Interim emergency guidelines
En el último decenio, los datos de las secuencias genéticas de los patógenos han adquirido un papel crucial en la detección y el manejo de los brotes de enfermedades infecciosas, contribuyendo al desarrollo de pruebas diagnósticas, medicamentos y vacunas y orientando la respuesta sanitaria.
PLoS Neglected Tropical Diseases https://doi.org/10.1371/journal.pntd.0004762
This study shows the importance of an integrated entomological and medical surveillance for the evaluation of arboviral disease risk, which is a precondition for designing cost-effective vector control programs.
BMJ,Dodd PJ, et al. Thorax 2017;72:559–575. doi:10.1136/thoraxjnl-2016-209421
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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Leptospirosis, a spirochaetal zoonosis, occurs in diverse epidemiological settings and affects vulnerable populations, such as rural subsistence farmers and urban slum dwellers. Although leptospirosis is a life-threatening disease and recognized as an important cause of pulmonary haemorrhage syndrom...e, the lack of global estimates for morbidity and mortality has contributed to its neglected disease status
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The authors conduct an integrated survey of Antimicrobial Resistant Organisms (AMR) in drinking water, wastewater and surface water in three settings in Bangladesh: rural households, rural poultry farms, and urban food markets. Results show that untreated water discharged from rural households, poul...try farms and urban markets are major contributors to surface water pollution and antibiotic resistant bacteria genes, calling for increased surveillance and monitoring.
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Note technique. Les centres de traitement de choléra fournissent des soins hospitaliers aux patients atteints de choléra
pendant les épidémies. Une prise en charge de qualité et l’isolement des patients atteints du choléra sont
essentiels pour prévenir les décès et aider à lutter con...tre la propagation de la maladie. Traditionnellement,
ces structures sont appelées centres de traitement du choléra (CTC) et unités de traitement du choléra (UTC).
Les CTC sont généralement de grandes structures mises en place au niveau central (zones urbaines, par
exemple), tandis que les UTC sont des structures plus petites, installées en périphérie (zones périurbaines ou
rurales, par exemple). Les CTC/UTC peuvent être mis en place en tant que structures indépendantes dans
des tentes ou à l’intérieur de bâtiments existants ou dans des unités sanitaires. Quelle que soit la structure,
les principes décrits dans ce document doivent être respectés.
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This rapid review report has identified the wastewater treatment plant (WWTP) options used in emergency settings, with decentralised wastewater treatment systems (DEWATS) and mobile wastewater treatment units performing most effectively and with minimal costs. Examples are taken from refugee camps a...nd internally displaced people (IDP) settlements due to the Iraq war, the Israeli-Palestine conflict, and the civil wars in Syria and Sudan. WWTP options used in Finland, Haiti, Iraq, Jordan, Palestine, Sudan and Turkey are discussed. Lessons learned from China and suggestions for the Rohingya crisis are also included.
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his document, a first of its kind, clearly sets out the standards for rehabilitation and provides guidance on building or strengthening the capacity of EMTs in this area.The importance of early rehabilitation for functional outcomes is well documented. Rehabilitation needs can pe...rsist far beyond the departure of EMTs; therefore, close, supportive collaboration must be established with local services. Emergency response presents an opportunity to rebuild devastated health systems and build local rehabilitation capacity. This document emphasizes the importance of aligning practices to the local context and maximizing opportunities for training and mentorship. The minimum standards and recommendations described will result in faster access of patients to rehabilitation services and equipment and a better transition between EMTs and local health facilities.
Available in English, German, Arabic, Chinese
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A field guide for accelerating and sustaining open defecation free communities through a Community-Led Total Sanitation approach
Follow-up MANDONA (FUM) is an action-oriented approach for accelerating community-wide sanitation and hygiene behaviour change following the initial triggering session. D...irectly based on Community-Led Total Sanitation (CLTS) principles, FUM involves a series of participatory, facilitated sessions that brings the entire community together to analyze their sanitation situation
and collectively undertake small, immediate and doable actions to end open defecation (OD) in the shortest time possible
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Accessed 15th of October 2015
No publication year indicated.
Sleeping sickness is controlled by case detection and treatment but this often only reaches less than 75% of the population. Vector control is capable of completely interrupting HAT transmission but is not used because of expense. We conducted a full scale field trial of a refined vector control tec...hnology. From preliminary trials we determined the number of insecticidal tiny targets required to control tsetse populations by more than 90%. We then carried out a full scale, 500 km2 field trial covering two HAT foci in Northern Uganda (overall target density 5.7/km2). In 12 months tsetse populations declined by more than 90%. A mathematical model suggested that a 72% reduction in tsetse population is required to stop transmission in those settings. The Ugandan census suggests population density in the HAT foci is approximately 500 per km2. The estimated cost for a single round of active case detection (excluding treatment), covering 80% of the population, is US$433,333 (WHO figures). One year of vector control organised within country, which can completely stop HAT transmission, would cost US$42,700. The case for adding this new method of vector control to case detection and treatment is strong. We outline how such a component could be organised.
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To provide information on trends on official development assistance (ODA) disbursement patterns for
reproductive health activities in 18 conflict-affected countries