INTRODUCTION: Lower extremity peripheral artery disease (PAD) is increasing in prevalence in low- and middle-income countries creating a large health care burden. Clinical management may require sub...stantial resources but little consideration has been given to which treatments are appropriate for less advantaged countries.
EVIDENCE ACQUISITION: The aim of this review was to systematically appraise published data on the costs and effectiveness of PAD treatments used commonly in high-income countries, and for an international consensus panel to review that information and propose a hierarchy of treatments relevant to low- and middle-income countries.
EVIDENCE SYNTHESIS: Pharmacotherapy for intermittent claudication was found to be expensive and improve walking distance by a modest amount. Exercise and endovascular therapies were more effective and exercise the most cost-effective. For critical limb ischemia, bypass surgery and endovascular therapy, which are both resource intensive, resulted in similar rates of amputation-free survival. Substantial reductions in cardiovascular events occurred with use of low cost drugs (statins, ACE inhibitors, anti-platelets) and smoking cessation.
CONCLUSIONS: The panel concluded that, in low- and middle-income countries, cardiovascular prevention is a top priority, whereas a lower priority should be given to pharmacotherapy for leg symptoms and revascularisation, except in countries with established vascular units.
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This guideline covers identifying, assessing and managing the long-term effects of COVID-19, often described as ‘long COVID’. It makes recommendations about care in all healthcare settings for a...dults, children and young people who have new or ongoing symptoms 4 weeks or more after the start of acute COVID-19. It also includes advice on organising services for long COVID.
Updated 11 November 2021
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In the wake of the Covid‑19 Pandemic, parts of the public health system at increased risk of reduced efficiency include healthcare services for women and children. This in turn ...could reverse all the progress achieved over the years in reducing maternal and child mortality. In this study, an attempt has been made to assess the indirect effect of the pandemic on maternal and child health services in public health facilities.
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The "Norma Técnica de Salud para la Atención integral de las Personas Afectadas por Tuberculosis" (Technical Health Standard for the Integral Care of Persons Affected by Tuberculosis)
incorpor...ates important innovations that standardise the programmatic management of tuberculosis (TB).
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To achieve our vision of providing Universal access to safe, affordable surgical and anesthesia care when needed, the PGSSC is working with several Ministries of Health to develop National Surgical,... Obstetric and Anesthesia Plans (NSOAP). This is a national health plan specifically focused on surgical capacity and access in a country - something which has been traditionally not present in most national health plans.
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Background
Access to medicines is important for long‐term care of cardiovascular diseases and hypertension. This study provides a cross‐country assessment of availability, prices, and affordability of cardiovascular disease and hypertension med...icines to identify areas for improvement in access to medication treatment.
Methods and Results
We used the World Health Organization online repository of national essential medicines lists (EMLs) for 53 countries to transcribe the information on the inclusion of 12 cardiovascular disease/hypertension medications within each country's essential medicines list. Data on availability, price, and affordability were obtained from 84 surveys in 59 countries that used the World Health Organization's Health Action International survey methodology. We summarized and compared the indicators across lowest‐price generic and originator brand medicines in the public and private sectors and by country income groups. The average availability of the select medications was 54% in low‐ and lower‐middle‐income countries and 60% in high‐ and upper‐middle‐income countries, and was higher for generic (61%) than brand medicines (41%). The average patient median price ratio was 80.3 for brand and 16.7 for generic medicines and was higher for patients in low‐ and lower‐middle‐income countries compared with high‐ and upper‐middle‐income countries across all medicine categories. The costs of 1 month's antihypertensive medications were, on average, 6.0 days’ wage for brand medicine and 1.8 days’ wage for generics. Affordability was lower in low‐ and lower‐middle‐income countries than high‐ and upper‐middle‐income countries for both brand and generic medications.
Conclusions
The availability and accessibility of pharmaceuticals is an ongoing challenge for health systems. Low availability and high costs are major barriers to the use of and adherence to essential cardiovascular disease and antihypertensive medications worldwide, particularly in low‐ and lower‐middle‐income countries.
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The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core ...ght medbox">health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs).
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Online Course. Infection prevention and control (IPC) is an essential component of healthcare quality and patient safety. In this module you will learn how and why healthcare-associated infections (...HAIs) occur and how IPC reduces their risk and spread.
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TB heroes
Hello, my name is Nurse X
My job is to promote integrated HIV and TB prevention, care, treatment and support. This ensures that we, and my team of health ...ght medbox">care service providers treat everyone who is living with HIV and TB to have all the antiretroviral therapy (ART) and HIV care services are provided with TB diagnosis and treatment at one facility. Services that we provide include * Infection control education * TB screening and diagnosis * HIV testing * Treatment for those who require it * Adherence support
Accessed November 2017
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Antimicrobial resistance has become one of the most eminent threats to global health and a rising concern for healthcare specialists. All around the world, many common infections are becoming resist...ant to the antimicrobial medicines used to treat them, resulting in high morbidity and mortality with serious social and economic implications. Additionally, there are few new antibiotics being developed but they are expensive and are not new classes. Antimicrobials are critical in the management of infectious diseases. They are also essential tools for protecting animal health and welfare, and contribute in production of safe food. Inappropriate use of antimicrobials can lead to resistance which is known as the antimicrobial resistance (AMR) resulting in high morbidity and mortality with serious social and economic implications.
