In case of resistance to rifampicin, fluoroquinolones become the preferred category of second-line drugs. Unfortunately, quinolone-resistant strains of...pan> Mycobacterium leprae have also been reported in several countries, probably due to the extensive use of quinolones for treating several types of infections. Clofazimine resistance is still rare but this antimicrobial cannot be given alone
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This update of the Guidelines for poison control, entitled Guidelines for establishing a poison centre, reflects the development ...bute-to-highlight medbox">of the role of poison centres in public health and the sound management of chemicals, described in section 1, and the opportunities provided by new technology. Assessments carried out under the IHR show
continuing gaps in capacity for managing chemicals (2). In particular, many countries still lack access to poison
centre services (3). There is therefore demand for updated guidance.
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This manual is addressed to health care providers dealing with Mycobacterium ulcerans disease (Buruli ulcer). The manual aims to achieve a better understanding of the disease, its clinical presentation and its surgical management. The manual is aime...d particularly at district health care providers. A comprehensive protocol, adapted to each form and stage of the disease, is presented together with comments on the levels of resources and capabilities necessary
to shorten the length of treatment, to prevent complications and to minimize undesired sequelae and thus to obtain the best possible outcome for each patient. Some sections include advice relevant to surgeons (e.g. relating to bone infection). However, the level to which particular comments are intended to apply should be clear from the context.
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During the past five decades, the incidence of dengue has increased 30-fold. Some 50–100 million new infections are estimated to occur annually in more than 100 endemic countries, with a document...ed further spread to previously unaffected areas; every year hundreds of thousands of severe cases arise, including 20 000 deaths; 264 disability-adjusted life years per million population per year are lost , at an estimated cost for ambulatory and hospitalized cases of US$ 514–1394, often affecting very poor populations. The true numbers are probably far worse, since severe underreporting and misclassification of dengue cases have been documented.
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The five hepatitis viruses have different epidemiological profiles, and their impact, duration, and transmission route also vary. The most common transmission routes contributing to the spread of hepatitis are exposure to infected blood via blood tr...ansfusion or unsafe injection practices, consumption of contaminated food and drinking water, and transmission from mother to child during pregnancy and delivery. Also, unsafe injection practices, including the use of unsterile needles and syringes, serve as a major pathway for the spread of hepatitis B and C, and reducing transmission of both diseases requires addressing these practices.
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WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process... for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatment of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
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As countries commit to achieving universal health coverage, it is imperative to ensure that the design and delivery of palliative care services place attention on quality of care, with action needed... across all domains of quality health services: effectiveness, safety, people-centredness, timeliness, equity, integration and efficiency. Providing compassionate, dignified and people-centred palliative care is an ethical responsibility of health systems.
This document provides a practical resource to support implementation of sustainable improvements in the quality of palliative care. It describes approaches to quality policy, strategy and planning for palliative care programmes and services, presents learning on quality of care arising from palliative care programmes, and offers considerations on measurement of quality palliative care services at all levels of the health system. The document also highlights relevant WHO resources available that further support the development of quality palliative care services.
The audience for this document is a general one that includes policy-makers, palliative care service planners, managers, practitioners and health care providers at all levels.
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• provide scientific information on the safety, efficacy, and quality control/ quality assurance of widely used medicinal plants, in order to fac...ilitate their appropriate use in Member States;
• provide models to assist Member States in developing their own mono- graphs or formularies for these or other herbal medicines; and
• facilitate information exchange among Member States.
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Hand hygiene is vital for safe health care delivery, yet practices at the point of care remain suboptimal worldwide. A comprehensive research agenda is therefore necessary to improve our understandi...ng of factors influencing hand hygiene behaviour and to strengthen appropriate interventions. This agenda will provide insightful ideas for researchers to focus their projects and funding proposals and will direct donors towards the areas of hand hygiene evidence that require urgent support and innovation. It will also guide decision-makers and stakeholders at the national and international level and support country efforts in updating and strengthening hand hygiene promotion programmes. Global collaboration and investment in hand hygiene research remain essential to promote safe and effective care worldwide.
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Scientists have known for more than half a century that patients could develop resistance to the drugs used to treat them. Alexander Fleming, who is credited with creating the first antibiotic, pen...icillin, in 1928, cautioned of the impending crisis while accepting his Nobel prize in 1945: “There is the danger that the ignorant man may easily underdose himself and by exposing his microbes to non-lethal quantities of the drug make them resistant.” Since then antibiotics have proved one of the most effective interventions in human medicine. Sadly, the overuse and misuse of this precious resource have brought us to a global crisis of antimicrobial resistance (AMR). To address this crisis nearly seven decades after Fleming’s lecture the first UN general assembly meeting on drug resistance bacteria was convened in September 2017.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack ...class="attribute-to-highlight medbox">of access to palliative care and symptom relief in low- and middle-income countries (LMICs) (1). Yet basic palliative care that can prevent or relieve most suffering due to serious or life-threatening health conditions can be taught easily to generalist clinicians, can be provided in the community and requires only simple, inexpensive medicines and equipment. For these reasons, the World Health Assembly (WHA) resolved that palliative care is "an ethical responsibility of health systems"(2). Further, most patients who need palliative care are at home and prefer to remain there. Thus, it is imperative that palliative care be provided in the community as part of primary care. This document was written to assist ministries of health and health care planners, implementers and managers to integrate palliative care and symptom control into primary health care (PHC).
