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The Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008, presents evidence-
based recommendations on the preferred methods for cleaning, disinfection and sterilization of patient-
care medical devices and for cleaning and disinfecting the healthcare environment. This docume
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nt
supercedes the relevant sections contained in the 1985 Centers for Disease Control (CDC) Guideline for
Handwashing and Environmental Control. 1 Because maximum effectiveness from disinfection and
sterilization results from first cleaning and removing organic and inorganic materials, this document also
reviews cleaning methods. The chemical disinfectants discussed for patient-care equipment include
alcohols, glutaraldehyde, formaldehyde, hydrogen peroxide, iodophors, ortho-phthalaldehyde, peracetic
acid, phenolics, quaternary ammonium compounds, and chlorine. The choice of disinfectant,
concentration, and exposure time is based on the risk for infection associated with use of the equipment
and other factors discussed in this guideline. The sterilization methods discussed include steam
sterilization, ethylene oxide (ETO), hydrogen peroxide gas plasma, and liquid peracetic acid. When
properly used, these cleaning, disinfection, and sterilization processes can reduce the risk for infection
associated with use of invasive and noninvasive medical and surgical devices. However, for these
processes to be effective, health-care workers should adhere strictly to the cleaning, disinfection, and
sterilization recommendations in this document and to instructions on product labels.
LAST UPDATE 2019
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Infectious diseases cause over one billion human infections per year, with millions of deaths each year globally. Extensive health and financial burden is seen from both established and emerging infectious diseases. Infectious diseases also affect plants and animals, which may pose threats to agricu
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lture and water supplies with additional impacts on human health. This Question and Answers, prepared by the World Health Organization (WHO) and Convention on Biological Diversity (CBD) Secretariat under their joint work programme on biodiversity and health, and launched of the occasion of the International Day for Biodiversity 2020, summarizes some of the interlinkages between biodiversity and infectious diseases.
WHO is continuously monitoring and responding to the COVID 19 outbreak. This Q&A will be updated as more is known about COVID-19, how it is affecting people worldwide, and the effectiveness of interventions against the disease.
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Adolescent girls and young women (AGYW) remain disproportionately affected by HIV in Eastern and Southern Africa (ESA), with 26 per cent of new infections attributed to this population. AGYW face many personal, social and structural barriers to access, uptake and use of traditional HIV prevention me
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thods. Oral Pre-exposure Prophylaxis (PrEP) is proven to be highly effective as an additional prevention choice for reducing the risk of HIV acquisition, including for AGYW. Successful uptake and adherence to PrEP is critical in its effectiveness as an HIV prevention method, however, the current demand for PrEP by AGYW is low with suboptimal adherence.
Within the ESA region, there is currently great impetus to address these challenges and scale up PrEP for AGYW. A critical aspect of this is to leverage the learnings and evidence from implementation of how to improve the demand and quality of PrEP programming for this population. Improving the Quality of Pre-Exposure Prophylaxis Implementation for Adolescent Girls and Young Women in Eastern and Southern Africa examines the current efforts in the region to accelerate and scale up evidence-based PrEP delivery platforms. The implementation brief provides current knowledge and builds on WHO guidance to provide key considerations for implementation, including driving demand and improving quality, as well as focus on wider combination prevention and integration agendas.
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The frequency of infectious disease epidemics is increasing, and the role of the health sector in the management of epidemics is crucial in terms of response. In the context of infectious disease epidemics, the use of climate-informed early warning systems (EWS) has the potential to increase the
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effectiveness of disease control by intervening before or at the beginning of the epidemic curve, instead of during the downward slope.
Currently, the initiation of interventions is heavily reliant on routine disease surveillance systems – data that often arrive too late for preventative response. However, forecasting of disease outbreaks using surveillance and weather information shows promising potential – there also remains further scope to examine seasonal climate forecasts. By combining these elements in new EWS based on computational models, it will be possible to improve both the timeliness and impact of disease control. The World Health Organization (WHO) is strengthening existing surveillance systems for infectious diseases to enable the development of more robust and timely EWS, which has resulted in the rapid development and innovation of EWS for disease outbreaks.
