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 Limitations of our study include the possible omission of unpublished initiatives, and that policies not evaluated with respect to antimicrobial use have not been captured in this review.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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Developing protocols for use with refugees
and internally displaced persons
Evidence for technical update of pocket book recommendations. Newborn conditions, dysentery, pneumonia, oxygen use and delivery, common causes of fever, severe acute malnutrition and supportive care
Model Chapter for textbooks for medical students and allied health professionals
Available in: English, French, Chinese, Spanish, Russian, Arabic, Thai, Korean, Tajik, Vietnamese, Uzbek
http://www.who.int/disabilities/cbr/guidelines/en/
Le secteur de la santé a beaucoup évolué au cours des 20 dernières années. Les innovations technologiques ainsi que notre connaissance des maladies ont contribué à allonger l’espérance de vie au 20ème siècle. Cependant, l’un des plus grands défis
aujourd’hui n’est pas de rester a...u fait des procédures cliniques les plus récentes ou des équipements de haute technologie dernier cri, mais plutôt d’améliorer la sécurité des soins dispensés dans des environnements complexes, sous pression et où la
rapidité d’action joue un grand rôle. Dans ce type d’environnements, les choses peuvent souvent mal tourner. Des événements indésirables surviennent. Des dommages non intentionnels, mais graves, affectent des patients dans le cadre de
la pratique clinique habituelle ou consécutivement à une décision clinique.
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The document will provide information for Ministries of Health and hospital sentinel sites on why and how to determine the denominator of at-risk children <5 years of age and rate of meningitis hospitalizations for a sentinel hospital site conducting IB-VPD surveillance. Such a methodology is curren...tly unavailable and this estimation is critical to enable interpretation of surveillance data, particularly pre- and post- vaccine introduction
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FIELD GUIDE for staff at the central, intermediate and peripheral level
Early Essential Newborn Care (EENC) Module 2.
Zika virus is primarily transmitted by the Aedes species of mosquito which is also responsible for the spread of dengue, Chikungunya and yellow fever viruses. In most areas, the primary vector of these viruses is Aedes aegypti, with Aedes albopictus a proven or potential vector in some settings. Wel...l-implemented vector control against Aedes using existing tools effectively reduces the transmission of viruses spread by these vectors. Pilot studies are being undertaken on new tools which have potential for future reductions in Aedes populations
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Le présent document donne des indications supplémentaires pour un usage responsable et prudent des
antimicrobiens chez les animaux élevés pour l’alimentation humaine. II convient de le lire en conjonction
avec le Code d’usages international recommandé pour le contrôle de l'utilisation de...s médicaments
vétérinaires (CAC/RCP 38-1993). Les objectifs visés sont la réduction au minimum de l'incidence
potentiellement défavorable sur la santé publique de l'usage d'agents antimicrobiens chez les animaux
élevés pour l’alimentation humaine et, en particulier, du développement d'une résistance aux antimicrobiens. II importe également d'assurer l'usage sûr et utile des médicaments vétérinaires antimicrobiens en médecine vétérinaire en en maintenant l'efficacité
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In the Region of the Americas, between epidemiological week (EW) 1 and EW 52 of 2018, a total of 560,586 cases of dengue were reported (incidence rate of 57.3 cases per 100,000 population), including 336 deaths. Of the total cases, 209,192 (37.3%) were laboratoryconfirmed and 3,535 (0.63%) were clas...sified as severe dengue. Cases reported in 2018 were higher than the total reported in 2017 but lower than the historical average reported in the previous 11 years (2006-2016) (Figure 1). Similarly, the proportion of cases of severe dengue and dengue with warning signs reported in 2018 was higher than the previous two years, but lower than the preceding ten years, and it remains below 1% which was reached in 2015.
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Assessment and Guidance for Strengthening Integration of Mental Health into Primary Health Care and Community-Based Service Platforms in Ukraine
Methicillin-resistant Staphylococcus aureus(MRSA) strainsor multidrug-resistant S.aureus, initially described in 1960s,emerged in the last decade as a cause of nosocomial infections responsible for rapidly progressive, potential fatal diseases including life-threatening pneumonia, necrotizing fascii...tis, endocarditis, osteomyelitis, severe sepsis, and toxinoses such as toxic shock syndrome. A multifactorial range of independent risk factors for MRSA has been reported in literature and include immunosuppression,hemodialysis, peripheral malperfusion, advanced age, extended in-hospital stays, residency in long-term care facilities (LTCFs), inadequacy of antimicrobial therapy,indwelling devices, insulin-requiring diabetes, and decubitusulcers, among others.
Hindawi Canadian Journal of Infectious Diseases and Medical Microbiology Volume 2019, Article ID 8321834, 9 pageshttps://doi.org/10.1155/2019/8321834
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