Community based interventions for the prevention and control of tuberculosis

Infectious Diseases of Poverty is an open access peer-reviewed journal publishing articles around essential public health questions relating to infectious diseases of poverty.

Abstract

In 2012, an estimated 8.6 million people developed tuberculosis (TB) and 1.3 million died from the disease. With its recent resurgence with the human immunodeficiency virus (HIV); TB prevention and management has become further challenging. We systematically evaluated the effectiveness of community based interventions (CBI) for the prevention and treatment of TB and a total of 41 studies were identified for inclusion. Findings suggest that CBI for TB prevention and case detection showed significant increase in TB detection rates (RR: 3.1, 95% CI: 2.92, 3.28) with non-significant impact on TB incidence. CBI for treating patients with active TB showed an overall improvement in treatment success rates (RR: 1.09, 95% CI: 1.07, 1.11) and evidence from a single study suggests significant reduction in relapse rate (RR: 0.26, 95% CI: 0.18, 0.39). The results were consistent for various study design and delivery mechanism. Qualitative synthesis suggests that community based TB treatment delivery through community health workers (CHW) not only improved access and service utilization but also contributed to capacity building and improving the routine TB recording and reporting systems. CBI coupled with the DOTS strategy seem to be an effective approach, however there is a need to evaluate various community-based integrated delivery models for relative effectiveness.

Keywords: Community-based interventions; Tuberculosis; DOTS; integrated delivery; CHWs

http://www.idpjournal.com/content/3/1/27?utm_campaign=&utm_medium=BMCemail&utm_source=Teradata

Des interventions infirmières et des sages-femmes pour la prévention des maladies non transmissibles (NCDs)

Nombreuses interventions existent pour pour faire face aux maladies non transmissibles (Non-Communicable Diseases ou NCDs en anglais) et celles-ci sont bien connues.

Afin d’ intensifier l’action, la participation des infirmières et des sages-femmes, qui représentent la plus grande catégorie de professionnels de la santé dans la plupart des pays, est essentielle.

L’expérience montre que les  interventions issues des soins infirmiers  et obstétricaux pour les NCDs peuvent aller au-delà de la prévention et du traitement et qu’elle peuvent inclure la promotion de la santé.

Ce document, publié par l’OMS, présente les interventions infirmières et des sages-femmes  pour la prévention des NCDs et le rôle que celles-ci jouent au niveau politique, de la recherche, du plaidoyer, de l’éducation  et dans la pratique.

Enhancing nursing and midwifery capacity to contribute to the prevention, treatment and management of noncommunicable diseasesHuman Resources for Health Observer – Issue No. 12

Accéder au document sur la page de l’OMS

Répondre à la pénurie mondiale de professionnels de la santé à travers le E-learning

 Sur mandat de l'Organisation mondiale de la Santé (OMS), des chercheurs de l'Imperial College de Londres ont mené une revue systématique de la littérature afin d'établir des données probantes à propos du E-Learning en tant que méthode d'apprentissage pour la formation de base des professionnels de la santé.

Les résultats, tirés d'un total de 108 études , ont montré que par l'apprentissage E-learning (en ligne et hors ligne) les élèves acquièrent des connaissances et des compétences aussi bien ou mieux par rapport à l'enseignement traditionnel.

Selon cette recherche, le E-learning pourrait permettre à des millions d'étudiants autour du monde de se former en tant que infirmiers/ères  ou médecins

Accéder à la page du site de l’OMS (en anglais)

Prévention du suicide: L’état d’urgence global

Le suicide  est devenu la deuxième cause de mortalité au niveau mondial chez les jeunes (15-29 ans)

L’OMS a publié pour la première fois un rapport concernant le suicide. Ce rapport présente l’épidémiologie et les facteurs de risque du suicide au niveau mondial, il fait l’état des lieux des connaissances actuelles en matière de prévention et donne des pistes pour la mise en place de stratégies nationales de prévention du suicide au niveau mondial. 

Le rapport Prévention du suicide: l’état d’urgence global, OMS, 2014 peut être téléchargé  sur le site

accéder au site Prévention du suicide de l’OMS

The great gap in health outcomes for African Americans

On April 28th QUARZ reported about health outcomes of the population of Baltimore, Maryland, where African Americans represent 64% of the city population.

In spite of having the same figures in term of health insurance coverage than the white population, African Americans have lower life expectancy, higher infant mortality rate, higher rate of low birth weight and higher  mortality rate from cardio-vascular diseases. African Americans have a ten fold increased risk of getting infected with HIV/AIDS and are five times more likely to die from the disease than white people.

access QUARZ post

Inégalités en santé et minorités ethniques

Autour du monde, l’état de santé des personnes issues de minorités ethniques est moins bon comparé au reste de la population. Les soins de santé accessibles à ces populations sont de moins bonne qualité.

A travers son  rapport 2013, le Minority Rights Group International décrit  les facteurs contribuant aux inégalités en santé et propose des pistes d’intervention afin que les pays puissent mieux répondre aux besoins de l’ensemble de leur population.

accéder à la page ONU web : droits des minorités 

NCD initiatives

In 2011 WHO organized the First global ministerial conference on healthy lifestyles and NCDs control. Based on The Global strategy for the prevention and control of NCDs and its action plan, the conference aimed at supporting Member States to develop and strengthen policies and programmes on healthy lifestyles and NCD prevention. 

The forum report describes the objectives, content and the meeting  outcomes  that would help to move NCD prevention and control forward ( p.19) Here are some key outcomes:

−There was broad agreement that NCD prevention and control is critical to national development (health, social and economic) and effective development cannot occur without addressing NCDs.

– Better epidemiological surveillance of NCDs is critical to demonstrate the extent of the problem and empower government action based on evidence and to monitor progress.

Health systems strengthening, including adequate and well-trained supply of health worker, should focus on integration across disease areas and particularly on community-based primary health care.

Implementing the agreed ‘best buys’, e.g. raising taxes on tobacco and alcohol are key opportunities to reduce risk factors and, potentially, generate revenue that can be used to tackle NCDs

 

The tremendous gap in death rates due to NCD

Non communicable diseases (NCD), such as diabetes, cardiovascular diseases, cancer, and chronic respiratory diseases represent a new epidemic worldwide.

NCD kill more than 36 million people each year. Nine million of all deaths attributed to NCD occur before the age of 60; 90% of these “premature” deaths occurred in low- and middle-income countries. (WHO fact sheet)

The difference in death rates due to NCD between countries shows once again the major inequities existing around the world  in term of access to prevention and treatment services for the population, for the same diseases.

WHO’s interactive map shows the NCD death rates around the world. access map here

Switzerland :292/100.000 population   USA:  413/100.000

Swaziland: 702/100.000   Haiti: 725/100.000   Laos 680.000/100.000

http://www.who.int/mediacentre/factsheets/fs355/en/