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Geneva, Switzerland, WHO, 2013 Oct.  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.
WHO global strategy for the prevention and control of sexually transmitted infections: Time for action.
Sexually Transmitted Infections. 2007; 83:508-509.Worldwide, sexually transmitted infections (STIs) continue to be a major cause of morbidity and mortality. Global estimates suggest that more than 340 million new cases of syphilis, gonorrhoea, chlamydial infection and trichomoniasis occurred throughout the world in 1999. Congenital syphilis, prevention of which is relatively easy and cost-effective, may still be responsible for as many as 14% of neonatal deaths. Up to 10% of those women who are untreated, or inadequately treated, for chlamydial and gonococcal infections may become infertile as a consequence. On a global scale, up to 4000 newborn babies each year may become blind because of gonococcal and chlamydial ophthalmia neonatorum. There is evidence that STIs may enhance both the transmission and acquisition of HIV infection, and that improved control of STIs may slow down HIV transmission. The prevention and control of STIs is not an easy task. Epidemiological patterns of STIs vary geographically and are influenced by cultural, political, economical and social forces. Many affected by STIs are in marginalised vulnerable groups. The asymptomatic nature of some STIs remains a challenge to healthcare providers in areas of the world where laboratory screening tests are unaffordable. (excerpt)
Assessment of ultrasound morbidity indicators of schistosomiasis in the context of large-scale programs illustrated with experiences from Malian children.
American Journal of Tropical Medicine and Hygiene. 2006 Dec; 75(6):1042-1052.We assessed morbidity indicators for both Schistosoma haematobium and Schistosoma mansoni infections and evaluated the appropriateness of the World Health Organization (WHO) guidelines for ultrasound in schistosomiasis in the context of large-scale control interventions. Abdominal and urinary tract ultrasonography was performed on 2,247 and 2,822 school children, respectively, from 29 randomly selected schools in Mali before the implementation of mass anthelminthic drug administration. Using two-level logistic regression models, we examined associations of potential factors with the risk of having a positive ultrasound global score (morbidity indicative of S. haematobium infection), abnormal image pattern scores, dilatation of the portal vein, and/or enlarged liver (morbidity indicative of S. mansoni infection). The WHO protocol was found useful for detection of S. haematobium pathology but overestimated the risk of portal vein dilatation and left liver lobe enlargement associated with S. mansoni infection. We conclude that ultrasonography should be included in large-scale control interventions, where logistics allow, but cautiously. (author's)
Emerging Infectious Diseases. 2006 Sep; 12(9):1311-1318.Most high-income countries implement tuberculosis (TB) infection control programs to reduce the risk for nosocomial transmission. However, such control programs are not routinely implemented in India, the country that accounts for the largest number of TB cases in the world. Despite the high prevalence of TB in India and the expected high probability of nosocomial transmission, little is known about nosocomial and occupational TB there. The few available studies suggest that nosocomial TB may be a problem. We review the available data on this topic, describe factors that may facilitate nosocomial transmission in Indian healthcare settings, and consider the feasibility and applicability of various recommended infection control interventions in these settings. Finally, we outline the critical information needed to effectively address the problem of nosocomial transmission of TB in India. (author's)
Manila, Philippines, WHO, Regional Office for the Western Pacific, 2004. 44 p.This framework, which draws on the Global strategic framework to reduce the burden of TB/HIV and on the Guidelines for phased implementation of collaborative TB and HIV activities, was developed based on the following two premises. First, the National TB Programme (NTP) needs to address the impact of HIV, i.e. higher caseload of TB and increasing drug-resistant TB, and to mobilize resources related to TB/HIV activities. Second, the National AIDS Programme (NAP) needs to prolong the life and reduce the suffering of PHA through better management of TB, and to mobilize resources for TB/HIV. The Regional framework is built on the strengths of the individual National TB and AIDS Programmes, and identifies areas in which both programmes complement each other in addressing TB/HIV. This approach is considered useful, not only for countries with a relatively high prevalence of HIV, such as Cambodia, but also for most of countries in the Region that are faced with a relatively low prevalence of HIV. The scope of the Regional framework comprises interventions against tuberculosis (intensified case- finding and cure and tuberculosis preventive treatment) and interventions against HIV (and therefore indirectly against tuberculosis), e.g. comprehensive prevention, care and support, including condoms, sexually transmitted infection (STI) treatment, safe injecting drug use (IDU) and antiretroviral (ARV) treatment. Key components of the Regional framework are: surveillance; diagnosis and referral, including voluntary counselling and testing (VCT) for HIV; interventions; and, areas of collaboration. The framework outlines the roles of the individual TB and HIV/AIDS programmes (i.e. “who does what”) and provides examples of how to operationalize the different components. (excerpt)