Les présentes lignes directrices ont pour objet de préparer les pays d’endémie à arrêter l’AMM à l’issue du traitement, à passer à la surveillance post-thérapeutique ainsi qu’à confirmer l’interruption de la transmission à l’issue de la phase 2 et à débuter la surveillance p...ost-élimination.
Le but est de fournir un outil actualisé pour atteindre et vérifier l’élimination de la
transmission d’Ovolvulus à l’issue des programmes d’élimination de l’onchocercose qui utilisent principalement l’AMM.
Les objectifs sont de :
• formuler des recommandations basées sur des preuves à l’intention des prestataires de soins et des décideurs en matière de politique pour démontrer et confirmer l’interruption de la transmission d’O. volvulus avant, pendant et après la surveillance post-thérapeutique ;
• informer les utilisateurs finaux des procédures nécessaires pour vérifier l’élimination de l’onchocercose humaine.
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HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination...; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
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Background
Chronic congestive heart failure is a common condition that, if untreated, markedly impairs the quality of life and is associated with a high risk of recurrent hospitalization and death.
Methods
This review is based on articles retrieved by a selective search in PubMed, as well as on r...elevant guidelines.
Results
Evidence-based treatment options are available only for congestive heart failure with a low ejection fraction. Pharmacotherapy is based on neurohumoral inhibition of the renin-angiotensin-aldosterone system and the adrenergic system. The prognosis of patients with this condition has been further improved recently through the introduction of combined angiotensin receptor antagonists and neprilysin inhibitors. Modern implantable devices are a further component of treatment. Implantable defibrillators and special pacemakers for cardiac resynchronization are well established; the utility of alternative devices (baroreflex modulation or cardiac contractility modulation) needs to be investigated in further studies. It was recently shown that the catheter-based treatment of secondary mitral regurgitation with a MitraClip improves the outcome of selected patients.
Conclusion
The treatment of chronic systolic heart failure as recommended in the relevant guidelines, with drugs and implanted devices if indicated, can significantly improve the clinical outcome.
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