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Diabetes mellitus is one of the most common noncommunicable diseases worldwide. In the Eastern Mediterranean Region there has been a rapid increase in the incidence of diabetes mellitus and it is now the fourth leading cause of death. The increasing prevalence of diabetes mellitus, the emergence of
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diabetes complications as a cause of early morbidity and mortality, and the enormous and mounting burden on health care systems make diabetes a priority health concern. These guidelines provide up-to-date, reliable and balanced information for the prevention and care of diabetes mellitus in the Region. The information is evidence-based and clearly stated to facilitate the use of the guidelines in daily practice. They are intended to benefit physicians at primary, secondary and tertiary level, general practitioners, internists and family medicine specialists, clinical dieticians and nurses as well as policy-makers at ministries of health. They provide the information necessary for decision-making by health care providers and patients themselves about disease management in the most commonly encountered situations.
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The war in Gaza has resulted in many hundreds of spinal cord injuries (SCI), which will have a devastating impact on those injured and their families for the rest of their lives.
The optimal management of SCI requires effective pre-hospital care,
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early specialized imaging (using CT or MRI) and in many cases early surgical interventions by a highly specialised neurosurgical team. Surgery requires many hours of use of a sterile operating room environment and supportive critical care capacity, as well as intensive post-operative care – none of which is currently possible due to the ongoing war, destruction, and disruption of health services in Gaza.
An alternative to surgery is conservative management – this requires intensive nursing care under full spinal precautions for many weeks in order to allow for bone and soft tissue healing and prevent further injury to the spinal cord. The patient is unable to move independently in bed during this period. Those caring for the patient need to be able to safely reposition them every 2 hours, and manage all their bowel and bladder care needs. The patient needs good nutrition and hydration at all times, as well as access to medication to support bowel care, manage pain (including neuropathic pain). A caregiver must remain with the patient to be trained to provide ongoing care and assist with daily care.
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Diabetes is one of the leading causes of death globally. India is home to the second-largest population suffering from diabetes. This underscores the need to build capacity of primary care physicians (PCPs) for better disease management. This narrat
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ive review article aims to describe the emergence of diabetes education and capacity-building programs for PCPs and its current situation in India. The review highlighted that major emphasis on diabetes was given only when the WHO estimated that morbidity and mortality due to diabetes would increase to 35% in India. As a result, National Diabetes Control Program was launched in 1987. Yet, very little attention was paid to diabetology in under-graduation. In the last decade, few public and private institutions have developed diabetes related capacity-building programs for PCPs independently or in collaborations. These programs include 16 fellowships, 4 diplomas, 12 certificate programs, and 6 other diabetes training programs, which have their own pros and cons. As medical science is changing rapidly, PCPs need to upgrade their skills and knowledge regularly to manage NCDs such as diabetes more effectively and efficiently. This can be possible only if scientific, evidence-based, and quality-oriented capacity-building programs are provided to the healthcare workforce.
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Over one third of all deaths in Kenya in 2019 were attributed to NCDs (Vos et al., 2020). The four major NCDs – CVDs, cancer,
diabetes and chronic respiratory diseases – accounted for 57% of these deaths. Furthermore, the direct and indirect economic
impact of NCDs is significant- Kenya is sai
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d to have lost Ksh 230 billion or 3.4% of its gross domestic product in 2016 from rising
NCD-related medical costs and indirect productivity losses. At the household level, an estimated decrease of 28.6% in income
due to NCDs was reported in 2007 (Mwai & Muriithi, 2016; Mensah et al., 2020). Therefore, preventing and managing NCDs are
significant public health and economic priorities.
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The primary goal of the guideline is to improve the quality of care and the outcome in people with type 2 diabetes in low-resource settings. It recommends a set of basic interventions to integrate management of diabetes into primary health
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care. It will serve as basis for development of simple algorithms for use by health care staff in primary care in low-resource settings, to reduce the risk of acute and chronic complications of diabetes. The guideline was developed by a group of external and WHO experts, following the WHO process of guideline development. GRADE methodology was used to assess the quality of evidence and decide the strength of the recommendations.
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The "WHO Package of Essential Noncommunicable (PEN) Disease Interventions for Primary Health Care" provides a set of cost-effective, evidence-based interventions to address noncommunicable diseases (NCDs) such as cardiovascular diseases, diabetes, c
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hronic respiratory diseases, and cancers. Designed for implementation in primary healthcare settings, especially in low-resource environments, the package includes protocols for screening, diagnosis, treatment, and management of these diseases. The document emphasizes an integrated approach, supporting universal health coverage by empowering healthcare workers with practical tools to improve NCD care. It aims to reduce premature mortality from NCDs and enhance global health equity.
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As part of efforts to celebrate World Asthma Day (WAD), May 2, 2023, and reduce the burden of asthma in Nigeria, the Nigerian Thoracic Society (NTS) has advocated education of asthma patients and carers as an integral part of asthma care to achieve
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optimal control of symptoms and exacerbation.
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These guidelines provide recommendations for the non-pharmacological aspects of infection prevention and control for acute respiratory diseases (ARD) in health care. Administrative and infection controls, including early detection, isolation and rep
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orting, and establishment of infection control infrastructure, are key components for containment and mitigation of the impact of pathogens that may constitute a major public health threat. In these guidelines, the options of using natural ventilation and/or exhaust fan assisted ventilation in health-care facilities (HCF) are considered.
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In the area of nutrition and HIV, children deserve special attention because of their additional needs to ensure growth and development and their dependency on adults for adequate care. It was therefore proposed to first develop guidelines for chil
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dren and thereafter consider a similar approach for other specific groups.
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a biological process related to virus and host interactions. In trying to protect the nutritional well-being or reverse the undernutrition experienced by infected children, issues of food insecurity, food quantity and quality as well as absorption and digestion of nutrients are considered. Interventions are proposed that are practical and feasible in resource-poor settings and offer a prospect for clinical improvement.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
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Kenya : Clinical Guidelines for Management and Referral of Common Conditions at Levels 2-3: Primary Care
Ministry of Medical Services, Kenya; Ministry of Public Health & Sanitation
World Health Organization WHO
(2009)
C_WHO
Clinical Management and Refferal Guidelines Vol. 2.
Recommended measures for medical and other staff who were involved in patient care or outbreak response during the Ebola outbreak in 2014
Robert-Koch-Institut
(2014)
This document describes recommended measures for dealing with medical and other staff employed either in patient care or in outbreak control during the 2014 Ebola outbreak.
For General Healthcare Settings in West Africa
The ongoing Ebola epidemic in parts of West Africa largely overwhelmed health-care systems in 2014, making adequate care for malaria impossible and threatening the gains in malaria control achieved
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over the past decade. The study suggests that untreated malaria cases as a result of reduced health-care capacity probably contributed substantially to the morbidity caused by the Ebola crisis. Mass drug administration can be an effective means to mitigate this burden and reduce the number of non-Ebola fever cases within health systems
Open Access through Wellcome Trust
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Health Economics Review, 2016 6:7 -Published: 11 February 2016
Updated Guideline.
The Emergency Triage Assessment and Treatment (ETAT) guidelines provide guidance on the most common emergency conditions in children presenting at the health facility. These include but are not limited to airway obstruction and other breathing problems; circulatory impairment or
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shock; severely altered CNS function (coma or convulsive seizures); and severe dehydration which require urgent appropriate care to prevent death.
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