Effective malaria prevention is threatened by widespread and increasing vector insecticide resistance. Failure to mitigate this threat will likely result in an increased burden of disease, with significant cost implications. This new framework provides support for the development of a national insec...ticide resistance monitoring and management plan as part of a national malaria strategic plan.
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PloS One October 2012 | Volume 7 | Issue 10 | e46943
Guidelines for Treatment and Management of Heart Failure in Indonesia
Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201...6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young people and adults with chronic hepatitis B a-
should be assessed; assessment of liver disease, includi...ng the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost effectiveness of currently available treatments; selection of first-line therapy; management of treatment failure or drug resistance; prophylactic treatment during im-
munosuppressive therapy; and monitoring for treatment response
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The guidelines are aimed at clinical professionals directly involved with and responsible for the care of adults with HIV infection, and at community advocates responsible for promoting the best interests and care of HIV-positive adults. They should be read in conjunction with other published BHIVA ...guidelines.
The 2016 interim update to the 2015 BHIVA antiretroviral guidelines has been published online to include tenofovir-alafenamide/emtricitabine as a preferred NRTI backbone for first-line therapy. Changes were based on new data and the consensus opinion of the writing committee. All changes to the guideline are highlighted and include updates to the chronic kidney disease and bone disease sections of special populations and some small changes to managing virological failure.
The 2019 interim statement provides updated advice on treatment with two-drug regimens
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Patients with retreatment tuberculosis (TB) represent those
who have been treated previously for onemonth ormorewith
anti-TB drugs and who have been diagnosed once again with
the disease.These patientsmainly include relapses, treatment
after failure, or loss to follow-up on a first-line treatmen...t
regimen [1]. The number of these patients is not negligible.
In 2014, of the 6.3 million TB cases that were notified
by National TB Programmes (NTPs) to the World Health
Organization (WHO), approximately 700,000 patients were
already previously treated
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Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(TB) patients. Objective: To assess whether differences in gender and HIV
status affect diagn...ostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
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n this study, low-dose azithromycin did not meet the prespecified non-inferiority margin compared with standard-dose azithromycin in achieving clinical and serological cure in PCR-confirmed active yaws. Only a single participant (with presumed latent yaws) had definitive serological failure. This wo...rk suggests that 20 mg/kg of azithromycin is probably effective against yaws, but further data are needed.
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Antimicrobial resistance (AMR) is a major global public health concern and a food safety issue. When pathogens become resistant to antimicrobial agents they can pose a greater human health risk as a result of potential treatment failure, loss of treatment options and increased likelihood and severi...ty of disease.
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Textes du Codex concernant la résistance aux antimicrobiens d’origine alimentaire
Textos del Codex sobre la resistencia a los antimicrobianos transmitida por los alimentos
Antimicrobial resistance (AMR) is a major global public health concern and a food safety issue. When pathogens become r...esistant to antimicrobial agents they can pose a greater human health risk as a result of potential treatment failure, loss of treatment options and increased likelihood and severity of disease
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Tuberculosis treatment failure results in increased risk of morbidity, drug resistance, transmission and mortality. There are few data about tuberculosis treatment outcomes in Burkina Faso. The current study investigated the factors associated with tuberculosis treatment failure in the central east ...health region of Burkina Faso.
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N Engl J Med 2022; 386:911-922, DOI: 10.1056/NEJMoa2104535
Four months of antituberculosis treatment was noninferior to 6 months of treatment in children with drug-susceptible, nonsevere, smear-negative tuberculosis (SHINE Study)
Indian markets caused a stir across the country.1
According to the Centre for Science and the Environment (CSE), a respected New Delhi-based NGO, most honey brands
sold in India contained varying amounts of antibiotics. Their consumption over time could induce resistance to antibiotics,
putting p...eople at risk of treatment failure in case of severe infections.
For the study, 12 samples were picked in Delhi, all well-known brands, including one each from Australia and Switzerland.
Antibiotics found included Chloramphenicol and various broad-spectrum drugs such as Ciprofloxacin and Erythromycin.
