April 2022 Volume 35 Issue 2 e00152-21
Population movements have turned Chagas disease (CD) into a global public health problem. Despite the successful implementation of subregional initiatives to control vectorial and transfusional Trypanosoma cruzi transmission in Latin American settings where t...he disease is endemic, congenital CD (cCD) remains a significant challenge. In countries where the disease is not endemic, vertical transmission plays a key role in CD expansion and is the main focus of its control. Although several health organizations provide general protocols for cCD control, its management in each geopolitical region depends on local authorities, which has resulted in a multitude of approaches. The aims of this review are to (i) describe the current global situation in CD management, with emphasis on congenital infection, and (ii) summarize the spectrum of available strategies, both official and unofficial, for cCD prevention and control in countries of endemicity and nonendemicity. From an economic point of view, the early detection and treatment of cCD are cost-effective. However, in countries where the disease is not endemic, national health policies for cCD control are nonexistent, and official regional protocols are scarce and restricted to Europe. Countries of endemicity have more protocols in place, but the implementation of diagnostic methods is hampered by economic constraints. Moreover, most protocols in both countries where the disease is endemic and those where it is not endemic have yet to incorporate recently developed technologies. The wide methodological diversity in cCD diagnostic algorithms reflects the lack of a consensus. This review may represent a first step toward the development of a common strategy, which will require the collaboration of health organizations, governments, and experts in the field.
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Gambiense human African trypanosomiasis is a deadly infectious disease affecting West and Central Africa, South Sudan and Uganda, and transmitted between humans by tsetse flies. The disease has caused several major epidemics, the latest one in the 1990s. Thanks to recent innovations such as rapid di...agnostic tests for population screening, a single-dose oral treatment and a highly efficient vector control strategy, interruption of transmission of the causative parasite is now within reach. If indeed gHAT has an exclusively human reservoir, this could even result in eradication of the disease. Even if there were an animal reservoir, on the basis of epidemiological data, it plays a limited role. Maintaining adequate postelimination surveillance in known historic foci, using the newly developed tools, should be sufficient to prevent any future resurgence.
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Full document available: https://www.icmr.nic.in/sites/default/files/guidelines/Gastric%20Cancer%20Final%20pdf%20for%20farrow_0.pdf | Prepared as an outcome of ICMR Subcommittee on Gastric Cancer | Coordinated by Division of Non Communicable Diseases | This Consensus Document on Management of Gastri...c Cancers summarizes the modalities of treatment including the site-specific anti-cancer therapies, supportive and palliative care and molecular markers and research questions. It also interweaves clinical, biochemical and epidemiological studies.
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En enero de 2020, el agente etiológico responsable de un grupo de casos de neumonía grave en Wuhan, China, fue identificado como un nuevo betacoronavirus (2019-nCoV), distinto del SARS-CoV y MERS-CoV (1) (2) (3). La secuencia genómica completa de este nuevo agente está disponible y se han desarr...ollado diferentes protocolos de detección, aunque aún no se han validado por completo. Sin embargo, a la luz de la posible introducción de un caso sospechoso relacionado con el 2019-nCoV en la Región de las Américas, la Organización Panamericana de la Salud / Organización Mundial de la Salud (OPS / OMS) recomienda a los Estados Miembros garantizar su identificación oportuna, el envío de las muestras a laboratorios Nacionales o de referencia y la implementación del protocolo de detección molecular para 2019-nCoV, según la capacidad del laboratorio.
Hasta la fecha, no es completamente claro el potencial patogénico ni la dinámica de transmisión del 2019nCoV. Por esta razón y a la luz del conocimiento de otros virus similares (MERS-CoV, SARS-CoV), es necesario mantener y fortalecer las medidas de bioseguridad y elementos de protección personal para el trabajo con muestras sospechosas de infección con patógenos respiratorios.
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Au cours de la dernière décennie, les données de séquençage génétique des agents pathogènes ont gagné en importance et contribuent désormais de façon déterminante à la détection et à la maîtrise des flambées de maladies infectieuses, en facilitant la mise au point de ...produits de diagnostic, de médicaments et de vaccins et en guidant lesactivités de riposte aux flambées(1-11). L’émergence du nouveau coronavirus, par la suite désigné « coronavirus 2 du syndrome respiratoire aigu sévère » (SARS-CoV-2), a encore accentué l’importance des données de séquençage génétique.
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Barriers to the prompt and effective diagnosis and treatment of malaria exist at both the community and health facility level. Household surveys measure malaria case management at the population level with standard indicators that assess treatment-seeking behavior, access to diagnostic testing, and ...access to appropriate treatment. Performance on these indicators varies widely from country to country. Among countries with Demographic and Health Surveys (DHS) or Malaria Indicator Surveys (MIS) completed between 2014 and 2016, advice and treatment was sought for a median of 47% of children under age 5 with fever.
