Your search found 145 Results

  1. 1
    392803
    Peer Reviewed

    Application opportunities of geographic information systems analysis to support achievement of the UNAIDS 90-90-90 targets in South Africa.

    Lilian RR; Grobbelaar CJ; Hurter T; McIntyre JA; Struthers HE; Peters RPH

    South African Medical Journal. 2017 Nov 27; 107(12):1065-1071.

    In an effort to achieve control of the HIV epidemic, 90-90-90 targets have been proposed whereby 90% of the HIV-infected population should know their status, 90% of those diagnosed should be receiving antiretroviral therapy, and 90% of those on treatment should be virologically suppressed. In this article we present approaches for using relatively simple geographic information systems (GIS) analyses of routinely available data to support HIV programme management towards achieving the 90-90-90 targets, with a focus on South Africa (SA) and other high-prevalence settings in low- and middle-income countries. We present programme-level GIS applications to map aggregated health data and individual-level applications to track distinct patients. We illustrate these applications using data from City of Johannesburg Region D, demonstrating that GIS has great potential to guide HIV programme operations and assist in achieving the 90-90-90 targets in SA.
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  2. 2
    375892

    Prevention and control of malaria in pregnancy: reference manual. 3rd edition, 2018 update.

    JHPIEGO

    Baltimore, Maryland, Jhpiego, 2018. 92 p. (USAID Award No. HRN-A-00-98-00043-00; USAID Leader with Associates Cooperative Agreement No.GHS-A-00-04-00002-00)

    The Malaria in Pregnancy reference manual and clinical learning materials are intended for skilled providers who provide antenatal care, including midwives, nurses, clinical officers, and medical assistants. The clinical learning materials can be used to conduct a 2-day workshop designed to provide learners with the knowledge and skills needed to prevent, recognize, and treat malaria in pregnancy as they provide focused antenatal care services.
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  3. 3
    375796

    World malaria report 2017.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2017. 196 p.

    The World malaria report, published annually, provides a comprehensive update on global and regional malaria data and trends. The latest report, released on 29 November 2017, tracks investments in malaria programmes and research as well as progress across all intervention areas: prevention, diagnosis, treatment and surveillance. It also includes dedicated chapters on malaria elimination and on key threats in the fight against malaria. The report is based on information received from national malaria control programmes and other partners in endemic countries; most of the data presented is from 2016.
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  4. 4
    323652

    WHO information note on the use of dual HIV/Syphilis rapid diagnostic tests (RDT).

    World Health Organization [WHO]. Department of Reproductive Health and Research

    Geneva Switzerland, World Health Organization [WHO], 2017. 8 p. (Information Note; WHO/RHR/17.01)

    This information note provides interim advice for countries using or planning to introduce dual HIV/syphilis rapid diagnostic test (RDT) in antenatal services and other testing sites pending forthcoming WHO programmatic guidance, including a WHO recommended testing strategy. This note also emphasizes the need to ensure the quality of HIV and syphilis testing using RDTs, as well as laboratory-based testing, to avoid false positive and false negative HIV and syphilis results
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  5. 5
    375712

    Statement on maternal sepsis.

    World Health Organization [WHO]. Department of Reproductive Health and Research; World Health Organization [WHO]. Human Reproduction Programme [HRP]

    Geneva, Switzerland, WHO, 2017. 4 p. (WHO/RHR/17.02)

    Strategic approaches to reduce maternal mortality in the past 15 years have mainly focused on clinical interventions and health system strengthening. The greatest attention has been on postpartum haemorrhage and hypertensive disorders, the two leading direct causes of maternal mortality. Further reducing maternal deaths is a priority for achieving the Sustainable Development Goals, implementing the UN Global Strategy for Women’s, Children’s and Adolescents’ Health and critical for the Strategies toward Ending Preventable Maternal Mortality (EPMM). However, the third most common direct cause of maternal mortality, maternal sepsis, received less attention, research and programming. Undetected or poorly managed maternal infections can lead to sepsis, death or disability for the mother and increased likelihood of early neonatal infection and other adverse outcomes. Recognizing the need to foster new thinking and to catalyse greater action to address this important cause of maternal and newborn mortality and morbidity, the World Health Organization (WHO) and Jhpiego have launched the Global Maternal and Neonatal Sepsis Initiative, dedicated to focusing additional effort, energizing stakeholders and accelerating progress in the area of maternal and neonatal infection and sepsis. This statement defines maternal sepsis and operationalizes the definition.
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  6. 6
    375642

    Managing complications in pregnancy and childbirth: a guide for midwives and doctors. Second edition.

