L'OMS établit des normes et des lignes directrices pour la surveillance des maladies afin d'aider les pays à détecter rapidement les flambées, à évaluer l'impact des interventions et à formuler des politiques de santé publique efficaces. Ces normes varient en fonction du type de maladie, mai...s incluent généralement la définition des cas, la collecte de données, la formation du personnel, le renforcement des capacités des systèmes d'information sanitaire, l'utilisation de plateformes comme DHIS2, et la communication des résultats aux décideurs pour une action rapide
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Le pilier 3 de la Stratégie technique mondiale de lutte contre le paludisme 2016–2030 consiste à faire de la surveillance du paludisme une intervention de base dans tous les pays d’endémie palustre et dans ceux ayant éliminé le paludisme mais où la transmission pourrait reprendre. Ce nouve...au manuel traite de thématiques qui se rapportent tant aux contextes dans lesquels on cherche à diminuer la charge du paludisme qu’à ceux où le paludisme est en cours d’élimination.
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Depuis 2010, la lutte contre le paludisme a permis de réaliser des progrès majeurs grâce à la distribution de moustiquaires, au diagnostic rapide, aux traitements à base d'artémisinine (ACT) et aux interventions préventives ciblées.
Le Plan Stratégique National de Lutte contre le Paludisme 2023–2026 du Togo définit les grandes orientations pour réduire de 65 % l’incidence et la mortalité liées au paludisme d’ici 2026, en comparaison avec les niveaux de 2022. Élaboré par le Programme National de Lutte contre le Pa...ludisme (PNLP), il s’inscrit pleinement dans les objectifs mondiaux fixés par l’Organisation mondiale de la Santé pour parvenir à l’élimination du paludisme d’ici 2030. Ce plan repose sur quatre axes stratégiques : la prévention à travers l’utilisation des moustiquaires imprégnées, la chimio-prévention et la lutte antivectorielle ; la prise en charge efficace des cas grâce au diagnostic rapide et au traitement par ACT ; le renforcement du système de santé et la gestion du programme ; ainsi que la surveillance, le suivi et l’évaluation des interventions. Une attention particulière est accordée à la digitalisation des outils, à l’amélioration de la qualité des données, à l’implication des communautés locales et à la réduction des inégalités régionales dans l’accès aux services. Intégrant les partenaires techniques et financiers, le secteur privé et les acteurs communautaires, ce document constitue une véritable feuille de route nationale pour coordonner et intensifier la lutte contre le paludisme sur la période 2023–2026.
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Esta publicación integra la experiencia acumulada de la OPS y las buenas prácticas desarrolladas por sus Estados Miembros en los últimos años, incluidas las discusiones y experiencias compartidas en las reuniones regionales celebradas sobre el tema, y pone el acento en la innovación y la inclus...ión social. Esto requiere cambiar con urgencia los paradigmas tradicionales, partiendo de las acciones específicas que reducen gradualmente la incidencia de la TB para dirigirnos hacia acciones multisectoriales de eficacia demostrada en la contención rápida de la epidemia.
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Este documento tiene como finalidad presentar un análisis de la situación de protección en Colombia a nivel nacional. El documento resalta los principales riesgos de protección y la rápida evolución de la vulneración de derechos humanos a la que se enfrenta la población colombiana y la pobla...ción refugiada y migrante presente en el territorio, en el marco del conflicto armado interno, desastres y Covid-19. Tras el análisis, se sugieren recomendaciones para abordar la crisis de protección que se evidencia en el país.
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A pesar de los avances, persisten importantes barreras para el diagnóstico y tratamiento oportunos de la malaria en las Américas, especialmente en zonas rurales y de difícil acceso. Para reducir la transmisión, es esencial ampliar el uso de pruebas de diagnóstico rápido y garantizar la disponi...bilidad gratuita de antimaláricos como bienes públicos. La OPS propone un marco estratégico para eliminar obstáculos, acelerar el inicio del tratamiento y contribuir a la eliminación de la enfermedad en la región.
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This is an open-access training course for frontline healthcare providers who manage acute illness and injury with limited resources. Produced in response to requests from multiple countries and international partners, the BEC package includes a Participant Workbook and electronic slide decks for ea...ch module. Integrating the guidance from WHO Emergency Triage, Assessment and Treatment (ETAT) for children and the Integrated Management of Adult/Adolescent Illness (IMAI), BEC teaches a systematic approach to the initial assessment and management of time-sensitive conditions where early intervention saves lives
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The response to a cholera outbreak must focus on limiting mortality and reducing the spread of the disease. It should be comprehensive and multisectoral, including epidemiology, case management, water, sanitation and hygiene, logistics, community engagement and risk communication. All efforts must b...e well coordinated to ensure a rapid and effective response across sectors.
