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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Modu
...
le 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
more
National Tuberculosis Programme and Senior Paediatricians
This guideline was first developed in 2007 but further updated in 2012 and 2016 to ensure the use of the latest evidence-based international recommendations on childhood TB. The guidelin ... es will fill the gaps in a systematic approach to TB in children and will help to achieve an internationally recommended standard of care at all levels of the health system in Myanmar. more
This guideline was first developed in 2007 but further updated in 2012 and 2016 to ensure the use of the latest evidence-based international recommendations on childhood TB. The guidelin ... es will fill the gaps in a systematic approach to TB in children and will help to achieve an internationally recommended standard of care at all levels of the health system in Myanmar. more
Child and adolescent mental health policy in South Africa: history, current policy development and implementation, and policy analysis
S. Mokitimi; M. Schneider; P. J. de Vries
International Journal of Mental Health Systems; BioMed Central
(2018)
CC
Mental health problems represent the greatest global burden of disease among children and adolescents. There is, however, lack of policy development and implementation for child and adolescent mental health (CAMH), particularly in low- and middle-in
...
come countries (LMICs) where children and adolescents represent up to 50% of populations. South Africa, an upper-middle income country is often regarded as advanced in health and social policy-making and implementation in comparison to other LMICs. It is, however, not clear whether this is the case for CAMH.
more
Zoonotic tuberculosis (TB) is a form of TB in people predominantly caused by the bacterial species, Mycobacterium bovis, which belongs to the M. tuberculosis complex. The implications of z
...
oonotic TB go beyond human health. The organism is host-adapted to cattle, where it is referred to as bovine TB, and it also causes TB in other animal species including wildlife. Bovine TB has an important economic impact and threatenslivelihoods.
more
Rev Panam Salud Publica. 2020;44:e153.
Este analisis publicada de la Revista Panamericana de Salud Pública determina el comportamiento de los indicadores de incidencia de tuberculosis (TB) y número de muertes por
...
TB en el marco de la meta 3.3 de los Objetivos de Desarrollo Sostenible (ODS) y su correlación con los determinantes sociales. Al ritmo de la disminución actual de la tasa de incidencia y del número de muertes por TB, la Región de las Américas no alcanzará las metas propuestas en los ODS y en la Estrategia Fin de la TB. Se requiere una implementación y expansión rápidas de las intervenciones en prevención y control de TB para lograrlo. Esto implica, entre otras acciones, reducir las barreras de acceso al diagnóstico y tratamiento y fortalecer las iniciativas para abordar los determinantes sociales.
more
Última modificação: 12.06.2020. Este protocolo apresenta aos profissionais de saúde e aos programas de controle da TB (das esferas estaduais e municipais) subsídios para implantar a vigilância da ILTB em seus territórios, ao tempo que apresen
...
ta estratégias de fortalecimento e ampliação da vigilância da ILTB onde essa já está implantada.
more
he WHO South-East Region in 2019 accounted for nearly a million missing TB patients from the estimated incidence. Active case-finding (ACF) or systematic screening for tuberculosis is an important tool to reach out to missing
...
TB patients. When appropriately implemented, the activity is cost effective, helps to reduce diagnosis and treatment delays, and prevents the spread of the disease. This document presents an analysis of published ACF studies from the Region. It can be used by Member States for effective planning, implementation and monitoring of these activities.
more
Zambia has completed the implementation of the National TB Strategic Plan (2017-2021) that set in motion the TB elimination agenda in Zambia through coordinated and accelerated
...
TB response. During this period, the National TB and Leprosy Programme (NTLP) registered tremendous success.
The NTLP is poised to attain the ambitious goal pronounced by the government of eliminating TB by 2030, in line with the Sustainable Development Goals (SDGs) and the World Health Organization End TB Strategy. The programme exponentially increased TB notifications from as low as 35,922 people with TB in 2018 to 40,726 in 2020 and in 2021 the TB notifications rose to 50,825 (a 25% increase against 2020 performance). The NTLP also registered incredible success in sustaining high TB Preventive Treatment (TPT) initiations among persons living with HIV and a high TB treatment success rate among drug-susceptible TB cases. New and relapse TB notifications in children below 15 years increased by 43%, from 2,724 in 2020 to 3,890 in 2021. TB notifications ratio between children aged 0-4 and 5-14 was 0.9, an improvement from what we achieved in 2018 (the ratio was 0.7). The proportion of TB patients who are HIV positive continued to decrease, reaching 34% in 2021 from 39% in 2020. Sustained increases in TB notifications, treatment success rate, and TPT initiations have resulted in a rapid decrease in the TB incidence rate that reached 307 per 100,000 population in 2021 against a rate of 391 in 2015.
more
A Clinical Guideline for the Diagnosis and Treatment of Drug-susceptible TB in Children and Adolescents
in South Africa. This new guidance is aligned with the updated WHO guidelines but has been adapted specifically for the South African context.