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This document summarizes current WHO guidance for public health surveillance of coronavirus disease 2019 (COVID-19) in humans caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
New elements include:
update of contact definitions, in line with latest cont...act tracing guidance
update of detection strategies in line with updated version of WHO SARS-CoV-2 testing guidance
reinfection evidence standardization and surveillance: molecular, genomic and immunological evidence of reinfection
inclusion of clinical case definition of Post COVID-19 condition as defined by WHO
definition of breakthrough infection
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Severe bacterial infections are a leading cause of morbidity and mortality among people with advanced HIV disease, after tuberculosis and cryptococcal disease. For countries to reach the end-AIDS targets for 2030, there is a need to establish a roadmap for managing severe bacterial infections and re...duce mortality. The purpose of the meeting was to
Review the current research and implementation data on the use of prophylactic antibiotics (specifically azithromycin/macrolides) as part of the AHD package of care; To review options for preventing SBIs that are in line with goals of reducing AMR; Present the current evidence on diagnostics for SBI; Discuss research gaps and implementation challenges.
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2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and th...ey have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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Entretanto, à luz da possível introdução de um caso suspeito relacionado ao COVID-19 na Região das Américas, a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS) recomenda que os Estados-membros garantam sua identificação oportuna, o envio de amostras a laborat...rios nacionais ou de referência e a implementação do protocolo de detecção molecular do COVID-19, dependendo da capacidade do laboratório. Até à data, o potencial patogênico e a dinâmica de transmissão do COVID-19 não são completamente claros. Por esta razão e à luz do conhecimento de outros vírus semelhantes (MERS-CoV, SRA-CoV), é necessário manter e reforçar as medidas de biossegurança e os equipamentos de proteção individual para o trabalho com amostras suspeitas de infecção com patógenos respiratórios.
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n the countries of the Region of the Americas, there are different forms of organization of health services at the first level of care. Some countries include certain laboratory, dental and diagnostic imaging practices in the first level of care, while other countries centralize these practices in t...he second and third levels of care. Consequently, so that the List of Priority Medical Devices (LPMD) could be adapted to these different forms of organization of health systems in the region of the Americas, modular lists were developed that complement the main list. In this way, to use the LPMD, only those modules that are planned to be offered in a first-level care center are selected, and it is those lists that are analyzed.
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WHO recommends artemisinin-based combination therapies for treating uncomplicated malaria, alongside studies to monitor treatment effectiveness. Given the threat of antimalarial resistance, including partial resistance in several African countries, molecular tools are vital for tracking resistance. ...In 2015, WHO launched the External Quality Assessment scheme for nucleic acid amplification testing to ensure reliable lab results. Coordinated by WHO and operated by the United Kingdom National External Quality Assessment Service for Parasitology, the scheme provides quality-controlled specimens and reports to help improve testing accuracy. Experts recently discussed expanding the scheme to include antimalarial resistance markers.
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The purpose of this guide is to provide updated clinical guidance on TB/HIV, with an emphasis on diagnostic aspects—including new techniques—as well as current treatment, while maintaining a public health approach. By compiling and consolidating the latest World Health Organization recommendatio...ns on the subject into a single guide, the aim is to create a reference and consultation document that is frequently used, and that unifies and standardizes the comprehensive management of TB/HIV co-infection in healthcare facilities based on the principle of “two diseases, one patient.” It also seeks to support the updating of national standards and guidelines on co-infection and to complement the coordinated work that must exist between TB and HIV prevention and control programs at all levels, within the framework of the twelve internationally recommended TB/HIV collaborative activities.
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Six months after its launch on 24 April, the Access to COVID-19 Tools (ACT) Accelerator has already delivered concrete results in speeding up the development of new therapeutics, diagnostics, and vaccines. Now mid-way through the scale-up phase, the tools we need to fundamentally change the course o...f this pandemic are within reach. But to deliver the full impact of the ACT-Accelerator – and ultimately an exit to this global crisis – these tools need to be available everywhere. On behalf of the ACT-Accelerator Pillar lead agencies – CEPI, Gavi, the Global Fund, FIND, Unitaid, Wellcome Trust, the World Bank, and the World Health Organization, as well as the Bill & Melinda Gates Foundation – I am pleased to share this document setting out the near-term priorities, deliverables and financing requirements of the ACT-Accelerator Pillars and Health Systems Connector. Urgent action to address these financing requirements will boost the impact of the ACTAccelerator achievements to date, fast-track the development and deployment of additional game-changing tools, and mitigate the risk of a widening gap in access to COVID-19 tools between low- and high-income countries. Delivering on this promise requires strong political leadership, financial investment, and incountry capacity building. COVID-19 cannot be beaten by any one country acting alone. We must ACT now, and ACT together to end the COVID-19 crisis.
