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Supporting the continuity of health and nutrition services in the context of COVID-19 in refugee settings
recommended
The 2014–2015 Ebola outbreak was catastrophic in West Africa but the indirect impact of increasing the mortality rates of other conditions was also substantial. The increased number of deaths caused by malaria, HIV/
...
AIDS, and tuberculosis attributable to health system failures exceeded deaths from Ebola.
With a relatively limited COVID-19 caseload, health systems may have the capacity to maintain routine service delivery in addition to managing COVID-19 cases. When caseloads are high, and/or health workers are directly affected, strategic adaptations are required to ensure that increasingly limited resources provide maximum benefit for the refugees and surrounding host population. The following are key considerations for UNHCR operations on prioritized health care services in the event of a COVID-19 outbreak. These are based on WHO Guidance for Maintaining Essential Health Services and UNHCR guidance for operations and where relevant operation or site level outbreak preparedness and response plans.
more
There is paucity of data on the burden and specific drivers operative in the pathogenesis of chronic obstructive pulmonary disease (COPD) in the African setting and populations. Lack of awareness
...
and inadequate knowledge on the aetio-pathogenesis of the disease together with inadequate capacity for COPD care contributes to preventive and management challenges. Thus, the majority of patients with COPD are misdiagnosed, misclassified and mismanaged or undertreated. With the struggling improvement in the quality of healthcare in Africa, studies conducted over the last 10 years indicates the rising trends in both the risk factors and the burden of COPD. The role of new risk factors such as indoor pollution, infections with human immunodeficiency virus (HIV) and pulmonary tuberculosis (TB), in the pathogenesis of COPD in Africa is increasingly being recognized. This literature review attempts to collect and synthesize information that could be useful in improving COPD care and informing the governments to take appropriate actions for prevention, diagnosis and management of COPD in Africa.
more
These 2025 guidelines respond to the need for better approaches to identify advanced HIV disease, improve the poor outcomes of people living with HIV being discharged from hospital and provide updated guidance for
...
treatment for Kaposi’s sarcoma through evidence-informed recommendations. The publication contains recommendations that are from previously published WHO guidelines documents on advanced HIV disease and introduces new recommendations that were developed in 2025.
more
HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes
...
and public health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
more
Pocket book of hospital care for children
recommended
Guidelines for the Management of common childhood Illness. 2nd edition
These guidelines focus on the management of the major causes of childhood mortality in most developing countries, such as newborn problems, pneumonia, diarrhoea, malaria, meningitis, septicaemia, measles
...
and related conditions, severe acute malnutrition and paediatric HIV/AIDS. It also covers common procedures, patient monitoring and supportive care on the wards and some common surgical conditions that can be managed in small hospitals.
A smart phone and tablet application is available from the Apple or Google Play Store.
Special attention is drawn to the following sections, which are particulary relevant within the COVID-19 context:
Chapter 4: information on cough and difficulty in breathing, pneumonia and bronchiolitis;
Chapter 10: information on essential supportive care including feeding, fluid and oxygen provision;
Annex 1: information on related practical procedures.
more
WHO recommends that pre-exposure prophylaxis (PrEP) be offered as an additional prevention choice for HIV-negative individuals at substantial risk of HIV infection as part of combination prevention approaches.
HIV drug resistance has been rarely reported among PrEP users who tested HIV positive i
...
n randomized controlled trials or open-label studies. However, PrEP-selected HIV drug resistance could potentially negatively impact the effectiveness of treatment options among PrEP users who acquire HIV, since there is a potential for overlapping resistance profiles between antiretroviral drugs used for both PrEP and first-line antiretroviral therapy.
more
Journal of the International AIDS Society Vol. 21 (2018) e25133
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal ... care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133 more
Many prevention of mother-to-child HIV transmission programmes across Africa initiate HIV-infected (HIV positive) pregnant women on lifelong antiretroviral therapy (ART) on the first day of antenatal ... care (“same-day” initiation). However, there are concerns that same-day initiation may limit patient preparation before starting ART and contribute to subsequent non-adherence, disengagement from care and raised viral load. We examined if same-day initiation was associated with viral suppression and engagement in care during pregnancy.
The data suggest that same-day ART initiation during pregnancy is not associated with lower levels of engagement in care or viral suppression through 12 months post-delivery in this setting, providing reassurance to ART programmes implementing Option B+.
https://doi.org/10.1002/jia2.25133 more
Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is pr
...
edicted that unless proven interventions are rapidly implemented in countries, in the short to medium term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
more
The primary objective of this book is to provide practical, up-to-date guidelines for the consulting clinician working with patients with HIV in primary care
Offering additional pre-exposure prophylaxis (PrEP) choices has the potential to increase uptake and effective use of PrEP, and of HIV prevention overall, as it allows people to choose a method that
...
they prefer.
In this guideline, WHO recommends an offering long-acting injectable lenacapavir (LEN) as an additional HIV prevention choice, as part of combination HIV prevention approaches. LEN, administered twice a year as PrEP, has been shown to be highly effective at reducing the risk of HIV acquisition. In this guideline, WHO also recommends using HIV rapid diagnostic tests (RDTs) for individuals initiating or continuing long-acting injectable PrEP, such as LEN and long acting injectable cabotegravir (CAB-LA). Flexible HIV testing approaches are essential for ensuring that testing does not become a barrier to accessing or continuing PrEP, including long-acting injectable options.
more
Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis. Web Annex B
Guidelines on lenacapavir for HIV prevention and testing strategies for long-acting injectable pre-exposure prophylaxis. Web Annex D
Panel Recommendations
Trop. Med. Infect. Dis. 2022, 7, 152. https://doi.org/10.3390/tropicalmed7080152
Developed through broad and inclusive consultation, and aligned with the WHO Global Health Sector Strategies and the Sustainable Development Goals,
...
the framework promotes a people-centred approach and antimicrobial stewardship across 5 key domains: prevention and response, surveillance, research and innovation, laboratory capacity, and governance.
more
The 7th edition of the Orange Guide provides practical guidance to health workers on the front line of TB control. It includes sections on HIV, MDR-TB and a review of the recommended treatment regim
...
ens
more
Community health workers (CHWs) enable marginalised communities, often experiencing structural poverty, to access healthcare. Trust, important in all patient–provider relationships, is difficult to build in such
communities, particularly when stigma associated with
...
HIV/AIDS, tuberculosis and now COVID-19, is widespread.
CHWs, responsible for bringing people back into care, must repair trust. In South Africa, where a national CHW programme is being rolled out, marginalised communities have high levels of unemployment, domestic violence and injury. In this complex social environment, we explored CHW workplace trust, interpersonal trust between the patient and CHW, and the institutional trust patients place in the health system
more