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The intention of this publication is to provide guidance on the Diagnosis and treatment of TB in children and adolescents and they may be downloaded and distributed as required. Distribution for remuneration is not permitted. No changes to the content or format of this publication is permitted.
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This Framework offers a coherent approach for eliminating tuberculosis (TB) in low-incidence countries. It is designed to guide national policy-makers and those responsible for technical aspects of the national
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TB response in accelerating efforts towards elimination. The document will also be informative for public health surveillance officers, practitioners and nongovernmental and civil society partners working on natioal TB care and prevention and serving the populations most vulnerable to TB.
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This report was developed by the WHO TB Vaccine Accelerator Finance and Access working group, co-led by WHO, Gavi and the Government of South Africa. It sets out the working group’s shared vision for equitable access to novel
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TB vaccines and will advance a shared understanding of the current landscape and its possible evolution in the future. It identifies six urgently needed solutions to accelerate access and financing and highlights the roles of different stakeholders to support the implementation of these solutions.
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Guideline: Nutritional care and support for patients with tuberculosis
Maria del Carmen Casanovas, Knut Lönnroth, Luz Maria De-Regil et al
World Health Organization
(2013)
C_WHO
Undernutrition increases the risk of tuberculosis (TB) and in turn TB can lead to malnutrition. Undernutrition is therefore highly prevalent among people with
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TB. It has been demonstrated that undernutrition is a risk factor for progression from TB infection to active TB disease and that undernutrition at the time of diagnosis of active TB is a predictor of increased risk of death and TB relapse. However, the evidence concerning the effect of nutritional supplementation on TB prevention and health outcomes among people with TB had not previously been systematically reviewed. This guideline provides guidance on the principles and recommendations for nutritional care and support of patients with TB as part of their regular TB care
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Healthcare-associated infections (HAI) are a significant burden globally, with millions of patients affected each year. These infections affect both high- and limited-resource healthcare settings, but in limited-resource settings, rates are approxim
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ately twice as high as high-resource settings (15 out of every 100 patients versus 7 out of every 100 patients). Furthermore, rates of infections within certain patient populations are significantly higher in limited-resource settings, including surgical patients, patients in intensive-care units (ICU) and neonatal units. It is well documented that environmental contamination plays a role in the transmission of HAIs in healthcare settings. Therefore, environmental cleaning is a fundamental intervention for infection prevention and control (IPC).It is a multifaceted intervention that involves cleaning and disinfection (when indicated) of the environment alongside other key program elements to support successful implementation (e.g., leadership support, training, monitoring, and feedback mechanisms). To be effective, environmental cleaning activities must be implemented within the framework of the facility IPC program, and not as a standalone intervention. It is also essential that IPC programs advocate for and work with facility administration and government officials to budget, operate and maintain adequate water, sanitation and hygiene (WASH) infrastructure to ensure that environmental cleaning can be performed according to best practices.
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Addressing comorbidities and risk factors for TB is a crucial component of Pillar one of the End TB Strategy, which focuses on integrated patient-centred care and prevention, including action on
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TB and comorbidities. The Framework for collaborative action on TB and comorbidities aims to support countries in the evidence-informed introduction and scale-up of holistic people-centred services for TB, comorbidities and health-related risk factors, with the goal of comprehensively addressing TB and other co-existing health conditions. It should be used in conjunction with relevant WHO guidelines. The Framework is intended for use by people working in ministries of health, other relevant line-ministries, policymakers, international technical and funding organizations, researchers, nongovernmental and civil society organizations, as well as primary care workers, specialist health practitioners, and community health workers who support the response to TB and comorbidities in both the public and private sectors.
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This guidance is intended for use in developing standalone TB strategic plans, or TB interventions as part of multidisease or health sector plans. It describes key considerations and steps for strat
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egic planning for TB in line with the World Health Organization’s End TB strategy, and the proposed structure of the NSP. The target audience of this publication are all stakeholders involved in national strategic planning for TB (e.g., ministry of health, other government ministries, private sector, civil society, affected communities, academic and research institutions, and technical and funding partners).
The current document is an update to the 2015 Toolkit to develop a national strategic plan for TB prevention, care and control.
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