Le présent document expose des recommandations exhaustives de l’OMS sur les soins prénatals systématiques à l’intention des femmes enceintes et des adolescentes. Le but de ces recommandations est de compléter les directives de l’OMS existantes sur la prise en charge des complications spé...cifiques associées à la grossesse. Elles sont destinées à refléter et à répondre à la nature complexe des problèmes entourant la pratique et la délivrance des soins prénatals et à donner la priorité à la santé et au bien-être de la personne – et pas seulement à la prévention de la mortalité et de la morbidité – selon une démarche visant le respect des droits de l’homme.
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Le Plan de Suivi et Évaluation du Plan Stratégique National de Lutte contre le Paludisme 2023–2026 est un document élaboré par le Ministère de la Santé et de l’Hygiène Publique du Togo, à travers le Programme National de Lutte contre le Paludisme (PNLP), en décembre 2023. Il sert de cad...re de référence pour suivre, évaluer et améliorer la mise en œuvre des interventions de lutte contre le paludisme au Togo.
Ce plan accompagne le Plan Stratégique National (PSN) 2023–2026 et vise à réduire de 65 % l'incidence et la mortalité du paludisme par rapport à 2022, en s’alignant sur les objectifs de la stratégie technique mondiale de l’OMS. Il précise les objectifs, les résultats attendus, les indicateurs de performance ainsi que les mécanismes de collecte, d’analyse et de dissémination des données sanitaires.
Le document détaille également les responsabilités des acteurs impliqués à tous les niveaux du système de santé (central, régional, périphérique), les outils à utiliser, ainsi que le budget prévu pour la période. Il insiste sur la digitalisation des campagnes (MID, CPS), la formation du personnel, la qualité des données et l'intégration des ONG, du secteur privé et de la médecine traditionnelle dans la lutte contre le paludisme.
Ce plan vise à garantir une prise de décision basée sur des données fiables, à améliorer la coordination nationale et à mobiliser efficacement les ressources pour atteindre les objectifs d’élimination du paludisme d’ici 2030.
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Le document « Directives nationales pour la prise en charge du paludisme en RDC », publié en 2023 par le PNLP et le Ministère de la Santé, définit les protocoles officiels pour diagnostiquer et traiter le paludisme sur l’ensemble du territoire. Il recommande l’usage systématique du te...st de diagnostic rapide avant tout traitement, et l’administration des CTA pour le paludisme simple et de l’artésunate injectable pour les cas graves. Le texte insiste sur la gratuité des soins pour les enfants de moins de 5 ans et les femmes enceintes, la gestion rationnelle des médicaments et la formation continue du personnel de santé. Ces directives visent à réduire la mortalité et à atteindre l’élimination du paludisme d’ici 2030.
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Le Plan Stratégique National de Communication pour le Changement Social et des Comportements en matière de Lutte contre le Paludisme 2021–2025 de la Côte d’Ivoire définit les grandes lignes pour améliorer la prévention et la prise en charge du paludisme à travers la communication. Il vise... à changer durablement les comportements des populations, en mettant l’accent sur l’utilisation correcte des moustiquaires imprégnées, le recours précoce au diagnostic et au traitement, et la participation active des communautés. Le document identifie les publics cibles, les messages clés, les canaux de communication adaptés (médias, acteurs communautaires, écoles, etc.) et prévoit des mécanismes de suivi-évaluation. L’objectif final est de réduire la morbidité et la mortalité liées au paludisme, en mobilisant tous les acteurs nationaux et locaux autour d’une communication efficace et inclusive.
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La Stratégie Nationale de Plaidoyer et de Mobilisation des Ressources en faveur de la Lutte contre le Paludisme 2024–2028 en République Démocratique du Congo vise à renforcer l’engagement politique, mobiliser des financements domestiques et internationaux et impliquer tous les secteurs (publ...ic, privé, société civile) pour réduire la mortalité liée au paludisme de 70 % et l’incidence de 50 % d’ici 2028.
