Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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The combined effects from ambient (outdoor) air pollution and indoor (household, in particular) air pollution cause approximately 7 million premature deaths every year, largely as a result of increased mortality from stroke, IHD, COPD, lung cancer and acute respiratory ...light medbox">infections (1). Air pollution can occur in both the outdoor and indoor environments. Cook-stoves in homes, motor vehicles, industrial facilities and forest fires are common sources of air pollution. Air pollutants with the strongest evidence for adverse health outcomes include particulate matter (PM; both PM 2.5 (i.e. particles with an aerodynamic diameter
equal to or less than 2.5 μm) and PM10 (i.e. particles with an aerodynamic diameter equal to or less than 10 μm), ozone (O 3), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ) and carbon monoxide (CO). Air pollution is however composed of many more pollutants (1).
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This threat assessment addresses the implications of the ongoing Marburg virus disease (MVD) outbreak in
Rwanda for the European Union/European Economic Area (EU/EEA). MVD is a severe disease in humans and,
although uncommon, it has the potential to cause epidemics with significant case fatality. ...All recorded MVD
outbreaks to date have originated in Africa. MVD is not an airborne disease and is considered not to be
contagious before symptoms appear. Direct contact with the blood and other body fluids of infected people
and animals or indirect contact with contaminated surfaces and materials like clothing, bedding and medical
equipment is required for transmission. The risk of infection is minimised when proper infection prevention and
control precautions are strictly followed. There is no approved treatment or vaccine for MVD; however, several
pharmaceuticals and candidate MVD vaccines are under investigation.
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The Indonesian government has reformed its laws, policies, and institutions to better manage disaster risk since the significant 2004 Indian Ocean Tsunami. The Government of Indonesia now has contingency plans for every disaster-prone city which identifies its vulnerabilities, outlines the relief re...sponse, and builds overall preparedness. In 2007, the government introduced a disaster management bill that incorporated disaster management prevention into disaster management response. In 2008, Indonesia created the National Disaster Management Agency (Badan Nasional Penanggulangan Bencana, BNPB). The new shift led to the strengthening of the country’s disaster management agency, and the addition of district branches and representatives. Despite the progress made, more work is needed at the local level as well as integration of disaster risk reduction in government departments.11 Under Indonesia’s 2007 Disaster Management law, provincial and district administrations are mandated to head disaster management during a crisis.
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A lot has happened this year. While we continued to tackle the COVID-19 pandemic, we were hit by disease outbreaks and
humanitarian crises. Yet, despite these challenges, we marched on, resolute in resolving critical health systems issues to increase
access to quality healthcare services. To furth...er our vision and bring concrete actions to reality, under
the leadership of the Government of South Sudan, we developed the Health Sector Strategic Plan to define the strategic
approaches, key interventions, mapping resource needs, and the implementation framework to strengthen the health system
to deliver essential quality health services equitably for 2023 to 2027. For WHO, this Plan will usher in a new reality -- access
to lifesaving or health-promoting interventions is doable and possible, making the health sector fairer, especially for those
unable to pay
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The WHO Ebola Virus Disease (EVD) Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with EVD. Providing guidance that is comprehensive and holistic for the optimal care of patients with EVD throughout their il...lness is important.
The living guidance is available in both pdf format (via the ‘Download’ button) and via an online platform in both French and English, and is updated regularly as new evidence emerges.
This first version of the Clinical management for EVD living guidance contains four new recommendations regarding use of therapeutics for EVD, this includes two strong recommendations for the use of monoclonal antibody therapies. This new living guideline is written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures (5, 6). The living guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.
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Volume 1 covers emergency triage assessment and treatment, and acute care for a severely ill or acutely injured patient for approximately the first 24 hours of care. It describes the clinical procedures commonly used in emergency and acute care, and gives a summary of the medicines used and the step...s necessary for infection control.
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The report provides a brief introduction to patents and licences and their effect on the market for antiretroviral (ARV) medicines. It gives an overview of the patent landscape with respect to a select number of ARV medicines in developing countries as of April 2014. The focus is primarily on those ...ARVs that are recommended by the World Health Organization (WHO) as well as new ARVs that have either recently obtained regulatory approval or are in phase III clinical trials.
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The immediate objective of the country visit to Cameroon was to ensure that the country is as operationally ready as possible to effectively and safely detect, investigate and report potential Ebola virus disease cases and to mount an effective response that will prevent a larger outbreak. After te...chnical working group meetings, field visits, a “table-top” exercise and a hospital-based simulation exercises were undertaken.
Key strengths and weaknesses were identified, and the following areas for improvement were proposed to the Ministry of Health: coordination, surveillance, contact tracing, infection prevention and control, rapid response teams, case management, social mobilization, laboratory, points of entry, budget, logistics.