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In the face of rapid increases in the number of hospitalizations due to COVID-19 in Latin America and the Caribbean, coupled with shortages of human and material resources, including medical equipment and gases, there is a need to redesign models of care in the Region to optimize available resources
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and ensure that more patients receive the quantity and quality of oxygen they need. Oxygen is included in the World Health Organization’s list of essential medicines and is used to care for patients at all levels of integrated health services networks. The efficacy of oxygen use in the treatment of patients with respiratory conditions caused by COVID-19 has been demonstrated, but there is great opportunity to improve the effectiveness of its use if it is used in a rational, sustainable, and safe way. Bearing in mind that the efficacy of a health technology is measured by its benefit under actual conditions of use, practical actions can be taken to improve the use of medical oxygen and avoid oxygen shortages. A drug is considered to be used rationally when patients receive it according to their clinical needs, in doses appropriate to their individual needs, for an appropriate period, and at a low cost to them and their community. By providing instruction on the rational use of oxygen and promoting it, negative repercussions can be avoided, such as loss of efficacy as a result of activities related to oxygen storage, distribution, and administration. Rational use of oxygen also involves controlling waste due to leaks in storage and distribution systems, use of gas at incorrect pressures, use of incorrectly adjusted flowmeters, and disconnections, among other problems. Another aspect to consider is the provision of adequate technical support for all oxygen production systems, in terms of maintenance and calibration, availability of electrical energy, and specific knowledge about these systems. For these reasons, a set of guidelines has been put together for the development of an efficient management system to deal with situations of oxygen scarcity, both now and in the future.
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Extreme heat events (EHEs) are a leading cause of weather-related injury and death in the United States, and under a changing climate, these meteorological episodes are predicted to increase in both frequency and intensity. Prolonged heat exposure from EHEs places an increased strain on the heart an
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d may lead to heat-related illness if the cardiovascular system fails to properly thermoregulate internal body temperature. Every individual is susceptible to heat-related illness, however, those with reduced cardiovascular function and pre-existing cardiovascular diseases are at a greater risk for morbidity and mortality during EHEs. This document gives an overview of our current understanding of heat exposure and its impact on cardiovascular health outcomes, an overview of the medications that may exacerbate heat-related cardiovascular illness, and asummary of the interaction between extreme heat and air pollutants, and their collective impact on cardiovascular health. Additionally, this document summarizes epidemiologic evidence and identifies gaps in the extant peer-reviewed literature on the effectiveness of strategies and interventions to protect against heat-related cardiovascular disease and death. This information is intended to aid health departments and other health professionals in understanding and responding to the impacts of heat exposure on cardiovascular health.
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Environmental Research Volume 151, November 2016, Pages 115-123
Dengue is the world’s most important arboviral disease in terms of number of people affected. Over the past 50 years, incidence increased 30-fold: there were approximately 390 million infections in 2010. Globalization, trade, travel,
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demographic trends, and warming temperatures are associated with the recent spread of the primary vectors Aedes aegypti and Aedes albopictus and of dengue. Overall, models project that new geographic areas along the fringe of current geographic ranges for Aedes will become environmentally suitable for the mosquito’s lifecycle, and for dengue transmission. Many endemic countries where dengue is likely to spread further have underdeveloped health systems, increasing the substantial challenges of disease prevention and control. Control focuses on management of Aedes, although these efforts have typically had limited effectiveness in preventing outbreaks. New prevention and control efforts are needed to counter the potential consequences of climate change on the geographic range and incidence of dengue, including novel methods of vector control and dengue vaccines.
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Introduction: Considering the global prevalence of coronavirus disease 2019 (COVID-19), a vaccine is being developed to control the disease as a complementary solution to hygiene measures—and better, in social terms, than social distancing. Given that a vaccine will eventually be produced, informa
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tion will be needed to support a potential campaign to promote vaccination.
Objective: The aim of this study was to determine the variables affecting the likelihood of refusal and indecision toward a vaccine against COVID-19 and to determine the acceptance of the vaccine for different scenarios of effectiveness and side effects.
Materials and Methods: A multinomial logistic regression method based on the Health Belief Model was used to estimate the current methodology, using data obtained by an online anonymous survey of 370 respondents in Chile.