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Chagas disease is caused by Trypanosoma cruzi, a protozoal organism primarily transmitted by triatomine insect vectors, also known as “kissing bugs.” It is a zoonotic disease originally described by Brazilian physician Dr. Carlos Chagas in 1909 and is widespread in Latin America. Although triato...mines and T. cruzi have long been endemic to the southern United States, awareness and identification of infected vectors and animals have recently increased throughout the United States. Canine Chagas disease can be acute or chronic and is predominantly characterized by inflammation and fibrosis of the heart, resulting in arrhythmias, myocardial dysfunction, heart failure, and sudden death, although many infected dogs are asymptomatic.
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Chagas heart disease (CHD) affects approximately 30% of patients chronically infected with the protozoa Trypanosoma cruzi. CHD is classified into four stages of increasing severity according to electrocardiographic, echocardiographic, and clinical criteria. CHD presents with a myriad of clinical man...ifestations, but its main complications are sudden cardiac death, heart failure, and stroke. Importantly, CHD has a higher incidence of sudden cardiac death and stroke than most other cardiopathies, and patients with CHD complicated by heart failure have a higher mortality than patients with heart failure caused by other etiologies. Among patients with CHD, approximately 90% of deaths can be attributed to complications of Chagas disease. Sudden cardiac death is the most common cause of death (55%-60%), followed by heart failure (25%-30%) and stroke (10%-15%). The high morbimortality and the unique characteristics of CHD demand an individualized approach according to the stage of the disease and associated complications the patient presents with. Therefore, the management of CHD is challenging, and in this review, we present the most updated available data to help clinicians and cardiologists in the care of these patients. We describe the clinical manifestations, diagnosis and classification criteria, risk stratification, and approach to the different clinical aspects of CHD using diagnostic tools and pharmacological and non-pharmacological treatments.
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Globally, over two million women live with obstetric fistula with the majority of the cases
being from Africa. In low-resource settings such as Zambia, obstetric fistula (OF) is a visible indicator of
gaps in maternal health care resulting in failure to provide adequate, accessible and quality m...aternal health
care, including family planning, skilled birth attendance, basic and emergency obstetric and neonatal care,
and affordable treatment of fistula. OF is preventable and treatable, and no woman in Zambia should continue to endure the condition. It is therefore necessary that Zambia intensifies national scale up of OF management centers including
community based interventions, train more surgeons and other health workers to provide quality and
affordable care closer to the women who are silently suffering from obstetric fistula.
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Chronic manifestations of Chagas disease present as disabling and life-threatening conditions affecting mainly the cardiovascular and gastrointestinal systems. Although meaningful research has outlined the different molecular mechanisms underlying Trypanosoma cruzi’s infection and the host-parasit...e interactions that follow, prompt diagnosis and treatment remain a challenge, particularly in developing countries and also in those where the disease is considered non-endemic. This review intends to present an up-to-date review of the parasite’s life cycle, genetic diversity, virulence
factors, and infective mechanisms, as well as the epidemiology, clinical presentation, diagnosis, and treatment options of the main chronic complications of Chagas disease.
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The waves of yellow fever transmission in the Region of the Americas in 2016–2018 involved the largest number of human and epizootic cases to be reported in several decades. Yellow fever is a serious viral hemorrhagic disease that poses a challenge for health professionals. It requires early recog...nition of signs and symptoms, which are often nonspecific, and it can mimic other acute febrile syndromes. Early detection of suspected or confirmed cases, monitoring of vital signs, life support measures, and treatment of acute kidney failure continue to be the recommended strategies for case management. This report is the result of discussions among experienced specialists in the Americas on the clinical management of yellow fever patients, especially during outbreaks and epidemics, in the context of current medical and scientific evidence and taking into account the technical guidelines already available in the countries of the Region. It includes flowcharts for initially addressing patients with clinical suspicion of yellow fever and proposes a minimum package of laboratory tests that may be useful in contexts where resources are limited. In addition, it considers aspects of health system organization for dealing with yellow fever outbreaks and epidemics.
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