A national overview with a case study from Tanahun district. The overall aims of this study are (1) to assess the extent to which social protection systems in Nepal address the needs of people with disabilities; and (2) to identify and document elements of good practice, as well as challenges, in th...e design and delivery of social protection for people with disabilities. As most social protection programmes in Nepal are targeted to various groups considered to be a high risk of poverty or marginalisation (e.g. orphans, widows), the research mainly focuses on disability-specific schemes, as they are relevant to a higher proportion of people with disabilities.
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This is the fifteenth edition of the lecture notes. They were first published in 1987 as a summary of the material used in the biannual epilepsy teaching weekend organised under the auspices of the UK Chapter of the International League against Epilepsy.
(Lecture series consist of a total of 59 cha...pters. Section one - introduction (chapter 1-2). Section two - basic science (chapters 3-5). Section (chapters 6-16). Section four - differential diagnosis (chapter 17-19). Section five - investigations (chapter 20-24). Section six - medical treatment of epilepsy (chapters 25-35). Section seven - outcome (chapters 36-40). Section eight - special groups (chapters 41-44). Section nine - surgical treatment of epilepsy (chapters 45-49). Section ten - social aspects (chapters 50-56). Section eleven - provision of care (chapters 57-59). All chapters available at: https://www.epilepsysociety.org.uk/lecture-notes-0#.Wq-cn8NubIU)
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Journal of the International AIDS Society, vol. 21 Issue no. 6 e 25142
Weaknesses in care programmes providing anti‐retroviral therapy (ART) persist and are often instigated by late HIV diagnosis and poor linkage to care. We investigated the potential for a home‐based counselling and testin...g (HBCT) campaign to be improved through the optimal timing and enhancement of testing rounds to generate greater health outcomes at minimum cost.
Countries implementing HBCT can reduce costs by optimally timing rounds and generate greater health outcomes through improving linkage, coverage, and retention. Tailoring HBCT campaigns to individual settings can enhance patient outcomes for minimal cost.
https://doi.org/10.1002/jia2.25142
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In health emergencies as in periods of stability, restoring access to primary health-care services is a priority in so far as many health problems can be dealt with by means of preventive care and
conventional therapy. Depending on the context, the ICRC must often take action in this area, taking i...nto account the level of emergency, the involvement of other actors, the possible evolution of the situation and the organization's operational strategies.
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The document provides a detailed overview of cholera, including its clinical features, diagnosis, treatment, and prevention. It explains the causes of cholera, its symptoms such as severe diarrhea and dehydration, and the importance of rehydration therapy (oral or intravenous) to reduce mortality. T...he document also emphasizes public health measures, including access to clean water, proper sanitation, and vaccination, as essential strategies to control and prevent cholera outbreaks. It serves as a comprehensive resource for healthcare professionals managing cholera cases and outbreaks.
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Hepatitis B (HBV) infection is a major public health problem and cause of chronic liver disease.
The 2024 HBV guidelines provide updated evidence-informed recommendations on key priority topics. These include expanded and simplified treatment criteria for adults but now also for adolescents; expa...nded eligibility for antiviral prophylaxis for pregnant women to prevent mother-to-child transmission of HBV; improving HBV diagnostics through use of point-of-care HBV DNA viral load and reflex approaches to HBV DNA testing; who to test and how to test for HDV infection; and approaches to promote delivery of high-quality HBV services, including strategies to promote adherence to long-term antiviral therapy and retention in care.
The 2024 guidelines include 11 updated chapters with new recommendations and also update existing chapters without new recommendations, such as those on treatment monitoring and surveillance for liver cancer.
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Antimicrobial resistance represents a big threat to public health. The Centers for Disease Control and Prevention (CDC) estimate that every year two million Americans are infected with a (multi-)drug resistant bacterium, resulting in 23,000 deaths. The WHO has repeatedly drawn attention to this majo...r health issue. In the worst-case scenario, we will shortly run out of effective antibiotics. Surgery and cancer therapy will then become very dangerous due to the risk of infection associated with such treatments. (Organ) transplantation will become close to impossible as the immunosuppression necessary for transplant patients makes them highly vulnerable to infections. Some infections we can easily treat today could turn deadly. It is therefore conceivable that infectious diseases once again become the leading cause of death as in early 20th century.
