This brief update on tuberculosis (TB) in the African region covers the state of TB in the WHO African region, strategic priorities and targets and the impact of COVID-19 on essential services. This is followed by key figures for the region, the role of WHO in country support and, recognizing the im...portance of diagnosis and drug susceptibility testing, a focus onstrengthening laboratory networks and the regional laboratory and diagnostic objectives. A brief update of the state of the science and how this is funded across the African region is provided, before closing with challenges and opportunities,strategic directions and a brief discussion of funding concerns. Discussions around the drivers of the disease, and issues of the poverty, inequality and stigma that continue to plague those living with TB are fully recognized, but are outside the scope of this report.
more
Interpeace has been working with the government and non-governmental actors in Rwanda for over 20 years, focusing on societal healing and participatory governance. Currently, Interpeace is implementing a holistic peacebuilding programme titled ‘Reinforcing community capacity for social cohesion an...d reconciliation through societal trauma healing in Rwanda’. This programme has four pillars: mental health and support; social cohesion and reconciliation; collaborative livelihoods; and prisoner rehabilitation and reintegration.
Interpeace and its partners have collaborated with national and international experts to design structured psycho-social interventions, scientifically known as ‘protocols’, which aim to support healing and peace processes. These protocols include resilience-oriented therapy, adaptations of sociotherapy, multifamily therapy, the collaborative livelihoods (COLIVE) protocol, the prisoner rehabilitation and reintegration curriculum, and the socio-emotional skills curriculum.
These protocols guide interventions in healing spaces for Genocide survivors, Genocide perpetrators, former combatants, and their descendants. They facilitate mutual healing and reconciliation, strengthen the mental resilience of individuals and communities, promote family cohesion, and address the intergenerational transmission of Genocide legacies. They also underpin initiatives to develop collaborative livelihoods and skills development, and the psychological rehabilitation and reintegration of prisoners, particularly those convicted of Genocide crimes.
more
Drugs and medical supplies are dispensed at the cutting edge level of the interface between the public health system and the people. Availability or lack of it brings either credit or discredit to the public health system. The primary reason for holding stocks of medicines and medical supplies in a ...proper scientific manner is to ensure continuous and uninterrupted availability to prevent stock-outs, especially of critical items of supply while at the same time ensuring that stocks of medicines do not get expired. An efficient inventory management is a pre-requisite for optimal stock management. It enables the management of health facilities to know the current pattern of consumption of drug trends over a period of time and also variances. The environmental control of the drugs and other medical supplies play an important role to keep the products' efficacy intact. Some medicines and vaccines need special storage temperature, otherwise, there may be wastage. The quality of the medicines can be adversely affected by poor storage, transportation and distribution. Thus, maintaining proper storage condition for health commodities is vital for ensuring their quality. So, by this training, CDMU wants to educate different people dealing with medicines and equip them for the roles they have to perform efficiently so that the wastage does not take place or can be minimized.
more
Practical guide intended for physicians, pharmacists, nurses and medical auxiliaries. This guide is not a dictionary of pharmacological agents. It is a practical manual intended for health professionals, physicians, pharmacists, nurses and health auxiliaries invoved in curative care and drug managem...ent. We have tried to provide simple, practical solutions to the questions and problems faced by field medical staff, using the accumulated field experience of Médecins Sans Frontières, the recommendations of reference organizations such as the World Health Organization (WHO) and specialized documentation in each field. Also available in French, Spanish and Arabic
more
The roadmap describes the actions needed to
achieve the three development goals for TB
vaccines set by the WHO:
1. A safe, effective and affordable TB vaccine
for adolescents and adults.
2. An affordable TB vaccine for neonates and
infants with improved safety and efficacy.
3. A therapeutic v...accine to improve TB
treatment outcomes
more
The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
more
An Act to repeal the Dangerous Medicines Act of 1973,to ensure the availability of certain drugs for exclusive medical, scientific and related purposes, while preventing their abuse; to prevent the diversion from lawful trade of controlled chemicals, controlled equipment and controlled materials for... use in the unlawful manufacture of such drugs; to render drug trafficking and related conduct as serious criminal offences and to ensure that trafficking and related conducted as serious criminal offences and to ensure that offenders or suspects are brought to justice; to render certain conduct by drug users as criminal offences, to provide for the treatment and rehabilitation of drug abusing or dependent offenders; to establish the Lesotho Narcotics Bureau; and for related matters.
more
Integrated Management of Childhood Illness (IMCI) is an integrated approach to child health that focuses on the holistic well-being of the child. IMCI aims to reduce death, illness and disability, and to promote improved growth and development among children under five years of age. IMCI includes bo...th preventive and curative elements that are implemented by families and communities as well as by health facilities.
This booklet contains useful information on childhood sickness and offers practical guidance on diagnosis and treatment of said illnesses. it is divided into 2 parts, one for infants (new born until 2 months) and from 2 months to 5 years. It also includes:
Antiretroviral Therapy ART) treatment for children
Skin problems
Counselling the mother or caregiver on infant and you child feeding
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD risk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood choles...terol.
