scholarly journals World Health Organization treatment guidelines for drug-resistant tuberculosis, 2016 update

2017 ◽  
Vol 49 (3) ◽  
pp. 1602308 ◽  
Author(s):  
Dennis Falzon ◽  
Holger J. Schünemann ◽  
Elizabeth Harausz ◽  
Licé González-Angulo ◽  
Christian Lienhardt ◽  
...  
Keyword(s):  
World Health Organization ◽  
Treatment Guidelines ◽  
Lung Resection ◽  
Patient Data ◽  
World Health ◽  
Patient Treatment ◽  
Drug Resistant ◽  
Second Line ◽  
First Choice ◽  
Health Organization

Antimicrobial resistance is a major global concern. Tuberculosis (TB) strains resistant to rifampicin and other TB medicines challenge patient survival and public health. The World Health Organization (WHO) has published treatment guidelines for drug-resistant TB since 1997 and last updated them in 2016 based on reviews of aggregated and individual patient data from published and unpublished studies. An international expert panel formulated recommendations following the GRADE approach. The new WHO guidelines recommend a standardised 9–12 months shorter treatment regimen as first choice in patients with multidrug- or rifampicin-resistant TB (MDR/RR-TB) strains not resistant to fluoroquinolones or second-line injectable agents; resistance to these two classes of core second-line medicines is rapidly detectable with molecular diagnostics also approved by WHO in 2016. The composition of longer regimens for patients ineligible for the shorter regimen was modified. A first-ever meta-analysis of individual paediatric patient data allowed treatment recommendations for childhood MDR/RR-TB to be made. Delamanid is now also recommended in patients aged 6–17 years. Partial lung resection is a recommended option in MDR/RR-TB care. The 2016 revision highlighted the continued shortage of high-quality evidence and implementation research, and reiterated the need for clinical trials and best-practice studies to improve MDR/RR-TB patient treatment outcomes and strengthen policy.

scholarly journals Treatment of COVID-19 with Chloroquine: Implication for Malaria Chemotherapy Using ACTs in Disease Endemic Countries

2020 ◽  
Author(s):  
Neils Ben Quashie ◽  
Nancy Odurowah Duah-Quashie
Keyword(s):  
Intermittent Preventive Treatment ◽  
Preventive Treatment ◽  
World Health ◽  
Cross Resistance ◽  
Drug Resistant ◽  
Combination Therapies ◽  
Parasite Resistance ◽  
Demand And Supply ◽  
First Choice ◽  
Health Organization

Abstract Based on reports of parasite resistance and on World Health Organization recommendation, chloroquine was replaced with the artemisinin-based combination therapies (ACTs) as the first choice of drugs for the treatment of uncomplicated malaria. Disuse of chloroquine led to restoration of drug-sensitive parasite to some extent in certain countries. Ever since chloroquine and hydroxychloroquine were touted as potential treatment for coronavirus disease 2019 (COVID-19), there has been a dramatic surge in demand for the drugs. Even in areas where chloroquine is proscribed, there has been an unexpected increase in demand and supply of the drug. This situation is quite worrying as the indiscriminate use of chloroquine may produce drug-resistant parasites which may impact negatively on the efficacy of amodiaquine due to cross-resistance. Amodiaquine is a partner drug in one of the ACTs and in some of the drugs used for intermittent preventive treatment. We herein discuss the consequences of the escalated use of chloroquine in the management of COVID-19 on chemotherapy or chemoprevention of malaria and offer an advice. We speculate that parasite strains resistant to chloroquine will escalate due to the increased and indiscriminate use of the drug and consequently lead to cross-resistance with amodiaquine which is present in some drug schemes aforementioned. Under the circumstance, the anticipated hope of reverting to the use of the ‘resurrected chloroquine’ to manage malaria in future is likely to diminish. The use of chloroquine and its derivatives for the management of COVID-19 should be controlled.

scholarly journals Diagnosing isolated hepatosplenic tuberculosis in an immunocompetent patient: a case report

2018 ◽  
Vol 48 (3) ◽  
pp. 232-234
Author(s):  
Om Dawani ◽  
Raja Samir Khan ◽  
Mujtaba Jamal Syed ◽  
Abdul Moid Shehzad ◽  
Ahmed Alratoot ◽  
...  
Keyword(s):  
Case Report ◽  
Early Diagnosis ◽  
World Health Organization ◽  
Immunocompetent Patient ◽  
Clinical Suspicion ◽  
World Health ◽  
Drug Resistant ◽  
Health Organization ◽  
Specific Symptoms ◽  
Strong Suspicion

For many years, tuberculosis (TB) has been endemic in Pakistan; many rare and unusual presentations have been reported. There is a myriad of non-specific symptoms which always requires a high index of clinical suspicion for TB. World Health Organization data suggest that Pakistan ranks as the fifth highest country burdened with TB and has the fourth highest prevalence of multi-drug resistant TB globally. With an annual incidence of 277 cases per 100,000, the importance of early diagnosis and treatment is self-evident. We present a case where a strong suspicion of isolated hepatosplenic TB in an immunocompetent patient justified a directed approach.

scholarly journals Global Divergence From World Health Organization Treatment Guidelines for Neonatal and Pediatric Sepsis

