Tools and Guidelines

Country health information systems provide a rich source of data on the burden of disease caused by tuberculosis (TB) and the effectiveness of programmatic efforts to reduce this burden, both of which are crucial for public health action. However, the available data are often underused, or not used at all. At least in part, this may reflect the absence of clear guidance on recommended approaches to the analysis of such data. This handbook is designed to address this gap through detailed practical examples of the analysis of TB surveillance data, in particular TB notification data, data from surveillance of anti-TB drug resistance, and mortality data compiled in national vital registration systems. It starts from the most basic kinds of analyses, and progresses to the description of more challenging topics such as the estimation of disease burden using multiple sources of evidence, including data from special surveys.

This issue of Bite Size Briefs is a summary of the Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations, which was published by the World Health Organization (WHO) in July 2014. The Consolidated Guidelines on HIV Prevention, Diagnosis, Treatment and Care for Key Populations aim to support countries provide more effective and comprehensive HIV services for the key populations, including men who have sex with men (MSM) and transgender people and include discussion of specific issues relating to adolescent key populations. Although, there is still a lack of evidence to support recommendation of PrEP to transgender women. In this brief we highlight the recommendations made in the Guidelines that are most relevant to MSM and transgender people.

The first edition of Guidance for national tuberculosis programmes on the management of tuberculosis in children was published in 2006. It resulted in the revision or development of guidelines for child TB management by national TB programmes in many TB-endemic countries. Now, however, newly published evidence and new recommendations have made it necessary to update the original 2006 guidance. Like the original, this second edition aims to inform the revision of existing national guidelines and standards for managing TB, many of which include guidance on children. It includes recommendations, based on the best available evidence, for improving the management of children with TB and of children living in families with TB. National and regional TB control programmes may wish to adapt these recommendations according to local circumstances.

It is estimated that there are more than half a million cases of tuberculosis (TB) in children occurring globally each year. In settings with a high overall incidence of TB, children can account for a large proportion (up to one-third) of all TB cases. As a consequence, TB is an important cause of morbidity and mortality in children in TB endemic countries. The focus is on the common challenges for diagnosis, treatment and prevention. It is often stated that the diagnosis of children is difficult. It is certainly difficult to confirm the diagnosis of TB in the majority of children with disease but the clinical diagnosis of TB in children can often be straightforward. It is often perceived that children with suspected TB disease or children in close contact with TB cases need referral to specialist paediatric services at central hospital level but this is not necessary for most cases. Therefore, the training material sets out to emphasize the management issues of the common cases in the usual scenario of presentation, not to replace the need for specialist referral and opinion.

The global community has committed itself to eliminating mother-to-child transmission (MTCT) of HIV and syphilis as a public health priority. The initiative to eliminate mother-to-child transmission (EMTCT) of HIV and syphilis focuses on a harmonized approach to improving health outcomes for mothers and children. The global community has set international and regional goals, and countries are scaling up programmes towards EMTCT of HIV and syphilis. This document outlines minimum global processes and criteria for validation of EMTCT of HIV and/or syphilis in a country; provides a description of global EMTCT validation targets and indicators; explains the operation of validation committees and secretariats; and reviews the validation procedure itself, including maintenance of validation status. This document is intended for use by national, regional, and global validation committees for EMTCT of HIV and/or syphilis, national AIDS and sexually transmitted infection (STI) programme managers, maternal and child health programme managers, monitoring and evaluation (M&E) officers, policy-makers and staff of technical agencies, and international partners involved in supporting initiatives for EMTCT of HIV and/or syphilis.

The factors that determine HIV transmission in internally displaced situations are complex and depend on the context. Internally displaced persons (IDPs) are defined as “persons or groups of persons who have been forced or obliged to flee or to leave their homes or places of habitual residence, in particular as a result of, or in order to avoid, the effects of armed conflict, situations of generalized violence, violations of human rights or natural or human-made disasters, and who have not crossed an internationally recognized state border”. Following immediate response in emergencies, including minimal initial HIV and reproductive health interventions, more comprehensive HIV programming needs to be developed for IDPs. A broader framework for response is needed because the focus of intervention shifts from individuals to general social situations, processes, and displacement phases in which IDPs and their families live, which may continue for long periods of time.

HIV is now a treatable condition and the majority of people who have HIV remain fit and well on treatment. Despite this, a significant number of people are unaware of their HIV infection and remain at risk to their own health and of unknowingly passing their virus on to others. Late diagnosis is the most important factor associated with HIV related morbidity and mortality. Patients should therefore be offered and encouraged to accept HIV testing in a wider range of settings. The new guidelines will provide flexibility and versatility for all healthcare providers and accommodate the decentralized approach being undertaken by the National AIDS Programme (NAP).

This handbook was written by a team of legal experts and reviewed by community activists working for improving the human rights situation of people with HIV and key populations most at risk of HIV. It is intended for people with HIV, people who are at higher risk of HIV, as well as their partners and family members. The handbook describes, step by step, how to behave when a rights violation occur, how to document it and how to seek help – directly from the authorities, or with the free help of legal professionals. It is supplemented by a set of user-friendly forms and free legal aid contracts. This handbook was designed for the legal systems of the countries in Eastern Europe and the CIS.

The publication aims to provide national statistical offices with detailed guidance on how to collect, process, disseminate and analyse data on violence against women. It lays out the role of statistical surveys in meeting policy objectives related to violence against women, the essential features of these surveys, the steps required to plan, organize and execute these surveys, the concepts that are essential for ensuring the reliable, valid and consistent measurement of women’s experiences in accordance with core topics and a plan for data analysis and dissemination.

The young men and women who took part at the 2012 UNiTE Youth Forum committed to launch the UNiTE Youth Network, a diverse group with ambitious ideas to serve as role models to their peers and inspire their communities to do more to end violence against women and girls. Peer education can be an effective tool to ensure social change as young people are often better equipped to understand the feelings, thoughts and experiences of other young people. This is why the Asia-Pacific UNiTE Campaign secretariat, together with a group of Asia Pacific regional members of the UNiTE Youth Network, developed this regionally focused, youth-friendly training manual for peer educators to help facilitate discussions on gender equality, violence against women, healthy relationships and positive activism.