Recommendations for Prevention and Treatment of Maternal Peripartum Infections
This brief provides highlights and key messages from World Health Organization’s recommendations for prevention and treatment of maternal peripartum infections, including policy and program implications for translating the guidelines into action at the country level. The ultimate goal of the WHO recommendations is to improve quality of care and to reduce preventable death and disability associated with peripartum infection for mothers and newborns. This brief (see – http://bit.ly/1L8O1Zv) is intended for policy-makers, programme managers, educators and providers. See the guidelines at http://apps.who.int/iris/bitstream/10665/186171/1/9789241549363_eng.pdf?ua=1
The International Fetal and Newborn Growth Consortium for the 21st Century, or INTERGROWTH-21st, is a global, multidisciplinary network of more than 300 researchers and clinicians from 27 institutions in 18 countries worldwide and coordinated from the University of Oxford. It is dedicated to improving perinatal health globally and committed to reducing the millions of preventable newborn deaths that occur as a result of preterm birth or poor intrauterine growth.
This website provides clinicians and researchers access to the INTERGROWTH-21st Global Perinatal Package. This package is comprised of new, globally-validated standards and practical training resources. The following standards are available todownload now:
Guinea worm disease nears eradication
Guinea worm disease, or dracunculiasis, is a parasitic disease caused by the nematode worm Dracunculus medinensis. People become infected when they drink water contaminated with copepods (water fleas), which are the vector of the disease. When the copepods are dissolved by gastric juice, larvae of dracunculus are released, and penetrate the stomach or intestine. Mating between male and female worms occurs in connective tissue about 3 months after infection, after which male worms die. Female worms migrate, usually to lower limbs, about 8–10 months after infection. Emergence of the worm through the skin to shed larvae causes an intense burning and itching sensation. Patients may try to relieve symptoms by immersing the lesion in water sources that are also used for drinking, which in turn allows larvae to infect copepods and continue the life-cycle. The disease is seldom fatal, but the only form of patient management is the slow extraction of the emerging female worm by winding it around a stick, which can take weeks during which time the patient may be too incapacitated to carry on activities of daily living.
Africa was once plagued with guinea worm disease, but it began to disappear as water treatment improved. Even in 1986 there were an estimated 3·5 million cases annually. However, the past 30 years have seen a decline in cases to just 22 in 2015. Only four countries are now affected: Chad, Ethiopia, Mali, and South Sudan (5 cases). There is no drug treatment or vaccination – only simple effective preventive measures which include stopping people from drinking water contaminated with copepods by providing safe water sources, filtering water through a fine mesh, boiling, or treating water sources with a larvicide to kill copepods. People with emerging guinea worms are prevented from entering water sources by community level case detection and guarding water supplies.
The Carter Center has coordinated funding, persuaded companies to donate larvicides and materials for water filters, liaised with governments, and even organised a 6 month “guinea worm cease fire” during Sudan's civil war.
See http://www.cartercenter.org/health/guinea_worm/index.html and The Lancet Infectious Diseases http://dx.doi.org/10.1016/S1473-3099(16)00020-7
Option B+ Monitoring & evaluation framework for antiretroviral treatment for pregnant and breastfeeding women living with HIV and their infants
Over the past decade, Prevention of Mother to Child HIV Transmission (PMTCT) programmes have rapidly evolved from delivering a single prophylactic drug to mothers to providing lifelong care and treatment for both mothers and children living with HIV. Lifelong treatment approaches-widely known as 'Option B+'-are expanding from pilots to universal implementation as revised national treatment guidelines are scaled up across generalized epidemic settings. This resource is intended for use among national M&E officers; PMTCT, paediatric, MNCH and HIV Care and Treatment programme managers; and other stakeholders (including donors, implementing partners, and civil society) in countries with generalized HIV epidemics and countries implementing the Option B/B+ approach to treatment. Using this framework, stakeholders can review, adapt and update current monitoring systems and continuously evaluate programmes, maximizing the potential impact of lifelong treatment programs to improve health outcomes and prevent HIV infections for women, their children and their families.