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6 June 2022
These WHO interim recommendations on the use of the Janssen Ad26.COV2.S (COVID-19) vaccine were developed on the basis of advice issued by the Strategic Advisory Group of Experts on Immunization (SAGE) and the evidence summary included in the background document referenced below.
Th...is document has been updated: Version 6 June 2022.
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The road map sets global targets and milestones to prevent, control, eliminate or eradicate 20 diseases and disease groups as well as cross-cutting targets aligned with the Sustainable Development Goals. Three foundational pillars will support global efforts to achieve the targets: accelerate progra...mmatic action (pillar 1), intensify cross-cutting approaches (pillar 2) and change operating models and culture to facilitate country ownership (pillar 3).
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The mandate of the National Tuberculosis Control Programme is to provide leadership and stewardship to accelerate intense and coordinated efforts to reduce the adult TB burden of 290 per 100,000 population recently established in the 2013 National TB Prevalence Survey. Other key challenges are low T...B case notification, unacceptably high TB death rates, low antiretroviral therapy (ART) coverage among TB/HIV patients and low drug-resistant notification and treatment.
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The present Consolidated guidelines include a comprehensive set of WHO recommendations for the treatment and care of DR-TB, derived from these WHO guidelines documents. The consolidated guidelines include policy recommendations on treatment regimens for isoniazid-resistant TB (Hr-TB) and MDR/RR-TB, ...including longer and shorter regimens, culture monitoring of patients on treatment, the timing of antiretroviral therapy (ART) in MDR/RR-TB patients infected with the human immunodeficiency virus (HIV), use of surgery for patients receiving MDR-TB treatment, and optimal models of patient support and care.
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Health Evidence Network Synthesis Report, No. 47
The increasing number of refugees, asylum seekers and irregular migrants poses a challenge for mental health services in Europe. This review found that these groups are exposed to risk factors for mental disorders before, during and after migration. ...The prevalence rates of psychotic, mood and substance use disorders in these groups are variable but overall are similar to those in the host populations; however, the rates of post-traumatic stress disorder in refugees and asylum seekers are higher.
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Background: Evidence based treatment interventions for young people with first-episode psychosis (FEP) and trauma histories is lacking. Although case formulation (CF) has been widely regarded in cognitive behavioural therapy manuals as beneficial, there is limited empirical research examining how cl...ients and therapists experience the process. Aim: This study aimed to explore young people’s reactions to CF in treatment for PTSD (post-traumatic stress disorder) and FEP
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The objective of this guidance document is to support the public health professionals
in implementing effective surveillance of cholera in at-risk, endemic and epidemic
areas. This document has been developed by the Surveillance Working Group of the
Global Task Force for Cholera Control (GTFCC) a...t the World Health Organization based
on the existing documents, guidelines, tools and articles related to surveillance of
cholera disease, as well as technical discussions with experts held during GTFCC
meetings.
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These guidelines have been developed to provide guidance to the Ministry of Health in managing applications for registration of human pharmaceutical products in Rwanda. It was compiled by the Technical Working Group (TWG) on Medicines Evaluation and Registration (MER) of the East African Community M...edicine Regulatory Harmonization (EAC MRH) Project. The group relied on their experiences and knowledge on medicines registration requirements of their individual Countries. World Health Organization (WHO) and the International Conference on Harmonization of Technical Requirements of Medicines for Human Use (ICH) and other available literature.
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WHO has updated its guidelines for COVID-19 therapeutics, with revised recommendations for patients with non-severe COVID-19. This is the 13th update to these guidelines.
Updated risk rates for hospital admission in patients with non-severe COVID-19
The guidance includes updated risk rates for... hospital admission in patients with non-severe COVID-19.
