Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los... años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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The objective of the study was the validation and implementation of GeneXpert MTB/RIF for routine use in the rapid detection of tuberculosis and sensitivity to rifampicin in clinical samples; for this, 1592 respiratory samples were collected and analyzed in the laboratory of Instituto Nacional de In...vestigación en Salud Pública Guayaquil. The analysis of the results of GeneXpert in comparison with smear microscopy showed an initial sensitivity of 99.8% and specificity of 93.2%; The analysis of discrepancies using the results of the culture as a reference method showed that the GeneXpert results considered false negatives turned out to be true negatives, the same happens with the false positives that correspond to true positives. Recalculated the sensitivity and specificity of the GeneXpert was 99.8% and 100% correspondingly. The comparison with the drugs susceptibility test showed a sensitivity of 91.4% and a specificity of 95.5% for the GeneXpert MTB/RIF system. It is concluded that the implementation of the GeneXpert system allows solution to certain problems associated with the application of conventional diagnostic methodologies, decreasing the waiting times, and increasing the sensitivity and specificity in the diagnosis of drug-resistant tuberculosis, thus generating a valuable opportunity for early diagnosis.
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Public Health Surveillance Protocol Tuberculosis
The Lancet Published Online
October 8, 2021 https://doi.org/10.1016/ S0140-6736(21)02143-7
Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS aborda o uso de hidroxicloroquina para prevenção da COVID-19. Segue-se a publicação de uma análise sistemática e NMA que reuniu dados de seis estudos com 6.059 participantes que não tinham COVID-...19 e receberam hidroxicloroquina. Três estudos envolveram participantes que tiveram uma exposição conhecida a uma pessoa com infecção por SARS-CoV-2. Em resposta à divulgação dos dados de estudos, o GDG da OMS desenvolveu recomendações sobre a hidroxicloroquina, um agente anti-inflamatório que atua por meio do bloqueio dos receptores Toll-like, reduzindo a ativação das células dendríticas. É usada para tratar a artrite reumatoide e o lúpus eritematoso sistêmico. Tem um efeito antiviral contra muitos vírus in vitro, inclusive o SARS-CoV-2, mas não foi demonstrado um efeito antiviral clinicamente útil para nenhuma infecção viral.
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A group-based stress managment course for adults.
Self-Help Plus (SH+) is WHO’s 5-session stress management course for large groups of up to 30 people. It is delivered by supervised, non-specialist facilitators who complete a short training course and use pre-recorded audio and an illustrated gui...de (Doing What Matters in Times of Stress) to teach stress management skills. The course is suitable for adults who experiences stress, wherever they live and whatever their circumstances. It has been shown to reduce psychological distress and prevent the onset of mental disorders. The format of SH+ makes it well-suited for use alongside other mental health interventions, as a first step in a stepped care programme, or as a community intervention delivered alongside broader community programming.
Download the audio files in English directly from the WHO Website https://www.who.int/publications/i/item/9789240035119
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The recently published World Health Organization (WHO) Strengthening infection prevention and control in primary care document collates existing standards, measurement and implementation approaches, and resources for infection prevention and control (IPC) in primary care. During its development, it ...became apparent that a number of already existing tools and resources have the potential to support facility-level implementation of IPC in primary care.
This toolkit brings together in one place a number of these tools and resources from WHO and other organizations, with a focus on those most relevant to primary care. These tools and resources have been compiled to support facility-level implementation in line with the recommended WHO IPC Hub and Task Force multimodal approach.
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World Health Organization, Food and Agriculture Organization of the United Nations & World Organisation for Animal Health. (2021). Antimicrobial resistance and the United Nations sustainable development cooperation framework: guidance for United Nations country teams. World Health Organization
Organización Mundial de la Salud, Organización de las Naciones Unidas para la Alimentación y la Agricultura & Organización Mundial de Sanidad Animal. (2021). La resistencia a los antimicrobianos y el marco de cooperación de las Naciones Unidas para el desarrollo sostenible: orientaciones ...para los equipos de las Naciones Unidas en los países. Organización Mundial de la Salud.
