The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection prevention and control (IPC). This living guideline
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is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
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In 2019, following a request from the Codex Committee on Food Hygiene (CCFH), the Codex Alimentarius Committee (CAC) approved new work at its 42nd Session on the development of guidelines for the control of Shiga toxin-producing Escherichia coli (STEC) in leafy vegetables and in sprouts.
The obje
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ctive of the report was to evaluate commodity-specific interventions used at all stages of fresh fruit and vegetable production from primary production to post-harvest activities, transportation, point of sale and consumer use. Emphasis was placed on the identification and evaluation of interventions used throughout the world to reduce microbiological hazards of fresh fruits and vegetables that contribute to the risk of foodborne illnesses, taking into consideration their effectiveness, practicality and suitability.
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In 2019, following a request from the Codex Committee on Food Hygiene (CCFH), the Codex Alimentarius Committee (CAC) approved new work at its 42nd Session on the development of guidelines for the control of Shiga toxin-producing Escherichia coli (STEC) in leafy vegetables and in sprouts.
The obje
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ctive of the report was to evaluate commodity-specific interventions used at all stages of fresh fruit and vegetable production from primary production to post-harvest activities, transportation, point of sale and consumer use. Emphasis was placed on the identification and evaluation of interventions used throughout the world to reduce microbiological hazards of fresh fruits and vegetables that contribute to the risk of foodborne illnesses, taking into consideration their effectiveness, practicality and suitability.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the
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patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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Tanzania, like other developing countries, is facing a higher burden of cardiovascular diseases (CVDs). The country is experiencing rapid growth of modifiable and intermediate risk factors that accelerate CVD mortality and morbidity rates. In rural and urban settings, cardiovascular risk factors suc
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h as tobacco use, excessive alcohol consumption, unhealthy diet, hypertension, diabetes, hyperlipidemia, overweight, and obesity, are documented to be higher in this review. Increased urbanization, lifestyle changes, lack of awareness and rural to urban movement have been found to increase CVD risk factors in Tanzania. Despite the identification of modifiable risk factors for CVDs, there is still limited information on physical inactivity and eating habits among Tanzanian population that needs to be addressed. Conclusively, primary prevention, improved healthcare system, which include affordable health services, availability of trained health care providers, improved screening and diagnostic equipment, adequate guidelines, and essential drugs for CVDs are the key actions that need to be implemented for cost effective control and management of CVDs. Effective policy for control and management of CVDs should also properly be employed to ensure fruitful implementation of different interventions.
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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
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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.
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Information on the causes of cancer at specific sites is important to cancer control planners, cancer researchers, cancer patients, and the general public. The International Agency for Research on Cancer (IARC) Monograph series, which has classified human carcinogens for more than 40 years, recently
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completed a review to provide up-to-date information on the cancer sites associated with more than 100 carcinogenic agents. Based on IARC’s review, we listed the cancer sites associated with each agent and then rearranged this information to list the known and suspected causes of cancer at each site. We also summarized the rationale for classifications that were based on mechanistic data. This information, based on the forthcoming IARC Monographs Volume 100, offers insights into the current state-of-the-science of carcinogen identification. Use of mechanistic data to identify carcinogens is increasing, and epidemiological research is identifying additional carcinogens and cancer sites or confirming carcinogenic potential under conditions of lower exposure. Nevertheless, some common human cancers still have few (or no) identified causal agents.
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The GOLD 2023 report provides a comprehensive update on the global strategy for diagnosing, managing, and preventing chronic obstructive pulmonary disease (COPD). It emphasizes that COPD is a leading cause of death worldwide, driven by risk factors such as tobacco smoking, air pollution, and genetic
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predispositions. The report outlines key updates, including new diagnostic criteria, the introduction of terms like "Pre-COPD" and "PRISm" for early identification, and expanded sections on comorbidities, pharmacological and non-pharmacological treatments, and rehabilitation. It stresses the importance of personalized treatment plans, early diagnosis, and addressing risk factors to mitigate the disease's impact. The report is aimed at guiding healthcare providers to improve COPD outcomes and adapt treatment approaches based on the latest evidence.
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All health and care workers require the knowledge and skills to prevent the transmission of Ebola virus or Marburg virus when providing care for patients. This course provides an overview of the mode of transmission of these viruses, the personal protective equipment required by health and care work
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ers and measures to take for rapid identification and isolation as well as managing the environment.
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The Country Cooperation Strategy is the World Health Organization (WHO)’s reference for country work guiding planning and resource allocation through alignment with national health priorities and harmonization with other development partners. It clarifies roles and functions of WHO in supporting t
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he national strategic plan for health through the Sector-Wide Approach and Malawi Growth and Development Strategy II. The Country Cooperation Strategy is based on a systematic assessment of the recent national achievements, emerging health needs,
challenges, government policies and expectations. An evaluation of the previous CCS was conducted and jointly discussed with the Ministry of Health as well as other key stakeholders. This process led to the identification of the, achievements, challenges and shortfalls of the previous CCS. Through this process the areas where WHO needed to focus on were also identified. The CCS development has also been done in parallel with the formulation of the new Health Sector Strategic Plan (HSSP) to ensure that there is a linkage between the two.
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Facilitators can be a mix of doctors, trainers of integrated management of childhood illness (IMCI), nutritionists, public health officers (or otherwise according to each country’s situation) and needs of individual countries. Some countries may consider it important to include a doctor in the t
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eam to ensure that certain components such as correct identification of danger signs, counselling on developmental milestones and some of the elements of feeding. Whatever the composition of the teams, facilitators should have good training, experience and good communication skills.
