Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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These WHO guidelines which were updated in 2018, are valid for any country and suitable to local adaptations, and take account of the strength of available scientific evidence, the cost and resource implications, and patient values and preferences.
The 2018 edition of the guidelines includes the re...vision of the recommendation regarding the use of 80% fraction of inspired oxygen (high FiO2) in surgical patients under general anaesthesia with tracheal intubation and the update of the section on implementation. Between 2017 and 2018, WHO re-assessed the evidence on the use of high FiO2 by updating the systematic review related to the effectiveness of this intervention to reduce SSI and commissioning an independent systematic review on adverse events potentially associated with it. Based on the updated evidence, the GDG decided to revise the strength of the recommendation from strong to conditional.
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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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WHO clinical guidelines.
For the first time, WHO has published guidelines to help (primarily) front-line healthcare providers give high-quality, compassionate, and respectful care to children and adolescents (up to age 18) who have or may have experienced sexual abuse, including sexual assault or r...ape.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released i...n 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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Overview: Risk communication and community engagement are essential for any disease outbreak response. This is particularly critical during outbreaks of Ebola which may create fear in the public and frontline responders alike due to severe presentation of symptoms, misunderstanding of the causes of ...illness and high fatality rates. This document outlines some of the key considerations for risk communication and community engagement response to Ebola outbreak in Democratic Republic of the Congo.
Ebola outbreaks have been associated with misinformation and false rumours. In the context of RCCE, rumours refer to unsubstantiated information, claims or beliefs about what is causing the disease or how it can be treated/cured. If not proactively addressed in culturally appropriate ways, misinformation and rumours can lead to the further rapid spread of the disease and unnecessary deaths, severe disease, suffering, and societal and economic loss.
The publication includes a 'Rumour Tracking Tool' (Annex II).
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To implement the set of recommendations on the marketing of foods and non-alcoholic beverages to children
With the growing obesity crisis among children, WHO and other public health advocates and consumer groups have called for restrictions on advertising of ‘unhealthy foods’ high in salt, ...sugar and fat to children. Each day, children in the South East Asia Region are exposed to large volume of marketing of unhealthy foods that may influence children’s food preferences and consumption patterns and is associated with childhood overweight and obesity.
The definition of ‘unhealthy’ is debatable, and therefore, an objective method of describing foods as healthy or unhealthy is needed. A nutrient profile model does just that and therefore, a nutrition profile model for South East Asia was developed. The model is consistent with international guidance for preventing chronic disease and is a simple system with clear cut-offs for defining which foods are not suitable for advertising to children.
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Estimating the size of key affected populations (KAP) provides important data for planning and implementing an effective response to the HIV epidemic. In the Philippines, these KAP include males who have sex with males (MSM), female sex workers (FSW), and injecting drug users (IDU). Given the diffic...ulty in reaching these populations, as well as their high mobility, the process consequently entailed a specific methodology to directly estimate the size of KAP.
The national estimate of MSM was 531,500 or 2.2% (1.8%-3.2%) of males aged 15-49. Within this MSM estimate, figures for transgender women (TGW) and male transactional sex workers (MSW) were determined. The national estimate for TGW was 122,800 or about 0.50% (0.40%-0.75%) of males aged 15-49, and 23% of the MSM population. Meanwhile, MSW comprised 0.35% (0.29%-0.53%) of the male population aged 15-49 and 16% of the MSM population, giving a best estimate of 86,600.
The estimate of combined RFSW and FFSW was 66,100 or 0.28% (0.19%-0.40%) of females aged 15-49. Meanwhile, there are approximately 10,000 to 21,700 IDU or 0.04%-0.09% of males aged 15-49.
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2nd edition. The 2018 Roadmap incorporates an additional critical population: adolescents. Despite making up 1 in 6 of the world’s people, adolescents have been largely overlooked as global momentum to address TB has grown. Spanning the ages of 10–19 years, adolescents are both at risk of TB and... represent an important population for TB control. They often present with infectious TB and frequently have multiple contacts in congregate settings, such as schools and other educational institutions. Nevertheless, few countries capture TB data in suitably age-disaggregated ways to allow full understanding of its impact in this group and even fewer provide the adolescent-friendly services our young people need to access diagnosis and care.
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Several diagnostic criteria of Post-traumatic Stress Disorder (PTSD) are remarkably similar to symptoms reported by individuals with depression, particularly as they manifest as cognitive processing deficits in children. Because of this overlap in profile and the high rate of comorbidity of PTSD and... depression (48% to 69%), pinpointing similarities/differences in cognitive processes related to each of these disorders is essential to accurate diagnosis. This study aims to examine cognitive performance profiles of 23 children who have been victims of PTSD and to compare their results with 23 children with depression and 24 controls.
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Overview
Learning objectives
• Name the general principles of essential care and practice.
• Name management principles of priority MNS conditions.
• Use effective communication skills in interactions with people with MNS conditions.
• Perform assessments for priority MNS conditions.
... Assess and manage physical health in MNS conditions.
• Know the impact of violence and gender-based violence on mental health.
