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世卫组织结婚纲要促进了对受TB影响影响的所有人提供高质量护理http://ow.ly/VzsM30iO8sO
结核病是一个全球公共卫生的ty, with 10.4 million people developing the disease in 2016 (10% among HIV co-infected individuals), 1.67 million deaths and 490 000 multidrug-resistant (MDR) plus an additional 110 000 rifampicin-resistant cases [1]。
2014年,世界卫生组织(WHO)推出了结束结核病战略[1] within the framework of the United Nations Sustainable Development Goals (SDGs). The new strategy was designed to be consistent with the preceding WHO-recommended strategies for TB care and control [2]:DOTS策略(于1994年推出,通过标准化解决流行病的要求,为有效的TB护理和管理活动创造了有效的TB护理和管理活动的基础,而停止结核病战略(于2006年推出,旨在解决新兴优先事项,如MDR-TB和TB / HIV共同感染)。
为了终止结核病疫情(t之一he SDG targets) several interventions need to be implemented. They include the core anti-TB interventions (diagnosis, treatment and prevention), which are described under Pillar I of the Strategy; and several socioeconomic and public health interventions, which are often under the responsibility of ministries other than the ministry of health (e.g.economy, finance, interior or justice) and are presented under Pillar II. Intensified research activities and innovation are covered by Pillar III.
结束结核病战略的多维干预及其对TB流行病的潜在影响figure 1那and apply to both high and low TB and HIV burden settings. In countries at low TB incidence (<10 cases per 100 000 population), optimal application of the principles of the strategy should allow approach of the pre-elimination threshold (<10 TB cases per million population) and hopefully also the TB elimination one (<1 TB case per million) by 2035 [4.-7.]。
一世n November 2017, WHO launched a core document: the “Compendium of WHO guidelines and associated standards: ensuring optimum delivery of the cascade of care for patients with tuberculosis”, hereafter referred to as the Compendium. It is structured into WHO-recommended TB standards and consolidates all current WHO TB policy recommendations into a single resource. The document thus provides a framework for reaching the ambitious targets in the End TB Strategy [3.]。
The aim of this editorial is to introduce this comprehensive resource to a wide audience. The Compendium is relevant for all healthcare providers (clinically oriented as well as public health-oriented readers) in both the private and public sectors.
The document describes the principles on which the End TB Strategy is based (such as ethical considerations, community engagement, public–private mix and engaging all care providers) and provides insight to the formal WHO policy development process. Furthermore, the Compendium covers the activities of Pillar I of the End TB Strategy, focusing on integrated, patient-centred diagnosis, treatment and prevention of TB in adults and children, within close collaboration involving civil society, the social sector, local communities and other stakeholders [3.]。
该纲要被制定为一个明确而简洁的仪器,以促进对受TB影响的每个人提供高质量护理的理解和规划。它遵循在寻求诊断,治疗和护理的TB的迹象或症状的人途径,包括关键算法和横切元件,这对于在TB护理的级联中患者以患者为中心的方法至关重要。
除了加速实施现有工具的情况下,有效的结核病响应必须通过快速摄取新的干预措施,例如快速诊断,新药物和数字平台,以使新的诊断,新药物和数字平台进行现代化护理。与社区,民间社会和所有合作伙伴合作,各国政府需要承担全面责任确保以人为本,现代,高质量的TB服务,并确保全面的关怀以及与TB的每个人的基本支持,这也要求在内部合作超越卫生部门。纲要与TB Care的国际标准原则一致[8.] and with the European Standards for TB Care [9.] in stressing the need to engage all care providers regardless of whether care is sought from public, voluntary, private or corporate care providers.
The Compendium will be updated regularly, including in digital format, to allow incorporation of new evidence emerging from the rapidly evolving TB diagnostic and treatment landscape.
The Compendium includes 33 standards (表1and2)。Table 1presents the WHO standards for early TB detection, reminding clinicians and other healthcare providers that prompt clinical evaluation for TB is essential (standards 1–4). Standards 5–10 are focused on the importance of quality-assured diagnostic tests for the detection of drug-susceptible and drug-resistant TB. Standards 11 and 18 provide guidance for the diagnosis and treatment of latent TB infection. Standards 12–17 relate to the treatment of both drug-susceptible and drug-resistant TB cases.
Table 2presents the summary of the WHO standards for TB comorbid conditions (standards 19–22), TB in children (standards 23–26), monitoring and evaluation activities (standard 27), and supportive approaches to the care of TB patients (standards 28–33).
鉴于该纲要是一份综合文件,总结了所有当前政策和支持结核病诊断处理和护理方式的综合文件,在起草局部适应世卫组织具体指导方针时会通知国家结核病计划。它还应作为私营部门临床医生的资源,以支持其受TB影响的所有患者的护理递送。
一种cknowledgements
汇编的贡献者是Annabel Baddeley,Annabel Baddeley,莫妮卡Dia,Dennis Falzon,Haileyesus Getahun,Chrillipper Gilzon,Philippe Glaziou,Malgosia Grzemska,Yohhei Hamada,Ernesto Jaramillo,Alexei Korobitsyn,Kutlönnroth,福邦Mirzayev,Linh Nguyen,Kinh Nguyen,Kefas Samson,Lana Syed,Mario Raviglione,Hazim Timimi,Mukund Uplekar,Wayne Van Gemert,Diana Weil,Karin Weyer和Matteo Zignol(所有全球结核病计划,世卫组织,日内瓦,瑞士)。
脚注
利益冲突:没有宣布。
- R.eceivedJanuary 16, 2018.
- 公认2018年3月5日。
- 这项工作的内容是作者或其雇主的版权。设计和品牌是版权所有©2018。