    World Health Organization [WHO]; United Nations Population Fund [UNFPA]; UNICEF

    Geneva, Switzerland, WHO, 2017. 492 p. (Integrated Management Of Pregnancy And Childbirth)

    Since the first edition was published in 2000, the Managing Complications in Pregnancy and Childbirth (MCPC) manual has been used widely around the world to guide the care of women and newborns who have complications during pregnancy, childbirth and the immediate postnatal period. The MCPC manual targets midwives and doctors working in district-level hospitals. Selected chapters from the first edition of the MCPC were revised in 2016 based on new World Health Organization recommendations, resulting in this second edition.
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  7. 7
    379137
    Peer Reviewed

    Uptake and performance of prevention of mother-to-child transmission and early infant diagnosis in pregnant HIV infected women and their exposed infants at seven health centres in Addis Ababa, Ethiopia.

    Girma M; Wendaferash R; Shibru H; Berhane Y; Hoelscheer M

    Tropical Medicine and International Health. 2017 Jun; 22(6):765-775.

    Objective To assess the uptake of WHO-recommended PMTCT procedures in Ethiopia's health services. Methods Prospective observational study of HIV-positive pregnant mothers and their newborns attending PMTCT services at seven health centers in Addis Ababa. Women were recruited during antenatal care and followed-up with their newborns at delivery, day 6 and week 6 postpartum. Retention to PMCTC procedures, self-reported ART adherence, and HIV infant outcome were assessed. Turnaround times of HIV early infant diagnosis (EID) procedures were extracted from health registers. Results Of 494 women enrolled 4.9% did not complete PMTCT procedures due to active denial or loss to follow-up. HIV was first diagnosed in 223 (45.1%) and ART initiated in 321 (65.0%) women during pregnancy. ART was initiated in a median of 1.3 weeks (IQR 0-4.3) after HIV diagnosis. Poor self-reported treatment adherence was higher post-partum than during pregnancy (12.5% versus 7.0%, p=0.002), and significantly associated with divorced/separated marital status (RR 2.2, 95% CI 1.3-3.8), low family income (RR 2.1, 95% CI 1.1-4.1), low CD4-count (RR 1.7, 95% CI 1.0-3.0), and ART initiation during delivery (RR 2.5, 95% CI 1.1-5.6). Of 435 infants born alive 98.6% received nevirapine prophylaxis. The mother-to-child HIV transmission rate was 0.7% after a median of 6.7 weeks (IQR 6.4-10.4), but EID results were received for only 46.6% within 3 months of birth. Conclusion High retention in PMTCT services, triple maternal ART and high infant nevirapine prophylaxis coverage were associated with low mother-to-child HIV transmission. Declining post-partum ART adherence and challenges of EID linkage require attention.
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  8. 8
    375280

    World Malaria Report 2016.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2016. 186 p.

    The World Health Organization’s (WHO) World Malaria Report 2016 reveals that children and pregnant women in sub-Saharan Africa have greater access to effective malaria control. Across the region, a steep increase in diagnostic testing for children and preventive treatment for pregnant women has been reported over the last five years. Among all populations at risk of malaria, the use of insecticide-treated nets has expanded rapidly. But in many countries in the region, substantial gaps in programme coverage remain. Funding shortfalls and fragile health systems are undermining overall progress, jeopardizing the attainment of global targets.
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  9. 9
    373335

    [The results of implementation of the International Bank for Reconstruction and Development Loan Project "Prevention, diagnosis, and treatment of tuberculosis and AIDS", a "tuberculosis" component]

    Tuberkulez I Bolezni Legkikh. 2010; (3):10-7.

