В отчете представлено описание комплексной модели лечения детского туберкулеза и опыта работы проекта в Таджикистане. На основе этого опыта сделаны не...оторые выводы и рекомендации по расширению масштабов оказания противотуберкулезной помощи детям в регионе Центральной Азии и Восточной Европы.
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Este documento presenta modelos de algoritmos que permiten investigar por métodos bacteriológicos a los pacientes para el diagnóstico de tuberculosis (TB), TB asociada al Virus de Inmunodeficiencia Humana (TB-HIV) y TB drogorresistente (TBDR).
Глобальными приоритетами для лечения туберкулеза (ТБ) и борьбы с ним являются улучшенное и ранее выявление случаев туберкулеза, в том числе случаев заболевания с о...трицательным мазком мокроты, которые часто ассоциируются с вирусом иммунодефицита человека (ВИЧ) и ранним возрастом, а также расширенные возможности для диагностики туберкулеза с множественной лекарственной устойчивостью (МЛУ-ТБ)
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Как и руководство 2006 года, настоящий документ предназначен для специалистов,
занимающихся разработкой государственных программ по борьбе с туберкулезом, педиатр...ов и других работников здравоохранения в странах с низким и средним уровнем дохода. Эти рекомендации не подходят для стран с высоким уровнем дохода, где распространенность ТБ невысока. Особенно важно проводить это различие при выборе методов диагностики и обследовании контактных лиц.
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Данное руководство содержит детальное описание стратегии диагностики и ведения пациентов с лекарственно-устойчивыми формами ТБ, прежде всего с туберкулезом с мн...жественной лекарственной устойчивостью (МЛУ-ТБ). Оно составлено с учетом важных изменений, отмеченных за последние годы, и предназначено для практикующих медицинских работников и программ борьбы с ТБ в странах с умеренными и ограниченными ресурсами.
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The strengthened plan aims to achieve and sustain a polio-free world through a focus on implementation and accountability. Emphasis will be on cutting outbreak response times; increasing vaccine demand; transforming campaign effectiveness; working systematically through integration; increasing acce...ss in inaccessible areas; transitioning towards government ownership; and improving decision-making and accountability.
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The new guidelines provide public health guidance on pharmacological agents for managing hyperglycaemia in type 1 and type 2 diabetes for use in primary health-care in low-resource settings. These guidelines update the recommendations for managing hyperglycaemia in the WHO Package of Essential NCD I...nterventions (WHO PEN) for primary care in low-resources settings, reviewing several newer oral agents as second- and third-line treatment: dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and thiazolidinediones. The guidelines also present recommendations on the selection of type of insulin (analogue versus human insulin) for adults with type 1 and type 2 diabetes.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions... (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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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 study aimed to estimate the cost-effectiveness of a community-based rehabilitation (CBR) programme known as Inspire2Care (I2C), implemented in Nepal by Karuna Foundation Nepal. In the absence of any gold standard methodology to measure cost-effectiveness, the authors developed a new methodology... to estimate the programme’s achievements and cost-effectiveness.
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Venturini et al. BMC Infectious Diseases 2014, 14(Suppl 1):S5 http://www.biomedcentral.com/1471-2334/14/S1/S5
La presente guía tiene además como objetivo, ser un respaldo y no una camisa de fuerza para los médicos, pues pretendemos con ella proveer evidencia sólida respecto a los riesgos, beneficios o consecuencias que puede generar la toma de una decisión en pacientes con tuberculosis. Como lo propone... el Ministerio Nacional de Salud en sus normas técnicas, se busca un manejo integral del niño con tuberculosis pulmonar, asegurando la oportunidad, la eficiencia y la calidad de la atención.
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Цель этого документа – повысить уровень осознания актуальности приоритетных направлений научных исследований по проблеме ТБ/ВИЧ (то есть по тем направлениям, кот...орые требуют срочного финансирования и внимания ученых), содействовать координации информационно-пропагандистской работы и стимулировать финансирование научных изысканий. Поставленная задача заключается в наращивании темпов осуществления высококачественных и интегрированных вмешательства по борьбе с ТБ/ВИЧ в условиях ограниченных ресурсов. В документе дается описание пересмотренной повестки дня по приоритетным научным вопросам, в основе которой лежат недавно полученные фактические данные по шести ключевым проблемам коинфекции ТБ и ВИЧ.
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2nd edition.
Like the original, this second edition of the guidance aims to inform the revision of existing national guidelines and standards for managing Tuberculosis (TB), many of which include guidance on children. It includes recommendations, based on the best available evidence, for improving ...the management of children with TB and of children living in families with TB. National and regional TB control programmes may wish to adapt these recommendations according to local circumstances
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To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
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The purpose of this manual is to define a limited number of indicators that will objectively describe the management and use of antimicrobials in hospitals and to provide tools and step-by-step instructions for designing and carrying out an assessment of antibiotic use and management in hospitals. T...he indicators in this manual will complement the existing WHO (1993) indicators of outpatient antimicrobial use suggested in How to Investigate Drug Use in Health Facilities (including percentage of encounters in which an antibiotic was prescribed and percentage of medicine costs spent on antibiotics) and will address the need for antimicrobial indicators for inpatient conditions.
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