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a dernière mise à jour a été effectuée dans le livret de la PCIME en 2014, mais depuis lors, des mises à jour importantes ont été effectuées sur la prise en charge du jeune nourrisson malade (MJN) âgé de moins de 2 mois. Cette mise à jour 2019 de la section sur le jeune enfant malade Pri
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se en charge du jeune enfant malade âgé de moins de 2 mois : IMCI chart booklet. remplace le IMCI chart booklet de 2014. Les nouvelles mises à jour reflètent les récentes lignes directrices sur la prise en charge des infections bactériennes graves possibles (IPSP) chez les jeunes nourrissons lorsque l'orientation vers un spécialiste n'est pas possible, publiées en 2015. Elles comprennent l'évaluation, la classification et l'orientation de la SYI avec PSBI ; et le traitement ambulatoire de la SYI avec infection locale ou respiration rapide (pneumonie) chez les nourrissons âgés de 7 à 59 jours. Les autres mises à jour comprennent : une nouvelle section sur la manière de réévaluer, de classer et de traiter la SYI avec PSBI lorsque l'orientation n'est pas possible dans les établissements de santé ambulatoires par des agents de santé formés à la PCIME ; des changements dans l'évaluation et la prise en charge des jeunes nourrissons pour l'infection par le VIH ; et l'identification des nourrissons de moins de 7 jours de qui ont besoin de soins kangourou.
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The majority of Countdown countries did not reach the fourth Millennium Development Goal (MDG 4) on reducing child mortality, despite the fact that donor funding to the health sector has drastically increased. When tracking aid invested in child survival, previous studies have exclusively focused on
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aid targeting reproductive, maternal, newborn, and child health (RMNCH). We take a multi-sectoral approach and extend the estimation to the four sectors that determine child survival: health (RMNCH and non-RMNCH), education, water and sanitation, and food and humanitarian assistance (Food/HA). Methods and findings: Using donor reported data, obtained mainly from the OECD Creditor Reporting System and Development Assistance Committee, we tracked the level and trends of aid (in grants or loans) disbursed to each of the four sectors at the global, regional, and country levels. We performed detailed analyses on missing data and conducted imputation with various methods. To identify aid projects for RMNCH, we developed an identification strategy that combined keyword searches and manual coding. To quantify aid for RMNCH in projects with multiple purposes, we adopted an integrated approach and produced the lower and upper bounds of estimates for RMNCH, so as to avoid making assumptions or using weak evidence for allocation. We checked the sensitivity of trends to the estimation methods and compared our estimates to that produced by other studies. Our study yielded time-series and recipient-specific annual estimates of aid disbursed to each sector, as well as their lower- and upper-bounds in 134 countries between 2000 and 2014, with a specific focus on Countdown countries. We found that the upper-bound estimates of total aid disbursed to the four sectors in 134 countries rose from US$ 22.62 billion in 2000 to US$ 59.29 billion in
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To support the achievement of health equity in the Region, the regional inter-agency movement Every Woman Every Child Latin America and the Caribbean (EWEC-LAC) advocates for and supports the use of equity and evidence-based policies, strategies and interventions to accelerate equitable progress in
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the health of women, children and adolescents. Although progress has been made, great inequities persist. Women from the LAC region’s poorest countries are almost four times more likely to die due to complications during childbirth than those living in the wealthiest countries. Through the years, several tools, instruments and methods (TIMs) have been developed by global, regional and country partners that can be used to conduct systematic equity-based analyses and/or re-designs of health systems, programs, strategies and interventions. The main purpose of this document is to present an overview of existing TIMs that can be used by policymakers, program managers, development partners, nongovernmental organizations, academia and civil society partners to strengthen systematic identification, analysis and responding to social inequities in the health of women, children and adolescents in LAC. The TIMs included were identified through a systematic search process
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions
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(FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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This information can be used to assess the extent of the damage and the needs of affected communities. Information should be gathered on the extent of damage to infrastructure, housing, and public facilities such as hospitals, schools, and water systems. This information can be used to prioritize th
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e response effort and to direct resources to where they are most needed.
In addition to gathering information on the extent of damage, it is also important to gather information on the number of people affected and the types of assistance they need. This may include information on the number of people who are injured, displaced, or in need of shelter, food, and water. This information can be used to prioritize the response effort and to ensure that assistance is provided in a way that meets the specific needs of affected communities.
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This information can be used to assess the extent of the damage and the needs of affected communities. Information should be gathered on the extent of damage to infrastructure, housing, and public facilities such as hospitals, schools, and water systems. This information can be used to prioritize th
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e response effort and to direct resources to where they are most needed.
In addition to gathering information on the extent of damage, it is also important to gather information on the number of people affected and the types of assistance they need. This may include information on the number of people who are injured, displaced, or in need of shelter, food, and water. This information can be used to prioritize the response effort and to ensure that assistance is provided in a way that meets the specific needs of affected communities.
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Advanced HIV disease (defined in persons living with HIV with a CD4 cell count of <200cells/mm3 or presenting with a WHO Stage 3/4 AIDS-defining illness) poses a challenge to many countries globally and is responsible for significant mortality and morbidity among people living with HIV. In 2017, WHO recommended a packa
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ge of care for the prevention and management of advanced HIV disease. The package was composed of screening tests, diagnostics, prophylaxis, rapid antiretroviral therarpy initiation and enhanced adherence counselling.
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