Le document propose des actions concrètes : plaidoyer auprès des décideurs pour des budgets accrus, exonération des intrants antipaludiques, introduction du vaccin R21/Matrix-M, création de partenariats public-privé, implication des leaders communautaires et campagnes de sensibilisation via les médias. Il s’aligne sur la stratégie mondiale de l’OMS et promeut une approche multisectorielle, coordonnée par le Programme National de Lutte contre le Paludisme avec l’appui de partenaires comme l’USAID et Breakthrough ACTION.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee...ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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In contrast to bilateral aid, aid disbursed from
multilateral institutions increased significantly at the onset
of the COVID-19 pandemic. Yet, at a time when a coherent
and effective multilateral response is needed most, the
COVID-19 pandemic revealed a shifting landscape of donor
agencies that... struggle with basic functions, such as crossnational coordination. While multilaterals are uniquely
positioned to transcend national priorities and respond
to pandemics, functionally we find official development
assistance (ODA) from these entities may increasingly
mimic the attributes of bilateral aid. We explore three
important, but not comprehensive, attributes of aid leading
up to and during the COVID-19 pandemic: (1) earmarking,
(2) donor concentration and (3) aid modality.
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Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, base...d on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The third edition includes guidance for HIV-associated TB, mental health conditions and diabetes, which are three conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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The document titled "Prevención y control del cólera" (Cholera Prevention and Control) provides essential guidance on preventing and managing cholera, a disease characterized by severe watery diarrhea and vomiting. Without prompt treatment, cholera can lead to death due to dehydration within hours.... The disease is primarily transmitted through the ingestion of food or water contaminated with the feces of an infected person.
To protect against cholera and other diarrheal diseases, the document emphasizes the importance of drinking safe water, such as bottled water with intact seals, boiled water, or water treated with chlorine products. Frequent handwashing with safe water and soap is recommended, and in the absence of soap, hands can be cleaned using ash or sand followed by rinsing with safe water. Proper sanitation practices, such as using latrines or burying feces and avoiding defecation near water sources, are crucial. The document also highlights safe food practices, including thoroughly cooking food (especially seafood), consuming it while hot, keeping it covered, and peeling fruits and vegetables. Ensuring the safe cleaning of kitchens and areas where the family bathes or washes clothes is also advised.
In case of diarrheal illness, the document stresses the immediate use of oral rehydration solution (ORS) to prevent dehydration and the importance of seeking medical attention as quickly as possible. Patients should continue ORS intake both at home and during transit to a health facility. These preventative measures and prompt treatment strategies are vital for reducing cholera transmission and mortality.
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Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already d...eprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
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The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o...f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
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The Malaria Ministerial Conference, co-hosted by WHO and the Government of Cameroon on 6 March 2024, brought together more than 400 stakeholders, including Ministers of Health and senior representatives from the African countries hardest hit by malaria, global health leaders, scientists, civil socie...ty and other partners. The pivotal meeting sought to leverage political commitment, scientific innovation and community engagement to reshape the trajectory of malaria control in high burden African countries, and beyond.
At the end of the meeting and in the weeks that followed, Ministers of Health from the 11 “High Burden High Impact” African countries (Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Nigeria, Sudan, Uganda and United Republic of Tanzania) signed the Yaoundé Declaration, pledging their “unwavering commitment” to the principle that “no one should die from malaria given the tools and systems available.” Success in reducing malaria morbidity and mortality will hinge on efforts by countries to translate this political commitment into actions and resources that will save lives.
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EID Journal , Volume 27, no.12 , Dec. 2021. Early Release
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections may be underestimated because of limited access to testing. We measured SARS-CoV-2 seroprevalence in South Africa every 2 months during July 2020–March 2021 in randoml...y selected household cohorts in 2 communities. We compared seroprevalence to reported laboratory-confirmed infections, hospitalizations, and deaths to calculate infection–case, infection–hospitalization, and infection–fatality ratios in 2 waves of infection. Post–second wave seroprevalence ranged from 18% in the rural community children <5 years of age, to 59% in urban community adults 35–59 years of age. The second wave saw a shift in age distribution of case-patients in the urban community (from persons 35–59 years of age to persons at the extremes of age), higher attack rates in the rural community, and a higher infection–fatality ratio in the urban community. Approximately 95% of SARS-CoV-2 infections were not reported to national surveillance.
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This document is to guide policy makers, managers, districts, health workers, communities, NGOs and all other stakeholders on how to implement newborn health services.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine | The aim of this study was to explore the risk factors for stillbirth and neonatal death and change in perinatal outcomes after the introduction of helping Babies Breathe Quality Improvement Cycle in Nepal.