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Systematic screening for TB disease is the systematic identification of people at risk for TB disease, in a predetermined target group, by assessing symptoms and using tests, examinations or other p
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rocedures that can be applied rapidly.
Systematic screening can benefit people who are at risk of getting TB, as early detection and start of treatment can improve their outcomes and reduce their costs. It can also benefit entire communities at higher risk for TB, by reducing the prevalence of TB disease and preventing future cases.
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In areas of Mexico, Central America, and South America, where the Trypanosoma cruzi parasite is present in triatomine bugs, improved housing and spraying insecticide inside housing to eliminate the bugs has significantly decreased the spread of Chagas dise
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ase. Screening of blood donations for Chagas is another important public health tool to help prevent spreading the disease through blood transfusions. Early detection and treatment of new cases, including mother-to-baby (congenital) cases, will also help reduce the burden of disease.
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A century after its discovery, Chagas' disease still represents a major public health challenge in Latin America. Moreover, because of growing population movements, an increasing number of cases of imported Chagas'
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disease have now been detected in non-endemic areas, such as North America and some European countries. This parasitic zoonosis, caused by Trypanosoma cruzi, is transmitted to humans by infected Triatominae insects, or occasionally by non-vectorial mechanisms, such as blood transfusion, mother to fetus, or oral ingestion of materials contaminated with parasites. Following the acute phase of the infection, untreated individuals enter a chronic phase that is initially asymptomatic or clinically unapparent. Usually, a few decades later, 40-50% of patients develop progressive cardiomyopathy and/or motility disturbances of the oesophagus and colon. In the last decades several interventions targeting primary, secondary and tertiary prevention of Chagas' disease have been attempted. While control of both vectorial and blood transfusion transmission of T cruzi (primary prevention) has been successful in many regions of Latin America, early detection and aetiological treatment of asymptomatic subjects with Chagas' disease (secondary prevention) have been largely underutilised. At the same time, in patients with established chronic disease, several pharmacological and non-pharmacological interventions are currently available and have been increasingly used with the intention of preventing or delaying complications of the disease (tertiary prevention). In this review we discuss in detail each of these issues.
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30 January 2020
This document outlines the standard operating procedures for detection and response to case/s of suspected novel coronavirus disease (2019-nCoV) in South Africa. The content of th
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is document should inform provincial preparedness plans.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challeng
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e for health professionals. It requires early recognition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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This document has been developed for the WHO Regional Office for the Eastern Mediterranean to establish a regional plan of action to support the countries of the Region to rapidly accelerate the scaling up of their capacities for the prevention and
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early detection of, and rapid response to, coronavirus disease 2019 (COVID-19), as required under the International Health Regulations (IHR 2005). The regional plan is aligned with the WHO global 2019 novel coronavirus strategic preparedness and response plan, but tailored to the regional context.
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Glaucoma is a leading cause of irreversible blindness globally. In Malawi, glaucoma accounts for 15.8% of the blindness among people aged 50 years and above. Blindness from glaucoma is preventable with early
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detection and timely treatment. However, glaucoma management remains a challenge to eye care providers due to its asymptomatic progression.
These guidelines inform eye care providers about the requirements for early detection of glaucoma, and the appropriate assessment and management of glaucoma patients. The guidelines also demonstrate the need for ophthalmologists to work with secondary-level eye care providers. With
glaucoma being a permanently blinding condition, it is vital to ensure that all eye care providers are adequately equipped with skills and resources for the early detection and management of glaucoma.
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On 31st December 2019, the World Health Organization (WHO) China Country Office was informed of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan City, Hubei Province of China. On 7th January 2020, Chinese authorities identified a new strain of Coronavirus as the causative age
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nt for the disease. The virus has been renamed by WHO as SARS-CoV-2 and the disease caused by it as COVID-19. The disease since its first detection in China has now spread to over 200 countries/territories, with reports of local transmission happening in more than 160 of these countries/territories. As per WHO (as of 1st April, 2020), there has been a total of 823626 confirmed cases and 40598 deaths due to COVID-19 worldwide.
In India, as on 2nd April, 2020, 1965 confirmed cases (including 51 foreign nationals) and 50 deaths reported from 29 States/UTs. Large number of cases has been reported from Delhi, Karnataka, Kerala, Maharashtra, Rajasthan, Tamil Nadu, Telangana and Uttar Pradesh.
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Cancer: Disease Control Priorities, Third Edition (Volume 3)
Gelband H., Jha P., Sankaranarayanan R. et al.
International Bank for Reconstruction and Development The World Bank
(2015)
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Volume 3, Cancer, presents the complex patterns of cancer incidence and death around the world and evidence on effective and cost-effective ways to control cancers. The DCP3 evaluation of cancer will indicate where cancer treatment is ineffective and wasteful, and offer alternative cancer care packa
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ges that are cost-effective and suited to low-resource settings. Main messages from the volume include:
-Quality matters in all aspects of cancer treatment and palliation.
