Report
A Project of the Joep Lange Institute July, 2018
Objetivos.
Estimar la carga de tuberculosis (TB) en menores de 15 años y describir las características clínico, epidemiológicas y los resultados del tratamiento antituberculoso en Ecuador.
Métodos.
Se realizó un estudio retrospectivo utilizando los datos del programa nacional de TB de los... años 2015 y 2016. Se estimaron la tasa y el porcentaje de casos de TB infantil y se describieron las características de la enfermedad y el resultado del tratamiento según las categorías de edad: 0-4, 5-9 y 10-14 años.
Resultados.
De los 10 991 casos de TB diagnosticados, 223 (2,03%) fueron menores de 15 años; según la región del país esta carga varió entre 0 y 5,5%. De los 223 casos, en 213 se había registrado el resultado del tratamiento y fueron incluidos en el estudio; 78 (37%) eran menores de 5 años y en 147 (69%) no hubo registro de la investigación de contactos. Sesenta y cinco (68%) de los adolescentes y 40 (51%) de los menores de 5 años tenían diagnóstico de TB pulmonar. La prevalencia de VIH fue 11,5% en los menores 5 años y 6,3% en el grupo de 10-14 años. El tratamiento fue satisfactorio en el 93% de los casos, (curación, 36,6%, tratamiento terminado, 56,8%).
Conclusiones:
Ecuador presenta un alto porcentaje de subdiagnóstico de TB infantil y una carga menor a la esperada, principalmente en menores de 5 años. La alta prevalencia de VIH y la falta de sistematización adecuada de la investigación de contactos en los adolescentes revelan la necesidad de considerar estrategias centradas en la familia y que involucren la capacitación del personal de salud en el manejo del paciente pediátrico centrándose en las necesidades específicas de cada población.
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The 2021 WHO health and climate change global survey report provides a valuable snapshot of the overall progress governments have made in addressing the health risks of climate change. The findings on key health and climate change indicators aim to empower policy makers to: make informed decisions o...n the implementation of policies and plans; identify evidence gaps; and better understand the barriers to achieving adaptation and resilience priorities in the health sector while maximizing the health benefits of sector-wide climate mitigation efforts.
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Why a 4°C warmer world must be avoided
Trop. Med. Infect. Dis. 2018, 3, 72;
The study identified some key determinants of untimely and incomplete childhood vaccinations in the context of Bangladesh. The findings will contribute to the improvement of age-specific vaccination and support policy makers in taking the necessary control ...strategies with respect to delayed and early vaccination in Bangladesh.
https://doi.org/10.3390/tropicalmed3030072
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Module 1
Clinical
July 2017
Module 1: Clinical. This module is for clinicians, including physicians, nurses and clinical officers. It gives an overview of how to provide PrEP safely and effectively, including: screening for substantial risk of HIV; performing appropriate testing before initi...ating someone on PrEP and while the person is taking PrEP; and how to follow up PrEP users and offer counselling on issues such as adherence.
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The evolving epidemic of type 2 diabetes mellitus has challenged health-care professionals. It stands among the leading causes of mortality in the present world. It warrants new and versatile approaches to improve mortality and the associated huge quality-adjusted life years lost to it once diagnose...d. A possible venue to lower the incidence is to assess the safety and efficacy of various diabetes prevention strategies. Diet and exercise have a well-developed role in the prevention of weight gain and, ultimately, diabetes mellitus type II in high-risk individuals. However, high-risk individuals can also benefit from adjunct pharmacotherapy. In light of this information, we decided to conduct a systematic review of randomized controlled trials. This article summarizes the evidence in the literature on the pharmacological prevention of diabetes in high-risk individuals.
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This document outlines the evaluation process that WHO undertakes to assess novel tools and strategies targeted at VBDs. Its aim is to articulate the linkage between the generation of evidence that demonstrates public health impact of novel interventions, and the development of policy recommendation...s based on the generated data. The document defines standards for the evaluation process, as well as the steps that an applicant needs to undertake, along with some guiding principles that aim to support applicants in the development of submissions with WHO.
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Journal of Tuberculosis Research, 2017, 5, 189-200
Background: In Benin, little is known about the influence of both gender and
HIV-status on diagnostic patterns and treatment outcomes of Tuberculosis
(TB) patients. Objective: To assess whether differences in gender and HIV
status affect diagn...ostic patterns and treatment outcomes of TB patients. Methods:
Retrospective cohort study of patients registered in 2013 and 2014 in
the three largest TB Basic Management Units in south Benin. Results: Of 2694
registered TB patients, 1700 (63.1%) were male. Case notification rates were
higher in males compared with females (96 vs 53/100,000 inhabitants). The
male to female ratio was 1:1 in HIV positive patients, but was 2:1 among HIV
negative cases. In HIV-positive patients, there were no differences in TB types
between men and women. In HIV-negative patients, there were significantly
higher proportions of females with clinically diagnosed pulmonary TB (p =
0.04) and extrapulmonary TB (p < 0.001). Retreatment TB was 4.65 times
higher amongst males compared with females. For New bacteriologically confirmed
pulmonary TB, no differences were observed in treatment outcomes
between genders in the HIV positive group; but significantly more unfavorable
outcomes were reported among HIV negative males, with higher rates of
failure (p < 0.001) and loss-to-follow up (p = 0.02). Conclusion: The study
has shown that overall TB notification rates were higher in males than in females
in south Benin, with more females co-infected with HIV. Unfavorable outcomes were more common in HIV-negative males.
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The scope of this PPC document is to serve as a guide to address the unmet public health need for a PPE system that protects the HW-F in tropical climate
s while caring for patients and providing heavy duty essential health services.
The characteristics described in this guidance are targeted fo...r PPE used in
health clinics, hospitals and communities in low resource settings where there is lack of advanced environmental controls and equipment. The purpose is to ensure harmonization in PPE design and its use to avoid confusion and exacerbating the risk of infections in HW-F. The principles of this PPC document can also be considered in risk reduction strategies
in other healthcare settings.
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Countries reported disruptions in all health-care settings. In more than half of countries surveyed, many people are still unable to access care at the primary care and community care levels. Significant disruptions have also been reported in emergency care, particularly concerning given the impact... on people with urgent health needs. Thirty-six per cent of countries reported disruptions to ambulance services; 32% to 24-hour emergency room services; and 23% to emergency surgeries.
Elective surgeries have also been disrupted in 59% of countries, which can have accumulating consequences on health and well-being as the pandemic continues. Disruptions to rehabilitative care and palliative care were also reported in around half of the countries surveyed.
Major barriers to health service recovery include pre-existing health systems issues which have been exacerbated by the pandemic as well as decreased demand for care.
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PLOS Medicine | www.plosmedicine.org
January 2013 | Volume 10 | Issue 1 | e1001371
This review of the IFRC support to the Sierra Leone Red Cross Society response to the 2012 cholera outbreak provides ideas and concepts to promote a more coherent and evidence based rationale on how to make more effective use of IFRC global assets to stop, control, mitigate and respond to cholera ep...idemics. No fit and healthy person should die from cholera – that should be the indicator of success.
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