Cochrane Database of Systematic Reviews 2021, Issue 2. Art. No.: CD009593. DOI: 10.1002/14651858.CD009593.pub5.
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisector...al population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
more
Principes directeurs à l’intention des programmes nationaux et autres partenaires
Guías para programas nacionales y otros interesados directos
Vers des ripostes au VIH et à la tuberculose opérant des transformations dans le domaine du genre
The WHO global health sector strategy on sexually
transmitted infections, 2016–2021 (1) includes country
milestones for achievement by 2020 and global
targets for achievement by 2030. In addition, countries
were called to identify national sexually transmitted
infection (STI) targets for... 2020 and beyond. Reporting
on these milestones, country targets and progress on
implementation at the country level is due as a report to
the World Health Assembly in 2021 (1)
more
Three classess of tests are now recommended in the latest consolidated guideles on tests for tuberculosis infection. It includes for the first-time a new class of Mycobacterium tuberculosis antigen-based skin tests (TBSTs), and the two existing classes of tests: the tuberculin skin test (TST) and t...he interferon-gamma release assays (IGRAs).
IGRAs and TBSTs use Mycobacterium tuberculosis complex specific antigens and represent a significant advancement to TST which has been used for over half a century.
more
San José, Costa Rica, Noviembre 4–5 noviembre 2008
Este documento complementa los contenidos del Seminario de formación y supervisión técnica en valoración de sospechas de ASI realizado durante los meses de febrero a mayo de 2007