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In 2017, 3.6 million of the estimated 10 million people with TB worldwide were “missed” by national TB programmes (NTPs). Two thirds of them are thought to access TB treatment of questionable quality from public
...
and private providers who are not engaged by the NTP. The quality of care provided in these settings is often not known or substandard. Closing these gaps and ensuring patient-centred care imply that quality-assured and affordable TB services must be made available wherever people choose to seek care.
more
This guidance note developed by UNICEF helps WASH staff in their preparedness and response to the current COVID-19 pandemic. It provides an overview of Infection Prevention
...
and Control (IPC) and its intersection with water, sanitation and hygiene (WASH). It also provides key actions that staff can implement to help prevent infection and its spread in health-care facilities: from human to human, among health care workers and patients, through droplets, and by touching surfaces contaminated with the virus. WASH, including waste management and environmental cleaning, is essential for IPC
more
Interim Guidance. This document provides guidance for: screening and triage of pregnant women in the context of an Ebola outbreak; infection prevention
...
and control (IPC) precautions for pregnant women at risk of EVD transmission during childbirth and complication management; management of pregnant EVD cases, contacts and survivors; lactation and Ebola virus disease.
more
These guidelines provide new and updated recommendations on the use of point-of-care testing in children under 18 months of age and point-of-care tests to monitor
...
treatment in people living with HIV; the treatment monitoring algorithm; and timing of antiretroviral therapy (ART) among people living with HIV who are being treated for tuberculosis.
New recommendations launched today outline key new actions that countries can take to improve the delivery of HIV testing, treatment and care services by providing greater options for differentiated approaches such as, supporting HIV treatment start in the community, ensuring that children are diagnosed and treated early, and that viral load treatment monitoring is more accessible, focused and triggers clinical action
more
This rapid communication outlines the main outcomes of a WHO convened Guideline Development Group (GDG) meeting, held in May-June 2021 on the topic of the management of TB in children and adolescen
...
ts. The rapid communication aims to inform staff from ministries of health and care providers across public and private sectors, technical partners and other stakeholders about the key findings, considerations and changes related to the diagnosis, treatment and care of TB for children and adolescents, in order to allow for planning at the country level ahead of the release of updated guidelines and an associated operational handbook. WHO will publish the guidelines and operational handbook in the coming months.
more
In many low- and middle-income countries, there is a wide gap between evidencebased recommendations and current practice. Treatment of major CVD ri
...
sk factors remains suboptimal, and only a minority of patients who are treated reach their target levels for blood pressure, blood sugar and blood cholesterol.
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.
more
WHO/FAO/OIE Guidelines for the surveillance, prevention and control of taeniosis/cysticercosis
WHOFAO
(2005)
Biology, Diagnosis and Treatment, Epidemiology and Prevention
Hypertension in adults: diagnosis and management
the National Institute for Health and Care Excellence (NICE)
the National Institute for Health and Care Excellence (NICE)
(2023)
CC
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults o
...
ver 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm diagnosis. Cardiovascular risk and target organ damage should be assessed, considering age, lifestyle, and other conditions. Initial treatment focuses on lifestyle changes such as diet, exercise, and smoking cessation, with medication advised for stage 1 hypertension at high cardiovascular risk or stage 2 hypertension. Regular monitoring and treatment adjustments are recommended to maintain target blood pressure levels, with specific guidance for people over 80 and those with additional conditions like diabetes or kidney disease. The guideline aims to reduce risks of heart attack, stroke, and other complications, supporting evidence-based treatment decisions in clinical practice.
more
This guidance note developed by UNICEF is intended to help WASH staff in their preparedness and response to the current COVID-19 pandemic. It provides an overview of Infection Prevention
...
and Control (IPC) and its intersection with water, sanitation and hygiene (WASH), and how staff can help prevent infection and its spread in schools, whether through human-to-human or by touching surfaces contaminated with the virus. WASH services, including waste management and environmental cleaning, are all important for IPC. This brief is available in English, Spanish, and French here.
more
COVID-19: Training slides based on guidelines for case-finding, diagnosis, management and public health response in South Africa
Centre for Respiratory Diseases and Meningitis and Outbreak Response
National Department of Health, South Africa
(2020)
C2
Outline
• Welcome and objectives
• Microbiology, epidemiology and clinical presentation
• Surveillance for imported cases including case definitions
• Laboratory diagnosis • Infecti
...
on prevention and hospital readiness
• Patient flow and actions required at each step
• Co-ordinating a public health response
more
This is an update (third edition) of the BACPR Standards & Core Components and represents current evidence-based best practice and a pragmatic overview of the structure
...
and function of Cardiovascular Prevention and Rehabilitation Programmes (CPRPs) in the UK. The previously described seven standards have now been reduced to six but without sacrificing any of the key elements and with a greater emphasis placed on measurable clinical outcomes, audit and certification. Similarly, the second edition provided an overview of seven core components felt to be essential for the delivery of quality prevention and rehabilitation, and this too has been reduced to six. The interplay between cardio-protective therapies and medical risk factors is almost impossible to disentangle for the vast majority of patients and even if specific drug therapies are deployed exclusively for risk factor modulation, the indirect effect will also be cardio-protective. Thus, these have been combined into a single core component – medical risk management.
more
This document provides guidance on the implementation of the shielding approach in camps and camp-like settings for refugees and internally displaced persons. It is intended f
...
or the displaced community itself, humanitarian actors and camp coordination / management authorities.
more
The core of the strategy is the goal for all patients to have better overall care, so that the numbers of deaths and cases of disability are reduced by 50% before 2030. For this to be achieved, four strategic aims will be pursued.
