A guide for practical implementation in adult and pediatric emergency department and urgent care settings
Antibiotic Stewardship (AS) is a coordinated program that promotes the appropriate use of antimicrobials to improve patient outcomes, reduce microbial resistance, and decrease the spread of multi-drug resistant organisms. In clinical settings, stewardship activities focus on measuring and improving ...how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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Rabies is a fatal viral zoonosis and serious public health problem.1 All mammals are believed to be susceptible to the disease, and for the purposes of this document, use of the term animal refers to mammals. The disease is an acute, progressive encephalitis caused by viruses in the genus Lyssavirus....
2 Rabies virus is the most important lyssavirus globally. In the
United States, multiple rabies virus variants are maintained in wild mammalian reservoir populations such as raccoons, skunks, foxes, and bats. Although the United States has been declared free from transmission of canine rabies virus variants, there is always a risk of reintroduction of these variants.The rabies virus is usually transmitted from animal to animal through bites. The incubation period is
highly variable. In domestic animals, it is generally 3 to 12 weeks, but can range from several days to months, exceeding 6 months.8 Rabies is communicable during the period of salivary shedding of rabies virus. Experimental and historic evidence documents that dogs, cats, and ferrets shed the virus for a few days prior to the onset of clinical signs and during illness. Clinical signs of rabies are variable and include inappetance, dysphagia, cranial nerve deficits, abnormal behavior, ataxia, paralysis, altered vocalization, and seizures. Progression to death is rapid. There are currently no known effective rabies antiviral drugs.
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En el presente documento se comunica el progreso logrado en la Región hacia la eliminación de la transmisión maternoinfantil del VIH y la sífilis entre los años 2010 y 2017. Se trata también del primer informe regional sobre la eliminación de la transmisión maternoinfantil y durante la prime...ra infancia de la hepatitis B y la enfermedad de Chagas congénita. Los resultados principales son los siguientes: El acceso de las embarazadas a la atención prenatal y del parto es alto en la Región de las Américas.
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Recommandations formalisées d'experts
Les procédures décrites dans cette POS concernent à la fois l'environnement dans lequel les tests
index sont effectués (par exemple, la construction d'une infrastructure qui garantit la confidentialité,
les formulaires disponibles sur place, le stockage des données physiques et numériques) ...et
également les actions requises des agents de santé qui effectuent le test index. Les personnes
chargées de la mise en œuvre de ces POS devront également connaître les POS concernant
l'identification et la réponse face à la violence dans le contexte des tests index. Les recommandations
relatives au contenu des services d'intervention en cas de violence sont fournies en Annexe A
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Die steigende Zahl der Menschen in Berlin ohne bzw. mit geringen Deutschkenntnissen führt zu einem wachsenden Mehrbedarf an Dolmetschleistungen in der Stadt. Sprachliche Hilfe bei der Verständigung in zahlreichen Lebensbereichen wird nötig – ob auf dem Amt, bei Arzt/Ärztin, vor Gericht oder de...m Standesamt. Beim Dolmetschen im Gemeinwesen stehen demnach gesellschaftliche Teilhabe und Inklusion im Mittelpunkt. Da Geflüchtete überdies oftmals von gewaltvollen Erfahrungen in den Heimatländern oder auf der Flucht erzählen müssen, kommt den Dolmetscher*innen und anderen beteiligten Akteur*innen hier eine besondere Verantwortung im Umgang mit ihnen zu. Nicht selten werden in diesem Kontext die Grenzen zwischen der beruflichen und der persönlichen Position der Dolmetscher*innen überschritten.
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Schistosomiasis is a helminthic infection and one of the neglected tropical diseases (NTDs). It is caused by blood flukes of the genus Schistosoma. It is an important public health problem, particularly in poverty-stricken areas, especially those within the tropics and subtropics. It is estimated th...at at least 236 million people worldwide are infected, 90% of them in sub-Saharan Africa, and that this disease causes approximately 300,000 deaths annually. The clinical manifestations are varied and affect practically all organs. There are substantial differences in the clinical presentation, depending on the phase and clinical form of schistosomiasis in which it occurs. Schistosomiasis can remain undiagnosed for a long period of time, with secondary clinical lesion. Here, we review the clinical profile of schistosomiasis. This information may aid in the development of more efficacious treatments and improved disease prognosis.
