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Expanding the Single-Visit Approach for Cervical Cancer Prevention: Successes and Lessons From Burkina Faso

Ouedraogo Y., Furlane G., Fruhauf T. et al. Global Health: Science and Practice (2018) CC

Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer...e limited to temporary screening campaigns. Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity. Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy. Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions. Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system. more

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Reducing surgical site infections in low-income and middle-income countries (FALCON): a pragmatic, multicentre, stratified, randomised controlled trial

Biccard, B.M.; V. Msosa, A.L Samateh et al. TheLancet (2021) CC

Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s... more

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Guideline for the Treatment of Leishmaniasis in the Americas
recommended

World Health Organization WHO (2022) C_WHO

2nd edition. These guidelines include several notable changes from the first edition. For cutaneous leishmaniasis, ketoconazole has been removed from the list of treatment options; the number of Leishmania species for which there is strong evidence for the efficacy of miltefosine has increased from ... more

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Surgical approaches to the urogenital manifestations of lymphatic filariasis

World Health Organization WHO (2019) C_WHO

During the 17 years since Surgical approaches to the urogenital manifestations of lymphatic filariasis was first published, there has been heightened awareness of the physical, economic and emotional burden of the genitourinary manifestations of filariasis. With the impetus to provide better guidanc... more

Hypertension - Screening, Diagnosis, Assessment, and Management of Primary Hypertension in Adultd in India

Ministry of Health & Family Welfare India Government of India (2017) CC

Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contributes to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven ... more

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Chemical and Biological Agents, Nuclear Events

Smithsonian Alerts (2018) C2

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Trastorno de ansiedad social: Más allá de la simple timidez

DEPARTAMENTO DE SALUD Y SERVICIOS HUMANOS DE LOS ESTADOS UNIDOS NIH (2017) CC

Si usted se ha sentido así durante por lo menos seis meses y estos sentimientos le hacen difícil hacer las tareas cotidianas, como hablar con otros en el trabajo o en la escuela, es posible que usted tenga un trastorno de ansiedad social.

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Trastorno de pánico: Cuando el miedo agobia

DEPARTAMENTO DE SALUD Y SERVICIOS HUMANOS DE LOS ESTADOS UNIDOS NIH (2017) C1

¿Hay ocasiones en que tiene ataques repentinos de ansiedad y temor abrumador que duran varios minutos? Tal vez el corazón le late rápidamente, comienza a sudar y siente como si no pudiera respirar o pensar. ¿Estos ataques ocurren en momentos impredecibles sin ningún factor desencadenante obvio... more

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Cuando Pensamientos Indeseados Toman Control: Trastorno Obsesivo-Compulsivo Instituto Nacional de la Salud Mental

Departemento de Salud y Servicios Humanos del los Esdados Unidos NIH (2010) C1

Trastornos de Ansiedad Personas que sufren trastornos de ansiedad se sienten extremada mente atemorizadas e inseguras. De vez en cuando, la mayoría de las personas sienten ansiedad por algo por un corto tiempo, pero quienes padecen trastornos de ansiedad se sienten así la mayor parte del tiempo. ... more