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Bangladesh is the world’s most polluted country. Air pollution shortens the average Bangladeshi’s life expectancy by 6.9 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m³ was met. Some areas of Ban
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gladesh fare much worse than average, with air pollution shortening lives by nearly 9 years in Dhaka, the country’s most polluted city.
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Pakistan is the world’s fourth most polluted country. Air pollution shortens the average Pakistani’s life expectancy by 3.8 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 Some areas of
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Pakistan fare much worse than average, with air pollution shortening lives by almost 7 years in the country’s most polluted regions, like Lahore and Peshawar.
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Nepal is the world’s third most polluted country. Air pollution shortens average Nepalese life expectancy by 4.1 years, relative to what it would be if the World Health Organization (WHO) guideline of 5 μg/m3 was met.1 The highest concentrations
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of air pollution are observed in Nepal’s southwestern districts, which share their borders with the highly-polluted Indo-Gangetic Plain of India. Here, residents stand to lose nearly 7 years of life expectancy.
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Air pollution’s impact on life expectancy in Nigeria is greater than that of HIV/AIDS and almost on par with malaria and unsafe water and sanitation, shortening the average Nigerian’s life expectancy by 1.8 years, relative to what it would be if the World Health Organization (WHO)
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guideline of 5 μg/m3 was met.1 Some areas of Nigeria fare much worse than average, with air pollution shortening lives by almost 4 years on average in parts of Taraba state in Northeastern Nigeria.
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Heart failure (HF) is a leading global public health problem with >64 million prevalent cases globally. Patients with HF with reduced ejection fraction (HFrEF) from low- and middle-income countries experience a 22% to 58% higher 1-year mortality rate than those in high-income countries.1
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Guideline-directed medical therapy (GDMT) consisting of ACE (angiotensin-converting enzyme) inhibitors or ARB (angiotensin receptor blockers) or ARNI (angiotensin receptor-neprilysin inhibitors), β-blockers, MRA (mineralocorticoid receptor antagonists), and SGLT2 (sodium-glucose cotransporter 2) inhibitors substantially reduces mortality among patients with HFrEF. These medicines are among the most cost-effective interventions and are thus included as the highest priority health system interventions recommended by the Disease Control Priorities Project.2 Despite this high-quality evidence, GDMT remains widely underutilized in low- and middle-income countries resulting in widespread undertreatment of patients with HFrEF due to health system-, provider-, and patient-level barriers.1 National essential medicines lists (EMLs) promoted by the World Health Organization (WHO) guide countries on which medications to purchase in the setting of limited resources and have resulted in higher procurement and availability of essential medicines in the public sector.3 We provide a cross-sectional analysis of national EMLs in 53 low- and middle-income countries, and availability, price, and affordability of GDMT in select countries to identify potential barriers to access to these essential medicines for patients with HFrEF.
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In this document, the Inter-American Committee of Cardiovascular Prevention and Rehabilitation, together with the South
American Society of Cardiology, aimed to formulate strategies, measures, and actions for cardiovascular disease prevention
and rehabilitation (CVDPR). In the context of the imple
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mentation of a regional and national health policy in Latin American
countries, the goal is to promote cardiovascular health and thereby decrease morbidity and mortality. The study group on
Cardiopulmonary and Metabolic Rehabilitation from the Department of Exercise, Ergometry, and Cardiovascular Rehabilitation
of the Brazilian Society of Cardiology has created a committee of experts to review the Portuguese version of the guideline
and adapt it to the national reality.
The mission of this document is to help health professionals to adopt effective measures of CVDPR in the routine
clinical practice. The publication of this document and its broad implementation will contribute to the goal of the World
Health Organization (WHO), which is the reduction of worldwide cardiovascular mortality by 25% until 2025.
