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Publication Years
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1
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso wer
...
e limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
Because of the limited access to more powerful diagnostic tools, there is a paucity of data regarding the burden of fungal infections in Burkina Faso. The aim of this study was to estimate the incidence and prevalence of serious fungal infections in this sub-Saharan country. We primarily used the na
...
tional demographic data and performed a PubMed search to retrieve all published papers on fungal infections from Burkina Faso and its surrounding West African countries. Considering the prevalence of HIV infection (0.8% of the population) and a 3.4% incidence of cryptococcosis in hospitals, it is estimated that 459 patients per year develop cryptococcosis. For pneumocystosis, it is suggested that 1013 new cases occur every year. Taking into account the local TB frequency (population prevalence at 0.052%), we estimate the prevalence of chronic pulmonary aspergillosis at 1120 cases. Severe forms of asthma with fungal sensitization and allergic bronchopulmonary aspergillosis are estimated to affect 7429 and 5628 cases, respectively. Vulvovaginal candidiasis may affect 179,000 women, and almost 1,000,000 children may suffer from tinea capitis. Globally, we estimate that roughly 1.4 million people in Burkina Faso (7.51% of the population) suffer from a serious fungal infection. These data should be used to drive future epidemiological studies, diagnostic approaches, and therapeutic strategies.
more
To guide One Health capacity building efforts in the Republic of Guinea in the wake of the 2014–2016 Ebola virus disease (EVD) outbreak, we sought to identify and assess the existing systems and structures for zoonotic disease detection and control. We partnered with the government ministries resp
...
onsible for human, animal, and environmental health to identify a list of zoonotic diseases – rabies, anthrax, brucellosis, viral hemorrhagic fevers, trypanosomiasis and highly pathogenic avian influenza – as the country's top priorities. We used each priority disease as a case study to identify existing processes for prevention, surveillance, diagnosis, laboratory confirmation, reporting and response across the three ministries. Results were used to produce disease-specific systems “maps” emphasizing linkages across the systems, as well as opportunities for improvement. We identified brucellosis as a particularly neglected condition. Past efforts to build avian influenza capabilities, which had degraded substantially in less than a decade, highlighted the challenge of sustainability. We observed a keen interest across sectors to reinvigorate national rabies control, and given the regional and global support for One Health approaches to rabies elimination, rabies could serve as an ideal disease to test incipient One Health coordination mechanisms and procedures. Overall, we identified five major categories of gaps and challenges: (1) Coordination; (2) Training; (3) Infrastructure; (4) Public Awareness; and (5) Research. We developed and prioritized recommendations to address the gaps, estimated the level of resource investment needed, and estimated a timeline for implementation. These prioritized recommendations can be used by the Government of Guinea to plan strategically for future One Health efforts, ideally under the auspices of the national One Health Platform. This work demonstrates an effective methodology for mapping systems and structures for zoonotic diseases, and the benefit of conducting a baseline review of systemic capabilities prior to embarking on capacity building efforts.
more
This Fiji contextualized manual was initially drafted for CANDO partners as a result of the work done by the humanitarian arms of the various Christian denominations. However as the work progressed it became evidently clear that the training was needed for all responders, and not only Christian resp
...
onders, and as such, the Christian component has been added as an Annex to this manual, whilst the entire manual is relevant and can be used to train all first responders in Fiji.
more
Multizentrische Analyse des Erkrankungsspektrums und der Versorgungsqualität anhand dezentralisierter Routinedaten des Verbunds PriCarenet
Health Equity Studies & Migration Report Series 2021-03
Guidelines on optimising oxygen use and ventilatory support in critically ill patients with COVID-19 (updated on 11/06/2021)
Surgical site infection (SSI) is the most common postoperative complication worldwide. WHO guidelines to prevent SSI recommend alcoholic chlorhexidine skin preparation and fascial closure using triclosan-coated sutures, but called for assessment of both interventions in low-resource settings. This s
...
tudy aimed to test both interventions in low-income and middle-income countries.
more
APS FORTE no SUS: no combate à pandemia
Padilla, M.; R.M. de Oliveira Costa et al.
Organização Pan-Americana da Saúde e Ministério da Saúde
(2021)
C_WHO
Challenged by the health emergency, Primary Health Care (PHC) professionals remodeled their work processes and realized that many of the innovations implemented in an emergency manner to respond to the pandemic of COVID are here to stay. The initiative APS Forte no SUS - no combate à pandemia de CO
...
VID-19 gathered experiences from all over the country, executed by engaged health workers who, despite the difficulties imposed by the new disease, fight daily to improve the offer and care in health in the Unified Health System (SUS). With the help of digital technologies, teams and professionals of the Family Health Strategy overcome daily one of the main challenges of APS in this pandemic: ensuring access to health services. Digital tools gain strength in the agenda for strengthening the SUS, so well represented in this initiative.
more
Association between Ambient Temperature and Hospitalization for Renal Diseases in Brazil during 2000–2015: A Nationwide Case-Crossover Study
Bo Wen, Rongbin Xu, Yao Wu, Micheline de Sousa Zanotti Stagliorio Coelho et al.