This document provides a framework for detecting and monitoring cholera outbreaks and organizing the response. It also includes a short section linking outbreak response to both preparedness and long-term prevention activities.
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Cholera is a diarrheal disease caused by the bacterium Vibrio cholera. The infection primarily spreads through contaminated water and food. Symptoms include the onset of acute diarrhea and/or vomiting, muscle cramps, and body weakness. If untreated, the infection can result in rapid dehydration and ...death within hours.
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Human African trypanosomiasis (HAT) has been an alarming global public health issue. The disease affects mainly poor and marginalized people in low-resource settings and is caused by two subspecies of haemoflagellate parasite, Trypanosoma brucei and transmitted by tsetse flies. Progress made in HAT ...control during the past decade has prompted increasing global dialogue on its elimination and eradication. The disease is targeted by the World Health Organization (WHO) for elimination as a public health problem by 2020 and to terminate its transmission globally by 2030, along-side other Neglected Tropical Diseases (NTD). Several methods have been used to control tsetse flies and the disease transmitted by them. Old and new tools to control the disease are available with constraints.
Currently, there are no vaccines available. Efforts towards intervention to control the disease over the past decade have seen considerable progress and remarkable success with incidence dropping progressively, reversing the upward trend of reported cases. This gives credence in a real progress in its elimination. This study reviews various control measures, progress and a highlight of control issues, vector and parasite barriers that may have been hindering progress towards its elimination.
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Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ...accomplish their role. This review aimed to evaluate the training of CHWs for the prevention and management of CVD and its risk factors in LMICs.
Methods A search strategy was developed in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and five electronic databases (Medline, Global Health, ERIC, EMBASE and CINAHL) were searched to identify peer-reviewed studies published until December 2016 on the training of CHWs for prevention or control of CVD and its risk factors in LMICs. Study characteristics were extracted using a Microsoft Excel spreadsheet and quality assessed using Effective Public Health Practice Project’s Quality Assessment Tool. The search, data extraction and quality assessment were performed independently by two researchers.
Results The search generated 928 articles of which 8 were included in the review. One study was a randomised controlled trial, while the remaining were before–after intervention studies. The training methods included classroom lectures, interactive lessons, e-learning and online support and group discussions or a mix of two or more. All the studies showed improved knowledge level post-training, and two studies demonstrated knowledge retention 6 months after the intervention.
Conclusion The results of the eight included studies suggest that CHWs can be trained effectively for CVD prevention and management. However, the effectiveness of CHW trainings would likely vary depending on context given the differences between studies (eg, CHW demographics, settings and training programmes) and the weak quality of six of the eight studies. Well-conducted mixed-methods studies are needed to provide reliable evidence about the effectiveness and cost-effectiveness of training programmes for CHWs.
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Ebola disease and Marburg disease outbreaks continue to occur in Africa, with increased frequency. In addition to resulting in high mortality and morbidity, the outbreaks generate fear and mistrust about the response activities within the communities affected.
Infection prevention and control (IP...C) is a key pillar in the outbreak response; adherence to IPC practices can prevent and control transmission of infections to health and care workers, patients and their family members.
During the 2014-2016 West African Ebola disease outbreak, there was an urgent need for rapid IPC guidance to help support ministries of health, health-care providers and non-governmental organizations (NGOs). In response, WHO produced several documents related to the outbreak based on expert opinion, including IPC-specific documents and documents on clinical management that also referenced key IPC principles and practices. Since that time, many practices in the field have become institutionalized.
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Diabetes mellitus (DM) is a global epidemic with significant morbidity. Diabetic
retinopathy (DR) is the specific microvascular complication of DM and affects 1 in 3 persons with DM. DR remains a leading cause of vision loss in working adult populations. Patients with severe levels of DR are report...ed to have poorer quality of life and reduced levels of physical, emotional, and social well-being, and they utilize more health care resources.
Epidemiological studies and clinical trials have shown that optimal control of blood glucose, blood pressure, and blood lipids can reduce the risk of developing retinopathy and slow its progression. Timely treatment with laser photocoagulation, and increasingly, the appropriate use of intraocular administration of vascular endothelial growth factor (VEGF) inhibitors can prevent visual loss in vision- threatening retinopathy, particularly diabetic macular edema (DME). Since visual loss may not be present in the earlier stages of retinopathy, regular screening of persons with diabetes is essential to enable early intervention.
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UNICEF analysis indicates that:
- Investments that increase access to high-impact health and nutrition interventions by poor groups have saved almost twice as many lives as equivalent investments in non-poor groups.
- Access to high-impact health and nutrition interventions has improved ra...pidly among poor groups in recent years, leading to substantial improvements in equity.
- During the period studied, absolute reductions in under-five mortality rates associated with improvements in intervention coverage were three times faster among poor groups than non-poor groups.
