Clinical Guidance across the continuum of care
Chapter 8_ARV Guidelines
Over 2 million children worldwide are living with HIV infection and 95% reside in sub-Saharan Africa with the majority infected through mother-to-child transmission. Infected children have a high mortality with 50% dying by 2 years of age. Their clinical presentation includes common childhood infect...ions, opportunistic infections and conditions associated with HIV/AIDS immune suppression.
more
The guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection, and at community advocates responsible for promoting the best interests and care of HIV-positive adults. They should be read in conjunction with other published BHIVA ...guidelines.
The 2016 interim update to the 2015 BHIVA antiretroviral guidelines has been published online to include tenofovir-alafenamide/emtricitabine as a preferred NRTI backbone for first-line therapy. Changes were based on new data and the consensus opinion of the writing committee. All changes to the guideline are highlighted and include updates to the chronic kidney disease and bone disease sections of special populations and some small changes to managing virological failure.
The 2019 interim statement provides updated advice on treatment with two-drug regimens
more
Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(TB) patients. Objective: To assess whether differences in gender and HIV
status affect diagn...ostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
more
Ade et al. BMC Health Services Research (2016) 16:5
Background: In the “Centre National Hospitalier de Pneumo-Phtisiologie” of Cotonou, Benin, little is known about
the characteristics of patients who have not attended their scheduled appointment, the results of tracing and the
possible b...enefits on improving treatment outcomes. This study aimed to determine the contribution of tracing
activities for those who missed scheduled appointments towards a successful treatment outcome.
Methods: A retrospective cohort study was carried out among all smear-positive pulmonary tuberculosis patients
treated between January and September 2013. Data on demographic and diagnostic characteristics and treatment
outcomes were accessed from tuberculosis registers and treatment cards. Information on those who missed their
scheduled appointments was collected from the tracing tuberculosis register. A univariate analysis was performed
to explore factors associated with missing a scheduled appointment
more
Of the 50 antibiotics in the pipeline, 32 target WHO priority pathogens but the majority have only limited benefits when compared to existing antibiotics. Two of these are active against the multi-drug resistant Gram-negative bacteria, which are spreading rapidly and require urgent solutions.
Gr...am-negative bacteria, such as Klebsiella pneumoniae and Escherichia coli, can cause severe and often deadly infections that pose a particular threat for people with weak or not yet fully developed immune systems, including newborns, ageing populations, people undergoing surgery and cancer treatment.
The report highlights a worrying gap in activity against the highly resistant NDM-1 (New Delhi metallo-beta-lactamase 1), with only three antibiotics in the pipeline. NDM-1 makes bacteria resistant to a broad range of antibiotics, including those from the carbapenem family, which today are the last line of defence against antibiotic-resistant bacterial infections.
more
Accessed on 31.01.2020
Suivant les recommandations de la Stratégie Stop TB le Sénégal s’inscrit dans une optique de renforcement de la prise en charge de la tuberculose dans ce groupe vulnérable. Pour ce faire, la mise en place de documents standardisés et consensuels de référence, adap...tés au contexte sénégalais est indispensable. Ce guide s’adresse à tous les prestataires de soins impliqués dans la prise en charge des enfants. Il peut être utilisé aussi bien au niveau opérationnel qu’au niveau des hôpitaux.
more
Ce plan stratégique 2013- 2017 s’inscrit dans la continuité du précédent et a pour but de contribuer à la réduction de la charge de la tuberculose au Sénégal d’ici 2015 conformément aux Objectifs du Millénaire (OMD 6 Cible 8) et aux cibles du partenariat Halte à la tuberculose.
Les i...nterventions porteront, principalement, sur les orientations stratégiques déclinées lors de la revue externe. Elles seront axées sur la poursuite d’une stratégie DOTS de qualité, le renforcement des interventions communautaires et la prise en charge des grands défi s (TB/VIH, TBMR, TB de l’enfant et le contrôle de l’infection). Durant cette période, l’implication des prestataires du privé sera accentuée et des stratégies de communication porteuses d’impact seront menées.
L’atteinte des objectifs de ce plan stratégique nécessitera une importante mobilisation de ressources et un plaidoyer fort sera mené auprès de tous les partenaires du secteur santé et en dehors.
more
The GAP articulates five objectives for tackling AMR, and sets out the tasks required to achieve them, highlighting
roles and responsibilities for country governments, the One Health Tripartite organizations (FAO, OIE and WHO) and other national and international partners. To ensure that all stakeh...olders assume their roles and responsibilities, and to assess whether they are collectively effecting the necessary change in AMR, the implementation of the GAP needs to be routinely monitored and evaluated. To that end, the Tripartite organizations co-developed a monitoring and evaluation (M&E) framework for the GAP, as outlined in this document
more
Nature Reviews Microbiology Vol. 17 (2019)pp.51-62
Antimicrobial susceptibility testing (AST) technologies help to accelerate the
initiation of targeted antimicrobial therapy for patients with infections and could potentially
extend the lifespan of current narrow- spectrum antimicrobials. Althoug...h conceptually new and
rapid AST technologies have been described, including new phenotyping methods, digital
imaging and genomic approaches, there is no single major, or broadly accepted, technological
breakthrough that leads the field of rapid AST platform development
more
Ce guide qui s’adresse à tous les prestataires de soins impliqués dans la prise en charge des enfants, peut être utilisé aussi bien au niveau des structures sanitaires publiques que privées.
Son objectif général est d’améliorer la prise en charge de la tuberculose de l’enfant au Sé...négal et plus spécifiquement de :
• renforcer le dépistage précoce des cas de tuberculose infantile
• proposer une approche standardisée de diagnostic et de traitement de la tuberculose de l’enfant
• proposer une approche standardisée de gestion des cas contacts de tuberculose
• améliorer la prise en charge de la co-infection TB/VIH et de la tuberculose multirésistante de l’enfant
more
Le secrétariat du RSI à l’OMS a développé un outil pour les missions d’EEC qui mesure les aptitudes du pays à prévenir, détecter et répondre rapidement aux menaces de santé publique, conformément aux exigences du RSI (2005). Cet outil est également utilisé pour l’exercice d’auto-...évaluation réalisé par le pays, préalablement à l’EEC. Les résultats ainsi obtenus permettent de préparer un plan d’action national multisectoriel destiné à renforcer la mise en œuvre du RSI (2005).
more