Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
more
The updated List of Essential Diagnostics contains 46 general tests that can be used for routine patient care as well as for the detection and diagnosis of a wide array of disease conditions, and 69 tests intended for the detection, diagnosis and monitoring of specific diseases.
The List is divid...ed into two sections depending on the user and setting: one for community settings, which includes self-testing; and a second one for clinical laboratories, which can be general and specialized facilities.
more
Breast cancer is the most common cancer worldwide and the leading cause of cancer deaths among women, disproportionately affecting low- and middle-income countries. The Global Breast Cancer Initiative strives to reduce breast cancer mortality by 2.5 percent per year, which over a 20-year period can ...save 2.5 million lives. The purpose of this core technical package is to outline a pathway for incremental, sustainable improvements tailored to country-specific needs based on three key strategies and objectives: health promotion for early detection; timely diagnosis; and comprehensive breast cancer management. This document provides a common framework linking policy makers, stakeholders, the clinical community, program managers and civil society to evidence-based systematic approaches that can facilitate health systems strengthening and reduce inequities in women’s health throughout their life cycles
more
GMS Zeitschrift für MedizinischeAusbildung 2015, Vol. 32(5),ISSN 1860-3572
Internationalizing higher education is considered to be a major goal for universities in Germany and many medical students aspire to include international experiences into their academic training. However, the exact meani...ng of “internationalizing” medical education is still poorly defined, just as is the possible pedagogic impact and effects. Against this background, this article presents the special track curriculum on global health (in German: Schwerpunktcurriculum Global Health, short: SPC) at Justus Liebig University Giessen, which was established in 2011 as a comprehensive teaching program to integrate international perspectives and activities systematically into the clinical years of the medical curriculum
more
El objetivo de esta guía es brindar recomendaciones prácticas al personal de salud que se hace cargo de las actividades de preparación y respuesta a las enfermedades contagiosas para asegurar que se mantenga el acceso a servicios de aborto seguro (SAS) cuando surja un brote de enfermedades contag...iosas. Es una guía operativa que puede servir para apoyar a los actores de la salud para que los SAS se mantengan durante los brotes y asegurar que las consideraciones necesarias de SAS se integren dentro de la respuesta al brote; no es una guía clínica. El enfoque centrado en la ubicación de este documento se dirige a los asentamientos frágiles y de ayuda humanitaria; sin embargo, las recomendaciones pueden aplicarse a brotes de enfermedades contagiosas a cualquier población con escasez de recursos. Esta guía busca complementar el trabajo llamado La salud sexual y reproductiva y los derechos durante los brotes de enfermedades contagiosas: Guía operativa para escenarios frágiles y de ayuda humanitaria.
more
These are two parallel guidelines, one for small hospitals and another one for large hospitals. In view of heavy burden of malaria and prevalence of drug resistant falciparum malaria in the South-East Asia Region, the guidelines were developed for use by medical personnel who treat severe malaria pa...tients, referred from lower-level health facilities. The guidelines were developed by the WHO Regional Office for South-East Asia and the WHO Collaborating Centre for the Clinical Management of Malaria, Faculty of Tropical Medicine, Mahidol University, Thailand. The guidelines are based on a review of current evidence, existing WHO guidelines and experience in the management of malaria in the Region.
more
AHRO Reviews of Nursing is an international open-access journal that promotes the dissemination of quality knowledge in all aspects of nursing practice
The AHRO Review of Nursing (ARN) is an international, open-access, peer reviewed, scientific journal that seeks to promote the dissemination of q...uality knowledge related to all spheres of nursing practice. The primary aim is to promote a high standard of clinically related scholarship which advances and supports the practice and discipline of nursing. The Journal also aims to promote the international exchange of ideas and experience that draws from the different cultures in which practice takes place. Further, ARN seeks to enrich insight into clinical need and the implications for nursing intervention and models of service delivery. Emphasis is placed on promoting critical debate on the art and science of nursing practice.
