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2
WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO.
It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen
...
t of diphtheria. There is a worldwide shortage of DAT and evidence based recommendations on the use of DAT were requested by many Member States.
The guidance also includes new recommendations on antibiotics. In patients with suspected or confirmed diphtheria, WHO recommends using macrolide antibiotics (azithromycin, erythromycin) rather than penicillin antibiotics.
This clinical practice guideline has been rapidly developed recognizing the global increase in diphtheria outbreaks. Outbreaks of diphtheria in Nigeria, Guinea and neighbouring countries in 2023 have highlighted the urgent need for evidence-based clinical practice guidelines for the treatment of diphtheria. Given the sporadic nature of outbreaks, many clinicians in the affected regions have never managed acute diphtheria and its related complications. Diphtheria remains a neglected disease and vaccination is the top priority. At the same time, for patients with diphtheria, access to antibiotics, DAT and supportive care can be lifesaving.
more
Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant
tuberculosis (XDR-TB) increasingly occur in resource-constrained settings.
In the context of a national response to MDR- and XDR-TB, health workers in
TB clinics (in distric
...
t hospitals and some accredited health centres) will need
to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB
treatment.
Management of MDR-TB: a field guide was created to help health workers
carry out these tasks. It is a job aid that medical officers and TB nurses
are meant use frequently during the day for quick reference. This module
is closely related to other clinical guideline modules in the Integrated
Management of Adolescent and Adult Illness (IMAI) series. In particular, the
approach to chronic disease management is taken from General principles
of good chronic care in the IMAI series.
more
Cholera Surveillance: Detecting and Reporting Cases
Johns Hopkins Bloomberg School of Public Health
(2015)
C1
The intention of this document is to clarify and outline the steps to effective cholera surveillance. It discusses when,
where and why surveillance for cholera is needed and how to establish a useful and cost-effective surveillance
system for ch
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olera. To make comments, corrections and additions, please contact the authors at stopchol@jhsph.
edu or jhsph.stopchol@jhu.edu.
Check also: DOVE Project www.stopcholera.org
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The Agency for Toxic Substances and Disease Registry (ATSDR) has produced a three-volume series entitled Managing Hazardous Material Incidents. The series is designed to help emergency response and health
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care professionals plan for and respond to hazardous material emergencies.
- Volume I Emergency Medical Services: A Planning Guide for the Management of Contaminated Patients
- Volume II Hospital Emergency Departments: A Planning Guide for the Management of Contaminated Patients
- Volume III Medical Management Guidelines for Acute Chemical Exposures
Volumes I and II are planning guides to assist first responders and hospital emergency department personnel in planning for incidents that involve hazardous materials.
Volume III is a guide for health care professionals who treat persons who have been exposed to hazardous materials.
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These are integrated National Guidelines 2013 for Prevention and Management of HIV, STIs & Other Blood Borne Infections in accordance with the last guidelines of the World Health Organization (WHO) published in June 2013 and adapted to the Rwandan n
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ational context. It thus responds to the need by the Ministry of Health to improve skills of actors in the health sector as well as the quality of care and treatment offered in both public and private health facilities countrywide.
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National Tuberculosis Programme
The National Strategic Plan (NSP) for Tuberculosis (TB) 2016-2020 builds on the past experiences for the National Tuberculosis Programme and its partners. This NSP provides a roadmap for delivering quality TB prevention and ... care service to the entire population, as an integral part of the country's move toward Universal Health Coverage. Between 1990 and 2015, Myanmar reduced the prevalence of TB by 50%, meeting the targets set by the Millennium Development Goals. Going forward, the country aims to further accelerate the rate decline. more
The National Strategic Plan (NSP) for Tuberculosis (TB) 2016-2020 builds on the past experiences for the National Tuberculosis Programme and its partners. This NSP provides a roadmap for delivering quality TB prevention and ... care service to the entire population, as an integral part of the country's move toward Universal Health Coverage. Between 1990 and 2015, Myanmar reduced the prevalence of TB by 50%, meeting the targets set by the Millennium Development Goals. Going forward, the country aims to further accelerate the rate decline. more
This Plan envisions a future with the elimination of cervical cancer as a public health problem as a result of universal access to sexual health and STI prevention services, HPV vaccines, effective
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screening and precancer treatment services, treatment of invasive cervical cancer, and palliative care. It foresees that all women and girls, regardless of age, race, ethnicity, socioeconomic status, HIV status, or disability will have timely access to quality cervical cancer prevention, care, and treatment so that they can live in good health throughout the life course and enjoy the health-related human rights.
