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WHO consolidated guidelines on tuberculosis: module 1: prevention: tuberculosis preventive treatment
The 2020 recommendations for the programmatic management of TB preventive treatment are the first to be released under the rubric of WHO consolidated TB guidelines (Module 1 – Prevention). The WHO
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consolidated TB guidelines will gradually group all TB recommendations and will be complemented by matching modules of a consolidated operational handbook. [1] The handbook will provide practical advice on how to put in place the recommendations at the scale needed to achieve national and global impact. The first handbook module in the series will be on the programmatic management of TB preventive treatment and will accompany the 2020 guidelines.
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WHO clinical guidelines.
For the first time, WHO has published guidelines to help (primarily) front-line healthcare providers give high-quality, compassionate, and respectful care to children and a
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dolescents (up to age 18) who have or may have experienced sexual abuse, including sexual assault or rape.
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Revised WHO classification and treatment of childhood pneumonia at health facilities
World Health Organization
(2014)
The revised guidelines present two major changes to existing guidelines: (A) there are now just 2 categories of pneumonia instead of 3 (“pneumonia” which is treated at home with oral amoxicillin and “severe pneumonia” which requires injectable antibiotics) and (B) oral amoxicillin replaces o
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ral cotrimoxazole as first line treatment, preferably in 250mg dispersible tablet form, twice daily for five days which can be reduced to three days in low HIV settings.
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The Ministry of Health has developed the first version of the Service Standards and Service Delivery Standards for the health sector in Uganda. The main objective is to provide a common understanding of what is expected by the public, service users
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and service providers in ensuring provision of consistently high quality service delivery. These standards also provide a roadmap for improving the quality, safety and reliability of healthcare in Uganda.
The application of these standards is expected to improve transparency and accountability in service delivery; fairness and equity in service provision; building a culture of quality management; regulation, management and control of public and private providers; and management of expectations of service recipients. more
The application of these standards is expected to improve transparency and accountability in service delivery; fairness and equity in service provision; building a culture of quality management; regulation, management and control of public and private providers; and management of expectations of service recipients. more
The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR
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-TB. The WHO Operational Handbook on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The operational handbook provides practical information and tools that complement the recommendations in the guidelines. The strategies described in the operational handbook are based on the latest WHO recommendations which were formulated by Guideline Development Groups using the GRADE approach. In many cases however, the recommendations in their current form lacked sufficient clinical and programmatic detail, which is important for implementation. This operational handbook complements the guidelines with practical advice based on best practices and knowledge from the fields such as pharmacokinetics, pharmacodynamics, microbiology, pharmacovigilance and clinical and programmatic management.
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Practice Parameter on Disaster Preparedness
Pfefferbaum, B., Shaw, J.A. & American Academy of Child and Adolescent Psychiatry (AACAP) Committee on Quality Issues (CQI)
American Academy of Child and Adolescent Psychiatry (AACAP)
(2013)
CC
AACAP OFFICIAL ACTION | This Practice Parameter identifies best approaches to the assessment and management of children and adolescents across all phases of a disaster. Delivered within a disaster system of care, many interventions are appropriate f
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or implementation in the weeks and months after a disaster. These include psychological first aid, family outreach, psychoeducation, social support, screening, and anxiety reduction techniques. The clinician should assess and monitor risk and protective factors across all phases of a disaster. Schools are a natural site for conducting assessments and delivering services to children. Multimodal approaches using social support, psychoeducation, and cognitive behavioral techniques have the strongest evidence base. Psychopharmacologic interventions are not generally used but may be necessary as an adjunct to other interventions for children with severe reactions or coexisting psychiatric conditions
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This handbook is intended primarily for front-line health care providers who are likely to see children (among other clients) in their day-to-day practice. These may include general practitioners, nurses, midwives, gynaecologists,
paediatricians, m
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ental health professionals, first responders and staff in emergency care.
Other professionals who may find it useful include social workers, those working in social welfare institutions, providers of psychosocial support, and those working in child care facilities and the education system.
Further, the content will benefit the work of policy-makers and managers to enable and support provision of clinical care to children experiencing, or who have experienced, child maltreatment.