-Cancer registries that track incidence, mortality, and survival paired with systems to capture causes of death are important to understanding the national cancer burden and the effect of interventions over time.
-Effective interventions exist at a range of prices. Adopting ‘resource appropriate’ measures which allow the most effective treatment for the greatest number of people will be advantageous to countries.
-Prioritizing resources toward early stage and curable cancers is likely to have the greatest health impact in low income settings.
-Research prioritization is no longer just a global responsibility.
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The purpose of cancer screening tests is to detect pre-cancer or early-stage cancer in asymptomatic individuals so that timely diagnosis and early treatment can be offered, where this treatment can
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lead to better outcomes for some people.
The aim of a cancer screening programme is either to reduce mortality and morbidity in a population by early detection and early treatment of a cancer (for example, breast screening) or to reduce the incidence of a cancer by identifying and treating its precursors (such as cervical and colorectal screening).
This short guide is designed to be a quick reference that contains the important ideas about cancer screening. Readers should refer to other publications for comprehensive discussion and detailed guidance on cancer screening programmes.
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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
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chronic HBV or HCV infection enables them to receive 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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9 March 2022, Timely and accurate diagnostic testing for SARS-CoV-2 is an essential part of a comprehensive COVID-19 response strategy. Ag-RDTs can be performed by individuals in which they collect their own specimen, perform a simple rapid test and interpret their test result themselves at a time a
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nd place of their choosing, termed COVID-19 self-testing. This interim guidance provides a new recommendation that COVID-19 self-testing, using SARS-CoV-2 Ag-RDTs, should be offered as part of SARS-CoV-2 testing services. It also includes implementation considerations that can guide decisions on whether, and how, to adopt self-testing in different contexts, including the populations being prioritized; the disease prevalence in that population; and the impact on accessibility of testing, health care services and result reporting.
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It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care providers to coordinate the continued care of children and adolescents with long-term conditions and dise
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ases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
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The strategy recommends that AU Member States should enhance, where feasible, existing COVID-19 surveillance to include:
Community-based surveillance to detect symptomatic cases early for treatment and to avert viral transmission;
Sentin
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el surveillance in high-risk populations to detect and track both presymptomatic and asymptomatic cases; and
Wastewater surveillance to monitor early environmental signs of virus transmission and identify communities where targeted interventions can be implemented to decrease transmission.
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This clinical management manual for Ebola Viral Disease in Liberia was developed after several ETUs were established in the country following the outbreak early this year. As the outbreak evolved, i
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t became evident that different SOPs were being used by clinicians across these treatment facilities. As a result of discussions held by the National Case Management Committee of the Incident Management System, various stakeholders were brought together to contribute their time and expertise to the development of this manual.
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ABSTRACT
More than 500 million people worldwide live with cardiovascular disease (CVD). Health systems today face fundamental challenges in delivering optimal care due to ageing populations, healthcare workforce constraints, financing, availability
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and affordability of CVD medicine, and service delivery.
Digital health technologies can help address these challenges. They may be a tool
to reach Sustainable Development Goal 3.4 and reduce premature mortality from
non-communicable diseases (NCDs) by a third by 2030. Yet, a range of fundamental barriers prevents implementation and access to such technologies. Health system governance, health provider, patient and technological factors can prevent or distort their implementation.
World Heart Federation (WHF) roadmaps aim to identify essential roadblocks on the pathway to effective prevention, detection, and treatment of CVD. Further, they aim to provide actionable solutions and implementation frameworks for local adaptation. This WHF Roadmap for digital health in cardiology identifies barriers to implementing digital health technologies for CVD and provides recommendations for overcoming them.
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This guide includes information relevant for tuberculosis (TB) program and laboratory managers, as well as Ministry of Health officials across disease programs interested in establishing integrated solutions for specimen referral. Though TB-focused
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in name, it offers integration-oriented assessment, design, and monitoring guidance related to improving coordination and efficiency, and is relevant for other programs as well. Country case studies include viral load and early infant diagnosis (EID) in Uganda and EID in Ethiopia.
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These guidelines provide recommendations for the non-pharmacological aspects of infection prevention and control for acute respiratory diseases (ARD) in health care. Administrative and infection controls, including early
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detection, isolation and reporting, and establishment of infection control infrastructure, are key components for containment and mitigation of the impact of pathogens that may constitute a major public health threat. In these guidelines, the options of using natural ventilation and/or exhaust fan assisted ventilation in health-care facilities (HCF) are considered.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the
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3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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Refugees and migrants face similar health threats from COVID-19 as their host populations. However, inadequate access to essential services and exclusion may makes early detection, testing, diagnosi
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s, contact tracing and seeking care for COVID-19 difficult for refugees and migrants thus increasing the risk of outbreaks in these population and presenting an additional threat to public health. This document offers guidance to Member States and partners for the inclusion of refugees and migrants, as part of holistic efforts to respond to COVID-19 epidemics in the general populations.
17 April 2020
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