2019 ◽  
Vol 38 (11) ◽  
pp. 1104-1106 ◽  
Author(s):  
Charlotte Jackson ◽  
Yingfen Hsia ◽  
Romain Basmaci ◽  
Julia Bielicki ◽  
Paul T. Heath ◽  
...  
Keyword(s):  
World Health Organization ◽  
Treatment Guidelines ◽  
World Health ◽  
Health Organization ◽  
Pediatric Sepsis

scholarly journals Directrices unificadas de la OMS sobre el tratamiento de la tuberculosis farmacorresistente

2020 ◽  
Keyword(s):  
World Health Organization ◽  
Tuberculosis Treatment ◽  
World Health ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Health Organization

Estas directrices unificadas se han actualizado con arreglo a los procesos del grupo de elaboración de las directrices que se llevaron a cabo entre el 2011 y el 2018 de conformidad con los requisitos de la OMS. Este documento sustituye a otras recomendaciones de la OMS relativas al tratamiento de la tuberculosis (TB) multirresistente y resistente a la rifampicina (TB-MDR/RR) publicadas desde el 201. En este documento se incluyen las preguntas sobre población, intervención, comparador y resultado (PICO, por su sigla en inglés) subyacentes a las recomendaciones y la posología revisada de los medicamentos utilizados en los esquemas de segunda línea, así como las referencias clave. En línea se puede encontrar más información sobre los procesos del grupo de elaboración de las directrices y los participantes en dicho grupo, los principales métodos utilizados para desarrollar las recomendaciones, los resúmenes de la evidencia de la clasificación de la valoración, elaboración y evaluación de las recomendaciones (GRADE por su sigla en inglés) resultante y los marcos de decisión para cada recomendación, así como datos inéditos, planes de análisis de datos e informes de revisiones sistemáticas. Las recomendaciones y demás información práctica para apoyar su implementación se reproducirán en una próxima actualización del manual de la OMS sobre el manejo programático de la TB. Versión oficial en español de la obra original en inglés: WHO consolidated guidelines on drug-resistant tuberculosis treatment. © World Health Organization 2019. ISBN: 978-92-4-155052-9.

scholarly journals World Health Organization Generic Protocol to Assess Drug-Resistant HIV Among Children <18 Months of Age and Newly Diagnosed With HIV in Resource-Limited Countries

2012 ◽  
Vol 54 (suppl_4) ◽  
pp. S254-S260 ◽  
Author(s):  
Silvia Bertagnolio ◽  
Martina Penazzato ◽  
Michael R. Jordan ◽  
Deborah Persaud ◽  
Lynne M. Mofenson ◽  
...  
Keyword(s):  
World Health Organization ◽  
World Health ◽  
Drug Resistant ◽  
Newly Diagnosed ◽  
Resource Limited ◽  
Health Organization

scholarly journals Investigating the Effectiveness of Current and Modified World Health Organization Guidelines for the Control of Soil-Transmitted Helminth Infections

2018 ◽  
Vol 66 (suppl_4) ◽  
pp. S253-S259 ◽  
Author(s):  
Sam H Farrell ◽  
Luc E Coffeng ◽  
James E Truscott ◽  
Marleen Werkman ◽  
Jaspreet Toor ◽  
...  
Keyword(s):  
World Health Organization ◽  
Large Scale ◽  
Treatment Guidelines ◽  
World Health ◽  
Who Guidelines ◽  
Preventive Chemotherapy ◽  
Treatment Frequency ◽  
School Aged Children ◽  
Ancylostoma Duodenale ◽  
Health Organization

Abstract Background Considerable efforts have been made to better understand the effectiveness of large-scale preventive chemotherapy therapy for the control of morbidity caused by infection with soil-transmitted helminths (STHs): Ascaris lumbricoides, Trichuris trichiura, and the 2 hookworm species, Necator americanus and Ancylostoma duodenale. Current World Health Organization (WHO) guidelines for STH control include mass drug administration (MDA) programs based on prevalence measurements, aiming at reducing morbidity in pre–school-aged children (pre-SAC) and school-aged children (SAC) by lowering the prevalence of moderate- to heavy-intensity infections to <1%. Methods We project the likely impact of following the current WHO guidelines and assess whether the WHO morbidity goals will be achieved across a range of transmission settings. We also investigate modifications that could be made to the current WHO treatment guidelines, and project their potential impacts in achieving morbidity and transmission control. Results While the standard guidelines are sufficient at low transmission levels, community-wide treatment (ie, involving pre-SAC, SAC, and adults) is essential if WHO morbidity goals are to be met in moderate- to high-transmission settings. Moreover, removing the recommendation of decreasing the treatment frequency at midline (5–6 years after the start of MDA) further improves the likelihood of achieving morbidity control in SAC. Conclusions We meld analyses based on 2 mathematical models of parasite transmission and control by MDA for the dominant STH species, to generate a unified treatment approach applicable across all settings, regardless of which STH infection is most common. We recommend clearly defined changes to the current WHO guidelines.

scholarly journals The future of drug-resistant tuberculosis treatment: learning from the past and the 2019 World Health Organization consolidated guidelines

2019 ◽  
Vol 54 (4) ◽  
pp. 1901272 ◽  
Author(s):  
José A. Caminero ◽  
Alberto L. García-Basteiro ◽  
Adrián Rendon ◽  
Alberto Piubello ◽  
Emanuele Pontali ◽  
...  
Keyword(s):  
World Health Organization ◽  
Tuberculosis Treatment ◽  
World Health ◽  
Drug Resistant ◽  
Drug Resistant Tuberculosis ◽  
The Past ◽  
Resistant Tuberculosis ◽  
The Future ◽  
Health Organization
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