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What at first glance appears to be simple causality – climate change leading to more and more migration – has triggered intense academic debate over the past ten years because the circumstances are complex. There is need for a thorough analysis
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in the ground between denying the problem and asserting immediate causality. In international relations, migration induced by climate change and environmental degradation is increasingly recognized as a problem, whether in the framework of international climate policy, international migration policy, development cooperation, or international crisis management. But considering the dimension of these major challenges, only small steps have been taken so far. The scope of the problem continues to be underestimated. Climate change is jeopardizing the livelihoods of more and more people. It is a risk multiplier. Although understanding of the connection between climate change and migration has increased, many questions have yet to be answered. We need more knowledge to better support the people affected.
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Therapeutics for Ebola virus disease
recommended
The WHO Ebola Virus Disease (EVD) Clinical management: living guidance contains the Organization’s most up-to-date recommendations for the clinical management of people with EVD. Providing gui
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dance that is comprehensive and holistic for the optimal care of patients with EVD throughout their illness is important.
The living guidance is available in both pdf format (via the ‘Download’ button) and via an online platform in both French and English, and is updated regularly as new evidence emerges.
This first version of the Clinical management for EVD living guidance contains four new recommendations regarding use of therapeutics for EVD, this includes two strong recommendations for the use of monoclonal antibody therapies. This new living guideline is written to accompany the optimized supportive care (oSoC) for EVD standard operating procedures (5, 6). The living guideline aims to summarize high quality evidence for EVD therapeutics and make recommendations for their use.
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The purpose of this manual is to define a limited number of indicators that will objectively describe the management and use of antimicrobials in hospitals and to provide tools and step-by-step instructions for designing and carrying out an assessme
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nt of antibiotic use and management in hospitals. The indicators in this manual will complement the existing WHO (1993) indicators of outpatient antimicrobial use suggested in How to Investigate Drug Use in Health Facilities (including percentage of encounters in which an antibiotic was prescribed and percentage of medicine costs spent on antibiotics) and will address the need for antimicrobial indicators for inpatient conditions.
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Patients with retreatment tuberculosis (TB) represent those
who have been treated previously for onemonth ormorewith
anti-TB drugs and who have been diagnosed once again with
the disease.These patientsmainly include relapses, treatment
after failure, or loss to follow-up on a
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first-line treatment
regimen [1]. The number of these patients is not negligible.
In 2014, of the 6.3 million TB cases that were notified
by National TB Programmes (NTPs) to the World Health
Organization (WHO), approximately 700,000 patients were
already previously treated
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WHO operational handbook on tuberculosis: module 4: treatment: tuberculosis care and support
recommended
The consolidated guidelines are complemented by an operational handbook which is designed to assist with implementation of the WHO recommendations by Member States, technical partners and others who are involved in the management of patients with DR
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-TB. The WHO Operational Handbook on Tuberculosis, Module 4: Treatment - Drug-Resistant Tuberculosis Treatment provides practical guidance on how to put in place the recommendations at the scale needed to achieve national and global impact.
The document provides information on different aspects of care and support for TB patients. In particular, the handbook provides practical guidance on the implementation of the interventions that enable treatment adherence such as social support, treatment administration options, digital adherence technologies. The practical guidance also includes models of care for all TB patients, models of care for children and adolescents, integrated care for TB, HIV and comorbidities, engagement of private sector, managing of TB in health emergencies. This new practical handbook also includes two important chapters on health education and counselling, and palliative care for patients with TB.
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Formularies are lists of antibiotics that are suggested for certain healthcare settings. In developing a recommended formulary, countries should consider the needs of patients and facilities where they receive care. For example, clinicians in rural or primary health centers may need wide access to
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first-line antibiotics (e.g., penicillin, ampicillin, TMP-SMX), but last resort antibiotics such as carbapenems or colistin might be limited to tertiary care hospitals. Efforts to create antibiotic formularies may be linked to efforts within countries to create or update essential medicine lists (EML).
