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Diarrhoeal Diseases Reference
CD-ROM - First Edition The World Health Organization


updated: 24 April, 2014

Diarrhoeal Diseases Reference
CD-ROM - First Edition

About The World Health Organization


Contact Information:
The World Health Organization
Headquarters Office in Geneva (HQ)
Avenue Appia 20
1211 Geneva 27
Switzerland

Telephone: +41 22 791 2111
Fax: +41 22 791 3111
Telex: 415 416
Telegraph UNISANTE GENEVA
Email:
Website: www.who.int


A final selection of WHO documents for inclusion in the
Diarrhoeal Diseases - CD-ROM - First Edition
will be made from the following list plus additions.

Selected publications and documents on
Diarrhoeal Diseases (including cholera) from the
World Health Organization



This page represents a list of selected WHO online publications and documents relating to
the Control and Management of Diarrhoeal Diseases and Cholera. It is not a complete list. These can be viewed in electronic format online, or downloaded for offline viewing.
Use your browsers Find / Search function to assist you in locating
a subject, country or keyword



WHO directory
Contact information for regional and field offices.
WHO European Regional Office


Major Publications


World Health Report
The World Health Report 2000 Health Systems: Improving Performance is an expert analysis of the increasingly important influence of health systems in the daily lives of people worldwide.

Previous World Health Reports:="http://www.who.int/whr/1999/en/">1999 - 1998 - 1997 - 1996 - 1995
http://www.who.int/whr/index.html

Fifty facts from the World Health Report 1998
Global health situation and trends 1955-2025 - Population: 1. The global population was 2.8 billion in 1955 and is 5.8 billion now. It will increase by nearly 80 million people a year to reach about 8 billion by the year 2025.

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http://www.who.int/whr/1998/en/

WHO Report on Infectious Diseases
Illness and death from infectious diseases can be, in most cases, avoided at an affordable cost. Those who have received this report have a unique responsibility, as they are leaders in society who can make a substantial contribution to the prevention and control of infectious diseases.

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Health and Environment in Sustainable Development:
This is an executive summary of the WHO report Health and Environment in Sustainable Development: Five Years after the Earth Summit. The summary contains extracts from the report, selected figures and tables, and the conclusions in full. To promote ease of reference, section headings and numbers of figures and tables have been maintained as used in the report. Bibliographic references have been excluded, however.

The report is a contribution by WHO to the five-year follow-up to the Earth Summit. This anniversary has provided an opportunity to assess the impact made by environmental health activities at local, national and global level during this period. The book brings together systematically quantitative data on health-and-environment linkages at the global level, with examples from regions and countries. Such linkages have already been described in the 1972 WHO report Health hazards of the human environment and in the 1992 WHO report Our planet, our health, but new information and new ways of considering health and environment issues have since emerged and form the basis of this report.

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http://www.who.int/topics/environmental_health/en/

Dr. Gro Harlem Brundtland, Director-General, World Health Organization - Speeches
Health for the 21st Century
Breaking the Poverty Cycle: Investing in Early Childhood
Weather, Climate and Health
Science and Health: WHO's Perspective
Epidemic of Tuberculosis – A Global Threat
How far have we come and where should we be going?
Global Trends in Child Health

Other WHO reports

  • Bulletin of the World Health Organization
  • Disease Outbreak News
  • Removing Obstacles to Healthy Development:="http://www.who.int/infectious-disease-report/">WHO Report on Infectious Diseases
  • WHO Publications
    Publications and periodicals issued by WHO
  • WHO Policy Documentation
    The WHO Policy information retrieval system provides access to WHO policies and related documents as well as administrative documents. It is a full text retrieval system allowing the user to navigate and search through the various infobases

Documentation Centres

World Health Assembly Documentation

Documentation related to the World Health Assembly. Available in multiple languages.

About WHO

The World Health Organization
Headquarters Office in Geneva (HQ)

Avenue Appia 20
1211 Geneva 27
Switzerland

Telephone: (+00 41 22) 791 21 11
Facsimile (fax): (+00 41 22) 791 3111
Telex: 415 416
Telegraph: UNISANTE GENEVA

Internet email

  • If you would like to request general information about WHO or current WHO events or if you need information for newspaper, TV, radio or other media reports, please email="mailto:info@who.int">info@who.int
  • If you would like to request WHO health information, information about WHO documentation or WHO history, please email="mailto:library@who.int">library@who.int
  • If you would like to request information about WHO publications, please email publications@who.int
  • If you would like to order a WHO publication, please email bookorders@who.int
  • If you have a question about copyright permission or translation rights, please contact permissions@who.int.

  • If you are experiencing problems sending email to someone at WHO, please contact="mailto:emailadmin@who.int">emailadmin@who.int
  • If you are encountering technical problems with the WHO web site (http://www.who.int), please email="mailto:webmaster@who.int">webmaster@who.int stating the exact URL and the specific problem you are experiencing.

Regional and Other Offices

About WHO: Diarrhoeal Diseases

About WHO: Diarrhoeal Diseases
Annually, at least 1 500 million episodes of diarrhoea occur in children under the age of five. An estimated 4 million children die each year as a result. Diarrhoea removes essential body fluids and vital nutrients, producing dehydration and Malnutrition.
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About WHO : Integrated Management of Childhood Illness
Every year some 12 million children die before they reach their fifth birthday, many of them during the first year of life. Seven in every ten of these child deaths are due to diarrhoea, pneumonia, measles, malaria or malnutrition - and often to a combination of these conditions. At least three out of four children taken to health facilities for care are suffering from one of these five conditions.

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About WHO: Preventing and Controlling Specific Health Problems
Vaccine-preventable diseases, Tropical diseases, Malaria, Tuberculosis, Diarrhoeal diseases, Acute respiratory infections, Integrated management of childhood illness, HIV/AIDS, Sexually transmitted diseases, New and emerging infectious diseases, heart disease, mental health

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About WHO: Food Safety
Food safety Hundreds of millions of people suffer from communicable diseases caused by contaminated food (including drinking water), which can be a major vehicle for cholera and other forms of epidemic diarrhoeal diseases, resulting in some 3 million deaths each year. Up to 70% of diarrhoea episodes in infants may be food borne in origin.

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About WHO: Monitoring the Environment
Access to safe drinking-water is essential for health and well-being. Since the end of the International Drinking Water Supply and Sanitation Decade (1981-1990), progress and investments in reaching the rural and periurban poor have been lagging. Over 1 000 million people do not have even minimal facilities for sanitary excreta disposal. More than 2.5 million infants and young children die each year from diarrhoeal diseases related to unsafe and poor sanitation, while approximately 1 500 million people are infected by intestinal worms resulting from faecal-oral contamination.

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Integrated Management of Childhood Illness (IMCI)

Integrated Management of the Sick Child
While a great deal has been learned from disease-specific control programmes during the past 15 years, the challenge remained of how to combine the lessons learned into a single method for more efficient and effective management of childhood illness. WHO and UNICEF responded by jointly developing an approach referred to as integrated management of the sick child.

