The Core Elements of Outpatient Antibiotic Stewardship provides a framework for antibiotic stewardship for outpatient clinicians and facilities that routinely provide antibiotic treatment. This report augments existing guidance for other clinical settings. In 2014 and 2015, respectively, CDC release...d the Core Elements of Hospital Antibiotic Stewardship Programs and the Core Elements of Antibiotic Stewardship for Nursing Homes. Antibiotic stewardship is the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients. Improving antibiotic prescribing involves implementing effective strategies to modify prescribing practices to align them with evidence-based recommendations for diagnosis and management.
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Antibiotic stewardship refers to coordinated efforts and activities that seek to measure and improve use of antibiotics. Implementation of ASPs has demonstrated positive public health and clinical impacts including reducing costs, lengths of hospital stays, and the burden of antibiotic resistance wh...ile maintaining or improving patient outcomes. The U.S. Centers for Disease Control and Prevention (CDC) released the Core Elements of Hospital Antibiotic Stewardship Programs in 2014, which outlines essential components for ASPs in hospitals and provides practical guidance for implementing a robust ASPin an acute care facility. Variations to the Core Elements have been developed to deal with the particular challenges in small, rural or critical access hospitals in the United States and in outpatient facilities and nursing homes.
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Report on Main Findings
The review encompasses three complementary components: 1) a review of published literature 2000-2015 on NCDs and their risk factors; 2) qualitative interviews with key actors engaged in NCD research in Myanmar; and 3) additional reviews of Myanmar ethical committee inqui...ries and postgraduate research on NCDs in Myanmar. This report outlines the key findings from the three components including a synthesis of the key outcomes from the literature review and qualitative interviews, and an assessment of the gaps in the evidence against a framework of evidence needs.
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The Lancet Volume 390, Issue 10110p2397-2409November 25, 2017.
Human African trypanosomiasis (HAT), also called sleeping sickness, is a parasitic infection that almost invariably progresses to death, unless treatment is provided. HAT caused devastating epidemics during the 20th century. Thanks to ...sustained and coordinated efforts during the past 15 years the number of reported cases has fallen to a historic low. Fewer than 3,000 cases were reported in 2015, and the disease is targeted for elimination by the World Health Organization. Despite recent success, HAT still poses a heavy burden on the rural communities where this highly focal disease occurs, most notably in Central Africa. Since patients are also reported from non-endemic countries outside Africa, HAT should be considered in differential diagnosis for all travellers, tourists, migrants and expatriates who have visited or lived in endemic areas. In the absence of a vaccine, disease control relies on case detection and treatment, and vector control. Available drugs are sub-optimal, but ongoing clinical trials give hope for safer and simpler treatments.
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Mpox is an emerging zoonotic disease caused by the mpox virus, a member of the Orthopoxvirus genus closely related to the variola virus that causes smallpox. Mpox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research. The first human case was recorde...d in 1970 in the Democratic Republic of the Congo (DRC) during a period of intensified effort to eliminate smallpox and since then the infection has been reported in a number of African countries. Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels, and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA. Two separate clades of the mpox virus are currently circulating in Africa: Clade I, which includes subclades Ia and Ib, and Clade II, comprising subclades IIa and IIb. Clade Ia and Clade Ib have been associated with ongoing human-to-human transmission and are presently responsible for outbreaks in the Democratic Republic of the Congo (DRC), while Clade Ib is also contributing to outbreaks in Burundi and other countries.
In 2022‒2023 mpox caused a global outbreak in over 110 countries, most of which had no previous history of the disease, primarily driven by human-to-human transmission of clade II through sexual contact. In just over a year, over 90,000 cases and 150 deaths were reported to the WHO. For the second time since 2022, mpox has been declared a global health emergency as the virus spreads rapidly across the African continent. On 13 Aug 2024, Africa CDC declared the ongoing mpox outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017.7 This declaration empowered the Africa CDC to lead and coordinate responses to the mpox outbreak across affected African countries. On August 14, 2024, the WHO declared the resurgence of mpox a Public Health Emergency of International Concern (PHEIC) emphasizing the need for coordinated international response.
As of August 2024, Mpox has expanded beyond its traditional endemic regions, with new cases reported in countries including Sweden, Thailand, the Philippines, and Pakistan. Sweden has confirmed its first case of Clade 1 variant, which has been rapidly spreading in Africa, particularly in DRC. The emergence of this new variant raises concerns about its potential for higher lethality and transmission rates outside Africa.
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This treatment guideline is intended to assist clinicians in the Behavioral Health department in treatment planning and service delivery for patients with Post Traumatic Stress Disorder (PTSD). It may also assist clinicians treating patients who have some of the signs and symptoms of PTSD but who do... not meet the full criteria of PTSD. The treatment guideline is not intended to cover every aspect of clinical practice, but to focus specifically on the treatment models and modalities that clinicians in our outpatient treatment setting could provide. These guidelines were developed through a process of literature review and discussion amongst clinicians in the Behavioral Health department and represent a consensus recommendation for service provision for this disorder. The guideline is intended to inform both clinical and administrative practices with the explicit goals of outlining treatment that is: effective, efficient, culturally relevant and acceptable to clinicians, program managers, and patients.
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This document was designed to inform educators, amongst others, about enhancing the pre-service curriculum with mental health Gap Action Programme Intervention Guide (mhGAP-IG) materials, which can provide future professionals with the theoretical and clinical knowledge they need to provide mental h...ealth in non-specialized health care settings.