The Lancet Regional Health – Americas
(2021)
CC
Climate change is increasing the risks of injuries, diseases, and deaths globally. However, the association between ambient temperature and renal diseases has not been fully characterized. This study aimed to quantify the risk and attributable burden for hospitalizations of renal diseases related to
...
ambient temperature.
more
This Study presents the key results of a research that analyses the implications of an ambitious agroecological transition across Europe, following the TYFA scenario. Published in 2018, what it proposes by 2050 is fully aligned with the objectives that the European Farm to Fork and Biodiversity stra
...
tegies aim to achieve by 2030, in particular regarding the decrease in pesticides, nitrogen, and antibiotics on the supply side, and the transition towards more plant-based diets on the demand side. Using a world biomass balance model (GlobAgri-AgT), the impact of the TYFA scenario in the EU on world land use, the EU physical trade balance, the provision of calories and global food security is analysed in addition to key policy levers to spur the transition.
more
COVID-19: Evolucao e manejo clinico (COVID-19: Evolution and clinical management)
A. dos Santos Filho, W. Marques, P. Dourado, et al.
Subsecretaria de Saúde Gerência de Informações Estratégicas em Saúde CONECTA-SUS
(2021)
CC
Since the description of the first case of COVID-19 in Wuhan, Hubei province in China, in December 2019, much knowledge has been accumulated about the dynamics of evolution of the SARS-CoV-2 virus, contagion, disease progression, prevention and treatment.
As pandemias virais costumam representar sérias ameaças ao equilíbrio dos sistemas de saúde, ao impor-lhes demandas extraor-dinárias e sustentadas, que podem ultrapassar a capacidade de atendimento, no que diz respeito tanto aos insumos e às tecnologias disponíveis, quanto aos recurs
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os humanos/profissionais capacitados. Trazem o enorme desafio de equilibrar igualdade entre as pessoas e equidade na distribuição de riscos e benefícios entre elas.
Diante desse cenário de casos cada vez mais frequentes de COVID-19 na
população, surge a premente necessidade de se avaliarem as melhores práticas para a otimização da utilização dos meios e recursos disponíveis. Dessa forma, considerando o iminente risco de indisponibilidade de leitos de terapia intensiva e respiradores para todos os indivíduos, acometidos ou não pela doença, torna-se fundamental estabelecer critérios clínicos, técnicos e éticos, para a melhor utilização dos mesmos, para se conseguir otimizar resultado e gerar o maior benefício possível.
more
This study aimed to analyze the geographical distribution of coronavirus disease 2019 (COVID-19) and to identify high-risk areas in space and time for the occurrence of cases and deaths in the indigenous population of Brazil. This is an ecological study carried out between 24 March and 26 October 20
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20 whose units of analysis were the Special Indigenous Sanitary Districts. The Getis-Ord General G and Getis-Ord Gi* techniques were used to verify the spatial association of the phenomena and a retrospective space–time scan was performed. There were 32 041 confirmed cases of COVID-19 and 471 deaths. The non-randomness of cases (z score = 5.40; P < 0.001) and deaths (z score = 3.83; P < 0.001) were confirmed. Hotspots were identified for cases and deaths in the north and midwest regions of Brazil. Sixteen high-risk space–time clusters were identified for the occurrence of cases with a higher RR = 21.23 (P < 0.001) and four risk clusters for deaths with a higher RR = 80.33 (P < 0.001). These clusters were identified from 22 May and were active until 10 October 2020. The results indicate critical areas in the indigenous territories of Brazil and contribute to better directing the actions of control of COVID-19 in this population.
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Community home based care guidelines
University of Western Cape; University of Cape Town, Maastricht University et al.
Learning Network
(2014)
CC
Community Health Committee Training
Key questions
What is already known?
Critical illness is common throughout the world and COVID-19 has caused a global surge of critically ill patients.
There are large gaps in the quality of care for critically ill patients, especially in low-staffed and low-resourced settings, and mortal
...
ity rates are high.
Essential Emergency and Critical Care (EECC) is the effective lifesaving care of low-cost and low-complexity that all critically ill patients should receive in all wards in all hospitals in the world.
What are the new findings?
The clinical processes that comprise EECC and the essential care of critically ill patients with COVID-19 have been specified in a large consensus among clinical experts worldwide.
The resource requirements for hospitals to be ready to provide this care has been described.
What do the new findings imply?
The findings can be used across medical specialties in hospitals worldwide to prioritise and implement essential care for reducing preventable deaths.
Inclusion of the EEEC processes could increase the impact of pandemic preparedness and response programmes and policies for health systems strengthening.
more
The brief highlights some findings as part of a project on Innovation for Cancer Care in Africa (ICCA)1. The study provides insights on the experiences of 62 Tanzanian cancer patients, the journey from their first symptoms to the point of diagnosis and treatment. The project brings together research
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ers from Tanzania, Kenya, India and the United Kingdom to address the opportunities and challenges of linking industry and health systems to widen access to cancer care in Tanzania and Kenya.
more
Consensual recommendations for outpatient management and home care
and home treatment of patients with COVID-19
COVID - 19 and PREGNANCY
Management guidelines for SARS-CoV-2 infection
