The second ECDC/EFSA/EMA joint report on the integrated analysis of antimicrobial consumption (AMC) and antimicrobial resistance (AMR) in bacteria from humans and food-producing animals addressed data obtained by the Agencies’ EU-wide surveillance networks for 2013–2015. AMC in both sectors, exp...ressed in mg/kg of estimated biomass, were compared at country and European level. Substantial variations between countries were observed in both sectors. Estimated data on AMC for pigs and poultry were used for the first time. Univariate and multivariate analyses were applied to study associations between AMC and AMR. In 2014, the average AMC was higher in animals (152 mg/kg) than in humans (124 mg/kg), but the opposite applied to the median AMC (67 and 118 mg/kg, respectively). In 18 of 28 countries, AMC was lower in animals than in humans. Univariate analysis showed statistically-significant (p < 0.05) associations between AMC and AMR for fluoroquinolones and Escherichia coli in both sectors, for 3rd- and 4th-generation cephalosporins and E. coli in humans, and tetracyclines and polymyxins and E. coli in animals. In humans, there was a statistically-significant association between AMC and AMR for carbapenems and polymyxins in Klebsiella pneumoniae. Consumption of macrolides in animals was significantly associated with macrolide resistance in Campylobacter coli in animals and humans. Multivariate analyses provided a unique approach to assess the contributions of AMC in humans and animals and AMR in bacteria from animals to AMR in bacteria from humans. Multivariate analyses demonstrated that 3rd- and 4th-generation cephalosporin and fluoroquinolone resistance in E. coli from humans was associated with corresponding AMC in humans, whereas resistance to fluoroquinolones in Salmonella spp. and Campylobacter spp. from humans was related to consumption of fluoroquinolones in animals. These results suggest that from a ‘One-health’ perspective, there is potential in both sectors to further develop prudent use of antimicrobials and thereby reduce AMR.
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Health care waste can be difficult to treat and dispose of safely. The environmental and health impacts of waste put extra pressure on resources. Therefore, it is important to try and reduce the quantities of waste wherever possible. Ensure waste is segregated properly at the point of disposal. It i...s cheaper and easier to manage general waste through a municipal waste system than infectious or sharps waste which needs treatment before final disposal. Organic general wastes like food and paper can be composted rather than being wasted. Non- hazardous general waste may also be sorted for recycling.
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نظرة عامّة على التقنيّات المستخدمة لمعالجة النفايات المُعدِية والحادّة الناتجة عن مرافق الرعاية الصحيّة
This document provides an overview of specific health care waste technologies for the treatment of solid ...infectious and sharp waste. For each technology, details of its operation, effects on the environment and health, requirements for installation, capacities for treating waste, examples of consumables and advantages and disadvantages are described. The document is designed for health care facility administrators and planners, WASH and infection prevention control staff, national planners, donors and partners.
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Based on scientific evidence, expert consensus and country experiences, the WHO core components for infection prevention and control (IPC) are the foundation for establishing or strengthening effective programmes at the national and facility level.
These new guidelines on core components of infecti...on prevention and control (IPC) at the national and acute health care facility level will enhance the capacity of Member States to develop and implement effective technical and behaviour modifying interventions. They form a key part of WHO strategies to prevent current and future threats from infectious diseases such as Ebola, strengthen health service resilience, help combat antimicrobial resistance (AMR) and improve the overall quality of health care delivery. They are also intended to support countries in the development of their own national protocols for IPC and AMR action plans and to support health care facilities as they develop or strengthen their own approaches to IPC.
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This document highlights the key aspects of safe health-care waste management in order to guide policy-makers, practitioners and facility managers to improve such services in health-care facilities. It is based on the comprehensive WHO handbook Safe management of wastes from health-care activities (...WHO, 2014), and also takes into consideration relevant World Health Assembly resolutions, other UN documents and emerging global and national developments on water, sanitation and hygiene and infection prevention and control.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). It emphasizes the importance of being prepared and responding quickly and outlines key actions and measures that the blood services should take to mit...igate the potential risk to the safety and sufficiency of the blood supplies during the pandemic.
