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1
The evidence base for differentiated care for stable patients has grown in recent years. There has been less attention, however, to developing differentiated models of care for patients with advanced or unstable HIV disease. Current clinical guideli
...
nes and policies regarding optimal packages of care for high-risk patients give few or no recommendations about how, by whom, or where they should be delivered for optimal impact.
more
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 st
...
roke, as well as aortic and peripheral artery diseases. In addition, diabetes is a major risk factor for 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
WHO‘s Global Strategy to Accelerate the Elimination of Cervical Cancer, launched today, outlines three key steps: vaccination, screening and treatment. Successful implementation of all three could
...
reduce more than 40% of new cases of the disease and 5 million related deaths by 2050.
more
Abridged version. In this abridged version of the Evidence-based Clinical Practice Guidelines for the Follow-Up of at-risk neonates, we provide recommendations for the care
...
of newborns up to 2 years of age, corresponding to the first phase of their follow-up. The recommendations are intended for all health sector staff responsible for the primary care of these neonates: general practitioners, family practitioners, pediatricians, neonatologists, pediatric ophthalmologists, pediatric otolaryngologists, nursing professionals, specialists in other fields, and multidisciplinary staff involved in the care process. The purpose of these guidelines is to facilitate policy implementation processes carried out by decision-makers and members of government bodies, and will also be useful for parents, mothers, and caregivers. The main topics covered by this document include the hospital discharge criteria, including screening tests; information and support for parents, mothers, and caregivers; screening at the follow-up visit, and the frequency of follow-ups until the infant is 2 years of age. These guidelines do not address matters related to nursing or comorbidities.
more
This field action guide focuses on the first psychosocial assessment to be conducted just after a calamity strikes or just after a major event in an ongoing armed conflict. While it is necessary to update that initial assessment as the emergency situation evolves through the different phases
...
of recovery (briefly outlined in the “phase chart”), this mini book is meant to guide the formation of a team to assess the psychosocial as well as physical needs of children, their families and the communities and then the recommendations the team makes for ensuing support.
more
2nd edition
WASH FIT is a risk-based, continuous improvement framework with a set of tools for undertaking water, sanitation and hygiene (WASH) improvements as part of wider quality improvements in
...
health care facilities. It is aimed at small primary, and in some instances secondary, health care facilities in low and middle income countries.
An app, for front line data collection is also available in the Android Google Play store or as a web app
more
High salt consumption is an important determinant of high blood pressure and reducing it would improve health outcomes by lowering cardiovascular disease and therefore death rates. Reducing salt intake has been identified as one
...
of the most effective public health measures and is one of the leading targets at global, regional and national levels to reduce the burden of noncommunicable diseases. The purpose of the Dietary Salt Intake Survey in the Republic of Moldova was to establish current baseline average consumption of salt (sodium), potassium and iodine through 24-hour urinary excretion testing among a random sample of the adult population (aged 18–69 years), and to assess the knowledge, attitudes, practices and behaviour around dietary salt in order to enable more efficient planning and the implementation of an effective salt-reduction strategy in the Republic of Moldova.
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Today’s children, and their children, are the ones who will live with the consequences of climate change.
WHO operational handbook on tuberculosis Module 5: Management of tuberculosis in children and adolescents
recommended
The practical guidance in the operational handbook aims to inform the development or revision of national policies and related implementation guidance on the management of TB in children and adolesc
...
ents under programmatic circumstances and at different levels of the health system. The operational handbook can also help countries adequately plan for the uptake of interventions to better address the specific needs of children and adolescents with or at risk of TB. It can contribute to national efforts to build capacity among national and subnational programme managers and among health workers at all levels of the health care system.
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22 April 2022, This document provides updated interim recommendations on the use of masks by health workers providing care to patients with suspected or confirmed COVID-19. This update is prompted by new evidence around mask use and COVID-19 transmi
...
ssion, as well as the emergence of variants of concern including Omicron. Masks continue to be a critical tool to prevent the spread of COVID-19. These interim guidelines supersede the recommendations provided in the WHO recommendations on mask use by health workers, in light of the Omicron variant of concern published on 22 December 2022.
WHO continually evaluates the emerging evidence and will review these interim recommendations within two months and issue new guidance as needed.
more
The Committee discussed the implications for preparedness for smallpox-like events reflected by the ongoing COVID-19 pandemic. The Committee noted how quickly diagnostics and vaccines could be developed and deployed when resources and political will were abundant. This rapidity was also due to the f
...
act that the genetic sequence of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had been shared worldwide. It was noted that in one country SARS-CoV-2 had been reconstructed in a laboratory from the viral genome sequence before the first case of COVID-19 had been reported, highlighting the benefits of synthetic biology technologies for accelerated development of diagnostics as well as the oft-described potential risks. Lessons learned about clinical care during the COVID-19 pandemic were also discussed.
more
The WHO continuously reviews available data on SARS-CoV-2 variants of concern. For this version, the global epidemiological
situation of the COVID-19 pandemic as
...
of 21 January 2022 – at a time when the Omicron VOC had been identified in 171
countries across all six WHO Regions and was rapidly replacing Delta worldwide – was considered Omicron has a substantial growth advantage, higher secondary attack rates and a higher observed reproduction number than Delta.
