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Management of critical COVID-19: Acute hypoxaemic respiratory failure and COVID-19: Recognize ARDS
recommended
WHO recommends prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
Hypoxaemic respiratory failure in ARDS commonly
...
results from intrapulmonary ventilation-perfusion mismatch or shunt and usually requires mechanical ventilation.
At any time, if there are urgent or emergent indications for intubation, do not delay.
We recommend prompt recognition of progressive acute hypoxaemic respiratory failure when a patient with respiratory distress is failing to respond to standard oxygen therapy and adequate preparation to provide advanced oxygen/ventilatory support.
WHO suggests that patients with severe or critical COVID-19 with acute hypoxaemic respiratory failure that do not require emergent intubation be treated with HFNO, or CPAP or NIV (BiPAP) over standard oxygen therapy.
more
For patients on NIPPV or HFNO with persistent hypoxaemia or respiratory distress:
• Check the equipment: inspect the exterior of the machine, the tubing (circuit), the mask for any sign of mechanical damage, confirm it fits securely without leak (if CPAP/BiPAP) and the filters are in place. Ensur
...
e the settings are appropriate and flow is maximized.
• Check the oxygen source: there is sufficient oxygen available and flowing through the device. If FiO2 > 50% of oxygen is needed, the ventilator must have a blender.
• Check there is no obstruction with secretions: patients with COVID-19 may have very thick secretions which may block small and large airways and cause sudden respiratory deterioration.
more
The document “Guidelines for Writing Outbreak Investigation Reports” by the European Centre for Disease Prevention and Control provides practical guidance on how to prepare clear, structured, and scientifically sound reports after investigating a disease outbreak. It is mainly intended for epide
...
miologists and public health professionals, particularly participants in the ECDC Fellowship Programme. The guide explains the purpose of outbreak investigation reports and describes the recommended structure and content of such reports, including sections such as background, objectives, methods, results, and conclusions. It also outlines how to present epidemiological, laboratory, and environmental findings, interpret the results, and formulate public health recommendations. Overall, the document aims to standardize outbreak reporting, improve the quality and clarity of reports, and ensure that investigation findings can effectively support public health decision-making and future outbreak prevention.
more
Après plus de trois ans sans cas, Haïti a signalé le 2 octobre 2022 un ensemble de cas de choléra dans la zone métropolitaine de Port-au-Prince, alors que le pays était sur le point d'être déclaré exempt de choléra.
Cette résurgence du choléra en Haïti survient dans un contexte opérat
...
ionnel complexe, au milieu d'un environnement socio-politique instable marqué par des blocus, des pénuries de carburant, des activités de bandes criminelles et une insécurité galopante. Les troubles civils et le manque d'accès aux communautés touchées aggravent la crise humanitaire complexe et entravent les efforts de réponse d'urgence.
more
After more than three years without cases, Haiti reported on 2 October 2022 a cluster of cholera cases in the metropolitan area of Port-au-Prince, just as the country was on the verge of being declared cholera- free.
This cholera resurgence in Haiti is happening in a complex operational context, am
...
id a volatile socio- political environment marked by blockades, fuel shortages, criminal gang activity and rampant insecurity. Civil unrest and lack of access to the affected communities are deepening the complex humanitarian crisis and hindering emergency response efforts.
more
Todo el personal de salud que presta servicios de atención a las mujeres, los bebés y las familias durante el período prenatal y posnatal tiene una función primordial en el establecimiento de la lactancia y su continuación. Este curso brinda a los profesionales de salud las habilidades bás
...
icas de asesoramiento para que puedan ayudar a las madres y los cuidadores. Los materiales incluyen módulos relacionados con las habilidades de asesoramiento, las prácticas de lactancia materna y alimentación de los lactantes, el apoyo a la lactancia materna y los procedimientos gerenciales. Los participantes no necesitan conocimientos previos sobre lactancia materna.
more
Mem Inst Oswaldo Cruz, Rio de Janeiro, Vol. 117: e210277chgsa, 2022. online | memorias.ioc.fiocruz.br
Scabies is a global health concern disproportionately affecting vulnerable populations such as refugees and asylum seekers. Greece is a main point of entry in Europe for refugees, but epidemiological data on scabies in this population are scarce. We aimed to describe the epidemiology of scabies, inc
...
luding trends over the study period.
more
Snakebite envenoming constitutes a serious medical condition that primarily affects residents of rural communities in Africa, Asia, Latin America, and New Guinea. It is an occupational, environmental, and domestic health hazard that exacerbates the already impoverished state of these communities. Co
...
nservative estimates indicate that, worldwide, more than 5 million people suffer snakebite every year, leading to 25,000–125,000 deaths, while an estimated 400,000 people are left with permanent disabilities.
more
Lack of trained providers capable of identifying which labouring women could benefit from assisted vaginal birth (AVB), and of safely performing the procedure is a major barrier for its use. Education and training are, therefore, considered crucial for building skills and confidence in conducting AV
...
B and there is evidence that it would be welcomed by healthcare providers. However, acquiring and maintaining AVB skills is a complex task that requires a supportive environment, mentorship, supervision and accountability. As with other practices to manage infrequent procedures and complications, continuous education and on-site supervision are essential to ensure the safe and sustainable use of AVB.
more
The majority of developing countries will fail to achieve their targets for Universal Health Coverage (UHC)1 and the health- and poverty-related Sustainable Development Goals (SDGs) unless they take urgent steps to strengthen their health financing. Just over a decade out from the SDG deadline of 20
...
