Временные рекомендации4 ноября 2020 г.
В данной редакции документа представлены обновленные рекомендации в таблице, посвященной важнейшим мерам по подготовке, обес...печению готовности и реагированию в связи с COVID-19 при различных сценариях передачи инфекции,
а также приводится обновленный полный перечень технических руководящих указаний ВОЗ по COVID-19.
(measures to prepare and provide readiness and a response plan for COVID-19)
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Orientations provisoires, 28 janvier 2021
Dans cette version mise à jour des orientations sur la sécurité biologique en laboratoire en rapport avec le SARS-CoV-2, le virus responsable de la maladie à coronavirus 2019 (COVID-19), les points suivants ont été ajoutés : aspects de... sécurité biologique relatifs à la réalisation des tests diagnostiques rapides antigéniques, manipulation des nouveaux variants du SARS-CoV-2 au laboratoire, mise à jour de la décontamination des tests avant leur élimination, équipement de protection individuelle (EPI) pour le prélèvement d’échantillons et, même s’ils ne concernent pas directement la sécurité biologique, dangers chimiques et leur élimination en toute sécurité.
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To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp...onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
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The Lancet Countdown is an international collaboration that independently monitors the health consequences of a changing climate. Publishing updated, new, and improved indicators each year, the Lancet Countdown represents the
consensus of leading researchers from 43 academic institutions and UN ag...encies. The 44 indicators of this report expose an unabated rise in the health impacts of
climate change and the current health consequences of the delayed and inconsistent response of countries around the globe—providing a clear imperative for accelerated action that puts the health of people and planet above all else.The 2021 report coincides with the UN Framework Convention on Climate Change 26th Conference of the Parties (COP26), at which countries are facing pressure to realise the ambition of the Paris Agreement to keep the global average temperature rise to 1·5°C and to
mobilise the financial resources required for all countries to have an effective climate response. These negotiations unfold in the context of the COVID-19 pandemic—a global health crisis that has claimed millions of lives, affected livelihoods and communities around the globe, and exposed deep fissures and inequities in the world’s capacity to cope with, and respond to, health emergencies. Yet, in its response to both crises, the world is faced with an unprecedented opportunity to ensure a healthy future for all.
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We reviewed the evidence on community-based interventions for the prevention and control of cutaneous leishmaniasis (CL). Community initiatives tailored towards awareness and mobilisation are regarded as a priority area in the Neglected Tropical Disease Roadmap 2021–2030 by the World Health Organi...zation. We searched nine electronic databases for intervention-based
studies. Two independent reviewers screened and assessed the articles for methodological quality using predefined criteria. We conducted a meta-analysis using a random effects model, along with narrative synthesis. Thirteen articles were eligible for inclusion, of which 12 were quantitative studies (quasi-experimental with control group and pre-post interventions) and one qualitative
study. All articles reported on health education interventions aimed at changing people’s knowledge, attitudes, and practices (KAP) in relation to CL. Participant groups included students, mothers, housewives, volunteer health workers, and residents in general. An increased score was recorded for all outcomes across all interventions: knowledge (SMD: 1.85, 95% CI: 1.23, 2.47), attitudes (SMD:
1.36, 95% CI: 0.56, 2.15), and practices (SMD: 1.73, 95% CI: 0.99, 2.47). Whilst our findings show that educational interventions improved people’s knowledge, attitudes, and practices about CL, we argue that this approach is not sufficient for the prevention and control of this disease. Knowledge does not always translate into action, particularly where other structural barriers exist. Therefore,
we recommend the design of more innovative community-based interventions with a broader focus (e.g., stigma, financial barriers, and healthcare access).
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Background
The ambitious development agenda of the Sustainable Development Goals (SDGs) requires substantial investments across several sectors, including for SDG 3 (healthy lives and wellbeing). No estimates of the additional resources needed to strengthen comprehensive health service delivery to...wards the attainment of SDG 3 and universal health coverage in low-income and middle-income countries have been published.
Methods
We developed a framework for health systems strengthening, within which population-level and individual-level health service coverage is gradually scaled up over time. We developed projections for 67 low-income and middle-income countries from 2016 to 2030, representing 95% of the total population in low-income and middle-income countries. We considered four service delivery platforms, and modelled two scenarios with differing levels of ambition: a progress scenario, in which countries’ advancement towards global targets is constrained by their health system’s assumed absorptive capacity, and an ambitious scenario, in which most countries attain the global targets. We estimated the associated costs and health effects, including reduced prevalence of illness, lives saved, and increases in life expectancy. We projected available funding by country and year, taking into account economic growth and anticipated allocation towards the health sector, to allow for an analysis of affordability and financial sustainability.
