3rd edition!Large File 17 MB!
This diagnostic and treatment manual is designed for use by medical professionals involved in curative care at the dispensary and hospital levels. We have tried to respond in the simplest and most practical way possible to the questions and problems
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faced by field medical staff, using the accumulated field experience of Médecins Sans Frontières, the recommendations of reference organizations such as the World Health Organization (WHO) and specialized works in each field.
Available in English, French, Spanish and Arabic
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Government of Nepal has an obligation to ensure availability of affordable and high quality basic health care services to its population
This chapter discusses the antibacterial treatment of leprosy infections. Antibiotic treatment is
a key component of leprosy treatment, as it is v
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ital 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).
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Working Document - Updated -February 2009
The WHO operational handbook on tuberculosis: tuberculosis preventive treatment is the companion, implementation guide to the 2020 WHO guidelines on TB preventive treatment.[1] Just as these guideli
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nes are the first to be released under the rubric of the WHO consolidated TB guidelines, this handbook will be the first in a modular series of practical guides meant for the implementers of various aspects of the programmatic management TB.
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Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young people and adults with chronic hepatitis B a-
should be assessed; assessment of liver disease, includi
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ng the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost effectiveness of currently available treatments; selection of first-line therapy; management of treatment failure or drug resistance; prophylactic treatment during im-
munosuppressive therapy; and monitoring for treatment response
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Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(TB) patients. Objective: To assess whether
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differences in gender and HIV
status affect diagnostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
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The pharmacological treatment of heart failure has evolved over the last three decades since the demonstration of the effect of angiotensinconverting enzyme inhibitors on major cardiovascular events
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in patients with heart failure with reduced ejection fraction. Composite analysis of heart failure with reduced ejection fraction trials and the recent identification of newer drug treatments show early benefits on the major cardiovascular outcomes, ushering in a change of the treatment strategy; from a ‘sequential’ initiation of the treatments to a ‘simultaneous’ initiation to harness the early benefits. The adoption and implementation of these changes at the bedside have been dismal in many healthcare settings. Papua New Guinea, like many other lower-to-middle-income countries, is facing many barriers that impact on the care of heart failure patients. It needs to adopt and implement these changes to provide evidence-based treatment for its people with heart failure with reduced ejection fraction.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for commo
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n syndromes in India. These guidelines are targeted for the health care settings. It aims to rationalize the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery disea
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ses. In addition, diabetes is a major risk factor for developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
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The Adult Standard Treatment Guidelines and Essential Medicines List for Hospital Level provide a platform for transparency to enable equitable access to safe, effective, and affordable treatment op
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tions at hospital level taking into consideration the changing clinical needs of our population and the pragmatic implications of the introducing a new health technology.
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