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Reducing mortality from major killers of children
Each year, more than eleven million children die from the effects of disease and inadequate nutrition. In some countries, more than one in five children die before they reach their fifth birthday, and many of those who do survive are unable to grow and develop to their full potential.

Seven out of 10 of childhood deaths in developing countries can be attributed to just five main causes, or often to a combination of them: pneumonia, diarrhoea, measles, malaria and malnutrition. Around the world, three out of every four children seen by health services are suffering from at least one of these conditions.

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Child Health Division

WHO Child Health and Development
Integrated Management of Childhood Illness, Acute Respiratory Infections, Diarrhoeal Diseases Cholera Documents, FAQ's, Links, Search, CHD IntraNet

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http://www.who.int/chd/

Links to Child Health Resources
Division of Child Health and Development (CHD) World Health Organization

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http://www.who.int/chd/links/linkmenu.htm

Division of Diarrhoeal and Acute Respiratory Disease Control
Diarrhoea and acute respiratory infections each kill more children under 5 than any other disease. The World Health Organization (WHO) estimates that in 1990 diarrhoea caused 3.2 million deaths in this age group and acute respiratory infections (ARI) a further 4.3 million deaths.

These 7.5 million deaths accounted for over half of all deaths among children under 5. Some of the ARI-related deaths were due to the respiratory manifestations of two diseases preventable by immunization: measles and whooping cough, but the vast majority were due to pneumonia. Half of the diarrhoea deaths were due to dehydration. Almost all of the deaths could have been prevented with simple, cheap treatment.

Each year children under 5 throughout the world suffer over 1.3 billion episodes of diarrhoea and 40 million episodes of pneumonia. For those who survive, these illnesses are major factors in their poor nutritional state.

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Oral Rehydration

Rice-based ORS
Oral rehydration therapy (ORT) using the WHO/UNICEF glucose-based Oral Rehydration Salts (ORS) solution is the preferred method for treating most children with dehydration due to diarrhoea (except those with severe dehydration); it has been used successfully in millions of cases worldwide. In many countries glucose-ORS solution is also recommended for home treatment of children with diarrhoea after they have been seen at a health facility, even when there are no signs of dehydration. Glucose-ORS solution works because glucose is rapidly absorbed by most patients with diarrhoea, and this causes salt and water also to be absorbed, thus replacing the faecal losses. Although glucose-ORS solution efficiently replaces faecal losses of water and salts, it has one important shortcoming: it does not reduce stool volume during diarrhoea or shorten the duration of the illness, which are the results that mothers and many health workers seek. If an ORS formulation could be developed that had the positive features of the standard glucose-ORS, including low cost safety, and stability during prolonged storage, but also appreciably reduced the rate of stool loss during illness and/or the duration of diarrhoea, it could have considerable advantages over glucose-ORS. Most importantly, it could be promoted as having a true antidiarrhoeal effect, which should lead to increased acceptance and use of ORS by both health workers and mothers, and perhaps also to a reduction in the use of ineffective "antidiarrhoeal" drugs and inappropriate antibiotics. This would represent a major advance in efforts to control diarrhoeal morbidity and mortality through appropriate case management. Clinical trials of rice-based ORS: Recent studies suggest that an ORS with these advantages may be possible. The first evidence came from clinical trials in Bangladesh and India, which showed that dehydrated diarrhoea patients given an ORS solution containing 50 grams of cooked rice powder in place of the usual 20 grams of glucose were satisfactorily rehydrated and had an appreciably reduced rate of stool output during treatment as compared with patients given glucose-ORS solution.
No. 7, August 1990
http://www.who.int/chd/publications/newslet/update/updt-07.htm

Education and Training - Manuals and Guidelines

Diarrhoea Management Training Course - Introduction
Guidelines for Conducting Clinical Training Courses at Health Centres and Small Hospitals
Diarrhoeal diseases are a leading cause of childhood mortality and morbidity in the developing world. These deaths are caused by dehydration, dysentery, and persistent diarrhoea. Dehydration from acute diarrhoea of all etiologies and in all age groups can be treated safely and effectively by the simple method of oral rehydration therapy (ORT). 11105 bytes; modified: Monday, May 31, 1999 (13:33)
http://www.who.int/chd/publications/cdd/dmtc/dmtcintr.htm

Diarrhoea Management Training Course
- Chapter 1: Training Objectives

Exactly what the training includes, how it is done, and how long it takes will differ from one facility to another. These things will depend on the number and type of participants and the resources and capabilities

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Diarrhoea Management Training Course
- Chapter 2: Handling Administrative Arrangements

Careful administrative planning is essential for the training to be successful. The planning steps are listed below. One or two instructors may do all of these steps, but it is advisable that the team of instructors and staff participate. Suggestions for each of these steps are provided in greater detail in this chapter. 27127 bytes; modified: Monday, May 31, 1999 (13:33)
http://www.who.int/chd/publications/cdd/dmtc/dmtc2.htm

Clinical Skills: A Self-Instructional Course
The Clinical Skills training course is designed to teach health workers to assess and treat cases of diarrhoea properly and to educate families about prevention and home treatment of diarrhoea. Primarily self-instructional, Clinical Skills is the first course designed especially for health workers who may be unable to attend a training course away from their worksites, but who have the important responsibility of treating diarrhoea. http://www.who.int/chd/publications/newslet/update/updt-19.htm

Medical Education: Teaching Medical Students about Diarrhoeal Diseases
Strengthening the Teaching of Diarrhoeal Diseases in Medical Schools - "Readings on Diarrhoea" is intended for medical students, especially during their clinical training in pediatrics. It will also be useful for physicians participating in training courses on the management of diarrhoea in children. The materials in this book are compatible with other WHO publications on the management and prevention of diarrhoea. Units that concern the management of children with diarrhoea are based on the WHO treatment chart "Management of the Patient with Diarrhoea" (1990). Portions of that chart are reproduced at appropriate places in this text. There are eight units to the training program: The epidemiology and etiology of diarrhoea
Pathophysiology of diarrhoea
Assessing the diarrhoea patient
Treatment of diarrhoea at home
Treatment of dehydrated patients
Dysentery, persistent diarrhoea and diarrhoea associated with other diseases
Diarrhoea and Nutrition
Prevention of Diarrhoea

http://www.who.int/child-adolescent-health/New_Publications/CHILD_HEALTH/Meded

Topics in International Health
Produced by the Wellcome Trust for use as an educational resource in tropical and international health. The series is divided into numerous CDs, each focusing on a specific disease or group of diseases. 6003 bytes; modified: Thursday, November 25, 1999 (15:42)
http://www.who.int/hlt/otherdata/English/topics.htm Strengthening the Teaching of Diarrhoeal Diseases in Basic Training Programmes
Manual for Instructors of Nurses and Other Health Workers

Advising Mothers on Management of Diarrhoea in the Home:
Instructions for Facilitators.

