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This publication is an updated version of the Management of Tuberculosis and HIV Coinfection clinical protocol released in 2007 by the WHO Regional Office for Europe. It is intended for all health care workers involved in preventing, diagnosing, treating and caring for people living with
...
TB and HIV in the specific settings of the WHO European Region.
more
The Millennium Development Goals (MDGs) showed
that global commitment and collective action
could significantly reduce the disease burdens of
three deadly communicable diseases: HIV/AIDS,
tuberculosis (TB) and malaria. The MDGs helped
focus eff
...
orts on these three deadly diseases
and leveraged disease-specific programmes and
financing, thus achieving significant progress.
more
July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in
...
the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
more
The manual is written for clinicians working at the district hospital (first-level referral care) who diagnose and manage sick adolescents and adults in resource constrained settings. It aims to support clinical reasoning, and to provide an effective clinical approach and protocols for the managemen
...
t of common and serious or potentially life-threatening conditions at district hospitals. The target audience thus includes doctors, clinical officers, health officers, and senior nurse practitioners. It has been designed to be applicable in both high and low HIV prevalence settings.
Volume 2 provides a symptom-based approach to clinical care for acute and subacute conditions (including mental health). It provides short summaries of the management of diseases that affect multiple systems of the body, focusing on communicable diseases. It also includes the chronic or long-term management of HIV, TB, alcohol, and substance use disorders.
more
Guide de poche pour l’agent de santé en première ligne
Ce guide s’intéresse plus particulièrement à certaines fièvres hémorragiques virales (FHV) Ebola, Marburg, FHCC, fièvre de Lassa [et Lujo] – qui surviennent en Afrique et risquent de donner lieu à une
...
transmission interhumaine. Il ne traite pas de la prise en charge d’autres infections virales, comme la dengue, la fièvre de la vallée du Rift et la fièvre jaune, qui entraînent également des manifestations hémorragiques, mais pour lesquelles il n’y a pas de transmission directe d’une personne à une autre
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Interim Guidance.
A number of medical problems have been reported in survivors, including mental health issues. Ebola virus may persist in some body fluids, including semen. Ebola survivors need comprehensive support for the medical and psychosocial challenges they face and also to minimize the ... risk of continued Ebola virus transmission. WHO has developed this document to guide health services on how to provide quality care to survivors of Ebola virus disease more
A number of medical problems have been reported in survivors, including mental health issues. Ebola virus may persist in some body fluids, including semen. Ebola survivors need comprehensive support for the medical and psychosocial challenges they face and also to minimize the ... risk of continued Ebola virus transmission. WHO has developed this document to guide health services on how to provide quality care to survivors of Ebola virus disease more
Polymerase Chain Reaction (PCR) has significantly helped in early diagnosis and commencement of specific interventions for diseases control. It also plays a critical role in understanding the disease epidemiology and unraveling the transmission
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dynamics of the disease. This manual intends to provide primary guidelines to assist health lab personnel in developing countries to establish a PCR diagnostic facility for efficient support to patient care as well as public health actions.
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Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the fir ... st day of antenatal care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133 more
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the fir ... st day of antenatal care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133 more
The five hepatitis viruses have different epidemiological profiles, and their impact, duration, and transmission route also vary. The most common transmission routes contributing to the spread of he
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patitis are exposure to infected blood via blood transfusion or unsafe injection practices, consumption of contaminated food and drinking water, and transmission from mother to child during pregnancy and delivery. Also, unsafe injection practices, including the use of unsterile needles and syringes, serve as a major pathway for the spread of hepatitis B and C, and reducing transmission of both diseases requires addressing these practices.
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Maldives has made significant strides in the area of infectious disease prevention and control. This is exemplified by elimination of malaria from Maldives in 2015 and successes in TB control. In addition, Maldives is a front runner in infectious di
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sease prevention through successful water, sanitation, hygiene and vaccination campaigns and coverage. However, given the limited evidence that exists with respect to the occurrence of resistant organisms in the nation, it is hard to estimate the exact antimicrobial resistance (AMR) scenario. Also, it becomes difficult to compare the current situation with other countries in the region. Moreover, limited evidence exists on the trends of use of antimicrobial agents (AMA) in Maldives. Although, recent prescription audits have indicated overuse of antibiotics, especially for common conditions such as flu, cough and fever.
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Interium guidance, 25 June 2021Timely and accurate diagnostic testing is an essential tool in preventing and controlling the spread of COVID-19. This document describes recommendations for national testing strategies and the use of PCR and rapid antigen tests in different
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transmission scenarios of the COVID-19 outbreak, including how testing might be rationalized in low resource settings. All testing should be followed by a strong public health response including isolating those who test positive and providing them care, contact tracing and quarantine of contacts.
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23 December 2020 This document summarizes WHO recommendations for the rational use of personal protective equipment (PPE) in health care settings and temporary strategies during acute supply shortages. This document also contains 2 Annex sections describing updated PPE use recommendations for health
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workers based on the transmission scenario, setting, and activity in the context of COVID-19 (Annex 1), and updated considerations for the decontamination or reprocessing of PPE (Annex 2). This guidance is intended for public health authorities, organizations, and focal persons involved in decisions regarding PPE distribution, management, and use by health workers.
Available in Arabic, French, English, Spanish and Russian
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In the current absence of vaccine for COVID-19, public health response target breaking the chain of infection by focusing on the mode of transmission. This paper summarizes current evidence-base around the
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transmission dynamics, pathogenic, and clinical features of COVID-19, to critically identify if there are any gaps in the current IPC guidelines.
