women, UNFPA and partners in seven countries in the ...East and Southern Africa region.
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This report of the EFSA and ECDC presents the results of zoonoses monitoring activities carried out in 2020 in 27 EU Member States (MS) and nine non-MS. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically.
In this report a nutrition governance framework was applied to research and analyse the provincial experience with nutrition policy in Pakistan, looking both at chronic and acute malnutrition. Twenty-one in-depth interviews with key stakeholders were also conducted along with a review of published a...nd grey literature. Findings were validated and supplemented by consultative provincial roundtable meetings. Punjab’s nutritional puzzle is that it has high levels of chronic malnutrition and micro-nutrient deficiencies despite a surplus production of food and a low poverty level. Under-nutrition is mainly linked to insufficient attention to preventive health strategies and to a lack of connection between relevant sectors such as Education, Health, Poverty, Safe Water and Sanitation, and Food. Strategic opportunities are recommended which include cross-party political support and ownership for nutrition, with steering by executive leadership; multi-sectoral action and functional integration of various departments and programmes with the creation of a central convening structure for effective cross-sectoral coordination; broadening of nutritional activities beyond salt iodization and vitamin A coverage; central co-ordination of monitoring and evaluation and effective partnerships between the state and non-state sector around data production, awareness, advocacy, and monitoring.
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with focus on the aspects important for Catholic Social Teaching-driven management
Breakthrough innovations have come to light that have proved to be more than 95% effective in preventing HIV infection with injections just twice a year. Once a year might even be possible. They could also be key for 40 million people living with HIV around the world who need better options for trea...tment. It’s not a cure or a vaccine, but it could be a game-changer if made accessible to all who could benefit.
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interim Guidance 1 December 2020. Updated version
This document provides updated guidance on mask use in health care and community settings, and during home care for COVID-19 cases. It is intended for policy makers, public health and infection prevention and control professionals, health care manag...ers and health workers.
The Annex provides advice on how to manufacture non-medical masks. It is intended for those making non-medical masks at home and for mask manufacturers
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Asbestos, the most frequent cause of occupational cancer, continues to be consumed ona massive scale, with millions of people exposed on a daily basis. This review explains why we havefailed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestosvictims are like...ly to remain high. Emerging and developed countries have to be reminded that asbestosexposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by thesurge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking andstimulated by manufacturers.
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Le document est une boîte à outils sur le choléra élaborée par l'UNICEF, conçue pour soutenir la prévention, la préparation et la réponse aux épidémies de choléra. Il fournit des directives sur l'assainissement de l'eau, l'hygiène et l'éducation sanitaire, ainsi que des outils pratique...s et des ressources pour gérer les épidémies. Il est destiné aux équipes de l'UNICEF, aux gouvernements et aux partenaires afin d'intégrer la prévention du choléra dans les programmes de développement et les stratégies de réponse aux urgences.
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