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A wide spectrum of disease severity has been described for Human African Trypanosomiasis (HAT) due to
Trypanosoma brucei rhodesiense (T.b. rhodesiense), ranging from chronic disease patterns in southern countries of East Africa to an increase in virulence towards the north. However, only limited d...ata on the clinical presentation of T.b. rhodesiense HAT is available. From 2006-2009 we conducted the first clinical trial program (I MPAMEL III) in T.b. rhodesiense endemic areas of
Tanzania and Uganda in accordance with international standards (ICH-GCP). The primary and secondary outcome measures were safety and efficacy of an abridged melarsoprol schedule for treatment of second stage disease. Based on diagnostic findings and clinical examinations at baseline we describe the clinical presentation of T.b. rhodesiense HAT in second stage patients from two distinct geographical settings in East Africa.
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Arsenical monotherapies were previously very successful for treating human African trypanosomiasis (HAT).
Melarsoprol resistance emerged as early as the 1970s and was widespread by the late 1990s.
Melarsoprol resistance represents the only example of widespread drug resistance in HAT patients wher...e the genetic mechanism has been established.
The current goal of elimination of HAT as a public health problem by 2020 may be undermined by the emergence and spread of resistance to current or new drugs.
Insights into potential resistance mechanisms for current and new drugs will facilitate predictions of the likelihood of resistance and will also facilitate rational approaches to minimizing, monitoring, and tackling the future emergence of resistance.
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Ce guide de référence a pour objectif d’expliquer en détail pourquoi la santé doit être intégrée dans la planification urbaine et territoriale et comment y parvenir. Il réunit deux éléments essentiels dont nous avons besoin pour construire des villes habitables sur une planète habitable... : les processus pour guider le développement des établissements humains — appelés dans cet ouvrage « Planification Urbaine et Territoriale » (PUT) ; et le souci de la santé humaine, du bien-être et de l’équité en matière de santé à tous les niveaux – du local au mondial et de la santé humaine à la santé planétaire.
Ce guide de référence identifie une sélection complète de ressources et d’outils existants pour soutenir l’intégration de la santé dans la PUT : notamment des activités de plaidoyers, des points d’entrées et des conseils, ainsi que des outils et des études de cas illustratifs. Toutefois, il ne fournit pas de prescriptions pour des scénarios spécifiques – ceux-ci doivent être déterminés par le contexte, les personnes et les ressources disponibles.
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La santé mentale fait partie intégrante de notre santé et de notre bien-être en général et constitue un droit humain fondamental. À l'échelle mondiale, les problèmes de santé mentale sont très répandus. Selon les données de l'Organisation mondiale de la Santé (OMS), environ une personn...e sur huit dans le monde vit avec un trouble mental (OMS, 2022a). Les troubles mentaux sont la principale cause d'incapacité, entraînant 1 année sur 6 vécues avec une incapacité (OMS, 2022a).
Les personnes atteintes de troubles mentaux graves meurent en moyenne 10 à 20 ans plus tôt que la population générale, principalement en raison de maladies physiques évitables. Des circonstances défavorables, notamment la pauvreté, inégalités sociales et économiques, urgences de santé publique, guerres et crise climatique, font partie des menaces structurelles mondiales pour la santé mentale, entraînant un risque plus élevé de souffrance de problèmes de santé mentale.
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This was a Phase 3, multi-center, randomized, open-label, parallel-group, active control study where 273 male and female patients with first stage Trypanosoma brucei gambiense HAT were treated at six sites: one trypanosomiasis reference center in Angola, one hospital in South Sudan, and four hospita...ls in the Democratic Republic of the Congo between August 2005 and September 2009 to support the registration of pafuramidine for treatment of first stage HAT in collaboration with the United States Food and Drug Administration. Patients were treated with either 100 mg of pafuramidine orally twice a day for 10 days or 4 mg/kg pentamidine intramuscularly once daily for 7 days to assess the efficacy and safety of pafuramidine versus pentamidine. Pregnant and lactating women as well as adolescents were included.
