Orientations provisoires, 28 janvier 2021
Dans cette version mise à jour des orientations sur la sécurité biologique en laboratoire en rapport avec le SARS-CoV-2, le virus responsable de la maladie à coronavirus 2019 (COVID-19), les points suivants ont été ajoutés : aspects de... sécurité biologique relatifs à la réalisation des tests diagnostiques rapides antigéniques, manipulation des nouveaux variants du SARS-CoV-2 au laboratoire, mise à jour de la décontamination des tests avant leur élimination, équipement de protection individuelle (EPI) pour le prélèvement d’échantillons et, même s’ils ne concernent pas directement la sécurité biologique, dangers chimiques et leur élimination en toute sécurité.
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In October 2021, the ACT-Accelerator (ACT-A) published its 12-month Strategic Plan and budget for the period October 2021 to September 2022. Building on the investment needs outlined in that document, the ACT-A Facilitation Council Financial and Resource Mobilization Working Group developed this Fin...ancing Framework to clarify sources of financing that could be used to fund the ACT-A budget. Specifically, this Financing Framework seeks to: • Confirm the overall investment required to meet global COVID-19 tools coverage targets for vaccines, tests, treatments and PPE, and how much of that funding would need to be channelled through ACT-A agencies versus through other initiatives and domestic efforts. • Identify the specific sources of financing that could be used to fund ACT-A and other complementary costs associated with the delivery of the global COVID-19 tools coverage targets, for example, donor grants, domestic resources, multilateral development bank instruments (including grants and loans) or a combination of sources. • Appeal to high-income countries and major upper middle-income countries with a clear and urgent grant financing ask and expectation of fair share voluntary contributions by participants to this ‘ask’ ahead of a potential pledging event in early 2022.
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Manuel destiné au personnel de santé. Le présent manuel est un guide spécialisé sur les techniques et les méthodes de laboratoire à utiliser pour le diagnostic de l’ulcère de Buruli, une maladie provoquée par Mycobacterium ulcerans. Destiné aux techniciens et aux scientifi ques de labora...toire travaillant sur cette maladie, le présent manuel décrit les méthodes exactes à mettre en oeuvre pour réaliser un certain nombre de tests diagnostiques. Les procédures recommandées, utilisables dans l’ensemble du système de santé, sont adaptées aux services périphériques, des districts et centraux et ce, conformément aux ressources, compétences et matériel variables que l’on trouve classiquement dans les pays où l’ulcère de Buruli est endémique.
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The WHO COVID-19 LENS (Living Evidence Synthesis) working group consolidated available evidence, based on rapid reviews of the literature and results of a living systematic review on pregnancy and COVID-19 (up to October 7, 2020), on potential mechanisms of vertical transmission of infectious pathog...ens, feasibility of vertical transmission of SARS-CoV-2, data related to interpretation of positive SARS-CoV-2 virologic and serologic neonatal tests, lessons from diagnosis of other congenital infections, and existing proposed definitions to classify timing of vertical transmission of SARS-CoV-2.
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23 March 2021
The meeting addressed the last key area, that is, determining the best method or combination of diagnostic methods for a control programme for S. stercoralis infections in humans.
Dr Montresor’s presentation highlighted that while there is currently no “gold standard” for the... diagnosis of S. stercoralis, there is a felt urgency to optimize diagnostic regimens that are currently available, and in the context of population-based testing (as opposed to individual focused diagnostics in clinical settings).
In other words, the diagnostic test(s) should have good accuracy, but we should remember that in public health we do not aim at individual diagnosis: rather, we need a tool that should help to estimate the prevalence in a population.
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COVID-19 is having a catastrophic impact on the most vulnerable communities around the world and is threatening decades of progress in the fight against HIV, TB and malaria. The Global Fund works with partners, countries and communities to fight COVID-19, adapt lifesaving HIV, TB and malaria program...s, and reinforce fragile systems for health. Through our COVID-19 Response Mechanism (C19RM ), the Global Fund is now the primary channel for providing grant support to low- and middle-income countries for COVID-19 tests, treatments (including medical oxygen), personal protective equipment (PPE) and critical elements of health system strengthening.