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospita...l stays, and the burden of antibiotic resistance while maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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This document provides guidance to African Union Member States based on a specific request from Member States for a checklist/guidance of the required personal protective equipment (PPE) needed by healthcare workers and ...hlight medbox">care givers for the Coronavirus Disease 2019 (COVID-19) pandemic. This document has been synthesised from currently available evidence (1-6), with consideration to the African context, and as such, can be adapted to the country context.
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A new publication - Waste Management during the COVID-19 Pandemic: from response to recovery - reviews current practices for managing waste from healthcare facilities, households and quarantine locations accommodating people with confirmed or suspec...ted cases of COVID-19. Jointly produced by UNEP, the Institute for Global Environmental Strategies and the International Environmental Technology Centre, the report considers various approaches, identifies best practices and technologies, and provides recommendations for policy-makers and practitioners to improve waste management, over the long term.
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In most contexts, the social stigma surrounding mental health issues exists because of cultural norms and a lack of understanding of mental health’s complexities and realities, resulting in isolat...ion, increased vulnerability, and lack of support for people with mental health problems.
This stigma has been exacerbated during COVID-19, as more people may need mental health or psycho-social support but cannot access it due to the cessation of in-person services and limited remote care option
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The meeting was held from 26 to 27 March 2018 to review and discuss the following topics:
Advances and challenges in the use of fTLC, and new approaches to detecting mycolactone using monoclonal antibodies (mAbs).
The status of development of rapid diagnostic tests (RDTs) targeting the MUL..._3720 protein.
The role of PCR as a reference test, and hurdles in providing a confirmatory diagnosis and in establishing a quality assurance programme.
New molecular tools with potential for implementation at a level lower than in the national or regional reference laboratory, such as loop-mediated isothermal amplification (LAMP) and recombinase polymerase amplification (RPA).
The need to harmonize and standardize methods for collection and preparation of specimens, so samples can be referred for diagnosis and stored for evaluation of new diagnostic tests in optimal conditions.
Barriers to accessing early diagnosis and treatment, including coordination at the programme level, and lack of adequate diagnostic tools.
Defining target product profiles (TPPs) to guide the development of new diagnostic tools that can be applied at different levels of the health system. Participants agreed that two TPPs would be developed to address the current gaps: (i) a rapid test for BU diagnosis at the primary health-care level; and (ii) a test for diagnosis of BU that can also assist in treatment monitoring and differential diagnosis at the district hospital or reference centre.
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The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the... principal cardiovascular diseases leading to death and disability. Atrial fibrillation (AF) is one of these conditions and is an increasing problem due to ageing of the world’s population and an increase in cardiovascular risk factors that predispose to AF. The goal of the AF roadmap was to provide guidance on priority interventions that are feasible in multiple countries, and to identify roadblocks and potential strategies to overcome them.
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With Asthma Day coming up, Edrine Osteen Mukalazi sat down with Dr. Rebecca Nantanda to discuss "Closing the gap on #Asthma care for children on the Health Pot show."
Leave on a comment and let ...us know whether this video has been educational for you.
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✽ Our guest Rebecca Nantanda ✽
⊳ Dr. Rebecca Nantanda is a member of the Institute Technical Board (ITB) of Makerere University Lung Institute.
⊳ She has been involved in research on respiratory diseases in children for the past 12 years with specific focus on pneumonia and asthma.
⊳ She has a number of publications in peer-reviewed journals and has made several presentations at International and Local Scientific conferences on the above subjects.
⊳ She is currently involved in research, clinical care and pre-service and in-service training of health care professionals.
⊳ Her qualifications contain MBChB (MUST), M.Med Paediatrics and Child Health (MUK), PhD, Postdoctoral Research Fellow, Sida- Makerere Research Program.
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Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence,
mortality, and ...activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethiopia using the American Thoracic Society/European Respiratory Society case definition of severe asthma.
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The volume presents data on the surgical burden of disease, disability, congenital anomalies, and trauma, along with health impact and economic analyses of procedures, platforms, and packages to improve ca...re in settings with severe budget limitations. Essential Surgery identifies 44 surgical procedures that meet the following criteria: they address substantial needs, are cost effective, and are feasible to implement in low- and middle-income countries. If made universally available, the provision of these 44 procedures would avert 1.5 million deaths a year and rank among the most cost effective of all health interventions.
Entire Volume large file: 19 MB!!!
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A new e-learning course has just been released, aimed at healthcare professionals working with patients in India exploring HPV screening and vaccination, assessment and diagnosis of cervical cancer, and palliative ... medbox">care for patients with advanced cervical cancer. The course was developed by ecancer in collaboration with Indian experts specialising in gynaecological cancers and supported by the National Cancer Grid, India - all the modules are completely open access and free to take.
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