This guide teaches a process and skills which will help the health worker to advise mothers on home case management correctly and effectively. The process will help the health worker to communicate all the essential information to the mother in a structured manner, and in a reasonable amount of time. It will also help the health worker to limit the amount of information to give, and it should make it easier for mothers to remember the advice. 42660 bytes; modified: Monday, May 31, 1999 (13:34)
http://www.who.int/chd/publications/cdd/advising/adv_mom2.htm

Diarrhoea Case Management The Treatment of Diarrhoea: A Manual for Physicians and Other Senior Health Workers
Diarrhoeal diseases are a leading cause of childhood morbidity and mortality in developing countries, and an important cause of malnutrition. On average, children below 3 years of age in developing countries experience three episodes of diarrhoea each year. In 1993 an estimated 3.2 million children below 5 years died from diarrhoea. Eight out of 10 of these deaths occur in the first two years of life. In many countries diarrhoea, including cholera, is also an important cause of morbidity among older children and adults.

1. Introduction,
2. Essential concepts concerning diarrhoea,
3. Assessment of the child with diarrhoea,
4. Management of acute diarrhoea without blood,
5. Management of suspected cholera,
6. Management of acute bloody diarrhoea (dysentery),
7. Management of persistent diarrhoea,
8. Management of diarrhoea with severe malnutrition,
9. Other problems associated with diarrhoea,
10. Antimicrobials and drugs,
11. Prevention of diarrhoea,

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http://www.who.int/chd/publications/cdd/textrev4.htm How Research Findings Have Improved Diarrhoea Case Management
1. Practical application of research, 2. Treatment advice for diarrhoea - WHO's Division of Diarrhoeal and Acute Respiratory Disease Control (CDR), among its many activities, supports research into ways of preventing and treating diarrhoeal diseases. The research is coordinated by CDR's Programme for Diarrhoeal Disease Control (CDD). Over the years this research has evaluated a number of new or improved approaches to the control of diarrhoeal diseases.

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http://www.who.int/chd/publications/newslet/update/updt-20.htm Improving the Practices of Pharmacists and Licensed Drug Sellers
1. Pharmacists as health care workers, 2. Successful training methods, 3. What field tests show - The importance of the private sector - If diarrhoea in children is to be managed correctly, there is need to look beyond public sector health facilities. Good management has to be promoted in the home, and there is also a need to improve the practices of all providers of care, particularly in the private sector.

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http://www.who.int/chd/publications/newslet/update/updt-18.htm Treatment of Diarrhoeal Diseases: Information for Pharmacists and other Drug Sellers
This guide contains information aimed at improving the practices of drug sellers in the treatment of diarrhoea. It is divided into nine sections:

1.How to use this guide
2.Choosing a target audience
3.Analyzing the target audience
4.Factors influencing drug sellers' practices
5.Planning an intervention
6.Developing printed materials
7.Training staff and testing the intervention
8.Monitoring and evaluation
9.Carrying out the intervention

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http://www.who.int/chd/publications/cdd/pharm/intro.htm The Outpatient Management of Bloody Diarrhoea in Young Children
1. What causes bloody diarrhoea, 2. Practical guidelines for treatment - About 10% of diarrhoeal episodes in children under 5 years of age have visible blood in the stool and these cause about 15% of diarrhoea-associated deaths in this age group. Compared with watery diarrhoea, bloody diarrhoea generally lasts longer, is associated with more complications, is more likely to adversely affect a child's growth, and has a higher risk of death.

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http://www.who.int/chd/publications/newslet/update/updt-16.htm The Management of Bloody Diarrhoea in Young Children
Bloody diarrhoea in young children is usually a sign of invasive enteric infection that carries a substantial risk of serious morbidity and death. This is especially true in the developing countries, where the problem occurs most frequently. Non-infectious causes account for a very small proportion of episodes of bloody diarrhoea.

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Disease Outbreak

1999 - Acute Diarrhoea in Sudan
The outbreak of acute diarrhoea which began in early March is continuing. The areas of Padak, Mading, Wanding, Lankien, Akobo and Burmat have reported a total of 892 cases with 24 death up to 27 April 1999.

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1999 - Diarrhoeal Disease / Cholera in Congo
WHO has been informed of an outbreak of diarrhoeal disease in Brazzaville, Congo. Some cholera cases have now been confirmed in this outbreak and more details on the current situation will be given as soon as they are available.

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1999 - Acute Watery Diarrhoea in Sudan
As of 19 March, 78 deaths caused by acute watery diarrhoea had been reported. The total number of cases is unknown. Investigations are being carried out by the Ministry of Health.

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1998 - Bloody Diarrhoea in Cameroon
Shigella dysenteriae type 1 (Sd1) has been confirmed as the organism responsible for the outbreak of bloody diarrhoea which started in Cameroon in November 1997. Since then 237 cases with 60 deaths have been reported.

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1998 - Cholera / Diarrhoea Outbreak in Liberia
The national health authorities of Liberia have reported an outbreak of cholera/diarrhoea which started at the end of May. The areas affected by the outbreak are Nimba County and Margibi County. Up to 26 June a total of 560 cases with 12 deaths had occurred.

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1998 - Cholera / Acute Diarrhoea in Somalia
A significant increase in the number of cases of acute diarrhoea has been reported to WHO by Médecins sans frontières (Spain), who have opened their cholera treatment centre in North Mogadishu as a result. An average of 14 cases are being admitted daily to this facility.

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1998 - Cholera-like Diarrhoeal Disease in the Congo
Since November 1997, 445 cases of which 83 were fatal (case fatality rate 20%) have been reported in Pointe-Noire in the southern part of the country. The cases occurred between 7 November 1997 and 27 January 1998.

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1998 - Diarrhoeal Diseases in Bangladesh
The devastating floods which are sweeping the country began in early July this year and 52 districts out of a total of 64 with nearly 20 million people (25% of the total population) are affected. The death toll was reported as 730 up to 7 September 1998. Most of the districts currently affected are also endemic for diarrhoeal diseases and some outbreaks of acute diarrhoea have occurred. Over 185,OOO people have so far been affected and 151 have died.

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http://www.who.int/emc/outbreak_news/n1998/sept/n30sept1998.html Bangladesh - Diarrhoeal Diseases in Bangladesh
The devastating floods which are sweeping the country began in early July this year and 52 districts out of a total of 64 with nearly 20 million people (25% of the total population) are affected. The death toll was reported as 730 up to 7 September 1998. Most of the districts currently affected are also endemic for diarrhoeal diseases and some outbreaks of acute diarrhoea have occurred. Over 185,000 people have so far been affected and 151 have died.

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Cases of Acute Bloody Diarrhoea in a Rural District by Month
January 1994- April 1995 Objective: To detect outbreaks of dysentery by monitoring the incidence of cases of acute bloody diarrhoea. Slide 7 of 32 ...

