Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r...egion in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
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UNAIDS Joint United Nations Programme on HIV/AIDS
Compared with other health areas, the mental health impacts of climate change have received less research attention. The literature on climate change and mental health is growing rapidly but is characterised by several limitations and research gaps. In a field where the need for designing evidence-b...ased adaptation strategies is urgent, and research gaps are vast, implementing a broad, all-encompassing research agenda will require some strategic focus.
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To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
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Guide to monitoring and evaluating
Advance chapters from the new edition
This paper brings together lessons from interviews with humanitarians and local responders, as well as existing literature, about the use of quarantine in urban environments during the humanitarian response to the Ebola Crisis
With hundreds of illustrations and clear instructions, A Community Guide to Environmental Health helps health promoters, development workers, environmental activists, and community leaders take charge of their environmental health in villages and cities alike. Also available in Arabic, Spanish, Chin...ese, Portuguese, Turkish, Dari, Malayan, Mongolian and Russian.
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PLoS ONE 13(8): e0202499. https://doi.org/10.1371/journal.pone.0202499
This was a school-based cross-sectional study conducted in 2015 among 305 school children aged 7–16 years from two primary schools located in Ilemela and Magu Districts, north-western Tanzania. Single stool and urine samples w...ere collected from each participant and examined for the presence of Schistosoma mansoni eggs, parasite antigen, and parasite DNA using KK thick smears, POC-CCA tests, and real-time PCR, respectively.
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Guidelines on obstructive sleep apnea in India.
MhGAP-IG – это примерное руководство, поэтому крайне важно адаптировать его в соответствии с уникальной национальной или местной ситуацией. Пользователи могут выбра...ь свои варианты приоритетных состояний или мер по адаптации и реализации Руководства в зависимости от имеющихся в наличии и преобладающих ресурсов.
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Scoping Question: For adults and children living with HIV, which antiepileptic medications (such as phenobarbital, phenytoin, carbamazepine or valproic acid) produce benefits and/or harms when compared to a placebo or controls?
Во многих странах суицид является одной из главных причин смерти среди детей и подростков. Одна из главных задач психиатрических служб – выяв-ление молодых людей ...з группы риска и предложение эффективных методов лечения. Данная глава содержит обзор суицидальности детей и подростков. Несуицидальные самоповреждения также будут рассмотрены, но основное внимание будет уделено суицидальным попыткам и завершенным суицидам. Обзор включает данные эпидемиологии, сведения о факторах риска и осо-бенностях этиологии, клинических проявлениях, диагностике, лечении и про-филактике. Поскольку акцент мы сделали на клинических проблемах, в этот обзор не вошли сведения о нейропсихобиологии суицидальности.
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Diante da natureza patogênica e virulenta do vírus SARS-CoV-2 e da evolução da epidemia de COVID, o governo decidiu, dia 15 de março de 2020, impor restrições à circulação da população para reduzir a propagação do vírus, proteger as pessoas em risco e preservar as cap...acidades do nosso sistema de saúde. O estrito respeito dos gestos de barreira sanitária foi enfatizado como corolário essencial dessas medidas.
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This curriculum will help you, and your community, understand the science of the virus that causes COVID-19 and other viruses like it. It will help you to figure out how this virus is impacting or affecting you or may impact you in the future. It will help you to understand the actions that you can ...take to keep yourself and your community safe.
It is available in 15 languages. Download for free at the website
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El plan de estudios le ayudará a usted, y a su comunidad, a entender la ciencia del virus que causa el COVID-19 y otros virus similares. Le ayudará a descubrir cómo este virus le afecta o puede afectarle en el futuro. Le ayudará a comprender las medidas que puede tomar para mantenerse a salvo y ...a su comunidad.
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Ce programme vous aidera, vous et votre communauté, à comprendre la science du virus qui cause le COVID-19 et d'autres virus similaires. Il vous aidera à comprendre comment ce virus vous affecte ou pourrait vous affecter à l'avenir. Elle vous aidera à comprendre les mesures que vous pouvez pren...dre pour assurer votre sécurité et celle de votre communauté.
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