Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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Pan African Medical Journal. 2016; 25:213 doi:10.11604/pamj.2016.25.213.88
Les maladies chroniques non transmissibles (MCNT) constituent un problème de santé publique. La transition épidémiologique coexiste avec les maladies infectieuses. En Afrique subsaharienne, leur ampleur est peu connue et l'OMS recommande aux pays à faible et moyen revenu de réaliser des enquê...tes STEPS portant sur les comportements, des mesures physiques et biochimiques. L'absence de données au niveau national justifie cette étude auprès d'un groupe spécifique. L'objectif de l'étude était de déterminer la prévalence des MCNT et de leurs facteurs de risque chez les militaires Sénégalais.
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Le défi des pays en voie de développement est la disponibilité de méthodes de diagnostic rapide et précis pour le management de la tuberculose. Des techniques moléculaires offrent cet avantage et nous avons utilisé le test GeneXpert MTB/RIF dans le diagnostic de la tuberculose extra-pulmonair...e pour évaluer sa performance par rapport aux méthodes conventionnelles.
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Introduction: Premier niveau de référence de la pyramide sanitaire du Bénin, les hôpitaux de zone sanitaire s’acquittent de leurs missions dans un contexte difficile. L’objectif de la présente étude a été d’évaluer la performance de l’hôpital de la zone sanitaire de Comè en 2013. ...
Pan African Medical Journal. 2014; 18:63 doi:10.11604/pamj.2014.18.63.3465
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A Training Curriculum for Providers
Informal health workers are important care providers in the region and continue to be so during the current Ebola Virus Disease (EVD) outbreak. Many are well respected and trusted members of the community who can mobilise large numbers of people for a particular activity and lend legitimacy to a par...ticular programme.
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This guide has been written for managers of national and district trachoma control programmes. It sets out, step-by-step, what is needed to assess the magnitude and extent of the trachoma problem in the area and how to plan, implement, monitor and evaluate a programme to control, and ultimately elim...inate, trachoma.
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his manual is for people who have had no formal training in counselling but wish to learn the necessary components to establishing an effective counselling relationship. It will be useful for anyone who is involved in counselling people with a mental health problem.
h...is manual aims at providing counsellors with information about the basic skills required in counselling in a practical and simple to understand format. It is meant to accompany the Healthy Activity Program (HAP) and Counselling for Alcohol Problems (CAP) manuals for counselling patients with depression and harmful/dependent drinking in primary care settings.
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The new review paper, The Impacts of Climate Change on Health, identifies the extent to which increasing emissions, extreme weather and temperatures elevate health risks, from infectious disease to malnutrition, and assesses the associated health burden. It concludes that the health burden will exce...ed the level of demand that health systems are prepared for.
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The objective of the evaluation is to understand whether the CHW program has achieved its intended objectives, thus contributing to the overarching objectives defined in the HSSP III of improving the health status of the population by “Ensuring universal accessibility of quality health services fo...r all Rwandans”.
This evaluation has focused on CHWs, who are selected, trained and deployed by the MoH to deliver a defined set of tasks at community level. CHWs are the central element of the Community Health Policy and of the community health strategy plan (CHSP) of the MoH.
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Evidence from Low and Middle Income Countries
The Healthy Activity Program manual aims at providing counsellors like you with information about counselling patients with moderate to severe Depression in primary care settings.
A Program To Improve The Care For Patients With Common Mental Disorders In Primary Health Care.
The essence of the MANAS model is to shift mental health care from mental health specialists to primarycare doctors and lay HCs (someone similar to other more widely available... health workers) working as aprimary care team to improve the coverage and efficiency in treating CMD. This manual has been prepared based on the experience gained through the MANAS program and incorporates feedback from doctors who were involved in the program implementation. It outlines the details of the MANAS model and provides information on treatments that are relevant to doctors working in Primary Health Clinics
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