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http://www.who.int/csr/labepidemiology/surveillancesystems/en/

Epidemic Control

Mozambique - The Fight Against Disease Increases
The next two to eight weeks are critical for Mozambique's health and aid workers fighting the threat of potential cholera and malaria epidemics, said the World Health Organization (WHO) today. The threat of a malaria epidemic in the country is increasing and will be at its most dangerous in around three to six weeks time as floodwaters gradually subside, the rains stop and warm temperatures return – ideal breeding conditions for mosquitoes.

http://www.who.int/inf-pr-2000/en/pr2000-16.html Guidelines for Cholera Control
These guidelines have been prepared by the Global Task Force on Cholera Control of the World Health Organization to help managers of national programmes for control of diarrhoeal diseases and others responsible for implementing cholera control activities. They may also be useful to international, bilateral, and nongovernmental agencies when deciding on appropriate assistance to countries for controlling cholera outbreaks.

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http://www.who.int/chd/publications/cholera/cholguid.htm Epidemic Diarrhoeal Disease Preparedness and Response. Training and Practice.
Participant's Manual

Introduction, Chapter 1: Preparedness and Detection, Chapter 2: Response, Chapter 3: Control Measures, Exercise Y: Case study (Rivas District outbreak)

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http://www.who.int/topics/cholera/publications/WHO_EMC_DIS_97_3Rev_1/en/ Epidemic Diarrhoeal Disease Preparedness and Response. Training and Practice.
Facilitator's Guide

Introduction, Checklist of Instructional Materials Needed at the Course, Checklist of Supplies Needed at the Course, Materials and Information to be Obtained before the Course Begins, Space Requirements Guidelines on Techniques, Detailed Guidelines, Summary of Chapter 1, Summary of Chapter 2, Summary of Chapter 3, Annexes, Annex 1: Evaluation, Annex 2: Sample draft for invitation letter, Annex 3: Suggested timetable

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http://www.who.int/topics/cholera/publications/WHO_EMC_DIS_97_4Rev_1/en/ Review of the Project for Improving Preparedness and Response to Cholera and Other Epidemic Diarrhoeal Diseases in Southern Africa
In 1993 following the concern of Southern African countries over the yearly epidemics of cholera that have been occurring since the late 1980's and the spread of epidemic dysentery in the region, a sub-regional programme was initiated by WHO to help countries affected to improve their capacity to be prepared and respond to epidemic diarrhoeal diseases. The programme was funded by voluntary contributions from Switzerland, Australia, Italy and the United States. The sub-regional team worked with Ministries of Health and other involved national government sectors, international agencies, as well as with non-governmental organizations. After three years project implementation, a joint evaluation team composed of WHO Headquarters and Regional Office for Africa, plus donors, met in Harare to review the outcome of the project. The evaluation group concluded that the project was very successful and should be replicated in other regions. Executive Summary, Background/Project Description, Purpose and Methods of the Review, Overall Achievements of the Project, Laboratory Strengthening, Analysis of the Status of the Project Implementation, Lessons Learned, Critical Activities to be Continued and Recommended Duration of Support, Replicability of Project, Recommendations

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http://www.who.int/topics/cholera/publications/WHO_EMC_DIS_97_5/en/ Cholera and Other Epidemic Diarrhoeal Diseases Control.
Technical Cards on Environmental Sanitation


Planning and management topics
- Emergency Interventions for Cholera Outbreaks
- Estimating Requirements for Water Quality Monitoring and Control
- Community Planning for Diarrhoeal Disease Control

Technology selection and construction topics
- Well Sinking in Non-Collapsing Formations
- Spring Protection
- Excreta Disposal Options
- Septic Tank Systems for Peri Urban Areas
- Ventilated Improved Pit Latrines
- Rainwater Harvesting Systems

Technology maintenance
- Afridev Handpump Maintenance
- Repair of the Model "A" Bushpump

Water quality and hygiene topics
- Household Water Treatment and Storage
- Disinfectants
- Cleaning and Disinfection of Wells
- Dosing Water with Hypochlorite Solutions
- Testing for Chlorine
- Cleaning and Disinfection of Storage Tanks, Tanker Trucks and Pipelines
- Sanitary Surveillance of Wells and Boreholes
- Sanitary Surveillance of a Distribution System
- Collection of Water Samples – Sampling
- Collecting Water Samples - Methods

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http://www.who.int/csr/resources/publications/cholera/WHO_EMC_DIS_97_6/en/ Guidelines for the Control of Epidemics Due to Shigella Dysenteriae Type 1
Shigella dysenteriae type 1 (Sd1) is an unusually virulent enteric pathogen that causes endemic or epidemic dysentery with high death rates. It is the only cause of large-scale, regional outbreaks of dysentery. In recent years, Sd1 has caused epidemic dysentery in Central America, south Asia, and central and southern Africa. An epidemic in Central America from 1969 to 1973 was responsible for more than 500,000 cases and 20,000 deaths. The epidemic in central and southern Africa began in 1979 and has affected at least nine countries. It is likely that most developing countries are at risk of epidemic dysentery due to Sd1. These guidelines are intended to assist national health authorities, public health officers and health care providers in their efforts to prevent and/or treat Sd1 disease. The text describes the epidemiology, clinical features and management of disease caused by Sd1, and interventions that can reduce both the incidence of Sd1 infections and mortality due to Sd1 disease.

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Cholera Cholera - WHO Fact Sheet
Surveillance and Response Global incidence, epidemiology, disease outbreaks, articles and publications, videos WHO Publications Diarrhoeal Diseases Infectious, Emerging Diseases International Travel and Health vaccination requirements and health advice 5305 bytes; modified: Monday, March 28, 2000 (12:57)
http://www.who.int/health-topics/cholera.htm Cholera - WHO Fact Sheet
Cholera is an acute intestinal infection caused by the bacterium Vibrio cholerae. It has a short incubation period, from less than one day to five days, and produces an enterotoxin that causes a copious, painless, watery diarrhoea that can quickly lead to severe dehydration and death if treatment is not promptly given. Vomiting also occurs in most patients. Fact Sheet N107- Revised March 2000
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http://www.who.int/inf-fs/en/fact107.html Some Frequently Asked Questions About Cholera
What is cholera? How is cholera spread? Where do outbreaks occur? Can cholera be prevented? What treatments are available? What about antibiotics and other drugs? Do vaccines confer protection? http://www.who.int/topics/cholera/faq/en/