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Antimicrobial resistance has become a serious public health threat for effective treatment of an ever increasing range of infections caused by bacteria, parasites, viruses and fungi. When infections can no longer be treated by first-
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line antibiotics, other antibiotics must be used, which are both more expensive and more toxic. Treatment and hospitalization is prolonged, and patients undergoing operations and other medical procedures are more vulnerable to infections. All this imposes a huge burden on health care systems and on the economy of countries. This is a major challenge to the health system in Mauritius which provides health care free of user cost to the whole population.
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Reporting Period: 4 to 10 April 2020
• In collaboration with the Ministry of Youth, UNICEF started training 50 young bloggers on how to identify and respond to fake news.
• UNICEF engaged with 97 social services to enable front-line social
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workers to carry out community prevention work and case management.
• With support from UNICEF, the nationwide distance learning program, “Mon école à la maison” was officially launched on TV, Radio, WebTV in addition to the free of charge SMS-based learning system.
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The African Palliative Care Association is pleased to publish the first edition of Palliative Care Standards for Africa. The development of these standards was achieved through wide consultation with service beneficiaries and providers, and the
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y have been developed to suit different levels of service delivery, from primary to tertiary. These standards are underpinned by the World Health Organization’s definition of palliative care, and recognise that scaling up palliative care requires a public health approach with four pillars: policy, education, drug availability and implementation. In addition, the increasing need to establish specific indicators of quality and effectiveness for palliative care has been a big driving force behind these comprehensive standards. It is APCA’s wish that they will provide a framework for the development of evaluation
and performance indicators that can facilitate programme improvement and development. The standards are designed to allow the development or improvement of palliative care across the different services levels, within the organisational capacity of various service providers. They describe a relationship between primary, intermediary and tertiary level service providers, with expectations for all providers articulated through detailed criteria for each standard. It is therefore expected that these standards will influence the planning and delivery of palliative care services at all levels of health care service delivery.
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A pocket guide to antibiotic prescribing for adults in South Africa 2015
Wasserman, S.; T. Boyles, M. Mendelson
SOUTH AFRICAN ANTIBIOTIC STEWARDSHIP PROGRAMME (SAASP)
(2015)
C2
The international community sits at the tipping pointof a post-‐antibiotic era, where common bacterial infections are no longer treatable with the antibiotic armamentarium that exists. In South Africa, t
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he identification of the first case of pan-‐resistant Klebsiella pneumoniae(Brink et al, J Clin Microbiol. 2013;51(1):369-‐72) marks a watershed moment and highlights ourtip of the antibiotic resistance ‘iceberg’ in this country. Multi-‐drug resistant (MDR)-‐bacterial infections, predominantly in Gram-‐negative bacteria such as Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosaand Acinetobacter baumanniiare now commonplace in South African hospitals. Whilst a number of expensive new antibiotics for Gram-‐positive bacterial infections have been manufactured recently (some of which are licenced for usein South Africa), no new antibiotics active against Gram-‐negative infections are expected in the next 10-‐15years. Hence what we have now, needs conserving
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and pr
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ovide a generic global framework available for local adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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This report aims to provide countries and suppliers with estimates of the global market for antiretroviral (ARV) medicines in low- and middle-income countries for 2021–2025. The report includes estimates of the global demand for active pharmaceutical ingredients (APIs) and ARV formulations for adu
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lts receiving first-line treatment to enable suppliers to plan adjustments to their manufacturing capacity and processes.
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Handbook of COVID-19 Prevention and Treatment
recommended
Handbook of COVID-19 Prevention and Treatment, expecting to share their invaluable practical advice and references with medical staff around the world. This handbook compared and analyzed the experience of other experts in China, and provides good reference to key departments such as hospital infect
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ion management, nursing, and outpatient clinics. This handbook provides comprehensive guidelines and best practices by China's top experts for coping with COVID-19.
This handbook, provided by the First Affiliated Hospital of Zhejiang University, describes how organizations can minimize the cost while maximizing the effect of measures to manage and control the coronavirus outbreak. The handbook also discusses why hospitals and other healthcare institutions should have command centers when encountering a large-scale emergency in the context of COVID-19. This handbook also includes the following：
- Technical strategies for addressing issues during emergencies.
- Treatment methods to treat the critically ill.
- Efficient clinical decision-making support.
- Best practices for key departments like inflection management and outpatient clinics.
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