Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan...ding an existing HIV and tuberculosis (TB) disease-specific CHW programme into a polyvalent, household-based model that subsequently included non-communicable diseases (NCDs), malnutrition and TB screening, as well as family planning and antenatal care (ANC).
Methods: We conducted a stepped-wedge cluster randomised controlled trial in Neno District, Malawi. Six clusters of approximately 20 000 residents were formed from the catchment areas of 11 healthcare facilities. The intervention roll-out was staggered every 3 months over 18 months, with CHWs receiving a 5-day foundational training for their new tasks and assigned 20–40 households for monthly (or more frequent) visits.
Findings: The intervention resulted in a decrease of approximately 20% in the rate of patients defaulting from chronic NCD care each month (−0.8 percentage points (pp) (95% credible interval: −2.5 to 0.5)) while maintaining the already low default rates for HIV patients (0.0 pp, 95% CI: −0.6 to 0.5). First trimester ANC attendance increased by approximately 30% (6.5pp (−0.3, 15.8)) and paediatric malnutrition case finding declined by 10% (−0.6 per 1000 (95% CI −2.5 to 0.8)). There were no changes in TB programme outcomes, potentially due to data challenges.
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Epilepsia, 55(4):475–482, 2014
doi: 10.1111/epi.12550
Lancet Respir Med 2020Published OnlineMarch 20, 2020https://doi.org/10.1016/S2213-2600(20)30121-1
In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable quality from public and private providers who are not engaged by the NTP. The quality of care provided i...n these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
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A survey of prevention, testing and treatment policies and practices
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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методические рекомендации на тему эпидемиологические исследования паркинсонизма,
The annual Joint Meeting of the Food and Agriculture Organization of the United Nations (FAO) Panel of Experts on Pesticide Residues in Food and the Environment and the World Health Organization (WHO) Core Assessment Group on Pesticide Residues (JMPR) was held in Rome, Italy, from 13 to 22 September.... The FAO panel of experts had met in preparatory sessions from 8 to 12 September. The Meeting was held in pursuance of recommendations made by previous Meetings and accepted by the governing bodies of FAO and WHO that studies should be undertaken jointly by experts to evaluate possible hazards to humans arising from the occurrence of pesticide residues in foods. During the meeting the FAO Panel of Experts was responsible for reviewing pesticide use patterns (use of good agricultural practices), data on the chemistry and composition of the pesticides and methods of analysis for pesticide residues and for estimating the maximum residue levels that might occur as a result of the use of the pesticides according to good agricultural use practices. The WHO Core Assessment Group was responsible for reviewing toxicological and related data and for estimating, where possible and appropriate, acceptable daily intakes (ADIs) and acute reference doses (ARfDs) of the pesticides for humans. This report contains information on ADIs, ARfDs, maximum residue levels, and general principles for the evaluation of pesticides. The recommendations of the Joint Meeting, including further research and information, are proposed for use by Member governments of the respective agencies and other interested parties.
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Division of Noncommunicable Diseases | draft guidelines on diagnosis and management of a chronic immune-mediated enteropathy called celiac disease. This disease is caused is mainly caused in genetically susceptible individuals by ingestion of gluten proteins that are present in wheat, barley and oat...s.
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Organisation mondiale de la Santé, Organisation des Nations Unies pour l’alimentation et l’agriculture & Organisation mondiale de la santé animale. (2021). Résistance aux antimicrobiens et plan-cadre de coopération des Nations Unies pour le développement durable : orientations pour le...s équipes de pays des Nations Unies. Organisation mondiale de la Santé.
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Chaque année, des milliers d’enfants béninois meurent ou n’arrivent pas à développer pleinement leur potentiel physique ou intellectuel du fait de la malnutrition chronique. La présente politique du secteur de la santé pour la nutrition se focalise sur la mère, lenourrisson,... l’enfant et l’adolescent et prend en compte les résolutions du récent forum national organisé à Cotonoudu 11 au 13 juin 2015, par le Conseil National de l’Alimentation et de la Nutrition(CAN)sur la lutte contre la malnutrition chronique axée sur la fenêtre d’opportunité des 1000 premiers jours de la vie (allant de la conception à la fin de la deuxième année de vie). Elle se fonde sur les principes d’équité?d’éthique et de transparence dans la gestion des problèmes nutritionnels.Cette politique est l’œuvre de la Direction de la Santé de la Mère et de l’Enfant (DSME) avec le soutien technique et financier de l’Organisation Mondiale de la Santé (OMS). Elle servira au cours des dix prochaines années (2016-2025) d’orientation à tous les acteurset partenaires qui contribuent à l’amélioration de l’état nutritionnel des cibles visées.
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doi: https://doi.org/10.1101/2020.11.30.20236570
Pre-Print Article
Standard Treatment Guideline