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The main objective of this mission was to assess the level of preparedness of Guinea-Bissau in respect of the WHO consolidated checklist. The checklist helps countries to assess and test their level of readiness it is being used to identify concrete action to be taken and where countries will requir...e support from partners. It lists 10 key components and tasks for both countries and the international community that should be completed within 30, 60 and 90 days from the date of issue of the list, with minimal requirements for equipment, material and human resources.
The components include: overall coordination; rapid response teams; public awareness and community engagement; infection prevention and control; epidemiological and laboratory surveillance; contact tracing; points of entry; laboratory; social mobilization and risk communication; budget.
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Cochrane Database of Systematic Reviews 2015, Issue 2. Art. No.: CD011386. DOI: 10.1002/14651858.CD011386.pub2
Free access from the website http://onlinelibrary.wiley.com/enhanced/doi/10.1002/14651858.CD011386.pub2
Watch a short film which accompanies this Cochrane Review and talks about applying ...the findings in relevant clinical settings at http://www.cochrane.org/news/new-evidence-helps-health-workers-fight-against-ebola
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Zika virus is primarily transmitted by the Aedes species of mosquito which is also responsible for the spread of dengue, Chikungunya and yellow fever viruses. In most areas, the primary vector of these viruses is Aedes aegypti, with Aedes albopictus a proven or potential vector in some settings. Wel...l-implemented vector control against Aedes using existing tools effectively reduces the transmission of viruses spread by these vectors. Pilot studies are being undertaken on new tools which have potential for future reductions in Aedes populations
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TB heroes
Hello, my name is Nurse X
My job is to promote integrated HIV and TB prevention, care, treatment and support. This ensures that we, and my team of health care service providers treat everyone who is living with HIV and TB to have all the antiretroviral therapy (ART) and HIV care services... are provided with TB diagnosis and treatment at one facility. Services that we provide include * Infection control education * TB screening and diagnosis * HIV testing * Treatment for those who require it * Adherence support
Accessed November 2017
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The Strategic plan aims to ensure alignment of preparedness and readiness actions in the nine countries focusing on eight technical areas: strengthening multisectoral coordination; surveillance for early detection; laboratory diagnostic capacity; points of entry; rapid response teams; risk communica...tion, social mobilization and community engagement; case management and infection prevention and control (IPC) capacities; and, operations support and logistics. The purpose of the WHO Regional Strategic Plan is to ensure that the countries bordering the Democratic Republic of the Congo are prepared and ready to implement timely and effective risk mitigation, detection and response measures should there be any importation of EVD cases.
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This module should always be used together with the
mhGAP Intervention Guide for Mental, Neurological
and Substance Use Disorders in Non-specialized Health
Settings (WHO, 2010), which outlines relevant general
principles of care and management of a range of other
mental, neurological and substa...nce use disorders.
(www.who.int/mental_health/publications/mhGAP_
intervention_guide/en/index.html)
In the future, this module may be integrated with other
products in the following ways:
– This module may be integrated – in its full form –
into future iterations of the existing mhGAP Intervention
Guide.
– The module will be integrated –in a simplified structure –
into a new product, the WHO-UNHCR mhGAP Intervention
Guide for Humanitarian Settings (planned for 2014).
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This updated Comprehensive Mental Health Action Plan 2013-2030 builds upon its predecessor and sets out clear actions for Member States, the WHO Secretariat and international, regional and national partners to promote mental health and well-being for all, to prevent mental health conditions for thos...e at-risk and to achieve universal coverage for mental health services. While the updated action plan includes new and updated indicators and implementation options, the original four major objectives remain unchanged: more effective leadership and governance for mental health; the provision of comprehensive, integrated mental health and social care services in community-based settings; implementation of strategies for promotion and prevention; and strengthened information systems, evidence and research.
In English, French, Spanish, Arabic and Russian available
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Each year, the WHO Global TB Report provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
The... 2021 edition of the report has been produced in a new and more web-centric format. This is designed to make the content available in smaller (more “bite-sized”) chunks that are easier to read, digest, navigate and use. There is a short and slim report PDF with 30 pages of main content plus six short annexes. This is accompanied by expanded and more detailed digital content on web pages. The total amount of content remains similar to that of previous years.
Available in English, French, Arabic and Chinese
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In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
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Expert Consensus Validation 2018.
This innovative approach aimed at improving and facilitating the screening, prescribing and monitoring of drug therapy for older patients, is currently being further developed in the area of Clinical Pharmacology at the University of Heidelberg in Mannheim. This ap...proach represents another advance in worldwide research efforts aimed at adding a new dimension to already-existing classification systems and negative listings of potentially inappropriate medications for the elderly.
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