The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by reducing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of... the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
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Three classess of tests are now recommended in the latest consolidated guideles on tests for tuberculosis infection. It includes for the first-time a new class of Mycobacterium tuberculosis antigen-based skin tests (TBSTs), and the two existing classes of tests: the tuberculin skin test (TST) and t...he interferon-gamma release assays (IGRAs).
IGRAs and TBSTs use Mycobacterium tuberculosis complex specific antigens and represent a significant advancement to TST which has been used for over half a century.
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Background:Neonatal mortality accounts for 43% of global under-five deaths and is decreasing more slowly than maternal or child mortality. Donor funding has increased for maternal, newborn, and child health (MNCH), but no analysis to date has disaggregated aid for newborns. We evaluated if and how a...id flows for newborn care can be tracked, examined changes in the last decade, and considered methodological implications for tracking funding for specific population groups or diseases. MethodsandFindings:We critically reviewed and categorised previous analyses of aid to specific populations, diseases, or types of activities. We then developed and refined key terms related to newborn survival in seven languages and searched titles and descriptions of donor disbursement records in the Organisation for Economic Co-operation and Development’s Creditor Reporting System database, 2002–2010. We compared results with the Countdown to 2015 database of aid for MNCH (2003–2008) and the search strategy used by the Institute for Health Metrics and Evaluation. Prior to 2005, key terms related to newborns were rare in disbursement records but their frequency increased markedly thereafter. Only two mentions were found of ‘‘stillbirth’’ and only nine references were found to ‘‘fetus’’ in any spelling variant or language
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP...C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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This guidance document has been produced by WHO to assist blood services in the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply, whether from an existing infectious agent that is changing in incidence and spread, or from a ...newly identified infectious agent. It is intended that this document be followed to guide the national blood service through the process of planning how to respond in a timely, controlled and appropriate way to any specific infectious threat that may subsequently emerge. It is acknowledged that it is not only the blood supply that may be affected by such emerging infectious threats; in those countries undertaking transplantation, the supply of cell, tissues and organs may also be threatened. Increasingly, blood services are taking overall national responsibility for transplantation in their capacity as the organization responsible for the collection, processing, storage and supply of cells, tissues and organs. This approach is both sensible and appropriate, as the overall donor selection and screening processes are the same or very similar. This guidance document can therefore also be used to assist those bodies responsible for the provision of cells, tissues and organs to prepare for an emerging infectious threat.
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading t...o 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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The development of this target product profile (TPP) was led by the WHO Department of Control of Neglected Tropical Diseases (NTD) following standard WHO guidance for TPP development. In order to identify and prioritize diagnostic needs, a WHO NTD Diagnostics Technical Advisory Group (DTAG) was form...ed, and different subgroups were created to advise on specific NTDs, including a subgroup working on the human African trypanosomiasis (HAT) diagnostic innovation needs. This group of independent experts included leading scientists, public health officials and endemic-country end-user representatives. Standard WHO Declaration of Interest procedures were followed. A landscape analysis of the available products and of the development pipeline was conducted, and the salient areas with unmet needs were identified.
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Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
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The purpose of this TPP is to communicate the minimum and ideal characteristics desired to meet the need for discriminating low levels of risk for transmission, i.e. targeted prevalence thresholds in the surveyed areas. An in vitro diagnostic test is needed for the detection of analyte(s) specific t...o Wuchereria bancrofti, Brugia malayi, and Brugia timori to aid in the surveillance of defined geographic areas as to whether infection and/or transmission potential has increased (recrudescence) or decreased (elimination of transmission).
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The number of confirmed COVID-19 cases detected and reported in each country is influenced by
many factors including limited access and/or utilization of healthcare and COVID-19 testing, limited
surveillance, lack of knowledge amongst the population about when to seek testing, an asymptomatic pres...entation, and other unknown issues. This is true in all countries of the world, and not Africa specific, however there are factors unique to Africa which may also affect the way the virus behaves there. COVID-19 prevalence data are critical for planning effective mitigation strategies and understandingthe true impact of the disease and relevant intervention measures in Africa, which might be quite different from regions with a different population age distribution or risk factor profile.
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2nd edition, July 2021. This WHO and HRP guideline is designed to help countries make faster progress, more equitably, on the screening and treatment of cervical cancer. It includes some important shifts in WHO’s recommended approaches to cervical screening, and includes a total of 23 recommendati...ons and 7 good practice statements.
Among the 23 recommendations, 6 are identical for both the general population of women and for women living with HIV and 12 are different and specific for each population.
Among the 7 good practice statements, 3 are identical for both the general population of women and for women living with HIV and 2 are different and specific for each population
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Interim guidance 2 February 2021 . Available in Arabic, Chinese, English, French, Ukranian, Russian
Health workers are at the front line of the COVID-19 outbreak response and as such are exposed to different hazards that put them at risk. Occupational hazards include exposure to SARS-CoV-2 and othe...r pathogens, violence, harassment, stigma, discrimination, heavy workload and prolonged use of personal protective equipment (PPE). This document provides specific measures to protect occupational health and safety of health workers and highlights the duties, rights and responsibilities for health and safety at work in the context of COVID-19.
