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This is a detailed manual giving a step by step approach to undertaking the pharmacovigilance of antiretrovirals. It is intended to be a source of practical advice for Pharmacovigilance Centres and health professionals involved in HIV/AIDS prevention and t
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reatment programmes. A number of WHO publications are available that provide a background to pharmacovigilance and, as far as possible, that material will not be repeated here. Health officials, planners, the staff of Pharmacovigilance Centres, public health teams and all health workers should become familiar with these publications, which are: • Safety of Medicines: A guide to detecting and reporting adverse drug reactions
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t hospitals and some accredited health centres) will need
to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB
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Management of MDR-TB: a field guide was created to help health workers
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After 100 years of chemotherapy with impractical and toxic drugs, an oral cure for human African trypanosomiasis (HAT) is available: Fexinidazole. In this case, we review the history of drug discovery for HAT with special emphasis on the discovery,
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pre-clinical development, and operational challenges of the clinical trials of fexinidazole. The screening of the Drugs for Neglected Diseases initiative (DNDi) HAT-library by the Swiss TPH had singled out fexinidazole, originally developed by Hoechst (now Sanofi), as the most promising of a series of over 800 nitroimidazoles and related molecules. In cell culture, fexinidazole has an IC50 of around 1 µM against Trypanosoma brucei and is more than 100-fold less toxic to mammalian cells. In the mouse model, fexinidazole cures both the first, haemolymphatic, and the second, meningoencephalitic stage of the infection, the latter at 100 mg/kg twice daily for 5 days. In patients, the clinical trials managed by DNDi and supported by Swiss TPH mainly conducted in the Democratic Republic of the Congo demonstrated that oral fexinidazole is safe and effective for use against first- and early second-stage sleeping sickness. Based on the positive opinion issued by the European Medicines Agency in 2018, the WHO has released new interim guidelines for the treatment of HAT including fexinidazole as the new therapy for first-stage and non-severe second-stage sleeping sickness caused by Trypanosoma brucei gambiense (gHAT). This greatly facilitates the diagnosis and treatment algorithm for gHAT, increasing the attainable coverage and paving the way towards the envisaged goal of zero transmission by 2030.
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Combination therapy is a cornerstone of modern malaria treatment, particularly in the context of widespread multidrug resistance. Using two or more antimalarial drugs with different mechanisms simultaneously enhances efficacy, shortens
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treatment duration, improves compliance and delays the development of resistance. Artemisinin-based combination therapies (ACTs), such as artemether–lumefantrine, artesunate–amodiaquine and artesunate–sulfadoxine/pyrimethamine, are highly effective in rapidly clearing parasites and reducing gametocyte carriage. They are also generally well tolerated. Non-artemisinin combinations, quinine-based regimens and novel combinations (e.g. piperaquine–dihydroartemisinin) offer alternative therapeutic options, although clinical experience with these remains limited. Although ACTs are the preferred first-line treatment, factors such as cost, local drug resistance patterns, safety during pregnancy and paediatric use must inform implementation and policy decisions.
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This guide is a resource for physicians and other health care professionals who provide care and treatment to patients with drug-resistant tuberculosis.
The World Health Organization's fact sheet on opioid overdose highlights the significant global health issue posed by opioids, which include natural, semi-synthetic, and synthetic compounds used primarily for pain management. Misuse and unsupervised use can lead to dependence and severe health probl
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ems. In 2019, approximately 600,000 deaths were attributed to drug use, with nearly 80% related to opioids; about 25% of these were due to overdose. An opioid overdose is characterized by pinpoint pupils, unconsciousness, and breathing difficulties. The fact sheet emphasizes the importance of increasing access to naloxone, an opioid antagonist that can rapidly reverse overdose effects, and advocates for training individuals likely to witness an overdose in its administration. It also underscores the need for comprehensive strategies, including preventive measures, treatment for opioid dependence, and policies to reduce opioid availability.
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The pamphlet "What is Addiction" explains addiction as a chronic, relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences. It highlights the dangers of different
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drug categories, including sedatives, stimulants, and hallucinogens, and their potential health and behavioral impacts. The document emphasizes the importance of combined medication and behavioral therapy in the treatment process, including detoxification, ongoing therapy, and relapse prevention. Additionally, it provides contact information for addiction treatment resources.