The goal is to accelerate progress toward the elimination of cervical cancer as a public health problem in the Americas by reducing incidence and mortality rates by one-third by 2030.
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The Zambia Population Based HIV impact assessment of 2016, reported the prevalence of viral hepatitis in Zambia as ranging between 5.6% among adults aged 15 to 59% in the general population, and 7.1% among HIV infected individuals. It is estimated that the majority of persons with chronic hepatitis
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B and/ or hepatitis C are unware of their infection and do not benefit from promotive, preventive and curative services designed to reduce onward transmission. Zambia introduced hepatitis B virus vaccine to the routine Under 5 vaccination schedule in 2005. Preliminary results from the ZAMPHIA indicate that hundreds of infections have been abated in children since then. However, its also clear that we continue to miss key opportunities to prevent transmission, diagnose and treat infections, prevent serious disease, and in many cases cure people. In addition, high risk groups inter alia health care workers still have limited access to the vaccine.
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Guidelines on Management of COVID-19 in Kenya
recommended
It has been over a year since Kenya identified the first case of COVID-19 in the country. The Government formed the National COVID-19 task force, which supported the country's response through multi-sectoral technical working groups on testing, case management, risk communication and community engag
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ement among others. An earlier version of the COVID case management guideline was released in April 2020 and capacity building of health care workers on diagnosis and treatment of COVID-19 was quickly carried out, even as counties prepared themselves by setting up isolation centres and supplies
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Lancet Planet Health 2022;6: e760–68
The emergence of COVID-19 has drawn the attention of health researchers sharply back to the role that food systems can play in generating human disease burden
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. But emerging pandemic threats are just one dimension of the complex relationship between agriculture and infectious disease, which is evolving rapidly, particularly in low-income and middle-income countries (LMICs) that are undergoing rapid food system transformation. This changing relationship is examined through four current disease issues.
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Evidence-based guidelines are one of the most useful tools for improving public health and clinical practice. Their purpose is to formulate interventions based on strong evidence of efficacy, avoid unnecessary risks, use resources efficiently, reduc
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e clinical variability and, in essence, improve health and ensure quality care, which is the purpose of health systems and services. These guidelines were developed following the GRADE methodology, with the support of a panel of clinical experts from different countries, all convened by the Pan American Health Organization. By responding to twelve key questions about the clinical diagnosis and treatment of dengue, chikungunya, and Zika, evidence-based recommendations were formulated for pediatric, youth, adult, older adult, and pregnant patients who are exposed to these diseases or have a suspected or confirmed diagnosis of infection. The purpose of the guidelines is to prevent progression to severe forms of these diseases and the fatal events they may cause. The recommendations are intended for health professionals, including general, resident, and specialist physicians, nursing professionals, and medical and nursing students, who participate in caring for patients with suspected dengue, chikungunya, or Zika. They are also intended for health unit managers and the executive teams of national arboviral disease prevention and control programs, who are responsible for facilitating the process of implementing these guidelines.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the
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health care settings. It aims to rationalize the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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WHO today released its first roadmap to tackle postpartum haemorrhage (PPH) – defined as excessive bleeding after childbirth - which affects millions of women annually and is the world’s leading cause of maternal deaths.
Despite being preventable and treatable, PPH results in around 70 000 de
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aths every year. For those who survive, it can cause disabilities and psychological trauma that last for years.
“Severe bleeding in childbirth is one of the most common causes of maternal mortality, yet it is highly preventable and treatable,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This new roadmap charts a path forward to a world in which more women have a safe birth and a healthy future with their families.”
The Roadmap aims to help countries address stark differences in survival outcomes from PPH, which reflect major inequities in access to essential health services. Over 85% of deaths from PPH happen in sub-Saharan Africa and South Asia. Risk factors include anaemia, placental abnormalities, and other complications in pregnancy such as infections and pre-eclampsia.