It should be read in conjunction with WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks, which provides general guidance on the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply.
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This manual presents a compelling case for action on carbapenem-resistant organisms (CROs) and describes the linkages between the prevention and control of CROs and the Global Action Plan on Antimicrobial Resistance (AMR). It describes how the eight recommendations contained within the World Health ...Organization (WHO) guidelines for the prevention and control of carbapenem-resistant Enterobacteriaceae, Acinetobacter baumannii and Pseudomonas aeruginosa in health care facilities relate to general measures (that is, the core components of infection prevention and control [IPC] programmes) that need to be in place in all countries and health care facilities to prevent and control health care-associated infections (HAIs). The use of a stepwise approach is proposed to support implementation and improvement, based on the evidence and experience of what has worked in several health care settings worldwide. The focus is on adoptable and adaptable information.
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Transmission-based precautions (TBP) are used in addition to standard precautions for patients with known
or suspected infection or colonization1 with transmissible and/or epidemiologically significant pathogens.
The type of transmission-based precautions assigned to a patient depends on the trans...mission route of the
microorganism: contact, droplet, or airborne
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: interim guidance, 17 February 2021
This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). It emphasizes the importance of being prepared and responding quickly and outlines key actions and measures that... the blood services should take to mitigate the potential risk to the safety and sufficiency of the blood supplies during the pandemic.
It should be read in conjunction with WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks, which provides general guidance on the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply.
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This document provides an overview of specific health care waste technologies for the treatment of solid infectious and sharp waste. For each technology, details of its operation, effects on the environment and health, requirements for installation, capacities for treating waste, examples of consuma...bles and advantages and disadvantages are described. The document is designed for health care facility administrators and planners, WASH and infection prevention control staff, national planners, donors and partners.
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Investment in all the drivers and facilitators of hand hygiene action in health care to ensure that it occurs at the point of care and other critical moments requires a multidisciplinary, multifaceted approach. WHO describes such an approach as a “multimodal improvement strategy” (MMIS) which is... at the core of its implementation models for hand hygiene and infection prevention and control (IPC) programmes. The focus of this document is on the resource considerations for investing in hand hygiene improvement in health care (primary, secondary and tertiary) using the MMIS approach.
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: interim guidance, 17 February 2021
This document provides interim guidance on the management of the blood supply in response to the pandemic outbreak of coronavirus disease (COVID-19). It emphasizes the importance of being prepared and responding quickly and outlines key actions and measures that... the blood services should take to mitigate the potential risk to the safety and sufficiency of the blood supplies during the pandemic.
It should be read in conjunction with WHO Guidance for National Blood Services on Protecting the Blood Supply During Infectious Disease Outbreaks, which provides general guidance on the development of national plans to respond to any emerging infectious threats to the sufficiency or safety of the blood supply.
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This document is an evidence-based policy for the implementation of sound tuberculosis (TB) infection control by all stake- holders. It recommends a combination of measures aimed at reducing the risk of TB transmission within populations. The emphasis is on early and rapid diagnosis, and proper mana...gement of TB patients.
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Emerg Infect Dis. 2020 Jul [date cited]. https://doi.org/10.3201/eid2607.200915
Infection control instructions call for use of alcohol-based hand rub solutions to inactivate severe acute respiratory syndrome coronavirus 2. We determined the virucidal activity of World Health Organization–recommen...ded hand rub formulations, at full strength and multiple dilutions, and of the active ingredients. All disinfectants demonstrated efficient virus inactivation.
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This is a detailed manual giving a step by step approach to undertaking the pharmacovigilance of antiretrovirals. It is intended to be a source of practical advice for Pharmacovigilance Centres and health professionals involved in HIV/AIDS prevention and treatment programmes. A number of WHO publica...tions are available that provide a background to pharmacovigilance and, as far as possible, that material will not be repeated here. Health officials, planners, the staff of Pharmacovigilance Centres, public health teams and all health workers should become familiar with these publications, which are: • Safety of Medicines: A guide to detecting and reporting adverse drug reactions
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IAEA Safety Standards for protecting people and the environment