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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46721

RESUMO

Semana Mundial de Aleitamento Materno, celebrada entre 1 e 7 de agosto, a Organização Pan-Americana da Saúde/Organização Mundial da Saúde (OPAS/OMS), o Ministério da Saúde do Brasil e a Sociedade Brasileira de Pediatria (SBP) se uniram em Brasília (DF) para reforçar a importância da amamentação não só para as crianças e para suas mães, mas para a sociedade como um todo.


Assuntos
Leite Humano , Saúde Materno-Infantil , Atenção Primária à Saúde , Nações Unidas , Organização Mundial da Saúde
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde | ID: lis-LISBR1.1-46680

RESUMO

A Organização Mundial da Saúde (OMS) tem metas ambiciosas para 2019. Entre os objetivos da agência da ONU, está a ampliação do acesso e da cobertura de saúde para atender a 1 bilhão a mais de pessoas na comparação com números atuais. A instituição também quer garantir que 1 bilhão de indivíduos estejam protegidos de emergências de saúde. Para tirar essas resoluções do papel, a OMS estipulou dez prioridades para o ano que se inicia.


Assuntos
Metas , Nações Unidas , Organização Mundial da Saúde
6.
J Glob Health ; 9(1): 010423, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31263546

RESUMO

Background: Tuberculosis (TB) is a major global health burden, which has been inadequately addressed. This study aims to analyze different patterns and gaps of care along the care cascade across countries and to develop a model to examine the relationship between performance of tuberculosis programmes in high and low burden countries along the tuberculosis care cascade and tuberculosis disease burden. Methods: We used the World Health Organization's Global TB Database for the year 2016 to construct tuberculosis care cascade consisting of four steps: incidence, diagnosed, treatment started and treatment completed. Based on the constructed care cascades, we analyzed the relationship between health system performance indicators and tuberculosis cascades performance: diagnosed rate, treatment started rate, and treatment completed rate. Results: There are wide differences in access to diagnosis and treatment between high-burden countries and non-high-burden countries. The largest gap was found between incidence and diagnosed rate, with 65% of diagnosed rate for high burden countries and 80% of diagnosed rate for non-high burden countries. We found variations in care performance among high-burden countries. We found a negative relationship between the population health indicators related to the mortality rate and TB care cascade performance. There was a positive relationship between immunization coverage rate and antenatal care indicators and TB care cascade performance. Conclusions: Well-functioning tuberculosis care cascades and effective health systems are important for the successful management of tuberculosis. While improving screening performance is essential for tuberculosis control especially for high-burden countries, resource should be allocated to improve health system performance, which is weak in high-burden countries. Performance of TB programmes across care cascade could be used as a useful tracer to measure performance of health systems.


Assuntos
Assistência à Saúde/organização & administração , Saúde Global/estatística & dados numéricos , Tuberculose/prevenção & controle , Bases de Dados como Assunto , Acesso aos Serviços de Saúde/estatística & dados numéricos , Humanos , Incidência , Modelos Organizacionais , Avaliação de Programas e Projetos de Saúde , Tuberculose/epidemiologia , Organização Mundial da Saúde
7.
J Glob Health ; 9(1): 010801, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31263547

RESUMO

Background: In 2013, the World Health Organization (WHO) launched the Rapid Access Expansion (RAcE) programme in the Democratic Republic of Congo, Malawi, Mozambique, Niger, and Nigeria to increase coverage of diagnostic, treatment, and referral services for malaria, pneumonia, and diarrhea among children ages 2-59 months. In 2017, a final evaluation of the six RAcE sites was conducted to determine whether the programme goal was reached. A key evaluation objective was to estimate the reduction in childhood mortality and the number of under-five lives saved over the project period in the RAcE project areas. Methods: The Lives Saved Tool (LiST) was used to estimate reductions in all-cause child mortality due to changes in coverage of treatment for the integrated community case management (iCCM) illnesses - malaria, pneumonia, and diarrhea - while accounting for other changes in maternal and child health interventions in each RAcE project area. Data from RAcE baseline and endline household surveys, Demographic and Health Surveys, and routine health service data were used in each LiST model. The models yielded estimated change in under-five mortality rates, and estimated number of lives saved per year by malaria, pneumonia and diarrhea treatment. We adjusted the results to estimate the number of lives saved by community health worker (CHW)-provided treatment. Results: The LiST model accounts for coverage changes in iCCM intervention coverage and other health trends in each project area to estimate mortality reduction and child lives saved. Under five mortality declined in all six RAcE sites, with an average decline of 10 percent. An estimated 6200 under-five lives were saved by malaria, pneumonia, and diarrhea treatment in the DRC, Malawi, Niger, and Nigeria, of which approximately 4940 (75 percent) were saved by treatment provided by CHWs. This total excludes Mozambique, where there were no estimated under-five lives saved likely due to widespread stockouts of key medications. In all other project areas, lives saved by CHW-provided treatment contributed substantially to the estimated decline in under-five mortality. Conclusions: Our results suggest that iCCM is a strategy that can save lives and measurably decrease child mortality in settings where access to health facility services is low and adequate resources for iCCM implementation are provided for CHW services.