    Due to the implementation of the International Bank for Reconstruction and Development (IBRD) loan project "Prevention, diagnosis, treatment of tuberculosis and AIDS", a "Tuberculosis" component that is an addition to the national tuberculosis control program in 15 subjects of the Russian Federation, followed up by the Central Research Institute of Tuberculosis, Russian Academy of Medical Sciences, the 2005-2008 measures stipulated by the Project have caused substantial changes in the organization of tuberculosis control: implementation of Orders Nos. 109, 50, and 690 and supervision of their implementation; modernization of the laboratories of the general medical network and antituberbulosis service (404 kits have been delivered for clinical diagnostic laboratories and 12 for bacteriological laboratories, including BACTEC 960 that has been provided in 6 areas); 91 training seminars have been held at the federal and regional levels; 1492 medical workers have been trained in the detection, diagnosis, and treatment of patients with tuberculosis; 8 manuals and guidelines have been prepared and sent to all areas. In the period 2005-2008, the tuberculosis morbidity and mortality rates in the followed-up areas reduced by 1.2 and 18.6%, respectively. The analysis of patient cohorts in 2007 and 2005 revealed that the therapeutic efficiency evaluated from sputum smear microscopy increased by 16.3%; there were reductions in the proportion of patients having ineffective chemotherapy (from 16.1 to 11.1%), patients who died from tuberculosis (from 11.6 to 9.9%), and those who interrupted therapy ahead of time (from 11.8 to 7.8%). Implementation of the IBR project has contributed to the improvement of the national strategy and the enhancement of the efficiency of tuberculosis control.
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  10. 10
    340313

    Pregnancy management in the context of Zika virus infection. Interim guidance update.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2016 May 13. [14] p. (WHO/ZIKV/MOC/16.2 Rev.1)

    The mosquito vector that carries the Zika virus thrives in warm climates and particularly in areas of poor living conditions. Pregnant women living in or travelling to such areas are at equal risk as the rest of the population of being infected by viruses borne by this vector. Maternal infection with Zika virus may go unnoticed as some people will not develop symptoms. Although Zika virus infection in pregnancy is typically a mild disease, an unusual increase in cases of congenital microcephaly, Guillain-Barré syndrome and other neurological complications in areas where outbreaks have occurred, has significantly raised concern for pregnant women and their families, as well as health providers and policy-makers. The aim of this document is to provide interim guidance for interventions to reduce the risk of maternal Zika virus infection and to manage potential complications during pregnancy. This guidance is based on the best available research evidence and covers areas prioritized by an international, multidisciplinary group of health care professionals and other stakeholders. Specifically, it presents guidance for preventing Zika virus infection; antenatal care and management of women with infection; and care during pregnancy for all pregnant women living in affected areas, with the aim of optimizing health outcomes for mothers and newborns. The guidance is intended to inform the development of national and local clinical protocols and health policies that relate to pregnancy care in the context of Zika virus transmission. It is not intended to provide a comprehensive practical guide for the prevention and management of Zika virus.
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  11. 11
    340923
    Peer Reviewed

    WHO meeting thrashes out R&D strategy against Zika.

    Maurice J

    Lancet. 2016 Mar 19; 387:1147.

    WHO convened a multidisciplinary consultation last week to identify the tools and interventions needed to outsmart the Zika epidemic. Towards the end of the meeting, delegates representing the major regulatory agencies in the USA, Europe, and Brazil, committed to putting Zika-related products on a regulatory fast-track. They also agreed that instead of waiting, as they usually do, for manufacturers to approach them, they would take the initiative and approach companies working on promising products. Their gesture, in a sense, encapsulates the success of the meeting in bringing together so many minds from so many disciplines to focus, for 3 intensive days, on a single issue of vital importance. (Excerpts)
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  12. 12
    340891

    Pregnancy management in the context of Zika virus. Interim guidance.

    World Health Organization [WHO]

    [Geneva, Switzerland], WHO, 2016 Mar 2. [7] p. (WHO/ZIKV/MOC/16.2)

    The mosquito vector that carries the Zika virus thrives in warm climates and particularly in areas of poor living conditions. Pregnant women living in or travelling to such areas are at equal risk as the rest of the population of being infected by viruses borne by this vector. Maternal infection with Zika virus may go unnoticed as some people will not develop symptoms. Although Zika virus infection in pregnancy is typically a mild disease, an unusual increase in cases of congenital microcephaly, Guillain-Barré syndrome and other neurological complications in areas where outbreaks have occurred, has significantly raised concern for pregnant women and their families, as well as health providers and policy-makers. The aim of this document is to provide interim guidance for interventions to reduce the risk of maternal Zika virus infection and to manage potential complications during pregnancy. This guidance is based on the best available research evidence and covers areas prioritized by an international, multidisciplinary group of health care professionals and other stakeholders. Specifically, it presents guidance for preventing Zika virus infection; antenatal care and management of women with infection; and care during pregnancy for all pregnant women living in affected areas, with the aim of optimizing health outcomes for mothers and newborns. The guidance is intended to inform the development of national and local clinical protocols and health policies that relate to pregnancy care in the context of Zika virus transmission. It is not intended to provide a comprehensive practical guide for the prevention and management of Zika virus infections.
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  13. 13
    340832

    Provisional remarks on Zika virus infection in pregnant women: Document for health care professionals.