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In 2015, to advance the global and national response to antimicrobial resistance (AMR), the World Health Assembly issued resolution WHA68.7 calling for all Member States to develop AMR national action plans that address the five objectives of the World Health Organization Global Action Plan (GAP) by... May 2017. The WHO GAP provides a framework to support countries in developing their national action plans on AMR. To operationalize and accelerate implementation of national action plans on AMR, WHO has developed a costing and budgeting tool and accompanying user guide. The purpose is to support countries in costing prioritized activities of an operational plan linked to their AMR national action plan, and identify existing funding and funding gaps to promote resource mobilization and sustainable implementation. The target audience of the publication are national policy makers and designated costing coordinators for national action plans on AMR.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed across all domains of quality health services: effectiveness, safety, people-centredness, timeliness,... equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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o support and guide countries and partners to strengthen a health systems response to address violence against women, WHO has produced several tools, including:
• clinical and policy guidelines;
• implementation handbooks and manuals;
• training curriculum;
• evidence-based polic...y, prevention and intervention strategy packages.
The resource package consolidates these documents to support countries to develop or update their national or subnational guidelines, protocols, standard operating procedures, health provider training materials, and multisectoral action plans to prevent and respond to violence against women.
The resource package is also intended to be used for training and sensitization of policy-makers, advocates, health care providers and managers of services and programmes to address violence against women.
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The United Nations Commission on Life-Saving Commodities (UNCLSC, 2012) defined 13 health products to end preventable deaths of woman and children. One of those 13 products is the neonatal resuscitator, is indispensable medical device to save newborns from asphyxia at birth. For the efficient use of... neonatal resuscitation, training of healthcare professionals using neonatal resuscitation manikins is the most effective approach. Critical lifesaving trainings calls for the need of neonatal resuscitation manikins with the right features.
The purpose of the WHO Neonatal resuscitation manikin: technical specifications is to provide a minimum standard baseline to meet the increasing demand to procure good quality, affordable, accessible, and appropriate neonatal resuscitation manikins. Towards the development of this baseline, this document includes compilation of available scientific evidence from technical literature, international publications, expert reviews, and an industry survey which was conducted by WHO medical devices team.
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Challenged by the health emergency, Primary Health Care (PHC) professionals remodeled their work processes and realized that many of the innovations implemented in an emergency manner to respond to the pandemic of COVID are here to stay. The initiative APS Forte no SUS - no combate à pandemia de CO...VID-19 gathered experiences from all over the country, executed by engaged health workers who, despite the difficulties imposed by the new disease, fight daily to improve the offer and care in health in the Unified Health System (SUS). With the help of digital technologies, teams and professionals of the Family Health Strategy overcome daily one of the main challenges of APS in this pandemic: ensuring access to health services. Digital tools gain strength in the agenda for strengthening the SUS, so well represented in this initiative.
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Coding of causes of death mentioning Multisystemic Inflammatory Syndrome associated with coronavirus disease
In order to streamline and effectively control compounding of medicinal products in hospitals and pharmacies, these Guidelines for Production of Extemporaneous and Hospital Based Sterile Preparations has been crafted. The purpose of these guidelines therefore is to assist pharmacists in ...discharging their legal and professional obligations to patients in the area of extemporaneous dispensing. This guidance will help to assure the safe and appropriate preparation and supply of extemporaneously prepared medicinal products to patients, where
the supply of such products is necessary.
Extemporaneous and hospital based sterile preparations are critical for patients whose clinical needs cannot be met by registered medicinal products. The guidelines outline the principles and application of the concepts of Good Manufacturing Practice (GMP) requirements for premises, equipment, personnel, storage, quality management system, quality control, compounding processes as well as documentation.
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The European Resuscitation Council Guidelines for Resuscitation provide specific instructions for how resuscitation should be practiced and take into account ease of teaching and learning, as well as the science. They were developed by Europeans and have been specifically written with European pract...ice in mind.
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