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Background: Asthma and chronic obstructive pulmonary disease (COPD) cause a considerable burden of morbidity
and mortality in low-income and middle-income countries (LMICs). Access to safe, effective, quality-assured, and
affordable essential medicines is variable. We aimed to review the existing ...literature relating to the availability, cost,
and affordability of WHO’s essential medicines for asthma and COPD in LMICs.
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Given the intimate association between silicosis and tuberculosis, understanding the epidemiology of the South African gold mining industry silicosis epidemic is essential to current initiatives to control both silicosis and tuberculosis in this population, one of the most heavily affected globally.... The study’s objectives were to compare the prevalence of silicosis among working black gold miners in South Africa during 2004–2009 to that of previous studies, including autopsy series, and to analyse the influence of silicosis and/or tuberculosis on exiting employment.
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From 2000 to 2010, Rwanda implemented comprehensive health sector reforms to strengthen the public health system, with the aim of reducing maternal and newborn deaths in line with Millennium Development Goal 5, among many other improvements in national health. Based on a systematic review of the lit...erature, national policy documents and three Demographic & Health Surveys (2000, 2005 and 2010), this paper describes the reforms and the policies they were based on, and provides data on the extent of Rwanda’s progress in expanding the coverage of four key women’s health services. Progress took place in 2000–2005 and became more rapid after 2006, mostly in rural areas, when the national facility-based childbirth policy, performance-based financing, and community-based health insurance were scaled up. Between 2006 and 2010, the following increases in coverage took place as compared to 2000–2005, particularly in rural areas, where most poor women live: births with skilled attendance (77% increase vs. 26%), institutional delivery (146% increase vs. 8%), and contraceptive prevalence (351% increase vs. 150%). The primary factors in these improvements were increases in the health workforce and their skills, performance-based financing, community-based health insurance, and better leadership and governance. Further research is needed to determine the impact of these changes on health outcomes in women and children.
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Version 1.1 July 2016
The purpose of this document is to describe standard operating procedures for viral load monitoring, including the schedule for viral load testing when used for routine monitoring of children, adolescents and adults on ART; interpretation of results; patient management; an...d specimen collection, preparation and transport. This template document to be adapted for use in various contexts and is one component of a viral load monitoring toolkit, to be used in conjunction with ICAP’s Viral Load Monitoring Flipchart and Enhanced Adherence Treatment Plan.
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This training and guidance module addresses the use of coercive and violent practices in mental health and related services with a particular focus on seclusion and restraint. It aims to promote a greater understanding of why these practices are used and build practical skills to help end these prac...tices. While the module itself focuses on ending these practices in the health care setting, much of the content can also be applied in other settings where seclusion and restraint occur, for example in the home and in the wider community.
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This module has been developed to provide training and guidance to improve the quality of care and human rights conditions in inpatient, outpatient and community based mental health and related services, following the conduct of a comprehensive assessment using the WHO QualityRights assessment toolk...it.
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PLoSONE 14(9):e0223104.https://doi.org/10.1371/journal.pone.0223104.
The survey centering on reasons behind community resistance was conducted in Butembo in November during a time of Ebola transmission. A researcher from Catholic University of Graben in Butembo and collaborators at the University o...f Alberta in Edmonton published their findings on Sep 26 in PLOS One.
To spark focus group discussions, the researchers used an 18-item questionnaire based on similar ones used during West Africa's outbreak in Guinea, where community resistance and episodes of violence also complicated the outbreak response.
Participants were a convenience sample of 670 adults from the region who were recruited by medical students at Catholic University of Graben. Those surveyed included clinicians, community members, and displaced persons.
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The Covid-19 pandemic has so far infected more than 30 million people in the world, having major impact on global health with collateral damage. In Mozambique, a public state of emergency was declared at the end of March 2020. This has limited people's movements and reduced public services, leading ...to a decrease in the number of people accessing health care facilities. An implementation research project, The Alert Community for a Prepared Hospital, has been promoting access to maternal and child health care, in Natikiri, Nampula, for the last four years. Nampula has the second highest incidence of Covid-19. The purpose of this study is to assess the impact of Covid-19 pandemic Government restrictions on access to maternal and child healthcare services. We compared health centres in Nampula city with healthcare centres in our research catchment area. We wanted to see if our previous research interventions have led to a more resilient response from the community.
METHODS: Mixed-methods research, descriptive, cross-sectional, retrospective, using a review of patient visit documentation. We compared maternal and child health care unit statistical indicators from March-May 2019 to the same time-period in 2020. We tested for significant changes in access to maternal and child health services, using KrushKall Wallis, One-way Anova and mean and standard deviation tests. We compared interviews with health professionals, traditional birth attendants and patients in the two areas. We gathered data from a comparable city health centre and the main city referral hospital. The Marrere health centre and Marrere General Hospital were the two Alert Community for a Prepared Hospital intervention sites.