    Pan American Health Organization [PAHO]; World Health Organization [WHO]. Regional Office for the Americas

    Montevideo, Uruguay, PAHO, 2016 Jan 25. [22] p.

    The aim of this document is to provide health care professionals in charge of the care of pregnant women with updated information based on the best evidence available for the prevention of infection, timely diagnosis, suggested therapy and monitoring of pregnant women, and notification of cases to the competent health authorities. The information presented in this document was updated on January 22, 2016; it may be further altered if new evidence appears on the effects / consequences of Zika virus Infection in pregnant women and their children. New updates may also be found regularly at www.paho.org/viruszika. (Excerpt)
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  14. 14
    340711

    Guideline: Managing possible serious bacterial infection in young infants when referral is not feasible.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2015. [52] p.

    This guideline, developed by a panel of international experts and informed by a thorough review of existing evidence, contains a number of recommendations on the use of antibiotics for neonates (0–28 days old) and young infants (0–59 days old) with PSBI in order to reduce young infant mortality rates. The guideline is intended for use in resource-limited settings in situations when families do not accept or cannot access referral care. The goal of the guideline is to provide clinical guidance on the simplest antibiotic regimens that are both safe and effective for outpatient treatment of clinical severe infections and fast breathing (pneumonia) in children 0–59 days old. In addition, the guideline seeks to provide programmatic guidance on the role of CHWs and home visits in identifying signs of serious infections in neonates and young infants.
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  15. 15
    337933

    WHO recommendations on postnatal care of the mother and newborn. 2013.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2013 Oct. [72] p.

    The postnatal period is a critical phase in the lives of mothers and newborn babies. Most maternal and infant deaths occur during this time. Yet, this is the most neglected period for the provision of quality care. WHO guidelines on postnatal care have been recently updated based on all available evidence. The guidelines focus on postnatal care of mothers and newborns in resource-limited settings in low- and middle-income countries. The guidelines address timing, number and place of postnatal contacts, and content of postnatal care for all mothers and babies during the six weeks after birth. The primary audience for these guidelines is health professionals who are responsible for providing postnatal care to women and newborns, primarily in areas where resources are limited. The guidelines are also expected to be used by policy-makers and managers of maternal and child health programmes, health facilities, and teaching institutions to set up and maintain maternity and newborn care services. The information in these guidelines is expected to be included in job aids and tools for both pre- and in-service training of health professionals to improve their knowledge, skills and performance in postnatal care. These recommendations will be regularly updated as more evidence is collated and analysed on a continuous basis, with major reviews and updates at least every five years. The next major update will be considered in 2018 under the oversight of the WHO Guidelines Review Committee.
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  16. 16
    337932

    Postnatal care for mothers and newborns: Highlights from the World Health Organization 2013 guidelines.

    Maternal and Child Survival Program; World Health Organization [WHO]

    [Geneva, Switzerland], World Health Organization [WHO], 2015 Apr. [8] p. (WHO/RHR/15.05; USAID Leader with Associates Cooperative Agreement No. GHS-A-00-08-00002-00; USAID Cooperative Agreement No. AID-OAA-A-14-00028)

    This evidence brief provides highlights and key messages from World Health Organization’s 2013 Guidelines on Postnatal Care for Mothers and Newborns. These updated guidelines address the timing and content of postnatal care for mothers with a special focus on resource-limited settings in low- and middle-income countries. This brief is intended for policy-makers, programme managers, educators and providers who care for women and newborns after birth.
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  17. 17
    383476
    Peer Reviewed

    Assessment of clinico-immunological profile of newly diagnosed HIV patients presenting to a teaching hospital of eastern India.