Assuntos
Administração de Caso/organização & administração , Mortalidade da Criança/tendências , Serviços de Saúde Comunitária/organização & administração , Prestação Integrada de Cuidados de Saúde , Acesso aos Serviços de Saúde/organização & administração , Mortalidade Infantil/tendências , Pré-Escolar , República Democrática do Congo/epidemiologia , Diarreia/mortalidade , Diarreia/terapia , Humanos , Lactente , Malária/mortalidade , Malária/terapia , Malaui/epidemiologia , Moçambique/epidemiologia , Níger/epidemiologia , Nigéria/epidemiologia , Pneumonia/mortalidade , Pneumonia/terapia , Avaliação de Programas e Projetos de Saúde , Organização Mundial da Saúde
8.
MMWR Morb Mortal Wkly Rep ; 68(26): 587-591, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31269012

RESUMO

All six World Health Organization (WHO) regions have established measles elimination goals, and three regions have a rubella elimination goal. Each region has established a regional verification commission to monitor progress toward measles elimination, rubella elimination, or both, and to provide verification of elimination* (1,2). To verify elimination, high-quality case-based surveillance is essential, including laboratory confirmation of suspected cases and genotyping of viruses from confirmed cases to track transmission pathways. In 2000, WHO established the Global Measles and Rubella Laboratory Network (GMRLN) to provide high-quality laboratory support for surveillance for measles, rubella, and congenital rubella syndrome (3). GMRLN is the largest globally coordinated laboratory network, with 704 laboratories supporting surveillance in 191 countries (4). This report updates a previous report and describes the genetic characterization of measles and rubella viruses during 2016-2018 (5). The genetic diversity of measles viruses (MeVs) and rubella viruses (RuVs) has decreased globally following implementation of measles and rubella elimination strategies. Among 10,857 MeV sequences reported to the global Measles Nucleotide Surveillance (MeaNS) database during 2016-2018, the number of MeV genotypes detected in ongoing transmission decreased from six in 2016 to four in 2018. Among the 1,296 RuV sequences submitted to the global Rubella Nucleotide Surveillance (RubeNS) database during the same period, the number of RuV genotypes detected decreased from five in 2016 to two in 2018. To strengthen laboratory surveillance for measles and rubella elimination, specimens should be collected from all confirmed cases for genotyping, and sequences from all wild-type measles and rubella viruses should be submitted to MeaNS and RubeNS in a timely manner.


Assuntos
Erradicação de Doenças , Saúde Global/estatística & dados numéricos , Vírus do Sarampo/genética , Sarampo/prevenção & controle , Vigilância da População , Vírus da Rubéola/genética , Rubéola (Sarampo Alemão)/prevenção & controle , Bases de Dados Factuais , Genótipo , Metas , Humanos , Laboratórios , Sarampo/epidemiologia , Vírus do Sarampo/isolamento & purificação , Rubéola (Sarampo Alemão)/epidemiologia , Vírus da Rubéola/isolamento & purificação , Organização Mundial da Saúde
9.
Acta Gastroenterol Belg ; 82(2): 329-332, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31314198

RESUMO

Colorectal cancer is one of the most commonly diagnosed cancers in the world. It is a heterogeneous disease with several histologic subtypes, and some of them are associated with adverse prognostic factors. Cribriform comedo-type adenocarcinoma (CCA) has been included as a colorectal adenocarcinoma subtype in the last World Health Organization (WHO) classification of gastrointestinal system tumors. Some authors have linked this subtype to an adverse prognosis, but to the best of our knowledge there is only one previous report assessing its histologic and prognostic features. We herein review a series of CCA of the colon, emphasizing its clinical and morphological features.


