Healthy Settings, a key component of Malawi’s Health Sector Strategic Plan (HSSP) 2011–2016, is the World Health Organization’s (WHO) holistic community-led approach to achieving health improv...ement by addressing social determinants of health, an approach which is central to the current WHO framework on integrated people-centred health services. Healthy Settings projects by their construct have many different components which vary from one group and community to another depending on their priorities: from housing, hospital improvements and waste management to “softer” interventions like leadership skills training and health promotion. It can be challenging to find relevant indicators to monitor and assess the impact of such a complex holistic project, this paper explores if social capital data can provide useful impact assessment indicators at the start of such a project. more

Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper health care is lim...ited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment. more

El Laboratorio de Micología del Centro Nacional de Salud Pública del Instituto Nacional de Salud (INS) ha elaborado el presente manual de procedimientos micológicos, a fin de actualizar y uniformizar los conocimientos referidos al diagnóstico micológico que se basa en la identificación precisa... de los agentes causales de las micosis, aislados a partir de muestras clínicas representativas, así como también en pruebas de susceptibilidad antifúngica. more