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This Interim Guidance outlines how key public health and social measures needed to reduce the risk of COVID-19 spread and the impact of the disease can be adapted for use in low capacity and humanitarian settings. The recommendations outlined here need to be adjusted to the scale of
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transmission, context and resources, in order to achieve the objective of managing COVID-19, namely to reduce transmission and facilitate the detection and management of infected and exposed individuals within the population. The Guidance is intended for humanitarian and development actors of all operational levels working with communities ocal authorities involved in COVID-19 preparedness and response operations in these settings, in support of national and local governments and plans. Additional considerations for support to residents of urban informal settlements and slums are available in Annex 1.
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Bioethics 519 (online) doi:10.1111/bioe.12145 Volume 29 Number 8 2015 pp. 488–596;
Pandemic plans recommend phases of response to an emergent infectious disease (EID) outbreak, and are primarily aimed at preventing and mitigating human-to-human transmi
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ssion. These plans carry presumptive weight and are increasingly being operationalized at the national, regional and international level with the support of the World Health Organization (WHO). The conventional focus of pandemic preparedness for EIDs of zoonotic origin has been on public health and human welfare. However, thisfocus on human populations has resulted in strategically important disciplinary silos. As the risks of zoonotic diseases have implications that reach across many domains outside traditional public health, including anthropological, environmental, and veterinary fora, a more inclusive ecological perspective is paramount for an effective response to future outbreaks.
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While there has been real progress in addressing the burden of disease in the WHO African region, the COVID-19 pandemic has highlighted the link between health, economics and security, as the region saw decades of progress threatened, including positive trends in decreasing inequality. In the Africa
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n Region the momentum towards achieving the 2030 SDG disease burden reduction targets (SDG targets 3.3, 3.4 and 3B) has stalled.
The COVID-19 pandemic was also a major threat to gains made, such as the eradication of polio in the region, declared in 2020; reduced numbers of new HIV infections in 2021 compared to 2010; and passing the 2020 milestone of the End TB Strategy, with a 22% reduction in new cases compared with 2015. However, the pandemic also disrupted essential health services in 92% of countries globally, 22.7 million children missed basic immunization, there was an increase in malaria and TB, and global deaths from TB rose for the first time since 2015.
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The WHO document "Integrating the prevention and control of noncommunicable diseases in HIV/AIDS, tuberculosis, and sexual and reproductive health programmes: implementation guidance" provides a framework for integrating noncommunicable diseases (NCDs) into existing health programs for HIV/AIDS, tub
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erculosis (TB), and sexual and reproductive health (SRH). It emphasizes the importance of a people-centered approach to enhance healthcare accessibility and efficiency, especially in low-resource settings. The document outlines strategies for strengthening policy, financing, capacity building, and health system infrastructure. It offers actionable steps, tools, and case studies to support countries in reducing the burden of NCDs through integrated, holistic care within primary health services.
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Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Uni
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on Framework for Antimicrobial Resistance Control 2020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
Africa bears a significant burden of infectious diseases, accounting for approximately 95% of malaria deaths, 70% of people living with HIV, and 25% of TB deaths globally. In 2019, AMR was linked to approximately 55,000 deaths from HIV, 30,000 from malaria, and 255,000 overall. Major drivers of AMR in the region include the overuse and misuse of antimicrobials in human and food systems, migration, suboptimal vaccination rates, and environmental contamination from hospital and pharmaceutical effluents. Additionally, there is a lack of access to quality-assured antimicrobials and diagnostics, compounded by inadequate knowledge about AMR. Unlike high-income countries, where indiscriminate antimicrobial use is the primary factor driving AMR, African countries face additional challenges, including a lack of access to clean and safe water, poor Water, Sanitation, and Hygiene (WASH) programs, inadequate infection prevention measures, and suboptimal vaccinations for preventable diseases. One in three hospitals in the region lacks clean, safe running water, and one in eight people defecate openly due to inadequate sanitation. Investments in WASH, infection prevention, and biosecurity could save approximately 700,000 lives annually.
Addressing AMR in Africa requires a comprehensive, multi-sectoral approach involving the entire society. Sustainable access to antimicrobials, including antibiotics, vaccines, and therapeutics, is crucial, as lack of access leads to more morbidity and mortality than AMR itself. Support for the region should focus on preventing infections, strengthening health and food systems, developing human resources, ensuring sustainable access to diagnostics and therapeutics, and investing in laboratory infrastructure to support surveillance and data generation.
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In this guideline, natural ventilation is considered
among one the effective measures to control infections in health care. This guideline provides
a design and operation guide for hospital planners, engineers, architects and infection control
personnel. The recommendations in this guidelin
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e followed a systematic
review of the literature on the association of ventilation and disease transmission, as well
as effective natural ventilation solutions for infection control.
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Guidelines on hepatitis B and C testing
recommended
Testing and diagnosis of hepatitis B (HBV) and C (HCV) infection is the gateway for access to both prevention and treatment services, and is a crucial component of an effective response to the hepatitis epidemic. Early identification of persons with chronic HBV or HCV infection enables them to recei
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ve the necessary care and treatment to prevent or delay progression of liver disease. Testing also provides an opportunity to link people to interventions to reduce transmission, through counselling on risk behaviours and provision of prevention commodities (such as sterile needles and syringes) and hepatitis B vaccination.
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