ARN is essential reading for anyone involved in nursing practice, whether clinicians, researchers, educators, managers, policy makers, or students. The development of clinical practice and the changing patterns of inter-professional working are also central to ARN's scope of interest. Contributions are welcomed from other health professionals on issues that have a direct impact on nursing practice.
more
Histoplasmosis is a disease caused by the fungus Histoplasma capsulatum. This disease is highly endemic in some regions of North America, Central America, and South America and is also reported in certain countries of Asia and Africa. It often affects people with impaired immunity, including people ...living with HIV, among whom the most frequent clinical presentation is disseminated histoplasmosis. The symptoms of disseminated histoplasmosis are non-specific and may be indistinguishable from those of other infectious diseases, especially disseminated tuberculosis (TB), thus complicating diagnosis and treatment. Histoplasmosis is one of the most frequent opportunistic infections caused by fungal pathogens among people living with HIV in the Americas and may be responsible for 5–15% of AIDS-related deaths every year in this Region. These guidelines aim to provide recommendations for the diagnosis, treatment, and management of disseminated histoplasmosis in persons living with HIV
more
Senegal has adopted the World Health Organization–Joint United Nations Programme on HIV/AIDS recommended 90-90-90 targets.5 The adoption of this strategy means that the country is expected, by 2020, to have 90% of its population living with HIV diagnosed, 90% of all those diagnosed receiving susta...ined HIV treatment, and 90% of those receiving antiretroviral therapy having suppressed viral load measures.5 To achieve these outcomes, having good clinical laboratory services for diagnosis and follow-up will be critical.6 More specifically, investments will be needed to improve laboratory infrastructure, and to facilitate the access and availability of routine viral load and early infant diagnosis (EID) measures through the implementation of point-of-care (POC) diagnostic platforms along with an efficient and sustainable quality assurance programme.
more
The report provides a brief introduction to patents and licences and their effect on the market for antiretroviral (ARV) medicines. It gives an overview of the patent landscape with respect to a select number of ARV medicines in developing countries as of April 2014. The focus is primarily on those ...ARVs that are recommended by the World Health Organization (WHO) as well as new ARVs that have either recently obtained regulatory approval or are in phase III clinical trials.
more
OpenWHO is an interactive, web-based, knowledge-transfer platform offering free online courses to improve the response to health emergencies. In summary, OpenWHO currently offers courses covering the following topics and languages to support the response to COVID-19:
A general introduction to ...emerging respiratory viruses, including novel coronaviruses (available in Arabic, Chinese, English, French, Russian, Spanish, Hindi, Hungarian, Indian Sign Language, Indonesian, Macedonian, Persian, Portuguese, Serbian, Turkish and Vietnamese);
Clinical care SARI (available in English, French, Russian, Spanish, Indonesian, Portuguese and Vietnamese);
Health and safety briefing for respiratory diseases – ePROTECT (available in Chinese, English, French, Russian, Spanish, Indonesian and Portuguese);
IPC for COVID-19 (available in Chinese, English, French, Russian, Spanish, Indonesian, Italian, Japanese, Macedonian, Portuguese, Serbian and Turkish);
COVID-19 operational planning guidelines and partners platform to support country preparedness and response (available in Chinese, English, French, Russian and Portuguese);
SARI treatment facility design (available in Arabic, English and Portuguese);
An introduction to Go.Data (available in English and in additional languages); and
How to put on and remove PPE for COVID-19 (available in English and in additional languages).
more
The article discusses the education strategy of the International Primary Care Respiratory Group (IPCRG) for 2014–2020, focusing on building capacity to improve respiratory care globally. It highlights the significant burden of respiratory diseases and the role of primary care in addressing this i...ssue. The IPCRG aims to enhance educational efforts, support healthcare professionals, and foster knowledge-sharing among its member countries. The strategy includes developing teaching programs, promoting leadership, and using innovative educational methods, such as distance learning and "teach the teacher" programs. The overall goal is to improve clinical practice and outcomes in managing respiratory conditions through targeted education and collaboration.
more
Chagas disease or American trypanosomiasis is, together with geohelminths, the neglected disease that causes more loss of years of healthy life due to disability in Latin America. Chagas disease, as determined by the factors and determinants, shows that different contexts require different actions, ...preventing new cases or reducing the burden of disease. Control strategies must combine two general courses of action including prevention of transmission to prevent the occurrence of new cases (these measures are cost effective), as well as opportune diagnosis and treatment of infected individuals in order to prevent the clinical evolution of the disease and to allow them to recuperate their health. All actions should be implemented as fully as possible and with an integrated way, to maximise the impact. Chagas disease cannot be eradicated due because of the demonstrated existence of infected wild triatomines
in permanent contact with domestic cycles and it contributes to the occurrence of at least few new cases. However, it is possible to interrupt the transmission of Trypanosoma cruzi in a large territory and to eliminate Chagas disease
as a public health problem with a dramatic reduction of burden of the disease.
more
Through the USAID-funded Organized Network of Services for Everyone’s Health (ONSE) Activity, MSH is assisting Malawi’s National Malaria Control Program to provide high-quality malaria services at the facility and community levels in 10 districts, covering nearly a third of the country.