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The sub-Saharan African region, carries 90% of the over 250 million cases of schistosomiasis occurring worldwide. In this region, after Nigeria, Tanzania is second country having the highest cases of schistosomiasis and approximately 51.5%0 of the Tanzanian population is either exposed or live in ar...eas with high risk of exposure. The country is endemic to both Schistosoma mansoni and Schistosoma haematobium, these infections are common in communities characterised with limited access to water, sanitation, hygienic practices and health services. Schistosoma mansoni infection is associated with hepatosplenic disease characterised with hepatomegaly, splenomegaly, progressive periportal fibrosis (PPF) which can lead to portal hypertension and its related sequelae, mainly ascites, liver surface irregularities, oesophageal varices and haematemesis. The main consequences of S. haematobium infection are haematuria, dysuria, nutritional deficiencies, urinary bladder lesions, hydronephrosis, urinary bladder squamous cell carcinoma and in children, growth retardation. Preventive chemotherapy using mass drug administration (MDA) of praziquantel targeting primary school aged children is the main strategy for controlling schistosomiasis in Tanzania.
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After five consecutive below-average rains, the humanitarian crisis in the Horn of Africa is expanding and deepening.
Combined with insecurity and macroeconomic volatility, the impact of the drought on food and nutrition security has been devastating. Across Ethiopia, Kenya and Somalia, an estima...ted 22 million people are now acutely food insecure because of the drought. The malnutrition situation is also critical. Some 5.1 million children across drought-affected areas of the three countries are acutely malnourished in 2023, with dire implications for their health, growth and survival. Concerningly, the upcoming March-May 2023 rains are also forecast to be below-average. Should these rains fail, and humanitarian assistance not be delivered at scale, food insecurity will continue to deteriorate.
Regardless of how the 2023 rains perform, extremely high humanitarian needs will persist through 2023 while a full recovery from a drought of this magnitude will take years. To address the devastating drought-induced hunger and malnutrition across the region, WFP is pursuing an integrated dual track approach; meeting immediate life-saving food and nutritional needs while simultaneously building resilience to extreme climate variability.
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Investing in Child Protection
Building Inclusive, Productive and Resilient Communities in Malawi
A qualitative assessment of knowledge gaps about female genital schistosomiasis among communities living in Schistosoma haematobium endemic districts of Zanzibar and Northwestern Tanzania.
PloS Neglected Tropical Diseases September 30, 2021 https://doi.org/10.1371/journal.pntd.0009789
Schistosoma... haematobium causes urogenital schistosomiasis and is widely distributed in Tanzania. In girls and women, the parasite can cause Female Genital Schistosomiasis (FGS), a gynecological manifestation of schistosomiasis that is highly neglected and overlooked by public health professionals and policy makers. This study explored community members’ knowledge, attitudes and perceptions (KAP) on and health seeking behavior for FGS.
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El objetivo de estas directrices es presentar el conjunto completo de recomendaciones y declaraciones de buenas prácticas de la OMS sobre el aborto
(African Development Bank policy research document 1)
The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without health aid. It also presents a theoretic...al model of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
Between 2000 and 2014, malaria control efforts were scaled up and worldwide deaths were cut in half. But declining health aid and deprioritized vertical aid (as for malaria), despite its potentially great efficiency, have led to rising numbers of cases. In 2016, 216 million cases of malaria were reported, up from 211 million in 2015. Africa was home to 90% of all malaria cases and 91% of malaria deaths in 2016. Progress appears to have stalled in the global fight against the disease.
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El informe de este año presenta una actualización de la situación de la seguridad alimentaria y la nutrición en América Latina y el Caribe, incluyendo también estimaciones actualizadas sobre el costo y la asequibilidad de una dieta saludable (Parte 1). Además, el informe examina el complejo e...scenario económico y social de la región y su impacto en el costo de las dietas saludables, para luego entregar un examen del costo y la asequibilidad de una dieta saludable a nivel subregional y nacional, incluyendo las asociaciones entre la inasequibilidad de una dieta saludable y los indicadores socioeconómicos y nutricionales (Parte 2). Además, esta edición del Panorama regional presenta un análisis de algunas políticas alimentarias y agrícolas que se están implementando en la región y que tienen el potencial de apoyar el acceso a dietas saludables, así como los factores y dinámicas a través de los cuales éstas actúan.
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