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The Updated guidelines on Management of tuberculosis in children and adolescents include new recommendations that cover diagnostic approaches for TB, shorter treatment for children with non-severe drug
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-susceptible TB, a new option for the treatment of TB meningitis, the use of bedaquiline and delamanid in young children with multidrug- and rifampicin-resistant TB and decentralized and family-centred, integrated models of care for TB case detection and prevention in children and adolescents.
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Substance abuse, is a dangerous relapsing brain disease requiring intensive treatment in a professional setting. Someone who is suffering from substance abuse will have cravings and compulsive drug
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use that persists even in the face of negative consequences. Although substance abuse may start out as voluntary, over time, the drug changes the way the brain works, leading to tolerance and addiction.
This site is focused on creating clear, accessible, and trustworthy content on substance abuse
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BMC Infectious Diseases (2019) 19:832
Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using
praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children
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and does not include neither adult individuals nor other public health measures. The Ijinga schistosomiasis project
examines the impact of an intensified treatment protocol with praziquantel MDA in combination with additional
public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly
endemic African setting using an integrated community-based approach.
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Antimalarial chemotherapy is crucial for reducing morbidity, mortality, and drug resistance, and is the cornerstone of malaria control. Existing antimalarial drugs act at different stages of the parasite’s life cycle. These drugs range from classi
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c agents such as chloroquine and quinine to newer artemisinin derivatives. They include tissue schizonticides, blood schizonticides, gametocytocides, and sporontocides. Artemisinin and its derivatives are the most effective and fastest-acting treatment against drug-resistant Plasmodium falciparum, achieving rapid parasite clearance and reducing transmission potential. Other key drugs include mefloquine, halofantrine, proguanil, sulfadoxine–pyrimethamine, atovaquone–proguanil, tetracyclines, clindamycin and azithromycin. Each of these drugs has a specific mechanism of action, pharmacokinetics, efficacy, safety profile and contraindications. Rational drug combinations and adherence to national treatment guidelines are essential for managing resistance, ensuring safety in vulnerable populations such as children and pregnant women, and optimising therapeutic outcomes in cases of both uncomplicated and severe malaria.
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Understand HIV transmission, prevention strategies, and treatment advances including antiretroviral therapy and PrEP. Access medical lectures and research updates on YouTube from Harvard, medical professionals, and health organizations covering
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drug resistance, vaccine development, and co-infections.
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Multi-month dispensing (MMD) is the prescribing and dispensing of three to six months of antiretrovirals
(ARV) and other medicines required for treatment of people living with HIV (PLHIV). This approach is in
contrast to the current standard of ca
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re approach where drug dispensing requires monthly clinical visits.
While many programs have moved to providing MMD for adults, implementation in children has been
particularly challenging. MMD takes a client-centered approach and has the promise of improving and
sustaining continuity of treatment and rates of viral suppression (VS), as well as reducing the provider the
provider workload and other burdens on the health system.
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Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmatic management of
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drug-resistant TB has been developed and forms part of the Five Year National Strategic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols more
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols more
Chagas disease affects approximately 6 million people, mainly in Latin America. Less than 1% of affected individuals receive proper antiparasitic treatment, and current drugs are inadequate to fight the entire spectrum of the disease. Against this b
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ackground, Novartis is pursuing an end-to-end approach, with activity on three fronts: drug discovery, clinical research and health system strengthening.
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The WHO South-East Asia (SEA) Region bears a high burden of tuberculosis (TB) and MDR-TB. In 2015, the Region accounted for nearly 200 000 or 35% of the global estimated new RR/MDR-TB cases eligible for treatment. Extensively
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drug-resistant TB (XDRTB) has also been reported from six countries of the SEA Region. MDR-TB could potentially replace drug-susceptible TB, and constitutes a threat to global public health security. The South- East Asia Regional Response Framework for DR-TB 2017–2021 complements the Ending TB in the South-East Asia Region: Regional Strategic Plan 2016–2020” and outlines key strategies for reducing morbidity, mortality and transmission of DR-TB.
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Front. Public Health 9:622809
The control and elimination of schistosomiasis have over the last two decades involved several strategies, with the current strategy by the World Health Organization (WHO) focusing mainly on treatment with praziquantel
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during mass drug administration (MDA). However, the disease context is complex with an interplay of social, economic, political, and cultural factors that may affect achieving the goals of the Neglected Tropical Disease (NTD) 2021-2030 Roadmap. There is a need to revisit the current top-down and reactive approach to schistosomiasis control among sub-Saharan African countries and advocate for a dynamic and diversified approach.
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