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This policy guideIine is intended for use by healthcare professionals invoIved in the management of Covid-19 in South Africa. The document provides guidance on diagnostic tests available, on antigen test performance and accessibility. 1t focuses on key issues such as when to
Perform antigen tests... how to use and interpret results. Capturing and reporting testing information is also covered.
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Chapitre 50. Le texte traite du paludisme grave, une forme sévère du paludisme principalement causée par Plasmodium falciparum. Il explique les circonstances dans lesquelles le diagnostic doit être évoqué, notamment en cas de fièvre au retour d'une zone tropicale. Le document décrit les exam...ens nécessaires, les signes cliniques et biologiques de gravité, et insiste sur l’urgence du traitement. Le traitement de référence est l’artésunate par voie intraveineuse, suivi d’une thérapie orale. Le texte aborde aussi les complications possibles, les critères d’hospitalisation et l’importance d’une prise en charge rapide et adaptée dans un service spécialisé.
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Edición General: Dirección Nacional de Normatización - MSP
Este manual ha sido desarrollado por profesionales de las instituciones del Sistema Nacional de Salud (SNS)
y especialistas expertos en la materia, bajo la coordinación de la Dirección Nacional de Normatización del
Ministerio de S...alud Pública (MSP) y la colaboración de la Organización Panamericana de la Salud (OPS).
Contempla lineamientos técnicos, operacionales y administrativos, con la finalidad de garantizar la atención
integral, oportuna y de calidad a los usuarios de los establecimientos del SNS, dando prioridad a la preven-
ción, detección, diagnóstico y tratamiento para el control de la TB.
Los autores han declarado no tener conflicto de interés y han procurado ofrecer información completa y
actualizada; sin embargo, en vista de los posibles cambios en las ciencias médicas, se recomienda revisar el
prospecto de cada medicamento que se planea administrar, para cerciorarse de que no se hayan producido
cambios en las dosis sugeridas o en las contraindicaciones para su administración. Esta recomendación cobra
especial importancia en el caso de medicamentos nuevos o de uso infrecuente
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La publicación describe los procedimientos estandarizados para la atención integral de las personas diagnosticadas con tuberculosis y Virus de Inmunodeficiencia Humana en los servicios de salud a nivel nacional, así como los procesos de atención integral en las personas diagnosticadas con tuberc...ulosis y virus de Inmunodeficiencia Humana (VIH), que incluyen acciones de prevención, diagnóstico, tratamiento y seguimiento.
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La guía se basa en las buenas prácticas existentes y se ha elaborado con la colaboración de enfermeras que trabajan en una amplia variedad de ámbitos, pero se enfoca principalmente en las áreas con recursos limitados. Representa el punto de vista del personal técnico ... de La Unión y de la red de Enfermeras y Profesionales Sanitarios entre los miembros de La Unión. Las mejores prácticas se presentan como una serie de pautas que se pueden adaptar a los servicios locales en países de ingresos bajos y medios y que fomentan la evaluación a través del uso de resultados cuantificables. Cada pauta corresponde a un punto importante en el diagnóstico o tratamiento de un paciente con TB, tomando como referencia las estrategias recomendadas por La Unión2, 3 y los regímenes de tratamiento recomendados por la Organización Mundial de la Salud (OMS) para TB susceptible a fármacos y TB resistente a fármacos.4, 5 A lo largo de esta guía, se remitirá a los lectores, a través de notas al pie, a la información relevante publicada en dos guías distintas de La Unión: Manejo de la Tuberculosis: Una guía esencial de buenas prácticas, 6ta edición, 2010 (denominada Guía Naranja)2y Lineamientos para el Manejo Clínico y Operativo de la Tuberculosis Drogorresistente, 2013 (denominada Guía de DR-TB).3 Otros materiales de referencia importantes se indican al final del documento y todos coinciden con las estrategias recomendadas a nivel internacional.
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La Organización Panamericana de la Salud publica la tercera versión de la lista de dispositivos médicos prioritarios (LDMP) para el primer nivel de atención, elaborada de acuerdo con la realidad epidemiológica de los países de la Región de las Américas y adaptada al contexto de la pandemia d...e COVID-19. Con vistas a que la LDMP pueda adaptarse a las diferentes formas de organización de los sistemas de salud de la Región, esta tercera versión incluye una lista principal (223 dispositivos médicos), un módulo de diagnóstico por imágenes (30 dispositivos médicos), un módulo de laboratorio (29 dispositivos médicos) y un módulo de odontología (69 dispositivos médicos). Los usuarios deben seleccionar solo los módulos que contienen las prácticas que se planifica ofrecer en un centro de atención de primer nivel y analizar las listas correspondientes.
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