This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stake- holders. It recommends a combination of measures aimed at reducing the risk of TB... transmission within populations. The emphasis is on early and rapid diagnosis, and proper management of TB patients.
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Joining efforts to control two trelated global epidemics.
Consolidated Guidelines
Geneva, 2016
The End TB Strategy
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 so...uthern countries of East Africa to an increase in virulence towards the north. However, only limited data 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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This World Health Organization (WHO) and the International Labour Organization (ILO) joint guidelines production aims at harnessing the contribution of employers and workers towards the control of TB. It covers all the practical steps involved in es...tablishing TB control activities, including (for large employers) starting and running a workplace TB control programme. They are intended for use in all countries in which TB incidence is high and the target audience for the guidelines includes employers, employee organizations, NTP managers, and agencies providing technical support for TB control.
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NATIONAL TUBERCULOSIS AND LEPROSY PROGRAMME
This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though ...="attribute-to-highlight medbox">TB-focused in name, it offers integration-oriented assessment, design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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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 drug-resistant ...ute-to-highlight medbox">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
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Specific measures are being taken within the National Tuberculosis Control Programme (NTP) to address the MDR TB problem through appropriate management of patients and strategies to prevent the propagation and dissemination of MDR ...bute-to-highlight medbox">TB.
The term "Programmatic Management of Drug Resistant TB" (PMDT) refers to programme based MDR TB diagnosis, management and treatment. This guideline promotes full integration of basic TB control and PMDT activities under the NTP, so that patients with TB are evaluated for drug resistance and are placed on the appropriate treatment regimen and properly managed from the outset of treatment, or as early as possible. The guidelines also integrate the identification and treatment of more severe forms of drug resistance, such as extensively drug resistant TB (XDR TB).
At the end, the guideline introduces new standards for registering, monitoring and reporting outcomes of multidrug resistant TB cases.
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To better adapt current case management practices and address excess mortality in otherwise treatable
cases will require better knowledge of the demographic characteristics of the patients and comorbidities
which can make severe dehydration harder... to tolerate physiologically. With this in mind, a scoping review
was undertaken, to explore the literature and summarise the existing evidence on cholera mortality and
reported risk factors.
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Background
Cardiovascular diseases (CVDs) are one of the global leading causes of concern due to the rising prevalence and consequence of mortality and disability with a heavy economic burden. The objective of the current study was to analyze the t...rend in CVD incidence, mortality, and mortality-to-incidence ratio (MIR) across the world over 28 years.
Methods
The age-standardized CVD mortality and incidence rates were retrieved from the Global Burden of Disease (GBD) Study 2017 for both genders and different world super regions with available data every year during the period 1990–2017. Additionally, the Human Development Index was sourced from the United Nations Development Programme (UNDP) database for all countries at the same time interval. The marginal modeling approach was implemented to evaluate the mean trend of CVD incidence, mortality, and MIR for 195 countries and separately for developing and developed countries and also clarify the relationship between the indices and Human Development Index (HDI) from 1990 to 2017.
Results
The obtained estimates identified that the global mean trend of CVD incidence had an ascending trend until 1996 followed by a descending trend after this year. Nearly all of the countries experienced a significant declining mortality trend from 1990 to 2017. Likewise, the global mean MIR rate had a significant trivial decrement trend with a gentle slope of 0.004 over the time interval. As such, the reduction in incidence and mortality rates for developed countries was significantly faster than developing counterparts in the period 1990–2017 (p < 0.05). Nevertheless, the developing nations had a more rather shallow decrease in MIR compared to developed ones.
Conclusions
Generally, the findings of this study revealed that there was an overall downward trend in CVD incidence and mortality rates, while the survival rate of CVD patients was rather stable. These results send a satisfactory message that global effort for controlling the CVD burden was quite successful. Nonetheless, there is an urgent need for more efforts to improve the survival rate of patients and lower the burden of this disease in some areas with an increasing trend of either incidence or mortality.
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Dans la plupart des pays, les services de lutte contre la tuberculose (TB) sont décentralisés jusqu’aux dispensaires
les plus périphériques et souvent au sein même des villages et des quartiers. Par contre, les services
de lutte contre le V...IH/Sida sont généralement beaucoup plus centralisés parce que la diffusion des
soins, notamment de la thérapie antirétrovirale (TARV), n’a commencé qu’assez récemment. De ce fait,
les patients qui ont besoin d’un traitement à la fois contre la tuberculose et le VIH/Sida peuvent être obligés
de se rendre dans deux établissements distincts et ainsi d’avoir à parcourir de longues distances pour
accéder aux soins. L’absence de services intégrés TB/VIH peut provoquer des retards dans le diagnostic
et le traitement, et même se traduire par un mauvais suivi des traitements, voire par des interruptions. Par
ailleurs, les patients ont à supporter la charge financière des frais de déplacement et des autres coûts indirects,
tels que de longs temps d’attente et une perte de revenu
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