Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to ...sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an...d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i...n various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.
22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.
This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.
Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.
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mBio, Vol. 6 Issue 2, March/April 2015
Available evidence demonstrates that direct patient contact and contact with infectious body fluids are the primary modes for Ebola virus transmission, but this is based on a limited number of studies. In this review, the authors address what we know and what ...we do not know about Ebola virus transmission. They also hypothesize that Ebola viruses have the potential to be respiratory pathogens with primary respiratory spread.
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Good primary care may lead to fewer avoidable hospitalizations, but unsafe primary care can cause avoidable illness and injury, leading to unnecessary hospitalizations, and in some cases, disability and even death.Implementing system changes and practices are crucial to improve safety at all levels ...of health care. Recognizing the paucity of accessible information on primary care, World Health Organization (WHO) set up a Safer Primary Care Expert Working Group. The Working Group reviewed the literature, prioritized areas in need of further research and compiled a set of nine monographs which cover selected priority technical topics. WHO is publishing this technical series to make the work of these distinguished experts available to everyone with an interest in Safer Primary Care.The aim of this technical series is to provide a compendium of information on key issues that can impact safety in the provision of primary health care.
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Afr J Tradit Complement Altern Med. (2013) 10(5):210-229
Plants are important sources of medicines. Herbal medicines in Lesotho are exposed to excessive exploitation and habitat destruction. Comprehensive information to promote proper use and conservation of these herbal medicines is lacking. ...This study described the uses of medicinal plants in Lesotho with comparative reference between practice and the literature, highlighting important ethno-medicinal information and conservation status of the plants. Additionally, the study established a repository and monograph for the herbal medicines in Lesotho.
http://dx.doi.org/10.4314/ajtcam.v13i1.20
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Today there are Community-based Rehabilitation (CBR) programmes in a large number of countries. In many countries, the CBR approach is a part of the national rehabilitation services. However, there is a lack of reliable data about persons with disabilities who benefit from CBR and the kind of benefi...ts they receive. This article reviews the disability data collection systems and presents some case studies to understand the influence of operational factors on data collection in the CBR programmes. The review shows that most CBR programmes use a variable number of broad functional categories to collect information about persons with disabilities, combined occasionally with more specific diagnostic categories. This categorisation is influenced by local contexts and operational factors, including the limitations of human and material resources available for its implementation, making it difficult to have comparable CBR data. Therefore, any strategies to strengthen the data collection in CBR programmes must take these operational factors into account.
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Int J Bipolar Disord (2018) 6:6 https://doi.org/10.1186/s40345‑017‑0110‑8
In 2001, the WHO stated that: "The use of mobile and wireless technologies to support the achievement of health objectives (mHealth) has the potential to transform the face of health service delivery across the globe".... Within mental health, interventions and monitoring systems for depression, anxiety, substance abuse, eating disorder, schizophrenia and bipolar disorder have been developed and used. The present paper presents the status and findings from studies using automatically generated objective smartphone data in the monitoring of bipolar disorder, and addresses considerations on the current literature and methodological as well as clinical aspects to consider in the future studies.
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This casebook collects 64 case studies, each of which raises an important and difficult ethical issue connected with planning, reviewing, or conducting health-related research. The book’s purpose is to contribute to thoughtful analysis of these issues by researchers and members of research ethics ...committees (RECs, known in some places as ethical review committees or institutional review boards), particularly those involved with studies that are conducted or sponsored internationally.
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Methicillin-resistant Staphylococcus aureus(MRSA) strainsor multidrug-resistant S.aureus, initially described in 1960s,emerged in the last decade as a cause of nosocomial infections responsible for rapidly progressive, potential fatal diseases including life-threatening pneumonia, necrotizing fascii...tis, endocarditis, osteomyelitis, severe sepsis, and toxinoses such as toxic shock syndrome. A multifactorial range of independent risk factors for MRSA has been reported in literature and include immunosuppression,hemodialysis, peripheral malperfusion, advanced age, extended in-hospital stays, residency in long-term care facilities (LTCFs), inadequacy of antimicrobial therapy,indwelling devices, insulin-requiring diabetes, and decubitusulcers, among others.
Hindawi Canadian Journal of Infectious Diseases and Medical Microbiology Volume 2019, Article ID 8321834, 9 pageshttps://doi.org/10.1155/2019/8321834
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The Global Antibiotic Resistance Partnership (GARP)-Mozambique team, in partnership with the Center for Disease Dynamics, Economics & Policy (CDDEP), has produced this report as part of a solid com-mitment to develop actionable policy proposals to tackle antibiotic resistance and improve appropriate... antibiotic access. It is the result of a thorough review of published and unpublished data on antibiotic resistance and a long internal consultation effort that engaged academic scientists, health professionals and other stakeholders within Mozambique.
