Clinical management handbook
Antimicrobial resistance (AMR) is a major public health challenge, which is recognized as high priority area by the Government of India. The increasing consumption of antibiotics is one of the key drivers of antimicrobial resistance seen in bugs of public health importance. Irrational prescription o...f broad-spectrum antibiotics, poor regulations around sale of antibiotics, self-medication, lack of education and awareness regarding responsible use of antibiotics have been identified as some of the key factors driving antimicrobial resistance in our country. The ‘National Health Policy’ (2017), addresses antimicrobial resistance as one of the key issues and prioritises development of guidelines regarding antibiotic use, limiting the over-the-counter use of antibiotics, restricting the use of antibiotics as growth promoters in livestock, and pharmaco-vigilance including prescription audit inclusive of antibiotic usage in the hospital and community.
more
The document contains a set of indicators that can be used for monitoring traditional and complementary medicine (T&CM) systems in a country.
The core indicator set consists of 16 indicators that were considered essential and collectively able to provide information on T&CM inputs, processes and ou...tputs. A longer list of reference indicators is also available for countries that wish to monitor more indicators or that want to consider alternative metrics that would better suit each country’s T&CM situation, priorities and monitoring capacities.
Each core and reference indicator is accompanied by a set of metadata. This provides information on the indicator rationale, definitions, data elements (numerator, denominator and data disaggregation), frequency of measurement, and data sources. It is a guide towards more standardized data measurement as well as data interpretation.
more
Antimicrobial resistance (AMR) is a major global public health concern and a food safety issue. When pathogens become resistant to antimicrobial agents they can pose a greater human health risk as a result of potential treatment failure, loss of treatment options and increased likelihood and severi...ty of disease.
more
Infectious diseases are constantly in transition. New diseases develop, known dis-eases become widespread or reemerge, and occasionally a disease is eradicated.Infectious diseases such as HIV, tuberculosis, and cholera are significant causes ofillness and death in many parts of the world. Health car...e personnel are on thefront lines, helping to protect their clients from infectious diseases and treatingthem when infections occur. During the course of their work, health care person-nel perform clinical procedures or other activities that can expose both them andtheir clients to potentially infectious microorganisms. Many of their clients aresick and thus may be more susceptible to infections or may have infections thatcan be transmitted to others. Fortunately, all staff working at health care facilities can perform simple proce-dures to minimize risk—to themselves and clients—and reduce the spread ofinfections. These practices can be integrated at minimal cost into the routineworkday at clinics and hospitals around the world. This reference booklet isspecifically designed for use at all levels of the health care system, from thelargest hospitals to the smallest dispensaries or health posts, in settings whereresources are scarce. This booklet, which was first published in 1999, has now been updated. Whilemost practices remain the same, there have been a few important changes—forexample, in recommendations related to hand hygiene and standard precautions.Nonetheless, this booklet continues to present practical recommendations forsimple and relatively low-cost procedures that can be implemented anywhere,with basic supplies and little to no high-technology equipment.
more
The infectious disease burden in India is among the highest in the world. A large amount of antibiot-ics are consumed in fighting infections, some of them saving lives, but every use adding to antibiotic resistance in bacteria. Antibiotic use is increasing steadily (table 1), particularly ... certain antibiotic classes (beta-lactam antibacterials), most notably in the more prosperous states. Resistance follows in lock-step.
more
Objective: To review the effectiveness of antibiotic stewardship interventions in hospitals in low- and middle-income countries.
The authors conduct an integrated survey of Antimicrobial Resistant Organisms (AMR) in drinking water, wastewater and surface water in three settings in Bangladesh: rural households, rural poultry farms, and urban food markets. Results show that untreated water discharged from rural households, poul...try farms and urban markets are major contributors to surface water pollution and antibiotic resistant bacteria genes, calling for increased surveillance and monitoring.
more
Government of Nepal has an obligation to ensure availability of affordable and high quality basic health care services to its population
This policy brief aims to provide a review of the current progress on implementing the Kenya national action plan on AMR, identifies critical gaps, and highlights findings to accelerate further progress in the human health sector. The target audience includes all those concerned with implementing ac...tions to combat antimicrobial resistance in Kenya.
more
Revised and expanded version of the Guidelines
This chapter discusses the antibacterial treatment of leprosy infections. Antibiotic treatment is
a key component of leprosy treatment, as it is vital to prevent the progression of the infection.
Treatment with rifampin and other antibiotics is highly effective and cures 98% of patients with
the ...leprosy infection. Furthermore, the relapse rate is very low, at about 1% over 5–10 years.
There is little M. leprae drug resistance in leprosy and few reports of multi-drug resistance (1, 2, 3,
4, 5, 6, 7, 8). An antibiotic treatment may take months or years to produce clinical improvement,
especially in patients with an initial high bacterial index (BI).
more
Chromoblastomycosis (CBM), represents one of the primary implantation mycoses caused by melanized fungi widely found in nature. It is characterized as a Neglected Tropical Disease (NTD) and mainly affects populations living in poverty with significant morbidity, including stigma and discrimination.
The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly re...placing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
more
Skin-related neglected tropical diseases, or “skin NTDs”, are historically neglected because active case detection, individual case management, significant resources and intensive effort are required to control, eliminate and eradicate them. Integrated control and management of skin NTDs offers ...a pathway to overcome some of these past challenges.
more
Rebuilding Liberia’s health system is crucial for improving the country’s overall health outcomes. This annual report highlights key achievements, challenges,and lessons learned in implementing programmes of technical cooperation with the Government of Liberia from January to December 2022. T...he key achievements are summarized under the thematic areas of Universal Health Coverage, Health Emergencies and Corporate and Enabling Support.
more
The COVID-19 pandemic has resulted in a double shock - health and economic. As of March 1, 2021, COVID-19 has cost more than 2.5 million lives and triggered an economic recession surpassing any economic downturn since World War II.
Part I of this paper explores the impact of this current macro-fisc...al outlook on the three primary sources of health spending. Drawing on experiences from previous economic crises, scenario analyses suggest a fall in government per capita spending on health in 2021 and 2022 unless governments make bold choices to increase the share of health in general government spending.
Part II of the paper discusses policy options to meet the spending needs in health. These options encompass strategies to make fiscal adjustments work and channel funds where they are most needed, as well as policies to stabilize the balance sheets of social health insurance (SHI) schemes. The paper explains how the health sector can play an active role in expanding fiscal space, contributing to tax reforms, most importantly pro-health taxes, and mobilizing and absorbing external financing, including debt relief.
more
The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline... is available both online and PDF.
This version of the living guideline (version 6.0) includes fifteen statements on IPC measures in health-care settings (screening and patient placement, ventilation, physical barriers, environmental cleaning, waste management, amongst others) as well as one statement on mask fit in the community context.
more
Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already d...eprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
more