There is now significant evidence that immune evasion contributes to the rapid spread of Omicron. Other factors may be a shorter
serial interval (by about 0.8 to 1.2 days compared to Delta) and potential increased intrinsic transmission fitness . There is
growing evidence that with Omicron, there is lower vaccine effectiveness (VE) against infection and symptomatic disease soon after vaccination compared to Delta. There is also evidence of accelerated waning of VE over time of the primary series against infection and symptomatic disease for the studied vaccines. Further studies are required to better understand the drivers of transmission and declining incidence in various settings. These factors include the intrinsic transmission fitness properties of the virus, degree of immune evasion, vaccination coverage and level of vaccine-derived and post-infection immunity, levels of social mixing and degree of application of public health and social measures (PHSM).
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The Infection prevention and control in the context of coronavirus disease 2019 (COVID-19): a living guideline consolidates technical guidance developed and published during the COVID-19 pandemic into evidence-informed recommendations for infection
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prevention and control (IPC). This living guideline is available both online and PDF.
**This version of the living guideline (version 5.0) **includes the following seven revised statements for the prevention, identification and management of SARS-CoV-2 infections among health and care workers:
a good practice statement on national and subnational testing strategies;
a good practice statement on passive syndromic surveillance of health and care workers;
a good practice statement on prioritizing health and care workers for SARS-CoV-2 testing;
a good practice statement on protocols for reporting and managing health and care worker exposures;
a good practice statement to limit in-person work of health and care workers with active SARS-CoV-2 infections;
a statement on high-risk exposures and quarantine; and,
a conditional recommendation on the duration of isolation for health and care workers.
Understanding the updated section
Prevention of infections in the health care setting includes a multi-pronged and multi-factorial approach that includes IPC and occupational health and safety measures and adherence to Public Health and Social Measures in the community by the health workforce. The underlying infection prevention and control strategy of this section is the notion that early identification of symptomatic cases, testing and quarantining/isolating health and care workers decreases the risk of nosocomial infection to patients and to other health and care workers.
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First edition, November 1997 | Revised July 2002
Tuberculosis continues to represent a severe public health problem in the Region of the Americas, even more so in the case of indigenous peoples, whose TB incidence is much higher than that
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of the general population. To achieve tuberculosis control in these communities, it is necessary to respond to communities’ diverse needs from an intercultural perspective that allows the application of a holistic approach—from a standpoint of equality and mutual respect—and considers the value of their cultural practices. In the Region of the Americas, although there has been progress toward recognizing the need for an intercultural approach to health services, obstacles rooted in discrimination, racism, and the exclusion of indigenous peoples and other ethnic groups persist. To respond to this situation, the Pan American Health Organization (PAHO) prepared this guidance which––based on an intercultural approach in accordance with the priority lines of the current PAHO Policy on Ethnicity and Health and its practical development in the Region’s indigenous populations––represent a support tool for implementing the End TB Strategy. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic. This publication integrates PAHO’s accumulated experience and best practices developed by its Member States in recent years, including discussions and experiences shared in regional meetings on the issue, and emphasizes innovation and social inclusion. This requires an urgent shift away from traditional paradigms, taking specific actions that gradually reduce TB incidence and moving toward effective multisectoral actions that have proven effective in quickly containing the epidemic.
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The new guidelines provide public health guidance on pharmacological agents for managing hyperglycaemia in type 1 and type 2 diabetes for use in primary health-care in low-resource settings. These guidelines update the recommendations for managing hyperglycaemia in the WHO Package
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of Essential NCD Interventions (WHO PEN) for primary care in low-resources settings, reviewing several newer oral agents as second- and third-line treatment: dipeptidyl peptidase-4 inhibitors, sodium-glucose co-transporter 2 inhibitors and thiazolidinediones. The guidelines also present recommendations on the selection of type of insulin (analogue versus human insulin) for adults with type 1 and type 2 diabetes.
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Consolidated Guidelines
Geneva, 2016
The End TB Strategy
Community-based health care, including outreach and campaigns,in the context of the COVID-19 pandemic
recommended
The COVID-19 pandemic is challenging health systems across the world. Rapidly increasing demand for care of people with COVID-19 is compounded by fear, misinformation and limitations on the movement of
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people and supplies that disrupt the delivery of frontline health care for all people...
This guidance addresses the specific role of community-based health care in the pandemic context and outlines the adaptations needed to keep people safe, maintain continuity of essential services and ensure an effective response to COVID-19. It is intended for decision-makers and managers at the national and subnational levels and complements a range of other guidance, including that on priority public health interventions, facility-based care, and risk communication and community engagement in the setting of the COVID-19 pandemic.
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he pandemic has produced an unprecedented economic and social crisis, and it could generate a food, humanitarian, and political crisis if urgent measures are not taken. The policy options for addressing the pandemic entail consolidating national plans and achieving intersectoral consensus. The respo
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nse should be structured in three nonlinear and interrelated phases—control, reactivation, and rebuilding—involving the participation of technical actors representing not only the field of health but also other social and economic areas. Measures implemented to control the pandemic as well as measures for the reactivation and rebuilding phases will require increased public investment in health until the recommended parameters are achieved.
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