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This book provides significantly expanded content and experience in relation to a broader stewardship context- for example, stewardship in specific populations, different countries as well as the role of different professions in stewardship to polit...ical and media engagement. We hope this book has something to offer everyone practicing in this area. Therefore, The British Society for Antimicrobial Chemotherapy [BSAC] in collaboration with ESGAP are very pleased to present this e-book on Global Antimicrobial Stewardship that is relevant to health care professions working in preventing and managing infection across the healthcare communities and health care facilities. It aims to support health care professionals, or teams, or policy makers interested in learning about bringing the principles of stewardship to the bed side
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Antimicrobial resistance (AMR) surveillance plays an important role in the early detection of resistant strains of public health importance and prompt response to outbreaks in hospitals and the comm...unity. Surveillance findings are needed to inform medical practice, antibiotic stewardship, and policy and interventions to combat AMR. Appropriate use of antimicrobials, informed by surveillance, improves patients’ treatment outcomes and reduces the emergence and spread of AMR. This protocol describes the steps and procedures to establish/enhance AMR surveillance in Latin America and the Caribbean.
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This curricula guide builds on several existing products of WHO and partners, aimed at supporting countries in their effort to address the first objective ...>of the GAP-AMR (to improve awareness and understanding of AMR). It is targeted specifically at health educators and policy planners, and applies a systematic modular and submodular collection of learning objectives and outcomes that are organized according to the key occupational groups involved in the use of antimicrobials in human health. It is hoped that educators, faculties of heath personnel training institutions, health regulatory institutions and other users will find it a useful resource in meeting their respective needs for strengthening health workers’ contributions to containing AMR.
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The brief concludes that sustaining the continuity of EHS requires policies that ensure a whole-society and systems strengthening approach. This involves increased health care investment, community engagement, disease ...ight medbox">control regulations, and multisector approaches to improve resilience, EHS quality, and equity.
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The issue of Antimicrobial resistance has become one of the most substantial health issues, prompting the World Health Assembly (WHA) to urge Member States to finalise tailor made national action pl...ans by May 2017, aligning them with objectives of the Global Action Plan (GAP). These cover awareness, surveillance and research, hygiene infection prevention & control, optimal use of antimicrobial medicines and economic case for sustainable investment. Indonesia, by virtue of its geographical terrain and complex interactions with diverse stakeholders, indicates a higher burden of AMR. Most of the country’s data currently relies on local studies conducted by labs and universities. To get a more accurate estimate of the situation, one has to rely on results from the Regional Resistance Surveillance Programme. By undertaking such measure, Indonesia would acquire data to detect AMR trends at a national level.
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Oral diseases are among the most common chronic diseases worldwide and constitute a major public health problem due to the huge health and economic burden on individuals, families, societies, and health care systems. The recent emphasis on the role of...n> determinants of health, common risk factors and their recognition in the context of the growing burden of noncommunicable diseases (NCDs) provides good opportunities for integrating oral health into NCD prevention and control efforts. This Strategy for oral health in South-East Asia, 2013-2020, presents guidance to Member States in developing national policy and action plans to improve oral health within existing socioeconomic, cultural, political and health system contexts. It expresses the consensus on major strategies in the area of oral health promotion as well as oral disease prevention and control for the South-East Asia Region aiming at reducing the health and socioeconomic burden resulting from oral diseases, reducing oral health inequities, and improving the quality of life of the population.
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This publication describes an arduous campaign to tackle the use of antimicrobials - specifically antibiotics - in the Danish swine-producing sector thanks to the collaboration between the regulator...y sector within the Ministry of Environment and Food, private veterinary practitioners and swine producers. The document is a retrospective tribute to all those who had the foresight to make significant changes to ensure consumer protection - improving hygiene at primary sites, developing options for intervention, identifying sites for intervention, setting targets, restructuring the relationship between the veterinary services and farmers, and implementing changes in behaviour for greatest impact
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The guide is suitable and can be used for the following audiences:
1. nurses and other trained healthcare workers who can use this manual as a self-study tool and then incorporate its guidance into their ...practice;
2. governmental and non-governmental employers of lay and professional TB treatment adherence workers, who can provide training and guidance to their staff using the guidance in this manual;
3. TB clinicians, programme managers, policy makers and other leaders, to make them aware of the full range of interventions required by a person on TB treatment to complete his or her treatment and thus understand the gap that often exists in the support provided to patients;
4. people who, with enhanced capacity and support, can act as peer counsellors and supporters for people affected by TB. This can include family members who, in most contexts, play an important role in offering support to people with TB.
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