- Because birth rates were higher among the poor, the reduction in the under-five mortality rate translated into 4.2 times more lives saved for every 1 million people. Indeed, of the 1.1 million lives saved across the 51 countries during the final year studied for each country, nearly 85 per cent were among the poor.
- Intensified focus on equity-enhancing policies and investments can help countries achieve the Sustainable Development Goal newborn and child mortality targets (SDG3.2).
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The occurrence of a case of wild polio in a previously polio free area as presently in Syria, whether through importation, laboratory accident, or mutation of vaccine virus (VDPV), should be considered a public health emergency, that requires a rapid and high quality response as utmost priority
In view of the ongoing political, peace and reconciliation, administrative and economic reforms as well as plans to establish the United Nations Development Assistance Framework (UNDAF) in 2018, WFP extended the current Protracted Relief and Recovery Operation (PRRO 200299), launched in January 2...013, by two years to include 2016 and 2017, with approved budget USD 343 million. To echo this extension and provide a more appropriate response to the country's rapid and multi-pronged transition, WFP adopted a transition strategy with gradually reduced emphasis on humanitarian assistance and greater focus on early recovery and development interventions. WFP's strategic engagement in-country was driven by the overarching goal to assist Myanmar to achieve the national Zero Hunger Challenge by 2025, and was guided by three priorities: emergency preparedness and response; nutrition; and provision of social safety nets.
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Clinical management standard operating procedures.
Ebola virus disease (EVD) is a life-threatening multisystem illness associated with fever and gastrointestinal (GI) symptoms that frequently leads to hypovolaemia, metabolic acidosis, hypoglycaemia, and multi-organ failure. The prolonged 2013–201...6 EVD outbreak in West Africa allowed for an evolution of care such that by outbreak end many patients received individualized and optimized supportive care (oSoC), including volume resuscitation, symptom control, laboratory and bedside monitoring of glucose, electrolyte levels and organ dysfunction, as well as rapid detection and treatment of co-infections, potentially contributing to the downward trend in the case fatality rate (CFR).
This guidance should serve as a foundation for oSoC that should be followed to ensure both the best possible chance for survival and allow for reliable comparison of investigational therapeutic interventions as part of a randomized controlled trial. This guideline provides recommendations for the management of adults and children.
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BACKGROUND: Growing political attention to antimicrobial resistance (AMR) offers a rare opportunity for achieving meaningful action. Many governments have developed national AMR action plans, but most have not yet implemented policy interventions to reduce antimicrobial overuse. A systematic evidenc...e map can support governments in making evidence-informed decisions about implementing programs to reduce AMR, by identifying, describing, and assessing the full range of evaluated government policy options to reduce antimicrobial use in humans.
METHODS AND FINDINGS: Seven databases were searched from inception to January 28, 2019, (MEDLINE, CINAHL, EMBASE, PAIS Index, Cochrane Central Register of Controlled Trials, Web of Science, and PubMed). We identified studies that (1) clearly described a government policy intervention aimed at reducing human antimicrobial use, and (2) applied a quantitative design to measure the impact. We found 69 unique evaluations of government policy interventions carried out across 4 of the 6 WHO regions. These evaluations included randomized controlled trials (n = 4), non-randomized controlled trials (n = 3), controlled before-and-after designs (n = 7), interrupted time series designs (n = 25), uncontrolled before-and-after designs (n = 18), descriptive designs (n = 10), and cohort designs (n = 2). From these we identified 17 unique policy options for governments to reduce the human use of antimicrobials. Many studies evaluated public awareness campaigns (n = 17) and antimicrobial guidelines (n = 13); however, others offered different policy options such as professional regulation, restricted reimbursement, pay for performance, and prescription requirements. Identifying these policies can inform the development of future policies and evaluations in different contexts and health systems. Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.
CONCLUSIONS: To our knowledge this is the first study to provide policy makers with synthesized evidence on specific government policy interventions addressing AMR. In the future, governments should ensure that AMR policy interventions are evaluated using rigorous study designs and that study results are published.
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We systematically reviewed Medline as well as the references of published review articles for relevant studies of adherence to multidrug treatment of both drug-susceptible and drug-resistant TB through February 3, 2018. We included randomized controlled trials (RCTs) as well as prospective and retro...spective cohort studies (CSs) with an internal or external control group that evaluated any adherence intervention and conducted a meta-analysis of their impact on TB treatment outcomes. Our search identified 7,729 articles, of which 129 met the inclusion criteria for quantitative analysis. Seven adherence categories were identified, including DOT offered by different providers and at various locations, reminders and tracers, incentives and enablers, patient education, digital technologies (short message services [SMSs] via mobile phones and video-observed therapy [VOT]), staff education, and combinations of these interventions.
https://doi.org/10.1371/journal.pmed.1002595
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