Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu...s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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This article summarises the process involved in developing the updated guideline and includes an infographic to highlight key IPC recommendations from the guideline, following the patient care pathway from the community to a ...o-highlight medbox">healthcare facility to discharge.
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The messages should be used to inform, educate and engage different audience groups depending on their level of risk, vulnerability, presence in contact areas, care of patients with Ebola, or engagement or attendance of burials.
This document provides guidance for countries on how to implement activities to achieve the interruption of yaws transmission. It is intended for use by national yaws eradication programmes, partners involved in the implementation of yaws eradicatio...n activities and WHO technical staff who provide technical support to countries in the eradication of yaws.
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A concept (leaflet)
This document outlines the concept of a stimulus package for rabies elimination. The aim of a stimulus package is to catalyse rabies control by starting community projects, building local capacity and using success to generate momentum for growth. Governments could apply for... a package, which would provide technical and material support to run small, successful rabies control projects. These in turn build evidence for the feasibility of larger scale elimination, generate enthusiasm foaction and promote investment for sustainability and up scaling. Data reporting in return for the packages would allow the documentation of successes and lessons learnt to benefit global elimination efforts more broadly.
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Policy brief. HIV testing services (HTS) and anti-retroviral therapy (ART) have been scaled up substantially. It is estimated that, globally, nearly 80% of people with HIV now know their status. With the offer of immediate ART initiation and improved treatment options, access to and uptake of treatm...ent have increased, too. Now, most people with HIV who know their status are obtaining treatment and care.
In response to these changes in the global HIV epidemic, WHO is encouraging countries to use three consecutive reactive tests for an HIV-positive diagnosis as their treatment-adjusted prevalence and national HTS positivity fall below 5% .
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9 April 2020
WHO has published the guidance “Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected” This document is intended for clinicians taking care of hospitalized adult and paediatric patients... with severe acute respiratory infection (SARI) when COVID-19 infection is suspected. Optimized supportive care should be provided to ensure the best possible chance for survival of COVID-19 patients as described in the WHO guidance:
1. Management of severe COVID-19 requires oxygen therapy and monitoring. Supplemental oxygen therapy should be given immediately to patients with SARI and respiratory distress, hypoxaemia or shock.
2. Management of critical COVID-19 (acute respiratory distress syndrome (ARDS)) requires advanced oxygen/ventilatory support.
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19 February 2021
The overall objective of this prospective meta-analyses (PMA) is to estimate the effect of anti-IL-6 therapy compared with usual care in hospitalized patients with suspected or confirmed COVID-19. The primary comparison is of the c...lass effect of anti-IL-6 therapies. It will also estimate the effects of specific anti-IL-6 therapies.
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Development of one or more vaccines for Neisseria gonorrhoeae is an important objective for sexual and reproductive health worldwide, and for the fight against antimicrobial resistance.
WHO preferred product characteristics (PPCs) ...tribute-to-highlight medbox">provide strategic guidance as to WHO’s preferences for new vaccines in priority disease areas. PPCs are intended to encourage innovation and development of vaccines for use in settings most relevant to the global unmet public health need.
Gonococcal vaccine PPCs describe global public health goals for gonococcal vaccines and preferred parameters pertaining to vaccine indications and target populations, safety and efficacy considerations, and immunization strategies.
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This document summarizes the results of the WHO-commissioned full value proposition for new tuberculosis (TB) vaccines. The assessment was commissioned to provide early evidence for national and global decision-makers involved in TB vaccine developm...ent and implementation, who include stakeholders involved in vaccine research, financing, regulation and policy-making, manufacturing, introduction and procurement. The goal is to accelerate development of effective vaccines against TB and their rapid introduction into countries.
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This report includes analysis from informal regional consultations in the African Region, the Caribbean and North America, Latin America, South-East Asia Region, European Region, Eastern Mediterranean Region, alongside three forums in the Western Pacific Region. It analyses the overarching similarit...ies, regional nuances and priorities raised across the six WHO regions for the meaningful engagement of individuals with lived experience.