Management of the Patient with Cholera
Cholera should be suspected when: - a patient older than 5 years develops severe dehydration from acute watery diarrhoea (usually with vomiting); or - any patient above the age of 2 years has acute watery diarrhoea in an area where there is an outbreak of cholera. Steps in the management of suspected cholera: Step 1. Assess for dehydration, Step 2. Rehydrate the patient, and monitor frequently. Then reassess hydration status, Step 3. Maintain hydration: replace ongoing fluid losses until diarrhoea stops, Step 4. Give an oral antibiotic to the patient with severe dehydration, Step 5. Feed the patient. 27004 bytes; modified: Monday, May 31, 1999 (13:34) WHO Guidance on Formulation of National Policy on the Control of Cholera
Adequate surveillance and reporting is essential for national and international efforts to control cholera. Case definitions: The primary purpose of collecting and reporting information on cases of cholera is to facilitate local and national control efforts. As cholera is notifiable under the terms of the International Health Regulations, standard definitions should be used and certain information should be included in reports from all levels of the health system. I. Surveillance and reporting
II. The use of the laboratory
III. Cholera Immunization
IV. Control of International spread of cholera
V. Use of antibiotics
VI. Tourism in cholera-affected areas
VII. Water supply and sanitation
VIII. Cholera and food: General considerations
IX. Cholera and International trade in food
X. Health Education http://www.who.int/chd/publications/cholera/cholpol.htm Cholera: Dealing with an Emergency
Reporting, 1. Laboratory testing of stool specimens, 2. Common sources of infection, 3. Effective control measures, 4. Ineffective control measures, 5. Cholera treatment

http://www.who.int/chd/publications/cholera/cholemer.htm
Cholera - WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases
Chapter 4 - 1. Background of disease, 2. Description of the data, 3. Trends, 4. Conclusions, 5. References & links, 6. Tables
http://www.who.int/csr/resources/publications/surveillance/WHO_CDS_CSR_ISR_2000_1/en/ Cholera and Epidemic Dysentery
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Dysentery

Dysentery - WHO Fact Sheet
Epidemic Dysentery, Children: Reducing Mortality, Integrated Management of Childhood Diseases, Publications and documents on diarrhoeal diseases, Surveillance and Response, Epidemic dysentery: global incidence, epidemiology, disease outbreaks, articles and publications

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http://www.who.int/health-topics/diarrhoeal.htm Epidemic Dysentery
Dysentery may be simply defined as diarrhoea containing blood. Although several organisms can cause dysentery, Shigella are the most important. Shigella dysenteriae type 1 (Sd1), also known as the Shiga bacillus, is the most virulent of the four serogroups of Shigella. Sd1 is the only cause of epidemic dysentery.

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Communication

Radio Guide: A Guide to Using Radio Spots in National CDD Programmes
The keys to effective promotion via radio are creativity and repetition. Although there are various types of radio materials that could be used to support CDD programmes, both of these criteria are best fulfilled by using radio spots. For these reasons, the CDD Programme and the HealthCom Project, Academy for Educational Development, have developed a manual called Radio guide: A guide to using radio spots in national CDD programmes.

This manual will interest national CDD programmes which actively promote home case management, which have some evidence that radio is an important channel in their country, and which are willing to commit the necessary time and resources.

http://www.who.int/chd/publications/newslet/update/updt-15.htm

Using Radio Spots to Support National CDD Programmes
The main focus of national diarrhoeal disease control (CDD) activities is to assure the correct treatment of child diarrhoea. This involves teaching parents how to take care of their children during and after diarrhoea episodes, including when to seek help from health professionals.

Face-to-face communication, such as that between a health worker and a caretaker, is the most effective way to teach parents how to treat their children during diarrhoea episodes. The WHO/CDD document Advising mothers on management of diarrhoea in the home teaches health workers the basic skills they need to advise parents how to manage their child's diarrhoea. But the advice given by health workers reaches only those people who come to health facilities, which may be only certain groups: families who live near enough to walk to the facility, or who can afford transport, or who are already convinced that the clinic is the best place to go for help, or those whose child is dangerously ill. In addition, a mother probably comes to the health facility only rarely, and it may be difficult for her to remember all the information learned at each visit.

Radio can complement face-to-face communication in national CDD programmes because it:
- Reinforces the advice that health workers are giving,
- Reaches those people who do not come to health facilities.

It can also:
- Help the CDD programme to promote behaviours that will help prevent diarrhoea
- Help inform people and raise awareness about a new idea, a new product, or a service that is available. ("When your child has diarrhoea, help him to eat and drink so he will stay strong." "ORS (oral rehydration salts) packets are now available free at district health posts.")
- Create a demand for services. ("Ask the doctor for advice on how to encourage your child to eat during diarrhoea." "Ask the nurse how to mix ORS correctly.")
- Remind people what they have already learned. ("Remember to take your child to the clinic if her diarrhoea has blood in it.")
- Motivate people, by presenting information in a compelling or entertaining way.

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Vaccine and Immunization

Diseases and Vaccines information - GPV, Global Programme for Vaccines and Immunization
Vaccine research information from GPV, Global Programme for Vaccines and Immunization ...

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Vaccine Research and Development - Diarrhoeal Diseases
Cholera, Rotavirus, Shigella, Enterotoxic Escherichia Coli,Thyphoid Fever

Vaccine and Immunization information from GPV, Global Programme for Vaccines and Immunization - Overall Objective: to obtain effective and safe vaccines against enteric diseases which: are easy to deliver, can be delivered in one (or few) doses, can be incorporated into existing schedules of vaccine delivery and are robust enough to retain their protective properties in the adverse conditions likely to be encountered in the developing world.

The spectrum of pathogens covered includes bacterial organisms such as Vibrio cholerae, enterotoxic Escherichia coli (ETEC), Shigella dysenteriae and Shigella flexneri, and Salmonella typhi as well as rotaviruses.

http://www.who.int/vaccine_research/documents/stateoftheart/en/ Surveillance and Response

Disease Surveillance and Response
The surveillance of a communicable disease is fundamental for disease prevention and control. Surveillance is defined as the "ongoing systematic collection, collation, analysis and interpretation of data; and the dissemination of information to those who need to know in order that action may be taken".

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Principles of Surveillance - Slide show
32 slides
http://www.who.int/csr/labepidemiology/surveillancesystems/en/

EMC Document Centre - By Titles
These documents offer an introduction to the activities and work of Communicable Disease Surveillance and Control. This department incorporates the former Division of Emerging and other Communicable Diseases Surveillance and Control and programmes from the Control of Tropical Diseases.

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http://www.who.int/emc-documents/_titles.html EMC Document Centre - By Publication Year
These documents offer an introduction to the activities and work of Communicable Disease Surveillance and Control. This department incorporates the former Division of Emerging and other Communicable Diseases Surveillance and Control and programmes from the Control of Tropical Diseases.

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http://www.who.int/emc-documents/_year.html EMC Document Centre - By Subject
These documents offer an introduction to the activities and work of Communicable Disease Surveillance and Control. This department incorporates the former Division of Emerging and other Communicable Diseases Surveillance and Control and programmes from the Control of Tropical Diseases.
http://www.who.int/emc-documents/index.html WHO Recommended Surveillance Standards. Second Edition
This document has been produced jointly by technical clusters of WHO, as well as by UNAIDS, in order to bring together WHO recommended standards for the surveillance of communicable diseases. It is not meant to replace existing technical guidelines or be an exhaustive description of surveillance of all diseases. This document serves only as a guide to good practice and may help to harmonize surveillance activities.

The purpose of this manual is to be a handy reference for key elements and contact information for all communicable diseases / syndromes associated with current WHO control programmes. It should be particularly useful at the Ministry of Health level in Member States, in approaching integrated surveillance of communicable diseases / syndromes.