Results: The results indicate that 49% of respondents were willing to be vaccinated, with 28% undecided or 77% of individuals who would potentially be willing to be inoculated. The main variables that explained the probability of rejection or indecision were associated with the severity of COVID-19, such as, the side effects and effectiveness of the vaccine; perceived benefits, including immunity, decreased fear of contagion, and the protection of oneself and the environment; action signals, such as, responses from ones' family and the government, available information, and specialists' recommendations; and susceptibility, including the contagion rate per 1,000 inhabitants and relatives with COVID-19, among others. Our analysis of hypothetical vaccine scenarios revealed that individuals preferred less risky vaccines in terms of fewer side effects, rather than effectiveness. Additionally, the variables that explained the indecision toward or rejection of a potential COVID-19 vaccine could be used in designing public health policies.
Conclusions: We discovered that it is necessary to formulate specific, differentiated vaccination-promotion strategies for the anti-vaccine and undecided groups based on the factors that explain the probability of individuals refusing or expressing hesitation toward vaccination.
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Preventing tuberculosis infection from progressing to tuberculosis disease is a crucial component of the goal to eliminate tuberculosis. When deciding on the use of tuberculosis preventive therapy among household contacts, policy makers regularly ask questions, such as whether tuberculosis preventiv
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e therapy is effective, safe, and feasible in a programme setting and what it will cost. For contact management and tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis, studies from high-income and low-income countries have shown feasibility, safety, and effectiveness.
However, there is scarce information on the cost of tuberculosis preventive therapy for multidrug-resistant and rifampicin-resistant tuberculosis. In The Lancet Global Health, Peter Dodd and colleagues show that household contact management strategies are cost-effective even in low-income and middle-income countries, which has important policy implications for achieving the END TB Strategy goals.
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Guidance for health care workers.
Both the REGN-EB3 and mAb114 are recommended for use in EVD. The two drugs should not be given together. The choice of which monoclonal antibody to use depends on availability, including emerging information about effect
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iveness.
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Guidance for health care workers.
Both the REGN-EB3 and mAb114 are recommended for use in EVD. The two drugs should not be given together. The choice of which monoclonal antibody to use depends on availability, including emerging information about effect
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iveness.
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Guidance for health care workers.
Both the REGN-EB3 and mAb114 are recommended for use in EVD. The two drugs should not be given together. The choice of which monoclonal antibody to use depends on availability, including emerging information about effect
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iveness.
more
Cocktail d’anticorps monoclonaux neutralisant REGN-EB3 contre la maladie à virus Ebola (MVE)
recommended
Guidance for health care workers.
Both the REGN-EB3 and mAb114 are recommended for use in EVD. The two drugs should not be given together. The choice of which monoclonal antibody to use depends on availability, including emerging information about effect
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iveness.
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Covid-19 Test to Treat Guidelines
recommended
n response to the outbreak, the Africa Centres for Disease Control and Prevention (Africa CDC) has been supporting African Union Member States in responding to the COVID-19 pandemic through a variety of interventions such as non-pharmaceutical interventions, quarantine, testing, isolation, contact t
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racing, and clinical management. The Test to Treat guideline aims to increase continental testing efforts and reduce COVID-19 transmission in Africa and put-up response measures to control the impact of the virus, both to limit spread and to reduce substantially the risks of severe health outcomes related to COVID-19 infection. These countermeasures include highly effective vaccines and boosters, rapid testing options for monitoring exposure, and effective therapeutic options for both pre-exposure prevention and treatment of mild-to-moderate disease, oxygen therapy for moderate-severe disease, all of which can potentially be updated efficiently as new variants emerge that may affect the effectiveness of the available tools.
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Nurses are critical to deliver on the promise of “leaving no one behind” and the global effort to achieve the Sustainable Development Goals (SDGs). They make a central contribution to national and global targets related to a range of health priorities, including universal health coverage, mental
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health and noncommunicable diseases, emergency preparedness and
response, patient safety, and the delivery of integrated, people-centred care.
No global health agenda can be realized without concerted and sustained efforts to maximize the contributions of the nursing workforce and their roles within interprofessional health teams. To do so requires policy interventions that enable them to have maximum impact and effectiveness by optimizing nurses’ scope and leadership, alongside accelerated investment
in their education, skills and jobs. Such investments will also contribute to the SDG targets related to education, gender, decent work and inclusive economic growth.
This State of the world’s nursing 2020 report, developed by the World Health Organization (WHO) in partnership with the International Council of Nurses and the global Nursing Now campaign, and with the support of governments and wider partners, provides a compelling case on the value of the nursing workforce globally.