Empower
...
and engage communities,
Ensure safe, effective treatment,
Strengthen health systems, and
Increase partnerships, coordination and resources Strong collaboration
more
Cervical cancer is the second most common cancer among women worldwide and causes a significant number of deaths in the South-East Asia Region. Nearly 200 000 new cases of cervical cancer occurred in SEA Region Member States in 200
...
8, giving an incidence of almost 25 per 100 000 and a mortality rate of almost 14 per 100 000. Cervical cancer can be prevented by early screening and vaccination. However, due to poor access to screening and treatment services, the vast majority of these deaths occur in women from nine Member States of the South-East Asia Region which account for more than one third of the global burden of cervical cancer.
more
Background: Cervical cancer accounts for 23% of cancer incidence and 22% of cancer mortality among women in Burkina Faso. These proportions are more than 2 and 5 times higher than those of developed
...
countries, respectively. Before 2010, cervical cancer prevention (CECAP) services in Burkina Faso were limited to temporary screening campaigns.
Program Description: Between September 2010 and August 2014, program implementers collaborated with the Ministry of Health and professional associations to implement a CECAP program focused on coupling visual inspection with acetic acid (VIA) for screening with same-day cryotherapy treatment for eligible women in 14 facilities. Women with larger lesions or lesions suspect for cancer were referred for loop electrosurgical excision procedure (LEEP). The program trained providers, raised awareness through demand generation activities, and strengthened monitoring capacity.
Methods: Data on program activities, service provision, and programmatic lessons were analyzed. Three data collection tools, an individual client form, a client registry, and a monthly summary sheet, were used to track 3 key CECAP service indicators: number of women screened using VIA, proportion of women who screened VIA positive, and proportion of women screening VIA positive who received same-day cryotherapy.
Results: Over 4 years, the program screened 13,999 women for cervical cancer using VIA; 8.9% screened positive; and 65.9% received cryotherapy in a single visit. The proportion receiving cryotherapy on the same day started at a high of 82% to 93% when services were provided free of charge, but dropped to 51% when a user fee of $10 was applied to cover the cost of supplies. After reducing the fee to $4 in November 2012, the proportion increased again to 78%. Implementation challenges included difficulties tracking referred patients, stock-outs of key supplies, difficulties with machine maintenance, and prohibitive user fees. Providers were trained to independently monitor services, identify gaps, and take corrective actions.
Conclusions: Following dissemination of the results that demonstrated the acceptability and feasibility of the CECAP program, the Burkina Faso Ministry of Health included CECAP services in its minimum service delivery package in 2016. Essential components for such programs include provider training on VIA, cryotherapy, and LEEP; provider and patient demand generation; local equipment maintenance; consistent supply stocks; referral system for LEEP; non-prohibitive fees; and a monitoring data collection system.
more
This WHO Guidance Note advocates for a comprehensive approach to cervical cancer prevention and control and is aimed at senior policy makers
...
and programme managers. It describes the need to deliver effective interventions across the female life course from childhood through to adulthood. These include community education, social mobilization, HPV vaccination, screening, treatment and palliative care. It outlines the complementary strategies for comprehensive cervical cancer prevention and control, and highlights collaboration across national health programmes (particularly immunization, reproductive health, cancer control and adolescent health), organizations and partners.
more
Clinical guideline, Methods, Evidence and Recommendations
In this guideline the following is covered: information needs of people with chronic hep
titis B and their carers; where children, young p
...
eople and adults with chronic hepatitis B a-
should be assessed; assessment of liver disease, including the use of non-invasive tests and genotype testing; criteria for offering antiviral treatment; the efficacy, safety and cost effectiveness of currently available treatments; selection of first-line therapy; management of treatment failure or drug resistance; prophylactic treatment during im-
munosuppressive therapy; and monitoring for treatment response
more
Background: Cardiovascular disease (CVD), mainly heart attack and stroke, is the
leading cause of premature mortality in low and middle income countries (LMICs).
Identifying
...
and managing individuals at high risk of CVD is an important strategy to prevent and control CVD, in addition to multisectoral population-based interventions to reduce CVD risk factors in the entire population.
Methods: We describe key public health considerations in identifying and managing individuals at high risk of CVD in LMICs.
Results: A main objective of any strategy to identify individuals at high CVD risk is to maximize the number of CVD events averted while minimizing the numbers of
individuals needing treatment. Scores estimating the total risk of CVD (e.g. ten-year risk of fatal and non-fatal CVD) are available for LMICs, and are based on the main CVD risk factors (history of CVD, age, sex, tobacco use, blood pressure, blood cholesterol and diabetes status). Opportunistic screening of CVD risk factors enables identification of persons with high CVD risk, but this strategy can be widely applied in low resource settings only if cost effective interventions are used (e.g. the WHO Package of Essential NCD interventions for primary health care in low resource settings package) and if treatment (generally for years) can be sustained, including continued availability ofaffordable medications and funding mechanisms that allow people to purchase medications without impoverishing them (e.g. universal access to health care). Thisalso emphasises the need to re-orient health systems in LMICs towards chronic diseases management.
Conclusion: The large burden of CVD in LMICs and the fact that persons with high
CVD can be identified and managed along cost-effective interventions mean that
health systems need to be structured in a way that encourages patient registration, opportunistic screening of CVD risk factors, efficient procedures for the management of chronic conditions (e.g. task sharing) and provision of affordable treatment for those with high CVD risk. The focus needs to be in primary care because that is where most of the population can access health care and because CVD programmes can be run effectively at this level.
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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).
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