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An Economist Intelligence Unit briefing paper | The Economist Intelligence Unit (EIU) undertook a study aimed at assessing the degree of commitment of 15 countries within the AsiaPacific region to integrating those with mental illness into their communities. The research was commissioned and funded... by Janssen Asia Pacific, a division of Johnson & Johnson Pte. Ltd. This report focuses on the results of this benchmarking study, called the Asia-Pacific Mental Health Integration Index. Drawing on lessons from the EIU’s 2014 European Mental Health Integration Index, this edition index compares the level of effort in each of the countries on indicators associated with integrating individuals suffering from mental illness into society. Data for the Index was collected between March and May 2016. The set of 18 indicators were grouped into four categories.
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Noncommunicable diseases (NCDs) such as cancer, cardiovascular diseases, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Turkey. This report provides evidence through three analyses that NCDs reduce economic output, and di...scusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs are equivalent to 3.6% of gross domestic product. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment.
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This article reexamines a set of study findings that directly relate to the influence of gender on workplace violence, synthesizes these findings with other research from Rwanda, and examines the subsequent impact of the study on Rwanda’s policy environment.
The NICE guideline "Hypertension in Adults: Diagnosis and Management" outlines recommendations for diagnosing and managing hypertension in adults over 18, including those with type 2 diabetes. It emphasizes accurate blood pressure measurement, recommending ambulatory or home monitoring to confirm di...agnosis. 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.
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The Liliane Foundation in collaboration with Enablement has been running a pilot focusing on children with neurodevelopmental disorders in 4 African countries called: Support Tools Enabling Parents (STEP). We can share details of the pilot including the evaluation report; report of a research proje...ct (with baseline and end line study); tools etc.
Write an Email to: h.cornielje@enablement.nl
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Q7. SCOPING QUESTION: In adults with moderate-severe depressive disorder, what is the effectiveness and safety of antidepressant medication (ADM) in comparison with psychological treatment?
The WHO mhGAP programme’s existing guidelines recommend that either structured brief psychological treatm...ents (e.g., interpersonal psychotherapy or cognitive behavioural therapy, including behavioural activation) or antidepressant medication (e.g., SSRIsi and tricyclic antidepressants) be considered in adults with moderate-severe depression. Health care workers need to know whether these treatments have different effects, including side-effects, in treating depressive disorder in the short and long term, in order to improve clinical decision-making.
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The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countries, the causes of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel sm...oke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa.
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The objectives of these WHO guidelines are to provide updated evidence- based recommendations for the treatment of persons with hepatitis C infection using, where possible, all DAA-only combinations. The guidelines also provide recommendations on the preferred regimens based on a patient’s HCV gen...otype and clinical history, and assess the appropriateness of continued use of certain medicines. This document also includes existing recommendations on screening for HCV infection and care of persons infected with HCV that were first issued in 2014
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The CSMH compiled a list of assessment measures that are in the public domain (free of charge) and available online for clinicians. Below are the recommended measures can be used in school mental health programs to help assess symptoms of clinical disorders (e.g. depression, anxiety, ADHD) an in som...e cases are useful for tracking student progress and outcomes over time.
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As a lower-middle-income country (LMIC), South Africa (SA) bears
the burden of maternal and neonatal mortality similar to other sub-
Saharan African countries. According to the Saving Mothers Report
2017/19, there has been a progressive and sustained reduction
in institutional maternal mortality... (iMMR) in the past three triennia
(2010-2019), from 320 per 100,000 live births to 120 per 100,000 live
births.
According to the Rapid Mortality Survey, the country’s infant mortality
rate has declined from 29 deaths per 1000 live births in 2014 to 25
deaths per 1,000 live births in 2018. The institutional neonatal death
rate showed a slight decrease from 12,7 deaths per 1,000 live births in
2016 to the current level of 12 per 1,000 live births and has remained
static at this level for the past three years (saDHIS).
Working towards the Sustainable Development Goal (SDG) of reducing maternal mortality to below 70 per 100 000 live births and neonatal mortality to 12 deaths per 1000 live births, South Africa aims to reduce institutional maternal mortality, neonatal mortality and stillbirths by 50% by 2030.
This Maternal, Perinatal and Neonatal Health Policy provides a
framework for the delivery of quality, comprehensive, and integrated
MNH services and will guide the development and review of guidelines
and related MNH interventions, including strengthening of the service
delivery platform, governance, leadership and accountability for
the provision of quality MNH services, development of advocacy
messages, and guiding civil society priorities and community
initiatives. The policy will also guide the development and review of
academic curricula and the setting of research priorities.
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Noncommunicable diseases (NCDs) such as cancer, cardiovascular disease, diabetes and chronic respiratory diseases and their risk factors are an increasing public health and development challenge in Kazakhstan. This report provides evidence through three analyses that NCDs reduce economic output and ...discusses potential options in response, outlining details of their relative returns on investment. An economic burden analysis shows that economic losses from NCDs (direct and indirect costs) comprise 2.3 trillion tenge, equivalent to 4.5% of gross domestic product in 2017. An intervention costing analysis provides an estimate of the funding required to implement a set of policy interventions for prevention and clinical interventions. A cost–benefit analysis compares these implementation costs with the estimated health gains and identifies which policy packages would give the greatest returns on investment. For example, the salt policy package achieved a benefit-to-cost ratio of 118.4 over 15 years, a return of more than 118 tenge for every 1 tenge invested.
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Evidence from a systematic review on antenatal zinc supplementation was evaluated as part of the World Health Organization (WHO) antenatal care (ANC) guideline development process in 2016, and the following recommendation on zinc supplementation was made: “Zinc supplementation for pregnant women i...s only recommended in the context of rigorous research.” The Guideline Development Group (GDG) made this recommendation because it felt that the evidence on the intervention was incomplete and that more research was necessary.
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Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological age...nts of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks.
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