RESULTS: Comparing 2019 quantitative maternal health services access indicators with those from 2020, showed decreases in most important indicators: family planning visits and elective C-sections dropped 28%; first antenatal visit occurring in the first trimester dropped 26%; hospital deliveries dropped a statistically significant 4% (p = 0.046), while home deliveries rose 74%; children vaccinated down 20%.
CONCLUSION: Our results demonstrated the negative collateral effects of Covid-19 pandemic Government restrictions, on access to maternal and child healthcare services, and highlighted the need to improve the health information system in Mozambique.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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This scoping study done in Myanmar offers the chance for FoodSTART+ to explore prospects for future partnerships in another important country of the region. The study was done from October 2016 to February 2017 and included visits to selected major potato and cassava production areas to meet with re...spective stakeholders and market actors.
Although root and tuber crop (RTC) production in Myanmar has gradually increased since the late 1990s, they still lag behind the other major crops like rice. No RTCs are included in the country’s list of primary important crops even though potatoes are regularly consumed in daily meals while other common RTCs like cassava, elephant foot yam and sweetpotato are consumed occasionally. RTCs primarily contribute to food security and livelihoods through the income generated from their sale, whether fresh or processed, rather than directly through consumption.
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This training and guidance has been developed to provide an in-depth understanding on what it means to respect legal capacity in mental health and related areas as well as concrete strategies to ensure that people are able to exercise their right to legal capacity in all areas of their life. In this... context a wide range of scenarios are used to describe how different models of supported decision making can be applied in practice.
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Supportive supervision is considered critical to community health worker programme performance, but there is relatively little understanding of how it can be sustainably done at scale. Supportive supervision is a holistic concept that encompasses three key functions: management (ensuring performance...), education (promoting development) and support (responding to needs and problems). Drawing on the experiences of the ward-based outreach team (WBOT) strategy, South Africa’s national community health worker (CHW) programme, this paper explores and describes approaches to supportive supervision in policy and programme guidelines and how these are implemented in supervision practices in the North West Province, an early adopter of the WBOT strategy. Outreach teams typically consist of six CHWs plus a nurse outreach team leader (OTL).
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Background: The human helminth infections include ascariasis, trichuriasis, hookworm infections, schistosomiasis, lymphatic filariasis (LF) and onchocerciasis. It is estimated that almost 2 billion people worldwide are infected with helminths. Whilst the WHO treatment guidelines for helminth infecti...ons are mostly aimed at controlling morbidity, there has been a recent shift with some countries moving towards goals of disease elimination through mass drug administration, especially for LF and onchocerciasis. However, as prevalence is driven lower, treating entire populations may no longer be the most efficient or cost-effective strategy. Instead, it may be beneficial to identify individuals or demographic groups who are persistently infected, often termed as being “predisposed” to infection, and target treatment at them.
Methods: The authors searched Embase, MEDLINE, Global Health, and Web of Science for all English language, humanbased papers investigating predisposition to helminth infections published up to October 31st, 2017. The varying definitions used to describe predisposition, and the statistical tests used to determine its presence, are summarised. Evidence for predisposition is presented, stratified by helminth species, and risk factors for predisposition to infection are identified and discussed.
Results: In total, 43 papers were identified, summarising results from 34 different studies in 23 countries. Consistent evidence of predisposition to infection with certain species of human helminth was identified. Children were regularly found to experience greater predisposition to Ascaris lumbricoides, Schistosoma mansoni and S. haematobium than adults. Females were found to be more predisposed to A. lumbricoides infection than were males. Household clustering of infection was identified for A. lumbricoides, T. trichiura and S. japonicum. Ascaris lumbricoides and T. trichiura also showed evidence of familial predisposition. Whilst strong evidence for predisposition to hookworm infection was identified, findings with regards to which groups were affected were considerably more varied than for other helminth species.
Conclusion: This review has found consistent evidence of predisposition to heavy (and light) infection for certain human helminth species. However, further research is needed to identify reasons for the reported differences between demographic groups. Molecular epidemiological methods associated with whole genome sequencing to determine ‘who infects whom’ may shed more light on the factors generating predisposition.
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This handbook and teaching guide on recovery has been designed to complement the QualityRights training module on Promoting Recovery in Mental Health and Related Services. The handbook and teaching guide covers much of the same material, but also contains additional text and exercises. It can be giv...en to participants at the end of the training sessions so that they are able to review the concepts and material learned during the training.
Alternatively, it can be used independently as a standalone document to deliver training on recovery over 4-5 training days. The handbook/ teaching guide does not rely on PowerPoint presentations to deliver the training. Instead all participants should have a copy of the handbook/ teaching guide and work through the text and exercises either in plenary or in groups based on the discretion of the facilitator for the training.
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