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Ebola virus (EBOV) and Marburg virus (MARV) are associated with severe, potentially fatal, systemic diseases. During the development of the Infection Prevention and Control Guideline for Ebola Disease and Marburg Disease, the
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Guideline Development Group (GDG) identified multiple research gaps in key areas and practices that lacked strong evidence to help in the formulation of recommendations. Because of the lack of strong evidence, there exists an array of research questions related to infection prevention and control (IPC) in the context of Ebola Disease (EBOD) and Marburg Disease (MARD). Identifying those that are priorities would help policy-makers target efforts and funding to support the most relevant studies. The objective of this research prioritization exercise was to identify the short- to medium-term (over the next two years) priority research questions for IPC in health care settings based on the gaps identified during the EBOD/MARD IPC guideline development process.
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Offering additional pre-exposure prophylaxis (PrEP) choices has the potential to increase uptake and effective use of PrEP, and of HIV prevention overall, as it allows people to choose a method that they prefer.
In this guideline, WHO recommends
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an offering long-acting injectable lenacapavir (LEN) as an additional HIV prevention choice, as part of combination HIV prevention approaches. LEN, administered twice a year as PrEP, has been shown to be highly effective at reducing the risk of HIV acquisition. In this guideline, WHO also recommends using HIV rapid diagnostic tests (RDTs) for individuals initiating or continuing long-acting injectable PrEP, such as LEN and long acting injectable cabotegravir (CAB-LA). Flexible HIV testing approaches are essential for ensuring that testing does not become a barrier to accessing or continuing PrEP, including long-acting injectable options.
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This comprehensive analysis outlines the recommended mental health services in HIV
care, delivery modalities, required resources, guideline integration, special population
considerations, and implementation strategies with real-world examples
Cervical intraepithelial neoplasia (CIN) is a premalignant lesion that may exist at any one of three stages: CIN1, CIN2, or CIN3. If left untreated, CIN2 or CIN3 (collectively referred to as CIN2+) can progress to cervical cancer. Instead of screening and diagnosis by the standard sequence of cytolo
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gy, colposcopy, biopsy, and histological confirmation of CIN, an alternative method is to use a ‘screen-and-treat’ approach in which the treatment decision is based on a screening test and treatment is provided soon or, ideally, immediately after a positive screening test. This guideline provides recommendations for strategies for a screen-and-treat programme
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Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant
tuberculosis (XDR-TB) increasingly occur in resource-constrained settings.
In the context of a national response to MDR- and XDR-TB, health workers in
TB clinics (in district hospitals and some accredited health centres) wil
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l need
to diagnose MDR-TB, initiate second-line anti-TB drugs, and monitor MDRTB
treatment.
Management of MDR-TB: a field guide was created to help health workers
carry out these tasks. It is a job aid that medical officers and TB nurses
are meant use frequently during the day for quick reference. This module
is closely related to other clinical guideline modules in the Integrated
Management of Adolescent and Adult Illness (IMAI) series. In particular, the
approach to chronic disease management is taken from General principles
of good chronic care in the IMAI series.
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The MSF qualification scheme is concerned with the pharmaceutical quality assessment for drugs. This procedure is applicable to products for international supply, i.e. products supplied through the MSF procurement centres. This qualification procedure is not applicable for local purchase, i.e. purch
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ase of drugs within the project countries. For quality assurance principles and assessment of drugs for local purchase refer to the guideline for local pharmaceutical market assessment.
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This section deals with implementing and improving infection control practices in hospitals, health centres and other health services in the outbreak area. It explains the need for, and implementation of, effective triage procedures, and basic requirements for infection control and supporting activi
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ties. Further guidance can be found in the MSF Infection Control Guideline
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Maternal and Neonatal health update: by the Nepal government, Health and population ministry, Health protection unit, Family health department, created in 2010 (English) 2067 (Nepali). Compiled together by: UNICEF, WHO, UNFPA, NHSSP, Nepal medical college hospital and other government health departm
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ents.
This is a training directory and reference guideline, very useful for physicians, students and for training purposes of medical staff. Majority of the content is for medical personnel. It gives detailed descriptions regarding procedures and how to perform them, and also regarding the statistics in Nepal, prevalence rates, morbidity and mortality rates.
Contents:
1) Nepal health status
2) Post Partum Hemorrhage (PPH)
3) Partograph
4) Hypertension during pregnancy
5) Status of Neonatal Health
6) Neonatal Resuscitation
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Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update
Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al.