Our ...team in Malawi share recent results on strengthening malaria services through Outreach Training and Supportive Supervision (OTSS).
Designed to provide ongoing support to clinicians, data, and laboratory staff, OTSS combines a standardized checklist with targeted mentorship and supportive supervision to identify areas for improvement and strengthen clinical and diagnostic services in health facilities.
This webinar shares lessons learned on how the application of OTSS, as part of broader quality assurance systems, impacts staff performance and improves the provision and quality of malaria services.
more
Psoriasis, which can involve the skin, nails and joints, is a chronic, painful, disfiguring and disabling noncommunicable disease (NCD) for which there is no cure. It negatively impacts on quality of life. Some of those who suffer from the disease develop chronic, inflammatory arthritis (psoriatic a...rthritis) that leads to joint deformations and disability. People with psoriasis are also reported to be at increased risk of developing other serious clinical conditions such as cardiovascular and other NCDs
more
In the area of nutrition and HIV, children deserve special attention because of their additional needs to ensure growth and development and their dependency on adults for adequate care. It was therefore proposed to first develop guidelines for children and thereafter consider a similar approach for... other specific groups.
The content of these guidelines acknowledges that wasting and undernutrition in HIV-infected children reflect a series of failures within the health system, the home and community and not just a biological process related to virus and host interactions. In trying to protect the nutritional well-being or reverse the undernutrition experienced by infected children, issues of food insecurity, food quantity and quality as well as absorption and digestion of nutrients are considered. Interventions are proposed that are practical and feasible in resource-poor settings and offer a prospect for clinical improvement.
The guidelines do not cover the feeding of infants 0 to 6 months old, because the specialised care in this age group is already addressed in other WHO guidelines and documents.
more
Medicines and Allied Substances [No. 3 of 2013 47 | An Act to continue the existence of the Pharmaceutical Regulatory Authority and re-name it as the Zambia Medicines Regulatory Authority; provide for the functions and powers of the Authority; provide for the registration and regulation of pharmacie...s, health shops and agro-veterinary shops; provide for the registration and regulation of medicines and allied substances; provide for the regulation of the manufacture, importation, exportation, possession, storage, distribution, supply, promotion, advertising, sale and use of medicines and allied substances; provide for the regulation and control of clinical trials; repeal and replace the Pharmaceutical Act, 2004; and provide for matters connected with, or incidental to, the foregoing.
more
Updated 17 April 2020
Improving care for women during pregnancy and around the time of childbirth to prevent and treat pre-eclampsia and eclampsia is a necessary step towards the achievement of the health targets of the Sustainable Development Goals (SDGs). Efforts to prevent and reduce morbidity a...nd mortality due to these conditions can help address the profound inequities in maternal and perinatal health globally. To achieve this, healthcare providers, health managers, policy makers and other stakeholders need up-to-date and evidence-informed recommendations to guide clinical policies and practices.
more
Esta primeira versão de Medicamentos para prevenção da COVID-19: Orientação dinâmica da OMS aborda o uso de hidroxicloroquina para prevenção da COVID-19. Segue-se a publicação de uma análise sistemática e NMA que reuniu dados de seis estudos com 6.059 participantes que não tinham COVID-...19 e receberam hidroxicloroquina. Três estudos envolveram participantes que tiveram uma exposição conhecida a uma pessoa com infecção por SARS-CoV-2. Em resposta à divulgação dos dados de estudos, o GDG da OMS desenvolveu recomendações sobre a hidroxicloroquina, um agente anti-inflamatório que atua por meio do bloqueio dos receptores Toll-like, reduzindo a ativação das células dendríticas. É usada para tratar a artrite reumatoide e o lúpus eritematoso sistêmico. Tem um efeito antiviral contra muitos vírus in vitro, inclusive o SARS-CoV-2, mas não foi demonstrado um efeito antiviral clinicamente útil para nenhuma infecção viral.
more
n light of the potential risk posed by SARS-CoV-2 variants, in January 2021 WHO organized an ad hoc consultation to discuss the development of an R&D agenda in response to existing and emerging SARS-CoV-2 variants.
The key objectives were to identify the critical research questions related to var...iants and agree on a research approach to address them. Six breakout groups covered a range of specific issues related to COVID-19 variants: Epidemiology and mathematical modelling; evolutionary biology; animal models; assays and diagnostics; clinical management and therapeutics; and vaccines.
This report is a summary of presentations and panel discussions.
more