Module 12:
Adolescents and young adults
July 2018
Module 12: Adolescents and young adults. This module is for people who are interested in providing PrEP services to older adolescents and young adults who are at substantial risk for HIV. It provides information on: factors that influence HIV... susceptibility among young people; clinical considerations for safety and continuation on PrEP; ways to improve access and service utilization; and inclusive monitoring approaches to improve the recording and reporting of data on young people.
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This document provides guidance on the application of non-pharmaceutical countermeasures to minimise the spread of the 2019 novel coronavirus (2019-nCoV) in the population. Some of the measures proposed refer specifically to certain phases of the epidemic (containment or mitigation phases), and can ...be adapted depending on the assessed severity/impact of the infection. Other measures are valid for all phases of an epidemic.
The guidance is based on the current knowledge of the 2019-nCoV and evidence available on other viral respiratory pathogens, mainly the Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), the Middle East Respiratory Syndrome-related coronavirus (MERS-CoV) and seasonal or pandemic influenza viruses.
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Guidelines
HIV testing services
July 2015
Revided Version
September 2013
Naicker et al. BMC Palliative Care (2016) 15:41 DOI 10.1186/s12904-016-0114-7
Participant Manual September 2012
Surveillance of Populations at High Risk for HIV Transmission
Antimicrobials are precious agents for combating infectious diseases and had saved millions of lives throughout the world. However, the current trend of increasing antimicrobial resistance (AMR) has become a global health problem with increased morbidity and mortality in infectious diseases. Sri La...nka is not an exemption and face many health related issues with multidrug resistant (MDR) organisms. Currently there is a global effort in combating antimicrobial resistance. WHO extends its fullest support and plays a major role in motivating the countries to combat antimicrobial resistance with national action plans in place. Sri Lanka has initiated combating AMR with multisectoral collaboration, under one health concept. The development of the National Strategic Plan (NSP) 2017-2022 provides the roadmap to combat AMR.
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Antimicrobial agents play an indispensable role in animal health and welfare management. At the same time, the need for prudent use is obvious to ensure good food safety outcomes and to manage the potential risk of antimicrobial resistance. The emergence of multi-resistant bacteria is posing challen...ges to health professionals and communities around the world for both human and animal health. These bacteria are not destroyed by the common antimicrobial agents and so pose a risk to people, particularly children, the elderly and those with poorly functioning immune systems, as well as to animals.
Throughout the years, the dairy sector has been very much aware of the need for responsible use and has, in many countries, implemented adequate measures throughout the dairy supply chain.
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The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp...ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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Updated with information on Ebola virus disease and Middle East respiratory syndrome coronavirus
A wide variety of health events ranging in severity may occur related to air transport, requiring different responses or, perhaps, no response at all. The target audience for this guidance document incl...udes the national focal points (NFP) for the IHR and public health authorities at PoE, as well as national aviation regulatory authorities, airport operators and personnel, aircraft operators, air crew and other stakeholders involved in air transport and emergency preparedness and response to public health events
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The Ghanaian Cabinet approved the antimicrobial resistance (AMR)Policy and Implementation plan(hereafter referred to as the national action plan or NAP)in December 2017, whilst the country case study was in progress. This has set in motion the implementation phase for Ghana, which is a long awaited... event since the drafting of the Policy started in 2011. This case study, whilst limited in its ability to interact with all stakeholders, has identified entrypoints within the operational divisions of Ghana Health Services,as potential areas where the AMR policy platform may seek to embed AMR activities. Much work has already been done within Ghana to identify the key entrypoints within the various ministries and government agencieswhere AMR can be incorporated. These stakeholders already form part of the AMR Policy Platform which is the governance structure for AMR and have been participating actively in the development of the AMR Policy and NAP activities formulation.
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Internationally, there is a growing concern over antimicro-bial resistance (AMR) which is currently estimated to ac-count for more than 700,000 deaths per year worldwide. If no appropriate measures are taken to halt its pro-gress, AMR will cost approximately 10 million lives andabout US$100 trillion... per year by 2050. In contrast tosome other health issues, AMR is a problem that con-cerns every country irrespective of its level of incomeand development as resistant pathogens do not respect borders.Despite the threat presented by AMR, the 2014 WorldHealth Organization (WHO) and the recent O’Neill re-port describe significant gaps in surveillance, standardmethodologies and data sharing. The 2014 WHOreport identified Africa and South East Asia as the regions without established AMR surveillance systems.
Tadesseet al. BMC Infectious Diseases (2017) 17:616 DOI 10.1186/s12879-017-2713-1
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Overuse of antimicrobial agents occurs globally in both community and hospital settings. Misuse of antibiotics can lead to a variety of adverse outcomes, including the development of antimicrobial resistanceand increased cost of hospitalization. This issuehas been particularly problematic in de...veloping countries, where antibiotic-management programs rarely exist and where antibiotics can be purchased without aprescription. In Thailand, the rate of antibiotic resistance among gram-positive and gram-negative or-ganisms has increased significantly over the past decade. These findings provide compelling evidence ofthe need for more-rational use of antimicrobial agents in Thailand.
Clinical Infectious Diseases2006; 42:768–752006 by the Infectious Diseases Society of America.
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile 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.
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The objectives of NAP are aligned with the global action plan based on national needs and priorities. The emphasis is on One Health approach with all sectors especially human health, animal health and environment contributing towards minimizing the emergence and impact of AMR in Jordan.
The purpose of these guidelines is to give practical advice to doctors so that all services and models of care used by doctors and health workers are encouraged to consider the use of telemedicine as a part of normal practice. These guidelines will assist the medical practitioner in pursuing a sound... course of action to provide effective and safe medical care founded on current information, available resources, and patient needs to ensure patient and provider safety.
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Journal of Biosocial Science / Volume 34 / Issue 04 / October 2002, pp 525 - 539
DOI: DOI:10.1017/S0021932002005254, Published online: 24 September 2002
This paper examines determinants of one aspect of sexual behaviour – coital frequency – among 2188 married women in the Central African Re...public using a secondary analysis of data from the Demographic and Health Survey of 1994–95. Female genital cutting (or circumcision) is practised in the Central African Republic and self-reported circumcision status was included in the questionnaire enabling it to be examined as a possible determinant of coital frequency. Multiple logistic regression was used to find a subset of factors independently associated with coital frequency.
Decreased coital frequency was found in those who had longer duration of marriage, those who were not the most recent wife in a polygamous marriage and those who had more surviving children. Coital frequency was higher in more educated women and those not contracepting because they wanted to get pregnant. After adjusting for confounders no association between
female genital cutting and coital frequency was found. The extent to which women can control coital frequency in this culture is not known and fertility desires may override any negative effects of circumcision on sexual pleasure.
It was therefore not possible to draw conclusions about how female genital cutting affects a woman’s desire for sexual intercourse and consequently there is a need to develop research methods further to investigate this question.
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A practical approach for developing policy and strategy to improve quality of care
The handbook outlines an approach for the development of national policies and strategies to improve the quality of care. Such policy and strategy can help clarify the structures, roles and responsibilities within n...ational quality efforts, support the institutionalization of a culture of quality, and secure buy-in from health system leaders and stakeholders
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