African Journal of Thoracic and Critical Care Medicine
(2021)
CC
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support
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optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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This practical manual is designed to support implementation of the World Health Organization (WHO) Guidelines on core components of infection prevention and control programmes at the national level, with special focus on countries with limited resources.
The Guidelines describe what is necessary
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(that is, recommendations) to effectively improve infection prevention and control (IPC). This practical manual outlines how to do this (that is, how to implement the Guidelines). It focuses on the development of a sustainable action plan informed by the local context to put into operation the Guideline recommendation
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IPCAT2 will assist countries to determine the core components already in place, that is, existing strengths, and to identify gaps or weaknesses to guide action planning. IPCAT2 corresponds to the six core component recommendations of the guidelines targeted at the national level.
It is very impor
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tant to understand that IPCAT2 is not intended to be used as an audit tool. Its purpose is to help assess, plan, organize and implement a national IPC programme. The tool provides a general overview of the status of IPC activities according to the guideline recommendations, rather than focusing on specific IPC practices/risk factors related to individual patients or specific.
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Guideline
Iron deficiency is one of the most common forms of nutritional deficiencies, particularly among vulnerable groups such as women, children and low-income populations. Iron deficiency often precedes anaemia, and anaemia during pregnancy is one of the strongest predictors of anaemia duri ... ng the postpartum period, beginning just after childbirth throughout the subsequent 6 weeks. The consequences of iron deficiency and anaemia during the postpartum period can be serious and have long-term health implications for the mother and her infant.
This guideline reviews the evidence on the safety and effectiveness of iron supplementation in postpartum women. more
Iron deficiency is one of the most common forms of nutritional deficiencies, particularly among vulnerable groups such as women, children and low-income populations. Iron deficiency often precedes anaemia, and anaemia during pregnancy is one of the strongest predictors of anaemia duri ... ng the postpartum period, beginning just after childbirth throughout the subsequent 6 weeks. The consequences of iron deficiency and anaemia during the postpartum period can be serious and have long-term health implications for the mother and her infant.
This guideline reviews the evidence on the safety and effectiveness of iron supplementation in postpartum women. more
Guidelines for drinking-water quality: Fourth edition incorporating the first and second addenda
recommended
Guidance has been updated on a number of chemicals: asbestos, bentazone, chromium, iodine, manganese, microcystins, nickel, silver, tetrachloroethene and trichloroethene. Guidance has also been added for chemicals not previously assessed in the Guidelines: anatoxin-a and analogues, cylindrospermopsi
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ns and saxitoxins. The new guidance on organotins has replaced the prior guidance focused on dialkyltins. With these updates, the guideline values for tetrachloroethene and trichloroethene have been revised while new guideline values for cylindrospermopsins, manganese, microcystins, and saxitoxins have been established .
Updated information on cyanobacteria has been included, introducing an alert level framework for early-warning and to guide short-term management responses. Guidance has also been updated in the sections on adequacy of water supply, climate change, emergencies, food production and processing, and radiological aspects, particularly on managing radionuclides when exceeding WHO screening values and guidance levels.
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This resource aims to provide relevant and practical guidance to DRR practitioners (policy and programme colleagues), on how to ensure inclusion - particularly of vulnerable groups - in Community-Based DRR (CBDRR) initiatives in Myanmar. It comprises an overall Framework for inclusive CBDRR and a nu
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mber of tools/resources including: 1) a checklist for inclusion in the 7 steps of the CBDRR process, 2) a guideline for documenting inclusion, 3) a template for assessing inclusion and 4) a compendium of tools and guidelines relevant to inclusive CBDRR.
The Inclusive Framework and Toolkit for Community-Based DRR in Myanmar is a resource produced by the Myanmar Consortium for Community Resilience (MCCR), a consortium led by ActionAid, with ACF, HelpAge, Oxfam, Plan and UN-Habitat. more
The Inclusive Framework and Toolkit for Community-Based DRR in Myanmar is a resource produced by the Myanmar Consortium for Community Resilience (MCCR), a consortium led by ActionAid, with ACF, HelpAge, Oxfam, Plan and UN-Habitat. more