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This Strategic Operating Framework (SOF) has been developed to guide WASH Sector partners in responding to humanitarian needs in Sudan in conjunction with the existing and forthcoming humanitarian response plans (2022 and 2023). This SOF is drafted in consultation with the Strategic Advisory Group (
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SAG) at the national level and will be revised as the humanitarian situation evolves in line with changes made to the WASH Cluster response plan and other guidance received by the SAG and the Technical Working Groups. However, by adhering to the cluster (Sector) approach, the partners agree to:
Assist the authorities in responding to the WASH needs of the population affected.
Promote a common understanding of the WASH sector needs and interventions in the response context among the WASH partners.
Ensure a well-coordinated response and consequently increase the efficiency, effectiveness, and impact of individual agency responses; and
Align towards common humanitarian principles and operational objectives.
Partners to conform to the broad operational framework outlined in this document. Agencies that breach these guidelines will be expected to provide clear justification to the WASH Sector and other WASH Sector partners through the SAG
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The road map 2030 was developed by WHO through an extensive global consultation, with indicators set for measuring progress against targets and milestones. This compendium of indicators provides a comprehensive and standardized listing of recommended indicators, including the 70 core indicators pres
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ented in the M&E framework. These indicators will also support reporting on strategies described in other road map companion documents to guide action against neglected tropical diseases include the sustainability framework, the global strategy on water, sanitation and hygiene, the One Health approach and the strategic framework for integrated control and elimination of skin-related neglected tropical diseases.
The purpose of this compendium is to guide monitoring and evaluation of programmes and thereby to improve their quality and effectiveness in alignment with the road map goals. It provides a standardized listing of the most widely used indicators relevant to countries, with uniformity in defining indicators to allow comparisons over time and among different programmes. Detailed metadata are provided for each of these indicators to facilitate validity, internal consistency, standardized measurement, estimation methods and comparability of data across countries.
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The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly re
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placing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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HIV, viral hepatitis and STI epidemics, particularly among people who inject drugs and other key populations, continue to be fuelled by laws and policies criminalizing sex work; drug use or possession; diverse forms of gender expression and sexuality; stigma and discrimination; gender discrimination
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; violence; lack of community empowerment and other violations of human rights. These sociostructural factors limit access to health services, constrain how these services are
delivered and diminish their effectiveness.
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The Transformation Agenda (TA) ushered in an ambitious reform process intended to transform the World Health Organization (WHO) into an organization that is proactive, results-driven, accountable and which meets stakeholder expectations, towards transforming and improving public health services in t
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he African Region. It aimed to achieve a WHO that is pro-results, which optimally and creatively targets technical work as well as make operations more responsive, with greater effectiveness in both communications and partnerships. The Africa Region has been the epicentre of the human immunodeficiency virus (HIV) epidemic and it’s one of the leading causes of disease and death on the continent. The WHO, with partners, has worked tirelessly for many years to control the threat and reduce the negative impact of the disease. Since the early 2000s, significant progress has been made in the global fight against the scourge of HIV. However, the WCA subregion was falling concerningly behind ESA on several key indicators of progress. In 2016, the WHO joined UNAIDS, UNICEF and other partners in a call for a strong and urgent response to support WCA countries to develop catch-up plans to triple and fast-track ART coverage, to enable the region to catch up with ESA by the end of 2020. Implementation of a widespread test-and-treat strategy, coupled with the scale-up of differentiated service delivery (DSD) and mobilization of requisite funding, accelerated WCA’s progress towards this goal. The HIV treatment catch-up and fast-track plan has achieved its target of seeing the West and Central African region (WCA) catch up with the Eastern and Southern African region’s (ESA) antiretroviral coverage rate of 78% in 2021, albeit later than the 2020 target time frame. A 33% improvement was achieved in WCA, against 21% in ESA, between 2015–2020. WCA achieved a significant 42% increase, compared to ESA’s 23%, between 2015 and 2021, to see WCA draw level with ESA at 78%. In the Democratic Republic of the Congo (DRC) alone, progress of up to 47% was observed between 2015 and 2020, for example. In addition, 1.6 million more People Living with HIV (PLHIV) were enrolled on antiretroviral treatment (ART) between 2015 and 2020.
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