    Bishnu S; Bandyopadhyay D; Samui S; Das I; Mondal P; Ghosh P; Roy D; Manna S

    Indian Journal of Medical Research. 2014 Jun; 139(6):903-12.

    BACKGROUND & OBJECTIVES: Newly diagnosed HIV patients may be asymptomatic or present with a wide range of symptoms related to opportunistic infections, acute seroconversion illness or other medical illnesses. This study was designed to evaluate the socio-demographic parameters, spectrum of the presenting clinical conditions and concurrent immunological status of newly diagnosed HIV patients and document the WHO clinical stages at the time of HIV diagnosis. METHODS: This cross-sectional, observational study was undertaken over a 12 month period at a tertiary referral hospital in eastern India. Three hundred sixty consecutive newly diagnosed HIV patients were selected for the study from the HIV clinic and medicine wards of this hospital. Demographic and clinical data and relevant laboratory investigations of the patients were recorded and analyzed. RESULTS: Mean age of patients was 36.38+/-10.62 yr, while 63.89 per cent were males. The main mode of transmission of HIV for males and females were unprotected exposure to commercial sex (139, 60.44%) and intercourse with HIV seropositive spouses (89, 68.46%), respectively. Fever (104, 28.89%), weight loss (103, 28.61%) and generalized weakness (80, 22.22%) were the predominant symptoms. Overall mean CD4 count was 176.04+/-163.49 cells/mul (males 142.19+/-139.33 cells/mul; females 235.92+/-185.11 cells/mul). Overall, 224 opportunistic infections were documented in 160 patients, opportunistic diarrhoea (44, 12.22%) and pulmonary tuberculosis (39, 10.83%) being the commonest. There were 83 and 133 patients in WHO clinical stages 3 and 4, respectively; 291 (80.83%) patients were eligible for initiation of first-line antiretrovirals at presentation. INTERPRETATION & CONCLUSIONS: Advanced immunodeficiency and burden of opportunistic infections characterize newly diagnosed HIV patients in eastern India. The physicians should keep in mind that these patients may have more than one clinical condition at presentation.
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  18. 18
    335420

    World malaria report 2013.

    World Health Organization [WHO]. Global Malaria Programme

    Geneva, Switzerland, WHO, 2013. [284] p.

    The World Malaria Report 2013 summarizes information received from malaria-endemic countries and other sources, and updates the analyses presented in the 2012 report. It highlights the progress made towards global malaria targets set for 2015, and describes current challenges for global malaria control and elimination.
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  19. 19
    335021

    Report of the Director General of the World Health Organization. Implementation of General Assembly resolution 66/289 on consolidating gains and accelerating efforts to control and eliminate malaria in developing countries, particularly in Africa, by 2015.

    World Health Organization [WHO]. Director-General

    [New York, New York], United Nations, General Assembly, 2013 Apr 5. [19] p. (A/67/825)

    The present report is submitted in response to General Assembly resolution 66/289. It provides a review of progress in the implementation of that resolution, focusing on the adoption and scaling-up of interventions recommended by the World Health Organization in 99 countries with ongoing malaria transmission and key challenges impeding progress, including a shortfall in financing for malaria control globally. It provides an assessment of progress towards the 2015 global malaria targets, including Millennium Development Goal 6, targets set through the African Union and the World Health Assembly and goals set through the Global Malaria Action Plan of the Roll Back Malaria Partnership. It elaborates on the challenges limiting the full achievement of the targets and provides recommendations to ensure that progress is accelerated up to and beyond 2015.
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  20. 20
    357340
    Peer Reviewed

    Challenges and priorities in the management of HIV/HBV and HIV/HCV coinfection in resource-limited settings.

    Easterbrook P; Sands A; Harmanci H

    Seminars In Liver Disease. 2012 May; 32(2):147-57.

    Liver disease due to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection is now emerging as an increasing cause of morbidity and mortality in human immunodeficiency virus- (HIV-) infected persons in resource-limited settings (RLS). Existing management guidelines have generally focused on care in tertiary level facilities in developed countries. Less than half of low-income countries have guidance, and in those that do, there are important omissions or disparities in recommendations. There are multiple challenges to delivery of effective hepatitis care in RLS, but the most important remains the limited access to antiviral drugs and diagnostic tests. In 2010, the World Health Assembly adopted a resolution calling for a comprehensive approach for the prevention, control, and management of viral hepatitis. We describe activities at the World Health Organization (WHO) in three key areas: the establishment of a global hepatitis Program and interim strategy; steps toward the development of global guidance on management of coinfection for RLS; and the WHO prequalification program of HBV and HCV diagnostic assays. We highlight key research gaps and the importance of applying the lessons learned from the public health scale-up of ART to hepatitis care. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
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  21. 21
    351893

    Confirmed malaria cases among children under five with fever and history of fever in rural western Tanzania.