Assuntos
Adenocarcinoma , Neoplasias Colorretais , Adenocarcinoma/patologia , Neoplasias Colorretais/classificação , Neoplasias Colorretais/patologia , Humanos , Prognóstico , Organização Mundial da Saúde
14.
Clin Biochem ; 71: 58-66, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31295477

RESUMO

OBJECTIVES: Replacements are required for the WHO International Standards (IS) for free PSA, coded 96/668 and total PSA (90:10), coded 96/670, which were established in 1999 to support efforts to harmonise PSA assays and address non-equimolarity. An important consideration is that the introduction of the replacements should have minimal impact on PSA measurements. DESIGN AND METHODS: We report the development of a replacement strategy, informed by field assessment of preparations through an external quality assessment scheme and the subsequent evaluation of the candidate ISs in worldwide collaborative studies. RESULTS: By immunoassay, data from participants confirmed the value assigned to the current standards. Robust geometric mean estimates of the free PSA content of the candidate replacement for 96/668 coded 17/102 was 0.533 µg/ampoule (n = 21). The ratio of the content estimates of 17/102:96/668 was 0.516 (GCV 12.5%, n = 21). Robust geometric mean estimates of the total PSA content of the candidate replacement for 96/670, coded 17/100, was 0.505 µg/ampoule (n = 22). The ratio of the content estimates of 17/100:96/670 was 0.490 (GCV 5.3%, n = 22). Through concomitant measurement of a panel of 15 representative patient samples, the candidate ISs were shown to exhibit commutability with patient samples that was comparable with that of the current ISs. CONCLUSION: On the basis of these results, the preparations coded 17/102 and 17/100 were established by the WHO Expert Committee on Biological Standardization as the 2nd ISs for free and total PSA (PSA-ACT+free PSA) respectively, with assigned contents of 0.53 µg/ampoule and 0.50 µg/ampoule.


Assuntos
Antígeno Prostático Específico/normas , Humanos , Padrões de Referência , Organização Mundial da Saúde
18.
J Assoc Physicians India ; 67(4): 30-34, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31299835

RESUMO

Introduction: Dengue fever management is guided by WHO guideline, the recent one being 2009; however, compliance to the guideline is difficult to assess and in India there is no data on it. The present study, a longitudinal pre-post interventional quality improvement study, was done to determine the compliance to the guideline on dengue patients before and after resident physicians' training during two peak seasons and their impact on survival. Methods: This study was conducted in a tertiary health care centre in North India over 18 months. Data of hospitalized patients who admitted with dengue fever diagnosis in a peak season was collected in the form of quality indicators as described by the WHO-2009 guideline on dengue. Resident physicians were then given appropriate training about the guideline during the off season. Data of new dengue patients in next peak season after resident training was collected and compared with the baseline by standard statistical tests. Results: The post-intervention compliances of all components increased (total mean score by giving one point to each of the quality indicators reached 7.9 from 6.4). The compliance to individual indicator also increased: the admission criteria (baseline, 44% to post-intervention, 52%, p = 0.37), classification criteria (91.7% to 96%, p = 0.33), correct staging/triage (42.9% to 86%, p <0.001), vitals monitoring (85.7% to 92%, p = 0.28), correct usage of bolus fluids (34.3% to 69.5%, p <0.001), crystalloid as choice of fluid (100% in both groups), proper fluid titration (26.2% to 56%, p <0.001), hematocrit monitoring (95.2% to 98%, p = 0.42), platelet transfusion when indicated (65.5% to 58%, p = 0.39), antibiotic use when required (61.5% to 80%, p = 0.03), and discharge criteria (100% in both groups). The mortality decreased from 7.1% (baseline) to zero (post-intervention). The median duration of hospital stay also reduced by 1 day. Conclusion: The study affirms that the compliance to WHO guideline on dengue management in India can be further improved by regular physician training on the guideline. Simultaneously, this educational intervention not only improves patient outcomes but also direct proper resource utilization especially platelet transfusion and antibiotic use. Furthermore, every hospital/institute should have an internal quality improvement program like this to improve the management of dengue patients. Future studies are needed to understand various barriers to 100% implementation of the guideline.


Assuntos
Dengue/terapia , Cooperação do Paciente , Melhoria de Qualidade , Fidelidade a Diretrizes , Guias como Assunto , Hospitais , Humanos , Índia , Organização Mundial da Saúde
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