Many risk factors can be managed if there is quality antenatal care, including access to ultrasound, alongside effective monitoring in the hours after birth. If bleeding starts, it also needs to be detected and treated extremely quickly. Too often, however, health facilities lack necessary healthcare workers or resources, including lifesaving commodities such as oxytocin, tranexamic acid or blood for transfusions.
“Addressing postpartum haemorrhage needs a multipronged approach focusing on both prevention and response - preventing risk factors and providing immediate access to treatments when needed - alongside broader efforts to strengthen women’s rights,” said Dr Pascale Allotey, WHO Director for Sexual and Reproductive Health and HRP, the UN’s special programme on research development and training in human reproduction. “Every woman, no matter where she lives, should have access to timely, high quality maternity care, with trained health workers, essential equipment and shelves stocked with appropriate and effective commodities – this is crucial for treating postpartum bleeding and reducing maternal deaths.”
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The Water and Sanitation for Health Facility Improvement Tool (WASH FIT) presents a framework and acts as a guide to support multisectoral action to improve water, sanitation and hygiene (WASH) in health
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care. Central to the WASH FIT methodology is training and incremental improvements.
Implementation of WASH FIT requires six preparatory steps at the national level, one of which is conducting national sensitization and training of trainers, followed by facility-level training. At the facility level, step 1 (of five) involves establishing and training a WASH FIT team.
The WASH FIT methodology is outlined in WASH FIT: A practical guide for improving quality of care through water, sanitation and hygiene in health care facilities. Second edition. (the WASH FIT guide), which includes a set of templates designed to help users with each phase of the improvement cycle.
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Following the encouraging initial results of the pilot project, the Ministry of Health is committed to increasing access to MDR-TB diagnosis, treatment and care. An expansion plan for the programmat
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ic management of drug-resistant TB has been developed and forms part of the Five Year National Strategic Plan for TB Control, 2011-2015. The long-term goals of the MDR-TB expansion plan are threefold:
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols more
1. Diagnosis of MDR-TB in all groups of patients at risk for MDR-TB
2. Diagnosis of MDR-TB in all HIV-infected TB patients
3. MDR-TB treatment for all patients diagnosed with MDR-TB under WHO-endorsed treatment protocols more
The Clinical Management of Patients with COVID-19 course series is developed for healthcare workers during the COVID-19 pandemic. The course provides crucial knowledge necessary to provide safe, effective quality patient care. Presentations address
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all aspects of clinical management, including facility preparation and surge planning; health worker infection prevention and control; interfacility transfer; clinical management of mild, moderate, and severely ill patients with COVID-19; special considerations for geriatric, pregnant, and pediatric patients with COVID-19; rehabilitation; and ethics and palliative care.
The course series consists of 6 courses, which include video lectures and downloadable presentations that have been updated with the latest guidance and evidence. Each module contains 5-8 lectures, and each lecture includes a quiz to evaluate knowledge acquisition.
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Viral hepatitis is defined as inflammation of the liver cells due to viral infection. The burden of liver disease in South Africa is mostly underestimated as viral hepatitis, in particular chronic infection, is a silent and neglected cause of morbidity and mortality. However, the burden of disease i
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s likely substantial given the prevalence of chronic viral hepatitis. This burden is further compounded by the lack of screening and access to care and treatment as well as inadequate disease surveillance, human and financial resources.
The National Guidelines for the Management of Viral Hepatitis were developed, with the purpose to:
inform healthcare workers in the public and private sectors about the disease, its epidemiology in South Africa and current methods of diagnosis and therapy
strengthen the healthcare response to viral hepatitis
empower communicable diseases workers and stakeholders to make informed decisions regarding appropriate and cost effective interventions
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The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted to hospital with SAM can ra
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nge between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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This standard Operating procedure (SOP) for JDWNRH is intended to describe and
address various important areas like admission procedure, on call process of the
doctors, interdepartmental consultation, patient discharge process and verity of
other areas which was so far solely based on verbal i
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nstruction in the workplace by
the seniors which very often led to mishaps and other associate problems. This SOP,
though not comprehensive, would serve as a guidebook for newly recruited health
staff as well as a reference book for existing health professionals in JDWNRH while
delivering health care services
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As our world changes, so too does the burden of disease. Globalisation, evolving trade and consumption patterns, and increased access to life-saving medical care are just some of the factors that have transformed the global
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health landscape.
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