    Mazigo HD; Meza W; Ambrose EE; Kidenya BR; Kweka EJ

    BMC Research Notes. 2011 Sep 13; 4(1):359-364.

    Background: The World Health Organization recommends that malaria treatment should begin with parasitological diagnosis. This will help to control misuse of anti-malarial drugs in areas with low transmission. The present study was conducted to assess the prevalence of parasitologically confirmed malaria among children under five years of age presenting with fever or history of fever in rural western Tanzania. A finger prick blood sample was obtained from each child, and thin and thick blood smears were prepared, stained with 10% Giemsa and examined under the light microscope. A structured questionnaire was used to collect each patient's demographic information, reasons for coming to the health center; and a physical examination was carried out on all patients. Fever was defined as axillary temperature = 37.5°C. Findings: A total of 300 children with fever or a history of fever (1 or 2 weeks) were recruited, in which 54.3% (163/300, 95%CI, 48.7-59.9) were boys. A total of 76 (76/300, 25.3%, 95%CI, 22.8 - 27.8) of the children had fever. Based on a parasitological diagnosis of malaria, only 12% (36/300, 95%CI, 8.3-15.7) of the children had P. falciparum infection. Of the children with P. falciparum infection, 52.7% (19/36, 95%CI, 47.1-58.3) had fever and the remaining had no fever. The geometrical mean of the parasites was 708.62 (95%CI, 477.96-1050.62) parasites/µl and 25% (9/36, 95%CI, 10.9 -39.1) of the children with positive P. falciparum had = 1001 parasites/µl. On Univariate (OR = 2.13, 95%CI, 1.02-4.43, P = 0.044) and multivariate (OR = 2.15, 95%CI, 1.03-4.49) analysis, only children above one year of age were associated with malaria infections. Conclusion: Only a small proportion of the children under the age of five with fever had malaria, and with a proportion of children having non-malaria fever. Improvement of malaria diagnostic and other causes of febrile illness may provide effective measure in management of febrile illness in malaria endemic areas.
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  22. 22
    351595
    Peer Reviewed

    [Clinical, epidemiological and microbiological characteristics of a cohort of pulmonary tuberculosis patients in Cali, Colombia] Caracteristicas clinicas, epidemiologicas y microbiologicas de una cohorte de pacientes con tuberculosis pulmonar en Cali, Colombia.

    Rojas CM; Villegas SL; Pineros HM; Chamorro EM; Duran CE; Hernandez EL; Pacheco R; Ferro BE

    Biomedica. 2010 Oct-Dec; 30(4):482-91.

    INTRODUCTION: The World Health Organization recommended strategy for global tuberculosis control is a short-course, clinically administered treatment, This approach has approximately 70% coverage in Colombia. OBJECTIVE: The clinical, epidemiological and microbiological characteristics along with drug therapy outcomes were described in newly diagnosed, pulmonary tuberculosis patients. MATERIALS AND METHODS: This was a descriptive study, conducted as part of a multicenter clinical trial of tuberculosis treatment. A cohort of 106 patients with pulmonary tuberculosis were recruited from several public health facilities in Cali between April 2005 and June 2006. Sputum smear microscopy, culture, drug susceptibility tests to first-line anti-tuberculosis drugs, chest X- ray and HIV-ELISA were performed. Clinical and epidemiological information was collected for each participant. Treatment was administered by the local tuberculosis health facility. Food and transportation incentives were provided during a 30 month follow-up period. RESULTS: The majority of patients were young males with a diagnostic delay longer than 9 weeks and a high sputum smear grade (2+ or 3+). The initial drug resistance was 7.5% for single drug treatment and 1.9% for multidrug treatments. The incidence of adverse events associated with treatment was 8.5%. HIV co-infection was present in 5.7% of the cases. Eighty-six percent of the patients completed the treatment and were considered cured. The radiographic presentation varied within a broad range and differed from the classic progression to cavity formation. CONCLUSION: Delay in tuberculosis diagnosis was identified as a risk factor for treatment compliance failure. The study population had similar baseline epidemiologic characteristics to those described in other cohort studies.
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  23. 23
    333326

    The Treatment 2.0 Framework for Action: Catalysing the next phase of treatment, care and support.