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This report addresses the future of basic education, ICT use in deprived locations, and the use of ICTs in primary school learning in 2020 and 2025, especially in deprived contexts. It draws on research evidence from the literature, the authors’ experiences of ICT use in education initiatives, int...erviews with practitioners and academics, a workshop, and consultations with Save the Children staff from many different countries, mostly conducted in August 2017
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This report on progress achieved in the WHO European Region and Member States in implementing the European food and nutrition action plan 2015–2020 presents selected epidemiological data on the nutritional status of populations throughout the Region and on implementation of policies recommended in... regional and global frameworks to promote healthy nutrition and prevent obesity. The data contained in the report are derived from the responses of Member States to the WHO Global nutrition policy review questionnaire.
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Health in All Policies: A Guide for State and Local Governments was created by the Public Health Institute, the California Department of Public Health, and the American Public Health Association in response to growing interest in using collaborative approaches to improve population health by embedd...ing health considerations into decision-making processes across a broad array of sectors. The Guide draws heavily on the experiences of the California Health in All Policies Task Force and incorporates information from the published and gray literature and interviews with people across the country.
The guide was developed through funding from the American Public Health Association and The California Endowment.
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Bioethics - Medical, Ethical and Legal Perspectives
There’s evidence that implementing the four medical ethics principles may be challenging especially in low income country contexts with extreme resource scarcity and limited capacity to facilitate deliberations on the different ethical dilemmas.... These challenges can partly be explained by the social, economic, and political contexts in which the decisions are made, as well as the limited time, training and guidance to facilitate ethical decision making. Based on current literature, and using the example of bedside rationing; this chapter synthesizes the challenges clinicians face when operationalizing the four principle; identifying the opportunities to address them. We suggest that clinicians’ ability to implement the four principles are constrained by meso‐ and macro‐level decision making as well as their lack of training, explicit guidelines, and peer support. To ameliorate this situation, current efforts to strengthen the clinicians’ capacity to make ethical decisions should be complimented with developing of context relevant guidelines for ethical clinical decision making. The renewed global commitment to the sustainable development goals and universal healthcare coverage should be recognized as an opportunity to leverage resources and champion the integration of equity and justice as a core value in resource allocation at the bedside, meso-, macro- and global levels.
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Wound care is a regular component of the package of care we offer in the majority of our health care facilities and represents a high volume of activities. The current practices in MSF projects are often based on the habits of each individual supervisor, the wound care material we off...er is partly outdated and does not allow optimal wound care. There is a need for standardization of wound care and it needs to be evidence based as much as possible, taking into account the realities of the field.
The scope of this document is to guide the caregiver in the wound care process. It does not intend to provide in depth information on wound healing or physiology. There is a wide range of literature and background information available for this purpose in the references and in the list of extra reading
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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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22 April 2022, This document provides updated interim recommendations on the use of masks by health workers providing care to patients with suspected or confirmed COVID-19. This update is prompted by new evidence around mask use and COVID-19 transmission, as well as the emergence of variants of conc...ern including Omicron. Masks continue to be a critical tool to prevent the spread of COVID-19. These interim guidelines supersede the recommendations provided in the WHO recommendations on mask use by health workers, in light of the Omicron variant of concern published on 22 December 2022.
WHO continually evaluates the emerging evidence and will review these interim recommendations within two months and issue new guidance as needed.
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In emergency or humanitarian settings, mobile clinics are used to bring essential lifesaving health care to communities affected by crises. Though there are standard emergency benefit packages for health services during emergencies, there are however no agreed or standard way of running mobile clini...cs in such settings. Drawing on the experiences of running mobile clinics in the NWSW and relevant literature, this manual provides a practical example of how to set up and run a mobile clinic in an African humanitarian setting in hard to reach communities with limited resources.
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The threat climate change poses to health, equity, and development has been rigorously documented. However, in an era marked by economic crisis, regional conflicts, natural disasters and growing disparities between rich and poor, the joint global actions required to address climate change have been ...vigorously debated – and critical decisions postponed.
This document, part of WHO’s Health in the Green Economy series, describes how many climate change measures can be “win-wins” for people and the planet.
These policies yield large, immediate public health benefits while reducing the upward trajectory of greenhouse gas emissions. Many of these policies can improve the health and equity of people in poor countries and assist developing countries in adapting to climate change that is already occurring, as evidenced by more extreme storms, flooding, drought and heatwaves.
WHO’s Department of Public Health and Environment launched the Health in the Green Economy initiative in 2010 to review potential health and equity “co-benefits” of proposed climate change measures – as well as relevant risks.
This review examines mitigation strategies discussed in the Fourth Assessment Report of the Intergovernmental Panel on Climate Change which constitutes the most broad-based global review of mitigation options by scientific experts.
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