World Health Organization

About: World Health Organization is a government organization based out in Islamabad, Pakistan. It is known for research contribution in the topics: Population & Public health. The organization has 13330 authors who have published 22232 publications receiving 1322023 citations. The organization is also known as: World Health Organisation & WHO.

Effect of a 19-item surgical safety checklist during urgent operations in a global patient population.

Abstract: Objective:To assess whether implementation of a 19-item World Health Organization (WHO) Surgical Safety Checklist in urgent surgical cases would improve compliance with basic standards of care and reduce rates of deaths and complications.Background:Use of the WHO Surgical Safety Checklist has been s

International study to evaluate PCR methods for detection of Trypanosoma cruzi DNA in blood samples from Chagas disease patients.

Abstract: BACKGROUND: A century after its discovery, Chagas disease still represents a major neglected tropical threat. Accurate diagnostics tools as well as surrogate markers of parasitological response to treatment are research priorities in the field. The purpose of this study was to evaluate the performance of PCR methods in detection of Trypanosoma cruzi DNA by an external quality evaluation. METHODOLOGY/FINDINGS: An international collaborative study was launched by expert PCR laboratories from 16 countries. Currently used strategies were challenged against serial dilutions of purified DNA from stocks representing T. cruzi discrete typing units (DTU) I, IV and VI (set A), human blood spiked with parasite cells (set B) and Guanidine Hidrochloride-EDTA blood samples from 32 seropositive and 10 seronegative patients from Southern Cone countries (set C). Forty eight PCR tests were reported for set A and 44 for sets B and C; 28 targeted minicircle DNA (kDNA), 13 satellite DNA (Sat-DNA) and the remainder low copy number sequences. In set A, commercial master mixes and Sat-DNA Real Time PCR showed better specificity, but kDNA-PCR was more sensitive to detect DTU I DNA. In set B, commercial DNA extraction kits presented better specificity than solvent extraction protocols. Sat-DNA PCR tests had higher specificity, with sensitivities of 0.05-0.5 parasites/mL whereas specific kDNA tests detected 5.10(-3) par/mL. Sixteen specific and coherent methods had a Good Performance in both sets A and B (10 fg/µl of DNA from all stocks, 5 par/mL spiked blood). The median values of sensitivities, specificities and accuracies obtained in testing the Set C samples with the 16 tests determined to be good performing by analyzing Sets A and B samples varied considerably. Out of them, four methods depicted the best performing parameters in all three sets of samples, detecting at least 10 fg/µl for each DNA stock, 0.5 par/mL and a sensitivity between 83.3-94.4%, specificity of 85-95%, accuracy of 86.8-89.5% and kappa index of 0.7-0.8 compared to consensus PCR reports of the 16 good performing tests and 63-69%, 100%, 71.4-76.2% and 0.4-0.5, respectively compared to serodiagnosis. Method LbD2 used solvent extraction followed by Sybr-Green based Real time PCR targeted to Sat-DNA; method LbD3 used solvent DNA extraction followed by conventional PCR targeted to Sat-DNA. The third method (LbF1) used glass fiber column based DNA extraction followed by TaqMan Real Time PCR targeted to Sat-DNA (cruzi 1/cruzi 2 and cruzi 3 TaqMan probe) and the fourth method (LbQ) used solvent DNA extraction followed by conventional hot-start PCR targeted to kDNA (primer pairs 121/122). These four methods were further evaluated at the coordinating laboratory in a subset of human blood samples, confirming the performance obtained by the participating laboratories. CONCLUSION/SIGNIFICANCE: This study represents a first crucial step towards international validation of PCR procedures for detection of T. cruzi in human blood samples.

The 2011 update of the World Health Organization guidelines for the programmatic management of drug-resistant tuberculosis

Abstract: Introduction: The production of guidelines for the programmatic management of drug-resistant tuberculosis fit into the mandate of the World Health Organization (WHO) to provide technical support to countries to reinforce care of drug resistant tuberculosis patients. Methods: WHO commissioned systematic reviews of evidence, including meta-analysis and modeling studies, to summarize evidence on priority questions regarding case finding, treatment regimens for multidrug-resistant TB (MDR-TB), monitoring of response to MDR-TB treatment and models of care. The quality of evidence assembled varied from low to very low. A multidisciplinary expert panel used the GRADE approach to develop recommendations based on best available evidence. Findings: The recommendations encourage the wider use of rapid drug-susceptibility testing with molecular techniques to detect rifampicin resistance and treat patients adequately. The use of culture remains important for the early detection of failure during MDR-TB treatment. The guidelines provide recommendations about the early use of anti-retroviral agents for TB patients with HIV who are on second-line TB drug regimens. Systems that primarily employ ambulatory models of care to manage MDR-TB patients are recommended over others based mainly on hospitalization. Conclusion: Practitioners and decision makers involved in MDR-TB care should be guided in their work by these updated recommendations. Additional research is necessary to improve the quality of existent evidence, particularly on regimen composition and duration of treatment.

Prognosis for interruption of malaria transmission through assessment of the mosquito's vectorial capacity.

Abstract: Prognosis for Interruption of Malaria Transmission Through Assessment of the Mosquito's Vectorial Capacity