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Maternal mortality has fallen significantly in recent years, especially in countries that have emphasized the prevention of its main causes, such as hemorrhagic and infectious complications and hypertension , including in the Region of the Americas. In its final report on the Plan of Action to Accel...erate the Reduction of Maternal Mortality and Severe Maternal Morbidity, the Pan American Health Organization (PAHO) reported a continuing downward trend in maternal mortality, with an 18.1% reduction in the maternal morbidity ratio during the period 2010-2015 . From a pathophysiological perspective, death events are a common end result of a wide spectrum of complications leading to multi-organ dysfunction. However, there is a group of women in this situation who survive, despite the seriousness of their condition. This high number of patients––who were in serious condition
but did not die––reflects the actual health conditions in an institution or a country. For this reason, there is a need to create indicators to estimate morbidity in women due to diseases and incidents that occur during pregnancy, childbirth, and the puerperium. To this end, we propose conducting epidemiological surveillance of an indicator that includes women who survived after presenting a potentially fatal complication during pregnancy, childbirth, or the puerperium, reflecting quality medical attention and care (5, 6). This indicator
is maternal near-miss (MNM), which refers to extremely severe maternal morbidity––cases of a severity that
brings women very close to the death event. After adjusting the definition to a specific population and time,
MNM is defined as a case in which a woman nearly died, but survived a complication that occurred during
pregnancy, childbirth, or within 42 days of termination of pregnancy
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To improve survival and quality of life among the 2.5 million children living with HIV, a comprehensive package of prevention, care and treatment is required. This package should include management of infections such as pneumonia, diarrhoea, malaria and ear infections, as well as common opportunisti...c infections and HIV-related co-morbidities. WHO is developing a series of guidelines on each of these conditions, following the GRADE approach. The document on the management of pneumonia and diarrhoea in HIV-infected infants and children is the first of this series. The recommendations are similar to those for non infected children, but they cover specific aspects related to HIV infection.
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Infectious Diseases of Poverty (2020) 9:74
To detect acute schistosomiasis, low-intensity infections, or to verify the success of treatment with
praziquantel, highly sensitive test methods are required. The aim of this study was therefore to demonstrate the
performance of Schistosoma mansoni spec...ific DNA detection in serum and urine using real-time polymerase chain
reaction (PCR) in an endemic area before and after treatment.
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The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on evaluation and tr...eatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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Purpose: This research study aimed to investigate the effectiveness of the services provided by CBR programmes in Jordan.
Method: This was a mixed- methods investigation. A survey was carried out with 47 participants (stakeholders and volunteers) from four CBR centres in Jordan. It comprised 18 que...stions that collected both qualitative and quantitative data with both closed- and open-ended questions. The quantitative data were analysed using SPSS Version 22.0. Qualitative data were analysed through thematic content analysis and open coding to identify emergent themes.
Results: 40.4% of the participants evaluated the effectiveness of CBR services as low. This mainly stemmed from the lack of efforts to increase the local community’s knowledge about CBR, disability and the role of CBR programmes towards people with disabilities.
Conclusions: A proposal was offered concerning the priorities of CBR programmes in Jordan. Efforts need to be directed at promoting livelihood and empowerment components in order to actualise the principles of CBR, mainly by promoting multispectral collaboration as a way of operation.
Implications: This study was inclusive of all types of disability. Barriers to the effectiveness of services may stem from accessibility issues to the families of persons with disabilities (hard to reach) or from CBR services themselves (hard to access). The culturally specific evaluative tool in this study was of “good” specificity and sensitivity, this evaluative instrument can be transferrable to measure the impact of CBR programmes in other settings.
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Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee...nage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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DPDx - Laboratory Identification of Parasites of Public Health Concern
Trypanosoma cruzi, is a parasitic protozoan that is the causative agent of Chagas disease (American trypanosomiasis). Currently, six distinct lineages of T. cruzi are classified into discrete typing units (TcI-VI), which vary in... their geographic occurrence, host specificity, and pathogenicity.
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Interim guidance, 6 October 2021
Direct detection of SARS-CoV-2 viral proteins (antigens) in nasal swabs and other respiratory secretions using lateral flow immunoassays (also known as rapid diagnostic tests, RDTs) offers a faster and less expensive method to test for SARS-CoV-2 than the reference ...method, nucleic acid amplification tests (NAATs). This interim guidance offers recommendations on the priority uses of antigen-detecting rapid diagnostic tests (Ag-RDTs) in specific populations and settings, including (i) for primary case detection in symptomatic individuals suspected to be infected and asymptomatic individuals at high risk of COVID-19, (ii) for contact tracing, (iii) during outbreak investigations and (iv) to monitor trends of disease incidence in communities. Ag-RDTs meeting minimum performance requirements can be used outside of clinical and laboratory settings, including in communities, by trained operators in accordance with instructions. The guidance additionally provides recommendations on implementation, product selection and storage.
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