• Provide psychosocial interventions to a person with a priority MNS condition and their
carer.
• Deliver pharmacological interventions as needed and appropriate in priority MNS
conditions considering special populations.
• Plan and perform follow-up for MNS conditions.
• Refer to specialists and links with outside agencies for MNS conditions as appropriate and
available.
• Promote respect and dignity for people with priority MNS conditions.
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The report discusses the epidemiological and social aspects of ageing, health and functional changes experienced with ageing, the impact of physical activity, assessment of the nutritional status of older persons, and nutritional guidelines for healthy ageing.
27 May 2021
All countries should increase their level of preparedness, alert and response to identify, manage and care for new cases of COVID-19. Countries should prepare to respond to different public health scenarios, recognizing that there is no one-size-fits-all approach to managing cases and o...utbreaks of COVID-19. Each country should assess its risk and rapidly implement the necessary measures at the appropriate scale to reduce both COVID-19 transmission and economic, public and social impacts.
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The global emergence of antimicrobial resistance (AMR) is posing a threat to human health. Putting resources into the containment of AMR – including surveillance – is one of the highest-yield investments a country can make to mitigate its impact. In 2015, WHO launched the Global Antimicrobial Re...sistance Surveillance System (GLASS), the first global collaborative effort to foster AMR surveillance in bacteria causing acute infections. As of December 2018, 71 countries are enrolled in GLASS. The aim of this report is to document participation efforts and outcomes across these countries, and highlight differences and constraints identified to date. This report follows on from the first GLASS Report – Early implementation 2016-17, published in January 2018, and drawing on data from GLASS first data call in 2017.
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Myanmar, as a country going through rapid socio-political transition and institutional development also suffers with a high burden of infectious disease. An ongoing challenge has been to effectively reach its 51 million population, most of whom battle tuberculosis, acute respiratory infections, diar...rhoea and malaria including amongst under-five children.
Limited research data on the occurrence of resistant organisms in the nation have, makes it hard to estimate the exact antimicrobial resistance (AMR) scenario. Limited peer reviewed evidence indicates significant divergence from the average resistance trends in APAC region. Nevertheless, several key steps by Government of Myanmar have been instrumental in paving the way for the country to join other nations in the South East Asia Region to speed up its plan on addressing the AMR crisis. Combating antimicrobial resistance would, however, require highest political commitment, multi-sectoral coordination, sustained investment and technical assistance.
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Since March, the COVID-19 pandemic has impacted operations and required a different approach to communication with communities.
UNHCR communication channels have been rapidly enhanced and enlarged to ensure the continued provision of vital health and protection information.
Fetal alcohol spectrum disorders (FASD) represent a range of physical, mental, and behavioral disabilities caused by alcohol use during pregnancy, or prenatal alcohol exposure (PAE). FASDs are considered to be one of the leading preventable causes of developmental disability. Despite its high preval...ence, FASD is often misdiagnosed or underdiagnosed, making interventions more challenging or delayed.
his publication was initially developed for use in Spanish-speaking countries of the Americas and is intended to serve as a training workbook for providers of various disciplines to learn about the fundamentals of diagnosing FASD and to apply them to several case scenarios. It also discusses ethical implications of diagnosing FASD to the mother and child. Target audiences include physicians, psychologists, allied health professionals, social workers, and other providers that may encounter individuals affected by FASD. It is ideally used as a supplement for in-person training by experts in the fields of dysmorphology, epidemiology, and neuropsychology.
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The WHO Guidance for Conducting a Country COVID-19 Intra-Action Review (IAR) was developed to guide countries to conduct periodic review(s) of their national and subnational COVID-19 response, so countries do not miss critical opportunities for learning and improvement to better respond to the COVID...-19 outbreak in their countries, especially as the possibility of a protracted pandemic becomes increasingly probable. The IAR is a country-led facilitated process conducted during the COVID-19 outbreak in-country, bringing together a small group of COVID-19 responders with knowledge of the public health response pillars under review. Although IARs can be conducted online or face-to-face, the online format is recommended, especially if community transmission remains high in the country. The IAR will identify practical areas for immediate remediation and sustained improvement of the ongoing response.
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A total of 18 laboratories from 13 countries participated in the four rounds of EQA: 10 laboratories from eight African endemic countries, four of which participated in all four rounds and three in three rounds. The overall results showed that the median performance of these laboratories improved ov...er the four rounds. However, the proportion of laboratories reporting false–positive cases remains high and indicates a problem of specificity probably due to contamination. The proportion of laboratories reporting both false–positive and false–negative results raises the issue of the quality of the data reported by WHO in Africa as well as the results of the studies carried out in these different laboratories in various countries.
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Meeting Report 27-29 October 2020
The overall goal of the meeting was to discuss recent changes in treatment regimens and diagnostics for drug-resistant TB and to determine how these impact on the definition of XDR-TB, with a view to revising this definition. The pre-existing definition of XDR-TB w...as formulated in 2006 at a meeting of the Global Taskforce on XDR-TB, convened by WHO, and has been in use for clinical and surveillance purposes, since this time.
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