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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and
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burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Syrian network for Humanitarian Rights Platform
recommended
March 2021. “A Decade of Destruction: Attacks on health care in Syria,” highlights with chilling detail how this 10-year war strategy has turned hospitals from safe havens into no-go zones where Syrian civilians now fear for their lives.
The figures and findings reflected in the 2020 PMR represent the independent analysis of the United Nations (UN) and its humanitarian partners based on information available to them. Many of the figures provided throughout the document are estimates based on sometimes incomplete and partial data set
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s using the methodologies for collection that were available at the time. The Government of Syria has expressed its reservations over the data sources and methodology of assessments used to inform the 2020 Humanitarian Needs Overview (HNO) as well as on a number of HNO findings reflected in the 2020 HRP. This applies throughout the document.
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Background Unrest in Chile over inequalities has underscored the need to improve public hospitals. Nursing has been overlooked as a solution to quality and access concerns, and nurse staffing is poor by international standards. Using Chile’s new diagnosis-related groups system and surveys of nurse
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s and patients, we provide information to policy makers on feasibility, net costs, and estimated improved outcomes associated with increasing nursing resources in public hospitals.
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This rapid review report has identified the wastewater treatment plant (WWTP) options used in emergency settings, with decentralised wastewater treatment systems (DEWATS) and mobile wastewater treatment units performing most effectively and with minimal costs. Examples are taken from refugee camps a
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nd internally displaced people (IDP) settlements due to the Iraq war, the Israeli-Palestine conflict, and the civil wars in Syria and Sudan. WWTP options used in Finland, Haiti, Iraq, Jordan, Palestine, Sudan and Turkey are discussed. Lessons learned from China and suggestions for the Rohingya crisis are also included.
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This report is not a formal evaluation, but rather a synthesis of the experiences, observations, and recommendations of a large group of experienced post-disaster shelter and recovery experts gathered from interviews, surveys, and direct discussions, and information derived from a desk review of the
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wide variety of available evaluations and reports.
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S’inscrivant dans le prolongement du Guide de gestion des abris d’évacuation, validant un mécanisme officiel de gestion jusqu’à une période de l’urgence ne dépassant pas les soixante-douze heures (72), ce document initie une tentative d’harmoniser les leçons apprises et bonnes pratiq
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ues, ventilées en fonction de diverses scénarios et d’indications précises dans la phase de réponse après les soixante-douze heures (72) de gestion de l’urgence et en offrant un portefeuille d’outils mis en œuvre de 2010 à 2014 .
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A technical and environmental comparative overview of common shelter typologies found in settlements across UNHCR operations
Journal of Clinical TB and other Mycobacterial Diseases
uberculosis (TB) in the gastrointestinal tract or peritoneum is an uncommon condition in clinical practice. Its rarity, combined with its nonspecific presentations, makes this kind of extrapulmonary tuberculosis difficult to diagnose as it can
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mimic other inflammatory or malignant conditions. Delays in treatment and frequent misdiagnosis can lead to hazardous complications. In countries like Ecuador where the disease is endemic, TB should always be considered in the differential diagnosis of a patients who present with nonspecific abdominal symptoms. In these scenarios, laparoscopy can be an invaluable tool when used with sufficiently high clinical awareness and adequate training.
Case presentation
We present the case of a 37-year-old female patient from Ecuador with a 1-year history of abdominal pain, nausea, intermittent vomits, night sweats, and weight loss. After clinical evaluation and a laparoscopic intervention, abdominal TB was detected and promptly treated. Antituberculosis chemotherapy was initiated, and the patient successfully reco
High clinical awareness is imperative when approaching abdominal TB due to its wide spectrum of clinical symptoms and its rarity. Early detection and prompt treatment are critical to minimize the possibility of hazardous complications.
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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
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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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The state of the Guinean health workforce is one of the country’s bottlenecks in advancing health outcomes. The impact of the 2014–2015 Ebola virus disease outbreak and resulting international attention has provided a policy window to invest in the workforce and reform the health system. This re
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search constitutes a baseline study on the health workforce situation, professional education, and retention policies in Guinea. The study was conducted to inform capacity development as part of a scientific collaboration between Belgian and Guinean health institutes aiming to strengthen public health systems and health workforce development. It provides initial recommendations to the Guinean government and key actors.
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Climate change triggers mounting food insecurity, poverty and displacement in Africa
Der extrem umfangreich recherchierte und lesenswerte IPPNW-Report beleuchtet die gesund-heitlichen und humanitären Folgen der deutschen Abschiebepraxis der vergangenen Jahre. Die Publikation soll zudem gezielt Wissen vermitteln, wie Gutachten besser verfasst werden kön-nen und welche Erfahrungen d
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ie Ärzt*innen gesammelt haben im Zusammenhang mit Abschiebungen.
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Association between Ambient Temperature and Hospitalization for Renal Diseases in Brazil during 2000–2015: A Nationwide Case-Crossover Study
Bo Wen, Rongbin Xu, Yao Wu, Micheline de Sousa Zanotti Stagliorio Coelho et al.
The Lancet Regional Health – Americas
(2021)
CC
Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to
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ambient temperature.
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English Analysis on World about Agriculture, Climate Change and Environment and more; published on 29 Sep 2021 by FAO and NEPAD
Since the notification of the first two confirmed cases of Vibrio cholerae O1 in the greater Port-au-Prince area on 2 October 2022, to 14 January 2023, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population, MSPP per its French acronym), reported a total of 24,232 suspe
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cted cases in 10 departments of the country, including 1,742 confirmed cases, 20,505 hospitalized suspected cases, and 483 registered deaths. This represents an increase in the last 7 days of 5% in suspected cases (N=1,188), 11% in confirmed cases (N=166) and 4% in deaths (N=19). As of 14 January 2023, 9 departments have confirmed cases (Artibonite, Centre, Grand-Anse, Nippes, Nord, Nord-Ouest, Ouest, Sud and Sud-Est). To date, the case fatality rate among suspected cases is 2.0%.
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