30, 3.6 billion people do not receive the most essential health services they need, and 100 million are pushed into poverty from paying out-of-pocket for health services. The evidence is strong that progress towards UHC, core to SDG 3, will spur inclusive and sustainable economic growth, yet this will not happen unless countries achieve high-performance health financing, defined here as funding levels that are adequate and sustainable; pooling that is sufficient to spread the financial risks of ill-health; and spending that is efficient and equitable to assure desired levels of health service coverage, quality, and financial protection for all people— with resilience and sustainability.
more
Advances in the treatment of pediatric cancer have made it possible to expand initiatives beyond cure and cover aspects such as early detection, continuity of treatment and reduction in toxicity. All this has paved the way for a more comprehensive vision of patient care, which means better chances o
...
f healing and a fuller life - objectives of the World Initiative against Childhood Cancer. Within this comprehensive care, psychosocial care includes the social, psychological, spiritual and functional dimensions of the disease process of patients. This series includes guidelines and standards based on evidence that guarantee the quality of said care. The standards are the result of discussion and review by different professionals from Latin America and the Caribbean. Module 1 focuses on psychosocial evaluation as a strategy to support the objectives of the World Initiative against Childhood Cancer, and as a tool for health professionals to gather the necessary information to offer these patients a comprehensive approach focused on well-being, adaptation to the disease process, and adherence to treatment.
more
Los avances en el tratamiento del cáncer pediátrico han permitido ampliar las iniciativas más allá de la curación y abarcar aspectos como la detección precoz, la continuidad del tratamiento y la reducción de su toxicidad. Todo ello ha abierto paso a una visión más integral del cuidado de lo
...
s pacientes, lo que supone mejores oportunidades de curación y una vida más plena, objetivos de la Iniciativa Mundial contra el Cáncer Infantil. Dentro de ese cuidado integral, la atención psicosocial incluye las dimensiones social, psicológica, espiritual y funcional del proceso de enfermedad de los pacientes. Esta serie recoge una serie de orientaciones y normas basadas en la evidencia que garantizan la calidad de dicha atención. Las normas son el resultado de la discusión y la revisión de distintos profesionales de América Latina y el Caribe. El módulo 1 se centra en la evaluación psicosocial como estrategia de apoyo a los objetivos de la Iniciativa Mundial contra el Cáncer Infantil y como herramienta para que los profesionales de la salud recaben la información necesaria para ofrecer a estos pacientes un abordaje integral enfocado en el bienestar, la adaptación al proceso de enfermedad y la adherencia al tratamiento.
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Trustworthy, evidence-based health guidelines form the basis of national policies affecting both patients and health-care workers. Emphasizing the link between robust evidence and people’s trust in their health systems, Dr Hans Henri P. Kluge, WHO Regional Director for Europe said at the launch ev
...
ent, “Trust and transformation are key words for us, especially when we talk about improving and strengthening our health systems. Transformation should first and foremost serve the interests of patients and health-care workers”.
While it is not always easy to demonstrate the immediate effect of guidelines on people’s health, there is no viable alternative to utilizing guidelines based on the best available evidence.
Yet, developing robust guidelines remains a challenge for most countries. “Guidelines need to be both simple to use and timely, they need to address people’s real needs, especially at the local level, and should ultimately reflect the resources available,” said Dr Natasha Azzopardi-Muscat, Director, Country Health Policies and Systems, WHO/Europe. “This means that any successful guideline needs to be adjusted and adapted to local contexts and realities.”
more
The document is a comprehensive practical guide for managing cholera epidemics. It includes detailed instructions on outbreak investigation, control measures, case management, and the organization of treatment facilities. It emphasizes strategies such as rehydration therapy, water sanitation, hygien
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e promotion, and vaccination to prevent the spread of cholera. The guide serves as a resource for healthcare professionals, logisticians, and public health officials to respond effectively to cholera outbreaks.
more
This guide helps pharmacists to understand their role in the hypertension program. From maintaining hypertensive drug stock, to drug dispensing, to recording and reporting, to awareness generation with patients.
This guide can be used to train medical officers to ensure BP is measured for all adults visiting the OPD, treat all patients with high BP, initiate treatment as per protocol, counsel patients for follow-up, refer patients to local care, and report data.
The "Primary Healthcare Standard Treatment Guidelines and Essential Medicines List" by the South African National Department of Health provides evidence-based guidelines for diagnosing and managing common medical conditions at the primary healthcare level. This document includes treatment protocols
...
for various health issues, such as infections, chronic diseases, maternal and child health, mental health, and emergency care. It aims to standardize care, promote rational medicine use, and ensure equitable access to essential medications across South Africa. The guidelines emphasize prevention, accurate diagnosis, and efficient treatment strategies to improve patient outcomes.
more
On 14 August 2024, the Director-General of the World Health Organization determined that the upsurge of mpox in a growing number of countries in Africa constitutes a new public health emergency of international concern (PHEIC) under the International Health Regulations (IHR) (2005)
Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to
...
sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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