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Building on the 2021 Interim guidance, this second version and update, incorporates the lessons and feedback from the hepatitis pilots that successfully demonstrated the feasibility ... measuring hepatitis B and C impact targets to demonstrate elimination, whilst highlighting challenges caused by high disease burden in some countries, as well as delays in reaching mortality targets due to the long natural history of disease progression to liver cirrhosis and hepatocellular carcinoma.
The path to elimination provides a framework with 3 levels of achievements for which WHO certification is available. Each stepwise progression from bronze to silver to gold tiers will promote an iterative expansion of prevention, diagnosis and treatment services for viral hepatitis services and strengthen measurement systems to support attainment of the 2030 elimination goals.
This updated version also includes changes, clarifications and new guidance on alternative measurement approaches for country validation of elimination. Through the validation process, WHO and partners continue to provide country support for strengthening health system capacity and patient-centred services that respect and protect the human rights of people living with viral hepatitis and ensures meaningful engagement of communities in the national, regional and global viral hepatitis response.
Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic ... infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accelerate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
Trachoma causes more vision loss and blindness than any other infection in the world. This disease is caused by Chlamydia trachomatis bacteria. Other variants or strains ... these bacteria can cause a sexually transmitted infection (chlamydia) and disease in lymph nodes.
This is photomicrograph of a conjunctival smear that revealed the presence of what are known as, intracytoplasmic inclusions Trachoma is easily spread through direct personal contact such as from fingers, through shared towels and clothes, and through flies that have been in contact with the eyes or nose of an infected person. When left untreated, repeated Chlamydia trachomatis infections in the eye can cause severe scarring on the inside of the eyelid. This can cause the eyelashes to scratch the cornea (trichiasis). In addition to causing pain, trichiasis permanently damages the cornea and can lead to irreversible blindness.
Chlamydia trachomatis infections spread in areas that lack access to safely managed drinking water and sanitation systems. Trachoma affects the most resource-limited communities in the world. Globally, almost 1.9 million people have vision loss because of trachoma, and it causes 1.4% of all blindness worldwide.1 In 2021, 136 million people lived in trachoma-endemic areas and were at risk of trachoma blindness.
Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force
This document updates recommendations for HIV testing by laboratories in the United States and offers approaches for reporting test results to pers...
The Public Health Burden of Secondhand Exposure to Commercial Tobacco Smoke Secondhand smoke, the combination of smoke from burning commercial toba...
The Guidelines for the Diagnosis, Treatment and Prevention of Leprosy provide state-...-the-art knowledge and evidence on leprosy diagnosis, treatment and prevention based on a public health approach in endemic countries. The target audience of this document includes policy-makers in leprosy or infectious diseases in the ministries of health (especially but not limited to endemic countries), nongovernmental organizations, clinicians, pharmaceutical companies, donors and affected persons
Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community ... workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
Guidelines for the Prevention of Tuberculosis in Health Care Facilities in Resource-limited Settings
These guidelines are designed for settings with limited resources to provide inexpensive and effective control strategies ... prevention of TB transmission in health care workers (HCW).
Euro Surveillance 2014;19(47):pii=20970, p.31-37
The intent of these guidelines is to develop a holistic, coordinated, proactive and technology driven strategy for management ... biological disasters through a culture of prevention, mitigation and preparedness to generate a prompt and effective response in the event of an emergency. The document contains comprehensive guidelines for preparedness activities, biosafety and biosecurity measures, capacity development, specialised health care and laboratory facilities, strengthening of the existing legislative/
regulatory framework, mental health support, response, rehabilitation and recovery, etc. It specifically lays down the approach for implementation of the guidelines by the central ministries/departments, states, districts and other stakeholders, in a time bound manner.
Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation ... ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance while maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
Antimicrobials are medicines, including antibiotics, antivirals, antifungals, and antiparasitics, that are used to prevent and treat infections in humans, animals, ... plants. Antimicrobial Resistance (AMR) arises when bacteria, viruses, fungi, and parasites no longer respond to these medicines, rendering them ineffective and making infections more difficult to treat. This resistance increases the risk of disease spread, severe illness, disability, and death. Although AMR is a natural phenomenon driven by genetic
changes in pathogens, it is significantly accelerated by human activities such as the misuse and overuse of antimicrobials in healthcare, agriculture, and animal husbandry.
This report has been developed, based on data provided by the TB & ORD surveillance system from across Rwanda. It provides a comprehensive picture of the occurrence and management ... TB & ORD and Leprosy in Rwanda. It is structured based on the 2013-2018 Rwanda TB national strategic plan (2013-2018 TB NSP) and on the 2014-2018 Rwanda Leprosy national strategic plan (2014-2018 Leprosy NSP).
