July 2021. This publication brings together important clinical and programmatic updates produced by WHO since 2016 and provides comprehensive, evidence-informed recommendations and good practice statements within a public health, rights-based and person-centred approach.
These guidelines bring in... the most recent guidance on HIV testing strategies - the entry point for HIV prevention and treatment - and include comprehensive guidance on infant diagnosis. Key recommendations are presented on rapid antiretroviral therapy (ART) initiation and the use of dolutegravir. Updated recommendations are included on the timing of ART for people with TB, and the use of point-of-care technologies for treatment monitoring.
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Pan American Journal of Public Health.
Objetivo. Identificar os fatores associados ao êxito do tratamento da tuberculose multirresistente (TBMR) relacionados ao paciente e à equipe de saúde nos seis municípios da Colômbia com o maior número de casos. Métodos. Mediante regresiones logísticas... bifactorial y multifactorial se analizó la asociación entre el tratamiento exitoso (curación o cumplimiento del tratamiento) y las características de los pacientes, y de los médicos, profesionales de enfermería y psicólogos vinculados al tratamiento. Se exploró la importancia del conocimiento en el manejo de los casos de TB-MDR mediante grupos focales con esos profesionales.
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Las Infecciones Asociadas a la Atención en Salud (IAAS) son reconocidas en la
actualidad como un problema de salud pública y existen lineamientos guber-
namentales en la mayoría de los países para constituir sistemas de vigilancia y
Programas de Prevención y Control de Infecciones para con...tener este fenóme-
no a nivel hospitalario.
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Orientations provisoires 19 juillet 2021
In the Region of the Americas, the leishmaniases are a group of diseases caused by various species of Leishmania, which cause a set of clinical syndromes in infected humans that can involve the skin, mucosa, and visceral organs. The spectrum of clinical disease is varied and depends on the interacti...on of several factors related to the parasite, the vector, and the host. Cutaneous leishmaniasis is the form most frequently reported in the Region and nearly 90% of cases present single or multiple localized lesions. Other cutaneous clinical forms, such as disseminated and diffuse cutaneous leishmaniasis, are more difficult to treat and relapses are common. The mucosal form is serious because it can cause disfigurement and severe disability if not diagnosed and treated early on. Visceral leishmaniasis is the most severe form, as it can cause death in up to 90% of untreated people.
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Document d'orientation pour le personnel de santé
Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los... años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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This is the ninth paper in our series, “Community Health Workers at the Dawn of a New Era”. Community health workers (CHWs) are in an intermediary position between the health system and the community. While this position provides CHWs with a good platform to improve community health, a major cha...llenge in large-scale CHW programmes is the need for CHWs to establish and maintain benefcial relationships with both sets of actors, who may have diferent expectations and needs. This paper focuses on the quality of CHW relationships with actors at the local level of the national health system and with communities.
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Methodology for evaluating national national arboviral disease prevention and and control of arboviral diseases in the Americas
Consensual recommendations for outpatient management and home care
and home treatment of patients with COVID-19
The Fourth National Climate Assessment (NCA4) fulfills that mandate in two volumes. This report, Volume II, draws on the foundational science described in Volume I, the Climate Science Special Report (CSSR).2 Volume II focuses on the human welfare, societal, and environmental elements of climate cha...nge and variability for 10 regions and 18 national topics, with particular attention paid to observed and projected risks, impacts, consideration of risk reduction, and implications under different mitigation pathways. Where possible, NCA4 Volume II provides examples of actions underway in communities across the United States to reduce the risks associated with climate change, increase resilience, and improve livelihoods.
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INTRODUCTION: The COVID-19 pandemic has disrupted health systems around the world. The objectives of this study are to estimate the overall effect of the pandemic on essential health service use and outcomes in Mexico, describe observed and predicted trends in services over 24 months, and to estimat...e the number of visits lost through December 2020.
METHODS: We used health information system data for January 2019 to December 2020 from the Mexican Institute of Social Security (IMSS), which provides health services for more than half of Mexico's population-65 million people. Our analysis includes nine indicators of service use and three outcome indicators for reproductive, maternal and child health and non-communicable disease services. We used an interrupted time series design and linear generalised estimating equation models to estimate the change in service use and outcomes from April to December 2020. Estimates were expressed using average marginal effects on the risk ratio scale.
RESULTS: The study found that across nine health services, an estimated 8.74 million patient visits were lost in Mexico. This included a decline of over two thirds for breast and cervical cancer screenings (79% and 68%, respectively), over half for sick child visits and female contraceptive services, approximately one-third for childhood vaccinations, diabetes, hypertension and antenatal care consultations, and a decline of 10% for deliveries performed at IMSS. In terms of patient outcomes, the proportion of patients with diabetes and hypertension with controlled conditions declined by 22% and 17%, respectively. Caesarean section rate did not change.
CONCLUSION: Significant disruptions in health services show that the pandemic has strained the resilience of the Mexican health system and calls for urgent efforts to resume essential services and plan for catching up on missed preventive care even as the COVID-19 crisis continues in Mexico.
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1.1 Why this course is needed
The first few hours and days of a newborn baby’s life are a critical window for establishing breastfeeding and for providing mothers with the support they need to breastfeed successfully. Since 1991, the Baby-friendly Hospital Initiative (BFHI) has helped to motivate... facilities providing maternity and newborn baby services worldwide to better support breastfeeding. It has been adopted by many countries and organizations. The BFHI aims to provide a health-care environment that supports mothers to acquire the skills necessary to exclusively breastfeed for six months, and to continue breastfeeding for two years or beyond.
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A toolkit for pharmacists.
Emerging data show that medication errors and adverse events cause significant harm to patients’ health and
well-being. It is estimated that the burden of adverse events due to medicines is now comparable to that of
widespread diseases, such as malaria or tuberculosis....1 The impacts of medication errors also represent a
burden for health systems, with the annual cost associated with medication errors estimated at USD 42 billion
worldwideharm
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