In other areas, overtreatment can occur with the use of non-evidence-based
protocols. The aim of using standard treatment protocols is to improve the quality
of clinical care, reduce clinical variability and simplify the treatment options,
particularly in primary health care. Standard treatment protocols can be developed by preparing new national treatment guidelines or by adapting or adopting international guidelines.
The Evidence-based protocols module uses hypertension and diabetes screening
and treatment as an entry point to control cardiovascular risk factors, prevent target organ damage, and reduce premature morbidity and mortality. A comprehensive risk- based approach for integrated management of hypertension, diabetes, and high cholesterol is included in the Risk-based CVD management module.
This module includes clinical practice points and sample protocols for:
1. hypertension detection and treatment
2. type 2 diabetes detection and treatment
3. identifying basic emergencies – care and referral.
HEARTS emphasizes adaptation, dissemination, and use of a standardized set of
simple clinical-management protocols, which should be drug- and dose-specific,
and include a core set of medications. The simpler the protocols and management tools, the more likely they are to be used correctly, and the higher the likelihood that a programme will achieve its goals.
more
BMC Infectious Diseases volume 23, Article number: 342 (2023).
Tuberculosis (TB) is among the leading causes of death globally. The disease has a huge burden in Namibia, with a case notification rate of at least 442 per 100,000. To date, Namibia is among the countries with the highest global TB bur...den, despite all efforts to reduce it. This study aimed to determine the factors associated with the unsuccessful treatment outcomes of the Directly Observed Therapy Short course (DOTS) programme in the Kunene and Oshana regions.
more
Malaria in pregnancy is a significant health problem in malaria-endemic areas. It not only causes substantial childhood morbidity and mortality but also increases the risks of adverse events for pregnant women and their developing fetuses. Most of the burden in these areas is due to infection with P...lasmodium falciparum. Artemisinin-based combination therapy (ACT) has been recommended as first-line treatment for uncomplicated P. falciparum malaria in all populations, including pregnant women in their second and third trimesters, since 2006. However, for women in their first trimester of pregnancy, WHO recommended as first-line treatment a combination of quinine and clindamycin.
Based on a review of the evidence conducted in 2022, WHO now recommends artemether–lumefantrine, the ACT with the most human safety data available, as the preferred treatment for uncomplicated P. falciparum malaria in the first trimester of pregnancy. This document presents all relevant evidence on the effects and safety in early pregnancy of artemisinins and partner medicines used in ACTs from both studies in experimental animals and observational studies in humans.
more
Antibiotics have been a critical public health tool since the discovery of Penicillin in 1928, saving the lives of millions of people around the world. In developing country like ours, where the burden of treatable disease is very high and access to health facilities and laboratories is difficult, a...ntibiotics have long acted as miracle drugs. Today, however, the emergence of drug
resistance in bacteria is reversing the miracles of the past eighty years, with drug choices for the treatment of many bacterial infections becoming increasingly limited, expensive, and in some cases, nonexistent. Diseases previously regarded as relatively easy to manage are much harder to treat as doctors must use “last-resort” drugs that are more costly, take longer to work
and are often unavailable or unaffordable in developing countries. Moreover, regular prescription of antibiotics, random treatment, over the counter sales, inadequate dosage, inclusion of antibiotics in animal feeds and agriculture has contributed equally to emergence of antibiotics resistance as silent epidemic within the country.
more
Antimicrobials are widely used in food animal production, and use is rapidly increasing.
In an era of growing demand for animal products, there is an increasing trend towards the industrial production of food animals, especially in lower- and middle-income countries (LMICs). One hallmark of this me...thod of animal production is the
use of antimicrobial drugs, which in the majority of cases are administered to healthy animals for purposes other than
treating or controlling disease (termed “therapeutic uses”)
more
Patients with diabetes are at increased risk of developing cardiovascular disease (CVD) with its manifestations of coronary artery disease (CAD), heart failure (HF), atrial fibrillation (AF), and stroke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor f...or developing chronic kidney disease (CKD), which in itself is associated with developing CVD. The combination of diabetes with these cardio-renal comorbidities enhances the risk not only for cardiovascular (CV) events but also for CV and all-cause mortality. The current European Society of Cardiology (ESC) Guidelines on the management of cardiovascular disease in patients with diabetes are designed to guide prevention and management of the manifestations of CVD in patients with diabetes based on data published until end of January 2023. Over the last decade, the results of various large cardiovascular outcome trials (CVOTs) in patients with diabetes at high CV risk with novel glucose- lowering agents, such as sodium–glucose co-transporter-2 (SGLT2) inhibitors and glucagon-like peptide-1 (GLP-1) receptor agonists (RAs), but also novel non-steroidal mineralocorticoid receptor antagonists (MRAs), such as finerenone have substantially expanded available therapeutic op-
tions, leading to numerous evidence-based recommendations for the management of this patient population.
more
Rappart sur les populations clés.
WHO’s Essential Medicines List and List of Essential Diagnostics are core guidance documents that help countries prioritize critical health products that should be widely available and affordable throughout health systems. The updated Essential Medicines List adds 23 medicines for children.