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Breastfeeding Breast-Feeding and the Use of Water and Teas.
Results from recent surveys indicate that the majority of neonates in Africa, Asia, and Latin America are breast-fed. However, the same surveys show that exclusive breast-feeding, i.e., giving the infant no other fluid or food than breast milk, is a very infrequent practice. Water and/or teas (such as camomile and fennel infusions) are offered to young infants, frequently from the first week of life, in the belief that they will relieve pain (e.g., from colic, earache), prevent and treat colds and constipation, soothe fretfulness, and, especially, quench thirst. The intake of such supplementary fluids is associated in young infants with an increased risk of disease and a shortening of the duration of breast-feeding. Moreover, several studies have shown that these fluids are not actually needed by healthy infants during the first semester of life if they are exclusively breast-fed. No. 1, Aug. 1992

http://www.who.int/chd/publications/newslet/update/updt-09.htm Breastfeeding Counselling: A Training Course
Breastfeeding: Training health workers. Health workers can play a key role in the protection, promotion and support of breastfeeding. Their presence at the time of delivery and their subsequent contacts with mothers and infants provide them with unique opportunities to help mother and baby to establish and maintain lactation. In the past two decades, there has been a rapid increase in our understanding, not only of the scientific basis of lactation and suckling, but also of effective management and prevention of breast-feeding problems, including the use of basic counselling skills. Research has shown that if health workers' attitudes and practices are supportive, it is more likely that mothers will breastfeed successfully and for a longer period. No. 14, Aug. 1994

http://www.who.int/chd/publications/newslet/update/updt-14.htm Not Enough Milk and Breastfeeding
WHO and UNICEF recommend that infants should be exclusively breastfed for at least the first four months of life, and if possible for 6 months. However, worldwide, few infants are breastfed exclusively for more than a few weeks. Even in societies where breastfeeding is still the norm, mothers often introduce complementary foods or drinks at an early age. One of the commonest reasons that mothers all over the world give for stopping breastfeeding or introducing complementary food early is that they think they do not have enough milk or that the quality of milk is poor. Some mothers worry about the amount of breastmilk they produce as early as the first days post-partum.

No. 21 Feb. 1995
http://www.who.int/chd/publications/newslet/update/updt-21.htm Hepatitis B and Breastfeeding
The question of whether breastfeeding plays a significant role in the transmission of hepatitis B has been asked for many years. It is important given the critical role of breastfeeding and the fact that about 5% of mothers worldwide are chronic hepatitis B virus (HBV) carriers. Examination of relevant studies indicates that there is no evidence that breastfeeding poses any additional risk to infants of HBV carrier mothers. The use of hepatitis B vaccine in infant immunization programmes, recommended by WHO and now implemented in 80 countries, is a further development that will eventually eliminate risk of transmission. This document discusses the issues relevant to breastfeeding and HBV transmission, and provides guidance from a WHO perspective.

No. 22 Nov 1996
http://www.who.int/chd/publications/newslet/update/updt-22.htm

Travel

International Travel and Health - Vaccination Requirements and Health Advice
This booklet is addressed to national health administrations responsible for providing advice on the health hazards of international travel, and to the practising physicians, travel agencies, shipping companies, airline operators, and other bodies who are called upon to give advice in individual cases. In addition to summarizing the vaccination requirements of individual countries, this booklet covers certain health hazards to which the traveller may be exposed and indicates the areas in which these hazards are most likely to occur. This is particularly important with malaria, which has continued to cause serious problems in recent years. It also recommends precautions that the wise traveller should take when visiting unfamiliar place

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International Travel and Health - Diarrhoea - Risks from Food and Drink:
Diarrhoea is by far the commonest cause of ill health in travellers. No vaccine is capable of conferring general protection against diarrhoea, which has many different causes. A new oral cholera vaccine composed of killed Vibrio cholerae O1 and B subunit cholera toxin provides short-term protection against strains of Escherichia coli that produce heat-labile enterotoxin (LT), which are one cause of diarrhoea in travellers.

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Cholera: Basic Facts for Travellers
What is cholera?, What should I do if I think I may have cholera?, Where are the outbreaks of cholera?, Do vaccinations work against cholera?, What can I do to avoid cholera?
http://www.who.int/topics/cholera/faq/en/index.html

Cholera: Basic Facts for Travellers
Cholera outbreaks occur every year in different parts of the world. Although potentially fatal, cholera can be easily prevented and treated. By following some simple and sensible rules, the traveller can avoid infection. Here are the basic facts about cholera.
http://www.who.int/vaccine_research/diseases/cholera/en/ WHO Publications: Travel Medicine
A Guide on Safe Food for Travellers, International Certificates of Vaccination, International Health Regulations, International Medical Guide for Ships, International Travel and Health 2000 edition online, Ports Designated in Application of the International Health Regulations, Yellow Fever Vaccinating Centres for International Health

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Reference

WHO: List of Non-Governmental Organization Abbreviations
http://www.wpro.who.int/NR/rdonlyres/8F239681-C4DE-4FEB-9C8D-CBD0B1D0BD40/0/abbreviations.pdf

Anti-infective Drug Resistance
WHO Global Strategy for Containment of Antimicrobial Resistance. Despite the enormous advances in health care in the last half-century, infectious diseases still account for 25% of deaths worldwide and 45% in low-income countries. As we increasingly recognize the role of infectious agents in other diseases, we will place even greater importance on treating and preventing infections.

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http://www.who.int/emc/amr.html Emerging Foodborne Diseases
Some foodborne diseases are well recognized, but are considered emerging because they have recently become more common. For example, outbeaks of salmonellosis have been reported for decades, but within the past 20 years the disease has increased in incidence on many continents.

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Ebola Haemorrhagic Fever
Ebola haemorrhagic fever (EHF) is one of the most virulent viral diseases known to humankind, causing death in 50-90% of all clinically ill cases. The disease has its origins in the jungles of Africa and Asia. Several different forms of Ebola virus have been identified and may be associated with other clinical expressions, on which further research is required. Fact Sheet N° 103 - Revised December 2000

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http://www.who.int/inf-fs/en/fact103.html Lassa Fever
Lassa fever is an acute viral illness of one to four weeks duration caused by Lassa virus, a member of the arenavirus family of viruses. The disease was first described in the 1950s, although the virus was not isolated until 1969. Consequences range widely in severity, from asymptomatic infection without illness to extremely severe illness which may have a fatal outcome.

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http://www.who.int/inf-fs/en/fact179.html Crimean-Congo Haemorrhagic Fever
Crimean-Congo haemorrhagic fever (CCHF) is a viral haemorrhagic fever of the Nairovirus group. Although primarily a zoonosis, sporadic cases and outbreaks of CCHF affecting humans do occur. 1998 has already witnessed 2 outbreaks, one in Pakistan affecting four people, with two deaths, and another in Afghanistan affecting 19 people with 12 deaths. The disease was first described in the Crimea in 1944 and given the name Crimean haemorrhagic fever.

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Fever in Young Children
The management of fever in young children with acute respiratory infections in developing countries. It is important that all febrile children are carefully assessed to find the cause of fever. Fever alone in a child with ARI is not a specific sign of pneumonia and is not an indication for antibiotic treatment. However, fever in the first two months of life is a sign of possible serious bacterial infection and referral to hospital is indicated for further investigation and treatment. In malarious areas, children with fever should, in addition, be treated according to the recommendations of the national malaria programme.

