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1
Core Elements of Hospital Antibiotic Stewardship Programs. Antibiotic Stewardship Program Assessement Tool
recommended
Centers for Disease Control and Prevention CDC
Centers for Disease Control and Prevention (CDC)
(2019)
C_CDC
A growing body of evidence demonstrates that hospital based programs dedicated to improving antibiotic use, commonly referred to as “Antibiotic Stewardship Programs (ASPs),” can both optimize the treatment of infections and reduce adverse events
...
associated with antibiotic use. This document summarizes core elements of successful hospital Antibiotic Stewardship Programs. It complements existing guidelines on ASPs from different American organizations.
more
This joint publication by UNAIDS and WHO emphasizes the importance of integrating HIV prevention, testing, treatment and care and mental health services for people living with HIV. It provides a compilation of tools, best practices, recommendations
...
and guidelines that facilitate the integration of interventions and services to address the interlinked issues of mental health and HIV. This publication is intended for global, regional and national policy-makers; programme implementers including at subnational levels; organizations working in and providers of HIV and mental health services; civil society; and community-based and community-led organizations and advocates.
more
Updated recommendations on simplified service delivery and diagnostics for hepatitis C infection
recommended
Policy Brief. 24 June 2022. This policy brief, one of two on the updated hepatitis C (HCV) guidelines, focuses on the new recommendations on simplified service delivery for a public health approach to HCV testing, care and
...
treatment. These recommendations include decentralization, integration and task-sharing, in addition to the use of point-of-care (POC) HCV viral load assays and reflex viral load testing.
more
As of 12 December 2022, over 645 million people worldwide have been diagnosed with COVID-19, with over 6.6 million deaths (4).
The Omicron variant, which emerged in late November 2021, and its subvariants, are now the dominant circulating viruses, contributing to the ongoing surge in several countr
...
ies (4). Vaccination has substantially reduced case numbers and hospitalizations in many countries,but limitations in global access to vaccines mean that many populations, including those in low- and middle-income countries, remain vulnerable. Even in vaccinated individuals, uncertainties remain about duration of protection and efficacy, and the degree of crossprotection with new variants.
There remains a need for more effective treatment and management for those affected by COVID-19. The pandemic – and the
explosion of both research and misinformation – has highlighted the need for trustworthy, accessible and regularly updated living
guidelines to place emerging findings into context and provide clear recommendations for clinical practice
more
The many faces of diabetes. Is there a need for re-classification? A narrative review
Sakran, N.; Graham, Yiitka.; Pintar, T.; et al.
BMC Endocrine Disorders Volume 22 Article Number 9
(2022)
CC
The alarming rise in the worldwide prevalence of obesity and associated type 2 diabetes mellitus (T2DM) have reached epidemic portions. Diabetes in its many forms and T2DM have different physiological backgrounds and are difficult to classify. Bariatric surgery (BS) is considered the most effective
...
treatment for obesity in terms of weight loss and comorbidity resolution, improves diabetes, and has been proven superior to medical management for the treatment of diabetes. The term metabolic surgery (MS) describes bariatric surgical procedures used primarily to treat T2DM and related metabolic conditions. MS is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Originally, BS was used as an alternative weight-loss therapy for patients with severe obesity, but clinical data revealed its metabolic benefits in patients with T2DM. MS is more effective than lifestyle or medical management in achieving glycaemic control, sustained weight loss, and reducing diabetes comorbidities. New guidelines for T2DM expand the use of MS to patients with a lower body mass index.
more
The burden of diabetes is enormous, positioning it as one of the main challenges facing public health today. Currently, it is estimated that 62 million people are living with diabetes in the Region of the Americas and projections show its prevalence will continue rising over the following years. The
...
Region shows the highest number of years of healthy life lost (through either disability or premature death) due to diabetes worldwide. The high costs associated with its treatment produce a heavy economic burden. Its complications can seriously affect the quality of life of people living with diabetes, their families, and society and overload health systems. This report shows the latest internationally comparable data on diabetes and its main risk factors by year, country, and sex. It also includes a summary of the countries health systems’ response to diabetes, including national plans, targets, surveillance, guidelines, and access to essential drugs and technologies, and synthesizes information about diabetes-related complications and the close relationship between diabetes and other pathologies, such as cardiovascular diseases, tuberculosis, and COVID-19. The data presented here reveal that, despite advances in national responses, diabetes continues to expand, and our response remains insufficient. This report aims to draw attention to the urgent need to strengthen efforts to prevent, diagnose, and control diabetes in the Region of the Americas.
more
Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing
...
guidelines is poor. A major revision of the GINA report was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.
more
Essential Medicines are those that satisfy the priority health care needs of the population. They are selected with due regard to public health relevance, evidence on efficacy, safety and comparative cost-effectiveness. This edition of the Essential Medicines List (EML) 2017 for Ghana has been deriv
...
ed from its companion Standard Treatment Guidelines 2017 to ensure harmony in treatment, procurement and re-imbursements. The medicines listed have been coded according to the Health Commodity
Codes Catalogue of the Ministry of Health (2008) and their levels of use, based on the type of health facility, including midwifery practice, have been indicated.
more
Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
...
ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
more
Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO
...
treatment guidelines for helminth infections are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
more
Issue Brief 33: Since 21 June 2023, 57 024 new cholera cases, including 399 new death have been reported worldwide (European Center for Disease Prevention and Control). In total, 25 countries have reported cases since the beginning of 2023. The major underlying causes of potential outbreaks are poor
...
environmental infastructure, lack of health care services, lack of save water and sanitation as well as increase population movement. Climate change becomes an additional trigger, as extreme climate events like cyclones,floods and droughts reduce access to clean water and create an ideal environment for cholera to thrive. The overall capacity to respond to the multiple outbreaks is obstructed by a global lack of resources.
