This is an abridged version of the 2019 Standards containing the evidence-based recommendations most pertinent to primary care. The tables and figures have been renum-bered from the original document to match this version. The complete 2019 Standards of Care do...cument, including all supporting references, is available at professional.diabetes.org/standards.
This is an abridged version of the American Diabetes Association’s Standards of Medical Care in Diabetes—2019. Diabetes Care2018;42(Suppl. 1):S1–S194. The complete 2019 Standards supplement, including all supporting references, is available at professional.diabetes.org/standards.
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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.
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Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.... Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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Health care waste management (HCWM) and infection prevention and control (IPC) represent serious concerns for HIV programs. Improperly handled infectious health care waste poses risks to health workers, their clients, the community, and the environment. Improper injection practices can lead to new H...IV and other infections for health workers and clients. Beginning in 2015, AIDSFree continued the work started by the Government of Nigeria and USAID in 2004 to strengthen activities in IPC and HCWM. This report describes AIDSFree's results over 15 months of implementation of HCWM and IPC activities in seven Nigerian states prioritized by the U.S. President's Emergency Plan for AIDS Relief (PEPFAR)
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Key populations brief
Accessed November 2017
Rev Panam Salud Publica. 2018;42:e45. https://doi.org/10.26633/RPSP.2018.45
Kit de ferramentas de avaliação e melhoria da qualidade e dos direitos humanos em serviços
de saúde mental e de assistência social
The results of the report clearly show that in 2020, a year dominated by the emergence of COVID-19 and its associated health and economic crises, governments around the world rose to the challenge. Sharp increases in government spending on health at all country income levels underpinned the rise in ...health spending to a new high of US $9 trillion (approximately 11% of global GDP). Government health spending generally increased and offset declines in out-of-pocket spending. Importantly, the rise in government health spending was part of a much broader fiscal response to the pandemic. In high income and upper-middle income countries social protection spending also increased sharply in as governments attempted to cushion populations from the economic impacts of COVID-19. In contrast to health and social protection, growth in education spending was relatively subdued. Countries face the further challenge of sustaining increased public spending on health and other social sectors in the face of deteriorating macroeconomic conditions and rising debt servicing. This also includes the challenge of sustaining external support for low income countries, which is essential for reducing ensuring poverty, ensuring access to health services and strengthening pandemic preparedness.
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The growing challenges for people in low and middle-income countries to access new medicines.
Analysis 58
Los módulos que conforman el paquete técnico HEARTS están dirigidos a los formuladores de políticas públicas y gerentes, directores o coordinadores de programas a diferentes niveles dentro de los ministerios de salud cuyo trabajo influye sobre la prestación de servicios de salud a nivel prima...rio para la atención de las enfermedades cardiovasculares. Dentro de cada módulo existen secciones dirigidas a actores en niveles específicos de los sistemas de salud, así como a diferentes grupos de profesionales. En ese sentido, todos los módulos requieren ser adaptados al contexto de cada país.
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This interim guidance is for LTCF managers and corresponding infection prevention and control (IPC) focal persons in LTCF and updates the guidance published in March 2020. The objective of this document is to provide guidance on IPC in LTCFs in the context of COVID-19 to 1) prevent COVID-19-virus fr...om entering the facility and spreading within the facility, and 2) to support safe conditions for visiting through the rigorous application of IPC procedures for the residents’ well-being. WHO will update these recommendations as new information becomes available.
Availabel in English, French, Russian and Spanish
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a pandemia COVID-19, y las medidas tomadas por los gobiernos de América Latina y el Caribe (ALC) en respuesta a ella, han generado efectos económicos y sociales muy adversos en la población. La CEPAL estima que la contracción del Producto Interno Bruto (PIB) de la región será de 5.3% en 2020, ...lo que hará que casi 30 millones de personas caigan en la pobreza (CEPAL, 2020). El Programa Mundial de Alimentos (WFP) ha estimado que, como consecuencia de la pandemia, el número de personas en inseguridad alimentaria severa en la región subirá a 15 millones en el 2020 (comparado con 5 millones en 2019).
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WHO published the first COVID-19 Strategic Response and Preparedness Plan (SPRP) on 3 February, 2020. This report highlights the main points of progress that were made up to 30 June 2020 under the three objectives outlined in the SPRP: scaling up international coordination and support; scaling up co...untry preparedness and response by pillar; and accelerating research and innovation. The report also discusses some of the key challenges faced so far, and provides an update on the resource requirements for the next phase of WHO’s response as part of an unprecedented whole-of-UN approach to the pandemic.
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O SAGE aplica os princípios da medicina baseada em evidências e estabeleceu um processo metodológico completo para emitir ou atualizar recomendações. Especificamente para vacinas contra a COVID-19, uma descrição detalhada dos processos metodológicos pode ser encontrada no esquema de evidênc...ias do SAGE para vacinas contra a COVID-19. Esse esquema contém orientações sobre como levar em consideração os dados provenientes de ensaios clínicos em apoio à emissão de recomendações baseadas em evidências específicas para vacinas.
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