Pneumonia and diarrhoea account for 23% of under-five mortality and were responsible for an estimated 1.17 million deaths in children under five globally. Furthermore, pneumonia and diarrhoea were responsible for 18% of mortality in children 5–9 years of age, resulting in an estimated 86 000 preve...ntable deaths globally in 2021. Existing World Health Organization (WHO) guidance on the clinical management of pneumonia and diarrhoea has mainly focused on children less than 5 years of age.
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The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (“pneumonia” which is treated at home with oral amoxicillin and “severe pneumonia” which requires injectable antibiotics) and (B) oral amoxicillin replaces o...ral cotrimoxazole as first line treatment, preferably in 250mg dispersible tablet form, twice daily for five days which can be reduced to three days in low HIV settings.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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Lancet 2013; 381: 1405–16
Series: Childhood Pneumonia and Diarrhoea no.1
This guide to local production of WHO-recommended handrub formulations is separated into two discrete but interrelated sections:
Part A provides a practical guide for use at the pharmacy bench during the actual preparation of the formulation. Users may want to display the material on the wall of ...the production unit.
Part B summarizes some essential background technical information and is taken from WHO Guidelines on Hand Hygiene in Health Care (2009). Within Part B the user has access to important safety and cost information and supplementary material relating to dispensers and distribution.
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This primer aims to guide health professionals on engaging with WASH-related issues. It gives an overview of WASH interventions and the status of WASH services globally and outlines key linkages with health. It provides examples of key actions that health actors can take to ensure WASH efforts effec...tively protect public health and highlights World Health Organization (WHO) activities to support those actions.
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Клинический протокол для Европейского региона ВОЗ
Глобальными приоритетами для лечения туберкулеза (ТБ) и борьбы с ним являются улучшенное и ранее выявление случаев туберкулеза, в том числе случаев заболевания с о...трицательным мазком мокроты, которые часто ассоциируются с вирусом иммунодефицита человека (ВИЧ) и ранним возрастом, а также расширенные возможности для диагностики туберкулеза с множественной лекарственной устойчивостью (МЛУ-ТБ)
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Данное руководство содержит детальное описание стратегии диагностики и ведения пациентов с лекарственно-устойчивыми формами ТБ, прежде всего с туберкулезом с мн...жественной лекарственной устойчивостью (МЛУ-ТБ). Оно составлено с учетом важных изменений, отмеченных за последние годы, и предназначено для практикующих медицинских работников и программ борьбы с ТБ в странах с умеренными и ограниченными ресурсами.
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guidance for health managers, health workers, and activists
Technical and operational ‘how-to’: practical considerations
This publication is an updated version of the Management of Tuberculosis and HIV Coinfection clinical protocol released in 2007 by the WHO Regional Office for Europe. It is intended for all health care workers involved in preventing, diagnosing, treating and caring for people living with TB and HIV ...in the specific settings of the WHO European Region.
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