This issue brief provides an overview of the current outbreaks, treatment guidelines, information material, countries strategies and more.
more
Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the prevalence of asthma is among the highest in the world. Asthma admissions are very common in children, l
...
eading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.
more
Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid
...
ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
more
DNDi is now striving to make fexinidazole available to the majority of people who have T.b. gambiense sleeping sickness. We are supporting a three-year access and pharmacovigilance study that began in 2020 and have so far carried out in-country training of relevant staff in 250 hospitals and
...
health centres in T.b. gambiense-endemic countries; and updated national treatment and pharmacovigilance guidelines in Angola, Central African Republic, the Democratic Republic of Congo, Equatorial Guinea, Guinea, and Chad.
more
Indicators for monitoring the 2016 United Nations Political Declaration on Ending AIDS
UNAIDS supports countries to collect information on their national HIV responses through the Global AIDS Monitoring (GAM) framework—an annual collection of 72 indicators on the response to HIV in a country. ... These data form part of the data set used to report back to the General Assembly.
Different from the HIV epidemiological estimates that countries produce for data on the state of the epidemic in a country—that is, data for making estimates on the number of people living with HIV, AIDS-related deaths, etc.—GAM collects information on HIV programmes, including the number of people living with HIV who know their HIV status and people on HIV treatment, and on stigma and discrimination. A full list of the indicators is given in the GAM guidelines. more
UNAIDS supports countries to collect information on their national HIV responses through the Global AIDS Monitoring (GAM) framework—an annual collection of 72 indicators on the response to HIV in a country. ... These data form part of the data set used to report back to the General Assembly.
Different from the HIV epidemiological estimates that countries produce for data on the state of the epidemic in a country—that is, data for making estimates on the number of people living with HIV, AIDS-related deaths, etc.—GAM collects information on HIV programmes, including the number of people living with HIV who know their HIV status and people on HIV treatment, and on stigma and discrimination. A full list of the indicators is given in the GAM guidelines. more
This training guide applies a participatory approach, reflecting the considerable evidence that adults learn best by practicing and reflecting on their experiences. It thus emphasizes exercises to improve skills in counseling that support clients to adopt optimal nutrition practices. Women’s nutri
...
tion and infant feeding in the context of HIV are also addressed. Guidelines to link the prevention of malnutrition with treatment via the Integrated Management of Acute Malnutrition are also included. It can also be conducted with nutrition managers to equip them to provide supportive supervision to health and community workers.
more
Integrated management of childhood illness. The last update was in the IMCI chart booklet in 2014, but since then there have been significant updates on the management of sick young infant (SYI) aged up to 2 months. This 2019 update of the sick young infant section Management of the sick young infan
...
t age up to 2 months: IMCI chart booklet. supersedes the 2014 IMCI chart booklet. The new updates reflect the recent guidelines on Managing possible serious bacterial infection (PSBI) in young infants when referral is not feasible published in 2015. It includes assessment, classification and referral of SYI with PSBI; and outpatient treatment of SYI with local infection or fast breathing (pneumonia) in infants 7-59 days old. Other updates include: a new section on how to reassess, classify and treat SYI with PSBI when referral is not feasible in outpatient health facilities by IMNCI trained health workers; changes in assessment and management of young infants for HIV infection; and identification of infants less than 7 days of who need Kangaroo Care.
more
Integrated management of childhood illness. The last update was in the IMCI chart booklet in 2014, but since then there have been significant updates on the management of sick young infant (SYI) aged up to 2 months. This 2019 update of the sick young infant section Management of the sick young infan
...
t age up to 2 months: IMCI chart booklet. supersedes the 2014 IMCI chart booklet. The new updates reflect the recent guidelines on Managing possible serious bacterial infection (PSBI) in young infants when referral is not feasible published in 2015. It includes assessment, classification and referral of SYI with PSBI; and outpatient treatment of SYI with local infection or fast breathing (pneumonia) in infants 7-59 days old. Other updates include: a new section on how to reassess, classify and treat SYI with PSBI when referral is not feasible in outpatient health facilities by IMNCI trained health workers; changes in assessment and management of young infants for HIV infection; and identification of infants less than 7 days of who need Kangaroo Care.
more
Integrated management of childhood illness. The last update was in the IMCI chart booklet in 2014, but since then there have been significant updates on the management of sick young infant (SYI) aged up to 2 months. This 2019 update of the sick young infant section Management of the sick young infan
...
t age up to 2 months: IMCI chart booklet. supersedes the 2014 IMCI chart booklet. The new updates reflect the recent guidelines on Managing possible serious bacterial infection (PSBI) in young infants when referral is not feasible published in 2015. It includes assessment, classification and referral of SYI with PSBI; and outpatient treatment of SYI with local infection or fast breathing (pneumonia) in infants 7-59 days old. Other updates include: a new section on how to reassess, classify and treat SYI with PSBI when referral is not feasible in outpatient health facilities by IMNCI trained health workers; changes in assessment and management of young infants for HIV infection; and identification of infants less than 7 days of who need Kangaroo Care.
more
Emergency health kits
recommended
WHO has developed standardized health kits of medicines and medical supplies to meet different health needs in humanitarian emergencies and disasters.
These kits are developed to provide reliable and affordable medicines and supplies quickly to those in need. The kits are used by United Nations age
...
ncies, nongovernmental organizations and national governments.
Based primarily on WHO’s Essential Medicines list and guidelines on treatment of specific medical conditions, the contents of the kits are frequently reviewed and updated to adapt to changing needs based on experience in emergency situations.
A certain number of kits are prepositioned in strategic locations to be mobilized quickly in times of need. Long term agreements with suppliers are also in place to ensure rapid shipment wherever needed.
more