It is the second publication in the WHO Intention to action series, which aims to enhance the limited evidence base on the impact of meaningful engagement and address the lack of standardized approaches on how to operationalise meaningful engagement. The Intention to action series aims to do this by providing a platform from which individuals with lived experience, and organizational and institutional champions, can share solutions, challenges and promising practices related to this cross-cutting agenda. The Intention to action series also aims to provide powerful narratives, inspiration and evidence towards the Fourth United Nations High Level Meeting on NCDs in 2025 and achieving the 2030 United Nations Sustainable Development Goals (SDGs).
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Evidence for technical update of pocket book recommendations. Newborn conditions, dysentery, pneumonia, oxygen use and delivery, common causes of fever, severe acute malnutrition and supportive care
Chapter 1 provides new data on the latest developments in the global treatment effort, highlighting positive trends as well as aspects that require improvement. Chapter 2 summarizes the impact of the scale-up in reducing AIDS-related mortality and n...ew HIV infections. Chapter 3 examines the sequence of steps in the continuum of care from HIV diagnosis to successful provision of ART services and outlines key supportive innovations. Chapter 4 discusses the implications and anticipated impact of the new "Consolidated guidelines on the use of ARV drugs for treating and preventing HIV infection
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Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei...ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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"Achieving, maintaining and improving accuracy, timeliness and reliability are major challenges for health laboratories. Countries worldwide committed themselves to build national capacities for the detection of, and response to, public ..."attribute-to-highlight medbox">health events of international concern when they decided to engage in the International Health Regulations implementation process. Only sound management of quality in health laboratories will enable countries to produce test results that the international community will trust in cases of international emergency. This handbook is intended to provide a comprehensive reference on Laboratory Quality Management System for all stakeholders in health laboratory processes, from management, to administration, to bench-work laboratorians. This handbook covers topics that are essential for quality management of a public health or clinical laboratory. They are based on both ISO 15189 and CLSI GP26-A3 documents"--Page 7.
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1st edition.
Unitaid’s report describes a slate of new devices that can more efficiently identify dangerously ill children so that they can be treated immediately. These tools make it easier to recognize danger signs, and support integrated approaches to reducing childhood deaths from the three ...greatest childhood killers: malaria, pneumonia and diarrhoea.
The report also highlights tests that can determine whether or not a child has an illness that can be treated with antibiotics. Viral infections are a common cause of childhood fevers, but cannot be cured with antibiotics. Although many children seeking care at clinics have fever, three-quarters by some estimates, only a small fraction of those have an illness that can be treated with an antimalarial or antibiotic drug
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Infectious disease outbreaks are periods of
great uncertainty. Events unfold, resources
and capacities that are often limited
are stretched yet further, and decisions
for a public health response must be
made quickly, even though the evide...nce
for decision-making may be scant. In
such a situation, public health officials,
policy-makers, funders, researchers, field
epidemiologists, first responders, national
ethics boards, health-care workers, and public
health practitioners need a moral compass
to guide them in their decision-making.
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This new guideline on non-clinical interventions to reduce unnecessary caesarean sections incorporates the views, fears and beliefs of both women and health professionals about caesarean sections. It also considers the complex dynamics and limitatio...ns of health systems and organizations and relationships between women, health professionals and organization of health care services.
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Q7. SCOPING QUESTION: In adults with moderate-severe depressive disorder, what is the effectiveness and safety of antidepressant medication (ADM) in comparison with psychological treatment?
The WHO mhGAP programme’s existing guidelines recommend that either structured brief psychological treatm...ents (e.g., interpersonal psychotherapy or cognitive behavioural therapy, including behavioural activation) or antidepressant medication (e.g., SSRIsi and tricyclic antidepressants) be considered in adults with moderate-severe depression. Health care workers need to know whether these treatments have different effects, including side-effects, in treating depressive disorder in the short and long term, in order to improve clinical decision-making.
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The revised guidelines contain recommendations for specific administrative, environmental controls and respiratory protection, following the assessment made by an external group of experts convened as members of the Guideline Development Group. Moreover, these guidelines focus on interventions speci...fic to preventing transmission of Mycobacterium tuberculosis bridging with the core components of infection prevention and control programmes at the national and acute health care facility level
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