This paper reviews the effects of vertical responses to COVID-19 on health systems, services, and people’s access to and use of them in LMICs, where historic and ongoing under-investments heighten vulnerability to a multiplicity of health threats. We use the term ‘vertical response’ to describ...e decisions, measures and actions taken solely with the purpose of preventing and containing COVID-19, often without adequate consideration of how this affects the wider health system and pre-existing resource constraints.
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Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t...hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
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Update, 23 de junio de 2022
Global AIDS Update 2018
Closing Gaps
Breaking Barriers
Righting injustices
Why bold action against inequalities is needed to en AIDS, stop COVID-19 and prepare for future pandemics
The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir...ometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
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Frontline health workers (FHWs) provide services directly to communities where they are most needed, especially in remote and rural areas. Many are community health workers and midwives, though they can also include local emergency responders/paramedics, pharmacists, nurses, and doctors who serve in... community clinics.
The growing burden of non-communicable diseases (NCDs) on low- and middle-income countries threatens many health systems that are already weakened. In many countries, health systems—and health workers—are not prepared to address the complex nature of NCDs. Health systems are often fragmented, and designed to respond to single episodes of care or long-term prevention and control of infectious diseases.1 Many countries also continue to face shortages and distribution challenges of trained and supported health workers. As most NCDs are multifactorial in origin and are detected later in their evolution, health systems face significant challenges to provide early detection as well as affordable, effective, and timely treatment, particularly in underserved communities.
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This document aims to provide interim guidance for microbiology and virology experts, other laboratory professionals, laboratory managers, infectious disease programme managers, public health professionals and other stakeholders that provide primary, confirmatory or advanced testing for SARS-CoV-2, ...including genomic sequencing, or are involved in making decisions on establishing or scaling up capability and capacity to detect and characterize circulating SARS-CoV-2 variants.
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Global actions to reduce antimicrobial resistance (AMR) include optimising the use of antimicrobial medicines in human and animal health. In countries with weak healthcare regulation, this requires a greater understanding of the drivers of antibiotic use from the perspective of providers and consume...rs. In Bangladesh, there is limited research on household decision-making and healthcare seeking in relation to antibiotic use and consumption for humans and livestock. Knowledge is similarly lacking on factors influencing the supply and demand for antibiotics among qualified and unqualified healthcare providers. The aim of this study is to conduct integrated research on household decision-making for healthcare and antibiotic use, as well as the awareness, behaviours and priorities of healthcare providers and sellers of antibiotics to translate into policy development and implementation
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The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guidelines and policies regarding optimal packages of care... for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
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Q4: Can convulsive epilepsy be diagnosed at first level care by a non-specialist health care provider in low and middle income country settings?
Настоящее руководство «Клиническое ведение случаев COVID-19» базируется на
вышеуказанных стратегических приоритетах и адресовано клиницистам, участвующим в
оказа...ии помощи пациентам с подозреваемой или подтвержденной инфекцией COVID-19.
Оно не предназначено для того, чтобы заменить индивидуальное клиническое суждение или
консультацию специалиста, но призвано помочь клиническим работникам в обеспечении
наиболее эффективного ведения случаев. Повышенное внимание в настоящем руководстве
уделяется вопросам, касающимся особых и уязвимых групп населения, таких как дети,
пожилые люди и беременные женщины.
Interim guidance on clinical management COVID-19
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This checklist is for any organization or person supporting the routine use of evidence in
the process of policy-making. Evidence-informed policy-making (EIPM) is essential for achieving the Sustainable Development Goals (SDGs) and universal health coverage (UHC). Its importance is emphasized in WH...O’s Thirteenth General Programme of
Work 2019–2023 (GPW13). This checklist was developed by the WHO Secretariat of Evidence-Informed Policy Network (EVIPNet) to assist its Member countries in institutionalizing EIPM. Government agencies (i.e. the staff of the Ministry of Health),
knowledge intermediaries and researchers focused on strengthening EIPM will find in this checklist some key steps and tools to help their work. While the health sector is a key target group for EVIPNet, this tool can be applied by stakeholders from
different social sectors
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Recommendations for in-patient management of COVID-19 in adult patients
Version 10, November 2020.
Research Article
Karo et al. BMC Infectious Diseases 2014, 14:148 http://www.biomedcentral.com/1471-2334/14/148
Oсобенности клинических проявлений и лечения заболевания, вызванного новой коронавирусной инфекцией (Covid-19) у детей (clinical guidelines pediatrics)
В борьбе с туберкулезом достигнуты значительные прорывы, среди которых ускоренные и более точные методы диагностики и первые новые лекарственные средства за 50 л...т, однако сохраняется губительное отставание во внедрении этих нововведений в практику и обеспечения доступа к ним для уязвимых и социально ущемленных групп населения, в том числе заключенных, людей, живущих с ВИЧ, внутренних и внешних мигранты и наркопотребителей
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В данном издании представлены результаты оценки системы материнской и неонатальной помощи в Кыргызстане и соответствующие программы. Здесь описана текущая деяте...льность, направленная на улучшение здоровья матери и новорожденного, и инновационные пути для решения существующих трудностей, а также предложена модель проведения оценки эффективности программ, которые созданы на основе доказательной медицины и могут изменить сложившуюся ситуацию.
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Consensual Recommendation for treatment of COVID-19 in older adults
Emergencias 2021: 33: 42-58