    World Health Organization [WHO]; Joint United Nations Programme on HIV / AIDS [UNAIDS]

    Geneva, Switzerland, WHO, 2011. [32] p.

    In June 2010, the UNAIDS Secretariat and WHO launched Treatment 2.0, an initiative designed to achieve and sustain universal access and maximize the preventive benefits of antiretroviral therapy (ART). Treatment 2.0 builds on '3 by 5' and the programmatic and clinical evidence and experience over the last 10 years to expand access to HIV diagnosis, treatment and care through a series of innovations in five priority work areas: drugs, diagnostics, costs, service delivery and community mobilization. The principles and priorities of Treatment 2.0 address the need for innovation and efficiency gains in HIV programmes, in greater effectiveness, intervention coverage and impact in terms of both HIV-specific and broader health outcomes. Since the launch of Treatment 2.0, the UNAIDS Secretariat and WHO have worked with other UNAIDS co-sponsoring organizations, technical experts and global partners to further elaborate and begin implementing Treatment 2.0. The Treatment 2.0 Framework for Action outlines the five priority work areas which comprise the core elements of the initiative and establishes a strategic framework to guide action within each of them over the next decade. The Framework for Action reflects commitments outlined in Getting to Zero: 2011 - 2015 Strategy, UNAIDS and the WHO Global Health-Sector Strategy on HIV, 2011 - 2015, the guiding strategies for the multi-sectoral and health-sector responses to the HIV pandemic. (Excerpt)
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  24. 24
    339305

    Engaging informal providers in TB control: what is the potential in the implementation of the WHO stop TB strategy? a discussion paper.

    Kaboru B; Uplekar M; Lonnroth K

    World Health and Population. 2011; 12(4):5-13.

    The World Health Organization (WHO) Stop TB Strategy calls for involvement of all healthcare providers in tuberculosis (TB) control. There is evidence that many people with TB seek care from informal providers before or after diagnosis, but very little has been done to engage these informal providers. Their involvement is often discussed with regard to DOTS (directly observed treatment - short course), rather than to the implementation of the comprehensive Stop TB Strategy. This paper discusses the potential contribution of informal providers to all components of the WHO Stop TB Strategy, including DOTS, programmatic management of multi-drug-resistant TB (MDR-TB), TB/HIV collaborative activities, health systems strengthening, engaging people with TB and their communities, and enabling research. The conclusion is that with increased stewardship by the national TB program (NTP), informal providers might contribute to implementation of the Stop TB Strategy. NTPs need practical guidelines to set up and scale up initiatives, including tools to assess the implications of these initiatives on complex dimensions like health systems strengthening.
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  25. 25
    332277

    Guidelines for the treatment of malaria. Second edition.

    World Health Organization [WHO]

    Geneva, Switzerland, WHO, 2010. [211] p.

    The World Health Organization Guidelines for the treatment of malaria provides evidence-based and up-to-date recommendations for countries on malaria diagnosis and treatment which help countries formulate their policies and strategies. In scope, the Guidelines cover the diagnosis and treatment of uncomplicated and severe malaria caused by all types of malaria, including in special groups (young children, pregnant women, HIV / AIDS), in travellers (from non-malaria endemic regions) and in epidemics and complex emergency situations. The first edition of the Guidelines for the treatment of malaria were published in 2006. The second edition introduces a new 5th ACT to the four already recommended for the treatment of uncomplicated malaria. Furthermore, the Guidelines recommend a parasitological confirmation of diagnosis in all patients suspected of having malaria before treating. The move towards universal diagnostic testing of malaria is a critical step forward in the fight against malaria as it will allow for the targeted use of ACTs for those who actually have malaria. This will help to reduce the emergence and spread of drug resistance. It will also help identify patients who do not have malaria, so that alternative diagnoses can be made and appropriate treatment provided. The new Guidelines will therefore help improve the management of not only malaria, but other childhood febrile illnesses.
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