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http://www.who.int/chd/publications/ari/fever.htm Malaria and Pneumonia
The overlap in the clinical presentation and treatment of malaria and pneumonia in children: report of a meeting (Geneva, 8 April 1991). Pneumonia and malaria are common conditions in young children. Pneumonia is the first or second leading cause of mortality in young children in most developing countries. In countries with significant falciparum malaria transmission, malaria is also amongst the leading causes of mortality. It is important that the overlap in their clinical presentations and treatment be understood. Understanding the interaction between the two diseases is important for case management guidelines, for training health workers, for communicating with caretakers of children, and for formulating household survey (and verbal autopsy) questions and interpreting their results.

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http://www.who.int/chd/publications/ari/malpnu.htm Tuberculosis situation in Ingushetia critical
The danger of tuberculosis (TB) spreading is becoming critical amongst an estimated 180 000 displaced persons in Ingushetia who have fled the fighting in neighbouring Chechnya. In response, WHO is working to strengthen health facilities and laboratories through the provision of supplies, equipment and training.

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A Standard Verbal Autopsy Method for Investigating Causes of Death in Infants and Children

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Zoonotic Non-0157 Shiga Toxin-Producing Escherichia Coli (STEC).
Report of a WHO Scientific Working Group Meeting. Berlin, Germany, 23-26 June 1998

Infections with Shiga toxin-producing Escherichia coli (STEC) bacteria are increasingly reported worldwide. Among STEC, O157:H7 is the classical serotype that was first associated with enterohaemorrhagic diseases in the early 1980's as a cause of serious outbreaks and sporadic cases of illness. However, over 100 different STEC serotypes, other than O157:H7, have now been associated with human illness. Non-O157 STEC, also first associated with human disease in the early 1980's, are only recently becoming recognized as important pathogens that cause a spectrum of disease in humans similar to that caused by serotype O157:H7. An increasing number of outbreaks and sporadic cases related to non-O157 have been reported.

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http://whqlibdoc.who.int/hq/1998/WHO_CSR_APH_98.8.pdf WHO Responds to New Challenges in Food Safety
The World Health Organization (WHO) has announced a plan for the expansion of its food safety programme in response to new challenges in food safety. New activities include generating more comprehensive data on foodborne diseases, creating a risk assessment body with the U.N. Food and Agriculture Organization (FAO) and investigating the causes for the increase in foodborne disease risk. WHO will also define what research is needed to determine whether there may be any positive or negative health implications arising from the consumption of genetically modified foods.

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http://www.who.int/inf-pr-2000/en/pr2000-04.html Better Quality at Lower Prices
"Some countries routinely pay 150% to 250% of world market prices for the essential drugs, while other countries complain of unreliable suppliers and poor quality drugs", stated Dr Hans Hogerzeil, of WHO’s Essential Drugs and Medicine Policy Department, at today’s launch of the guide Operational Principles for Good Pharmaceutical Procurement.

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Emergency and Humanitarian Action
The dramatic and continuing rise in the number and severity of natural and man-made disasters calls for a strengthened and more proactive WHO role in helping to mitigate their impact. It is estimated that in 1994, as many as 250 to 300 million people were affected by such disasters.

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Focused Programme Reviews
Periodic evaluations are an essential component of the functions of the WHO Programme for the Control of Diarrhoeal Diseases (CDD). One approach, supported by the Programme between 1983 and 1991, entailed a comprehensive programme review methodology. This review methodology involved teams of external experts who worked with their national counterparts and who reviewed all components of the national programme. The result of this process was usually an extensive list of recommendations for the national CDD programme.

No. 13, Oct. 1993
http://www.who.int/chd/publications/newslet/update/updt-13.htm How Surveys Can Contribute to Programme Success
The WHO Division of Diarrhoeal and Acute Respiratory Disease Control (CDR) has issued three sets of updated survey guidelines: two for the assessment of the quality of case management in health facilities (the CDD Health Facility Survey Manual and the ARI Health Facility Survey Manual); and one for the assessment of the case management of diarrhoea and ARIs at the household level (the CDD/ARI Household Survey Manual). This issue of Update provides an overview of the updated survey manuals, and provides guidance about how they can be used to improve CDD and ARI programmes.
No. 17, Oct. 1994
http://www.who.int/chd/publications/newslet/update/updt-17.htm

On-Line Publications and Documents Catalogs

WHO Publications: Diarrhoeal Disease
1991-1999
- Dietary Management of Young Children with Acute Diarrhoea
- Guidelines for Cholera Control
- Integrated Management of Childhood Illness
- Management and Prevention of Diarrhoea (The)
- Rational Use of Drugs in the Management of Acute Diarrhoea in Children (The)
- Readings on Diarrhoea

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http://www.euro.who.int/childhealtdev/publications/publicationstop CHD Publications and Documents Catalog
This page represents the full list of currently available publications and other documents relating to the Integrated Management of Childhood Illness (IMCI) , the former Division of Diarrhoeal and Acute Respiratory Disease Control (CDR), the former Programme for the Control of Diarrhoeal Diseases including Cholera (CDD) and the former Programme for the Control of Acute Respiratory Infections (ARI). Not all of the documents named are available for distribution.

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Selected Publications and Documents on Diarrhoeal Diseases (including Cholera)
Selected publications and documents on Diarrhoeal Diseases (including cholera) Division of Child Health and Development (CHD) World Health Organization This page represents a list of publications and other documents relating to the Control of Diarrhoeal Diseases.

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Selected Publications and Documents on Acute Respiratory Infections
Selected publications and documents on Acute Respiratory Infections Division of Child Health and Development (CHD) World Health Organization This page contains a list of publication and other documents related to Acute Respiratory Infections in children.

Management and General Interest: General, Management, Epidemiology, Etiology and Statistics
Health Services: Prevention and control, Education and training, Manuals and guidelines
Research: Case management research, Behavioural research, Health systems research, Disease prevention research, Scientific papers, General

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http://www.who.int/chd/publications/ari/aripub.htm WHO Publications: AIDS
World Health Organization - AIDS Publications 1991-1998
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Infectious Diseases - Action Against Infection newsletter
Action Against Infection - A Newsletter for WHO and its partners.

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Weekly Epidemiological Record WER
The World Health Organization (WHO) Weekly Epidemiological Record (WER) serves as an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the International Health Regulations and on other communicable diseases of public health importance, including the newly emerging or re-emerging infections. The WER is distributed every Friday in a bilingual English/French edition. The electronic edition is free of charge. 21258 bytes; modified: Wednesday, April 20, 2000 (08:59)

http://www.who.int/wer/index.html


WHO - CHD "Update" Series
- Hepatitis B and breastfeeding
- Not enough milk
- How research findings have improved diarrhoea case management
- Clinical skills: a self-instructional course
- Improving the practices of pharmacists and licensed drug sellers
- Revised Survey Manuals
- The outpatient management of bloody diarrhoea in young children
- Radio Guide: A guide to using radio spots in national CDD programmes
- Breastfeeding counselling: A training course / Conseil en allaitement maternel: cours de formation
- Focused Programme Reviews
- Breast-feeding and the use of water and teas (Facts about infant feeding)
- Rice-based Oral Rehydration Salts
- Rotavirus Vaccines

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WHO Library Catalog

The WHO Library catalog provides bibliographic references for WHO documentation:

1. Books published by WHO offices which are available for sale or can be consulted in local libraries.

2. Journal articles in WHO periodicals or articles in other journals which report on WHO work; these articles are available in local libraries or through local document delivery services.