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In 2021 ACT-Accelerator will intensify its drive for equity and scale in the delivery of essential COVID-19 tools, while managing emerging viral risks. To address these major shifts and maintain momentum, ACT-Accelerator has defined four strategic priorities for 2021: Rapidly scale up the delivery o...f at least 2 billion doses of vaccines. Bolster R&D, evaluations & regulatory pathways to optimize products and address variants. Stimulate rapid and effective uptake and use of COVID-19 tests, treatments, and PPE. Ensure a robust pipeline of essential tests, treatments, and PPE.
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This updated manual provides a basic understanding of the principles of laboratory and point-of-care (POC) testing in the context of screening and diagnostic approaches, as well as antimicrobial susceptibility testing, as components of sexually transmitted infections (STIs) control. As with previous... editions, this manual covers each disease in a separate chapter which provides detailed information on specimen collection, transport and laboratory testing. Two useful annexes covering media, reagents, diagnostic tests and stains (recipes) and laboratory supplies are included at the end of the manual.
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Yaws is targeted for eradication by 2030, using a strategy based on mass drug administration (MDA) with azithromycin. New diagnostics are needed to aid eradication. Serology is currently the mainstay for yaws diagnosis; however, inaccuracies associated with current serological tests makes it difficu...lt to fully assess the need for and impact of eradication campaigns using these tools. Under the recommendation of the WHO Diagnostic Technical Advisory Group (DTAG) for Neglected Tropical Diseases(NTDs), a working group was assembled and tasked with agreeing on priority use cases for developing target product profiles (TPPs) for new diagnostics tools.
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1st edition.
Unitaid’s report describes a slate of new devices that can more efficiently identify dangerously ill children so that they can be treated immediately. These tools make it easier to recognize danger signs, and support integrated approaches to reducing childhood deaths from the three ...greatest childhood killers: malaria, pneumonia and diarrhoea.
The report also highlights tests that can determine whether or not a child has an illness that can be treated with antibiotics. Viral infections are a common cause of childhood fevers, but cannot be cured with antibiotics. Although many children seeking care at clinics have fever, three-quarters by some estimates, only a small fraction of those have an illness that can be treated with an antimalarial or antibiotic drug
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The article "Asthma treatment in children: A guide to screening for and management of hypothalamic-pituitary-adrenal axis suppression" discusses the risks associated with the use of corticosteroids in pediatric asthma treatment. It highlights that prolonged corticosteroid use can suppress the hypoth...alamic-pituitary-adrenal (HPA) axis, potentially leading to adrenal insufficiency, especially during stress. The article reviews diagnostic and screening approaches, recommending specific tests and management strategies based on current evidence. It emphasizes the need for monitoring children on corticosteroids to mitigate the risk of serious complications and suggests modifications in treatment to prevent HPA axis suppression.
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- The goal of diagnostic testing for Ebola and Marburg virus diseases is to identify cases to provide timely and appropriate care and to stop disease transmission.
- All individuals meeting the case definition for Ebola or Marburg virus diseases should be tested.
- The recommended sample type ...for testing for orthoebolaviruses and orthomarburgviruses is whole blood or plasma for living patients, and oral swab for deceased individuals.
- Laboratory confirmation of Orthoebolavirus and Orthomarburgvirus infections and further species identification should be done using nucleic acid amplification testing (NAAT).
- If a suspected case tests negative (living patient) and the blood was drawn less than 72 hours after symptom onset, a second test should be performed with blood drawn more than 72 hours after symptom onset.
- All manipulations in laboratory settings of samples originating from suspected, probable or confirmed cases of Ebola and Marburg virus diseases should be conducted with appropriate biosafety measures according to a risk-based approach.
- Whole or partial genome sequencing can be used to characterize viruses and complement epidemiologic investigations.
- Member States are strongly encouraged to share genetic sequence data (GSD) in publicly accessible databases.
- Member States are required to immediately notify the World Health Organization (WHO) under the International Health Regulations (IHR) 2005 of positive laboratory results.
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The Mediclinic article on silicosis provides an overview of this occupational lung disease caused by inhaling silica dust. It explains that inhaled silica particles lead to lung scarring and nodule formation, progressively impairing breathing. The article outlines symptoms such as shortness of breat...h, severe cough, fatigue, loss of appetite, chest pains, and fever. Diagnosis involves a medical examination, detailed occupational history, lung function tests, and imaging like chest X-rays or CT scans to detect lung scarring and nodules. While silicosis is irreversible with no specific cure, management focuses on preventing further silica exposure and treating complications. Preventive measures include maintaining high occupational health standards to control silica dust exposure.