The current COVID-19 virus variants tend to cause less severe disease while immunity levels are higher due to vaccination, leading to lower risks of severe illness and death for most patients.
This update includes new baseline risk estimates for hospital admission in patients with non-severe COVID-19. The new ‘moderate risk’ category now includes people previously considered to be high risk including older people and/or those with chronic conditions, disabilities, and comorbidities of chronic disease. The updated risk estimates will assist healthcare professionals to identify individuals at high, moderate or low risk of hospital admission, and to tailor treatment according to WHO guidelines:
**High: **People who are immunosuppressed remain at higher risk if they contract COVID-19, with an estimated hospitalization rate of 6%.
**Moderate: **People over 65 years old, those with conditions like obesity, diabetes and/or chronic conditions including chronic obstructive pulmonary disease, kidney or liver disease, cancer, people with disabilities and those with comorbidities of chronic disease are at moderate risk, with an estimated hospitalization rate of 3%.
Low: Those who are not in the high or moderate risk categories are at low risk of hospitalization (0.5%). Most people are low risk.
Review of COVID-19 treatments for people with non-severe COVID-19
WHO continues to strongly recommend nirmatrelvir-ritonavir (also known by its brand name ‘Paxlovid’) for people at high-risk and moderate risk of hospitalization. The recommendations state that nirmatrelvir-ritonavir is considered the best choice for most eligible patients, given its therapeutic benefits, ease of administration and fewer concerns about potential harms. Nirmatrelvir-ritonavir was first recommended by WHO in April 2022.
If nirmatrelvir-ritonavir is not available to patients at high-risk of hospitalization, WHO suggests the use of molnupiravir or remdesivir instead.
WHO suggests against the use of molnupiravir and remdesivir for patients at moderate risk, judging the potential harms to outweigh the limited benefits in patients at moderate risk of hospital admission.
For people at low risk of hospitalization, WHO does not recommend any antiviral therapy. Symptoms like fever and pain can continue to be managed with analgesics like paracetamol.
WHO also recommends against use of a new antiviral (VV116) for patients, except in clinical trials.
The update also includes a strong recommendation against the use of ivermectin for patients with non-severe COVID-19. WHO continues to advise that in patients with severe or critical COVID-19, ivermectin should only be used in clinical trials.
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WHO and UNITAID
in collaboration with IMPAACT (International Maternal Pediatric Adolescent AIDS Clinical Trials) network, PENTA (Paediatric European Network for Treatment of AIDS) foundation and experts from the Paediatric Antiretroviral Working Group
Individual psychological help for adults impaired by distress in communities exposed to adversity.
The manual describes a scalable psychological intervention called Problem Management Plus (PM+) for adults impaired by distress in communities who are exposed to adversity. Aspects of Cognitive Behavi...oural Therapy (CBT) have been changed to make them feasible in communities that do not have many specialists. To ensure maximum use, the intervention is developed in such a way that it can help people with depression, anxiety and stress, whether or not exposure to adversity has caused these problems. It can be applied to improve aspects of mental health and psychosocial well-being no matter how severe people’s problems are.
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Lancet Public health 2022 January 6, 2022 https://doi.org/10.1016/ S2468-2667(21)00249-8
Growth in the number of individuals living with dementia underscores the need for public health planning efforts and policy to address the needs of this group. Country-level estimates can be used to inform nati...onal planning efforts and decisions. Multifaceted approaches, including scaling up interventions to address modifiable risk factors and investing in research on biological mechanisms, will be key in addressing the expected increases in the number of individuals affected by dementia.
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Effective malaria case management requires quick access to diagnostics and antimalarial treatments to reduce illness and death. Artemisinin-based combination therapy (ACT) has been essential to malaria treatment since 2001, as it combines artemisinin for rapid parasite reduction with a partner drug ...to ensure complete cure. However, resistance to antimalarial drugs, where parasites survive standard doses, threatens malaria control.
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