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Advanced HIV disease (defined in persons living with HIV with a CD4 cell count of <200cells/mm3 or presenting with a WHO Stage 3/4 AIDS-defining illness) poses a challenge to many countries globally and is responsible for significant mortality and morbidity among people living with HIV. In 2017, WHO... recommended a package of care for the prevention and management of advanced HIV disease. The package was composed of screening tests, diagnostics, prophylaxis, rapid antiretroviral therarpy initiation and enhanced adherence counselling.
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When Ebola hit Liberia in 2014, an atmosphere of fear and confusion contributed to the spread of the virus by making people unwilling to come forward for testing and treatment. Oxfam trained and equipped community health volunteers to go door-to-door, giving information and advice, encouraging anyon...e showing symptoms to go for tests, and keeping their family members informed about the progress of their treatment. The approach won the trust of communities and helped to slow the spread of the disease. This case study gives an overview of the programme, including aims, results and a personal story.
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2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood diseases. Children do not readily expectorate and th...ey have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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Zika and dengue viruses remain significant public health threats. These viruses share the same Aedes (Stegomyia) mosquito vectors and geographic distributions but infections cannot be readily distinguished clinically and need to be differentiated from each other, and from other circulating arboviral... and non-arboviral pathogens, using laboratory tests. This document provides guidance on current testing strategies for Zika and dengue virus infections with updates to the previous interim guidance for laboratory testing for ZIKV, addressing pregnant and non-pregnant patients respectively, and incorporates current guidance for dengue virus diagnostic testing. The choice of laboratory assays and interpretation of test results require careful consideration of epidemiology, patient history, and limitations of existing diagnostic tests.
This interim guidance is for use by staff of laboratories testing for Zika and dengue virus infections and for clinical practitioners and public health professionals providing clinical management or surveillance.
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Preventive chemotherapy with praziquantel (PZQ) is the cornerstone of schistosomiasis control. However, a single dose of PZQ (40 mg/kg) does not cure all infections. Repeated doses of PZQ at short intervals might increase efficacy in terms of cure rate (CR) and intensity reduction rate (IRR). Here, ...we determined the efficacy of a single versus four repeated treatments with PZQ on Schistosoma mansoni infection in school-aged children from Côte d'Ivoire, using two different diagnostic tests.
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Cardiovascular diseases remain the leading cause of morbidity and mortality worldwide. There are significant differences in the burden of cardiovascular disease and associated risk factors, across high-income countries and low- and middle-income countries. Cardiac imaging by echocardiography, cardia...c computed tomography, cardiac magnetic resonance imaging, single-photon emission computed tomography, and positron emission tomography myocardial perfusion imaging are well-established non-invasive tests that aid in the diagnosis, risk stratification, and management of various cardiac diseases. However, there are significant inequalities in availability and access to imaging modalities in low- and middle-income countries attributed to financial constraints, disparities in healthcare and technical infrastructure. In the post-COVID-19 pandemic era, these disparities are exaggerated by the continued technological advancements driving innovations in the field of cardiovascular (CV) imaging in high-income countries, while there is an urgent need to provide sustainable access to diagnostic imaging for patients in economically strained healthcare systems in regions like Africa. This review aims to highlight the inequalities in the burden of cardiac disease, associated risk factors, and access to diagnostic CV imaging tests, while also exploring the need for sustainable solutions to implementing CV imaging all over the world.
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The article "An Official ATS Workshop Report: Issues in Screening for Asthma in Children" summarizes discussions from a workshop organized by the American Thoracic Society (ATS) on the challenges of asthma screening in children. The report reviews the effectiveness of population-based asthma screeni...ng programs, highlights the limitations of current methods, and discusses case detection as an alternative. It assesses asthma's impact as a public health issue, explores the feasibility of screening tests, and examines the economic and practical challenges. The workshop concludes that broad population-based screening may not be justified without better evidence and targeted efforts to improve follow-up care and treatment access.
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