3. WHO technical documents; the citations for these free distribution documents often include a link to the full text of the document--look for a line at the end of the bibliographic record that says "Electronic Access" and gives an internet address.

To search the library catalog go to the= WHO Library and Information Networks for Knowledge (LINK) and click on "WHOLIS (Library catalogue)".

Enter the cursor into the "words or phrases" line and type in what you are searching for

OR

Enter the cursor into the "subject" line and type in your subject (the catalog uses US National Library of Medicine Subject Headings (MeSH)

OR

To narrow your search to WHO documentation only, enter the cursor into the "words or phrases" line, type in "WHO" and also enter the cursor into the "subject" line and type in the subject. You limit this search by language, and/or years of publication.

For additional information, a tutorial for using the Library Catalog can be found at:

http://www.who.int/hlt/aboutlib/English/catscripte.htm
.

Or if you need assistance or additional information, please email library@who.int

WHO Publications Catalog

The WHO Publications catalogue covers over 700 formal WHO publications organized by subject category. In addition WHO issues around 300 informal technical documents each year (identified by WHO/ prefix). These can be located by searching the online library catalogue.

If you need assistance or additional information, please email publications@who.int.


Official Web Site Locator for the United Nations System of Organizations

System to search all Web Sites participating in the United Nations International Organizations Network Search scheme. This is an alphabetic index of websites of the United Nations System of Organizations, including joint initiatives and special projects which exist to address specific, substantive areas of interest. Entries listed in bold are members of the Administrative Committee on Coordination (ACC).

Publications and Documents in Print

Please note that not all articles in this list are available on request. Authored articles in this list are for information purposes only and are not available. These can be obtained from libraries or general publishers.


How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions



Readings on Diarrhoea - Student Manual

1992, vii + 147 pages [C, E, F; S from PAHO]
ISBN 92 4 154444 9
Sw.fr. 20.-/US $18.00; in developing countries: Sw.fr. 14.-
Order no. 1150386 -


How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions

"Readings on Diarrhoea" may be used as a source of practical information and as a manual of treatment guidelines. It will be more effective, however, if used in combination with organized teaching activities on diarrhoeal diseases, such as lectures, discussions, demonstrations, and supervised practice in treating cases. Readers are urged to check their understanding of the material by answering the questions that follow each unit. A companion book "References on Diarrhoea" contains related background articles that summarize current research and provide additional information on most topics covered in this text. This is made available to medical school libraries and other institutions conducting training in diarrhoea case management. An "Instructor's Manual" is available which provides guidance for medical faculty and other teachers about how the material in each unit of the text may be most effectively taught.

A collection of eight teaching units conveying essential information about the pathophysiology, clinical features, diagnosis, epidemiology, treatment and prevention of diarrhoea in children. Addressed to medical students undergoing clinical training in paediatrics, the manual aims to equip students with all the knowledge needed to assess patients, plan treatment, and prevent deaths through proper case management. Information, which is specific to conditions in developing countries, ranges from an explanation of the clinical features seen in different forms of dehydration, through advice on how to communicate with mothers, to a discussion of the role of feeding in the management of diarrhoea. Recommended lines of action draw their authority from published research and extensive WHO experience in programmes for the treatment and prevention of diarrhoea. The first two teaching units provide fundamental information about the epidemiology, clinical types of diarrhoea, causative agents, modes of transmission, pathophysiology, and implications for treatment. Subsequent units explain how the clinical assessment of patients should be performed and interpreted, discuss ways of teaching mothers to treat diarrhoea at home, describe clinical measures for the treatment of dehydrated patients, and discuss the special procedures to be followed during the treatment of dysentery, persistent diarrhoea, and diarrhoea associated with other illnesses. The remaining units cover the nutritional management of diarrhoea in children, including those suffering from severe malnutrition, and explain how physicians can promote prevention, particularly through the education of mothers and other family members. Each unit concludes with a list of exercises. Further practical information is presented in a series of annexes, which include illustrated, step-by-step instructions for intravenous rehydration and nasogastric rehydration.

The complete set of these materials, including tables and diagrams can also be ordered from CDH.


Dietary Management of Young Children with Acute Diarrhoea
A Practical Manual for District Programme Managers
Second edition

D.B. Jelliffe and E.F.P. Jelliffe
1991, 29 pages [E, F, R; S from PAHO]
ISBN 92 4 154428 7
Sw.fr. 8.-/US $7.20; in developing countries: Sw.fr. 5.60
Order no. 1152316


How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions

Sets out principles and practices designed to guide the correct early feeding of young children suffering from acute diarrhoea. Addressed to district programme managers, the book advocates an approach to management that combines feeding practices, backed by the latest scientific knowledge, with efforts to uncover cultural beliefs that may either support or impede successful management.

The book opens with a brief review of findings relevant to the dietary management of acute diarrhoea as a means of preventing malnutrition. The second chapter offers a guide to the selection of foods during and after diarrhoea, emphasizing the importance of issuing medical advice in keeping with an awareness of traditional beliefs and practices that may influence acceptance. A chapter on prevention concentrates on dietary measures, for infants and during weaning, that can decrease the likelihood of swallowing harmful bacteria or viruses and increase resistance to infection. The book concludes with a tabular guide to the dietary management of diarrhoea according to four stages, moving from diarrhoea without obvious dehydration to convalescence.

"... an eminently sensible and easily understood publication..."
— Catering and Health

"... the essence of nutrition and health ... a strictly practical, valuable manual of instruction..."
— Nutrition and Health


Integrated Management of Childhood Illness: A WHO/UNICEF Initiative

Bulletin of the World Health Organization, Vol. 75, 1997, Supplement 1
1997, 128 pages [E, with summaries in F]
ISBN 92 4 068750 5
Sw.fr. 20.-/US $18.00; in developing countries: Sw.fr. 14.-
Order no. 0037501

How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions

Reports the design and findings of field studies conducted during the development of the new WHO/UNICEF strategy for the integrated management of childhood illness (IMCI). The strategy responds to the fact that 70% of the 11 million childhood deaths that occur each year in the developing world are due to five conditions: pneumonia, diarrhoea, measles, malaria and malnutrition. Central to the strategy's implementation are a set of clinical guidelines for integrated case management at first-level health facilities and an 11-day course for training health workers to use the guidelines correctly.

The research reported in this volume is part of an ongoing effort to ensure that the IMCI clinical guidelines and training course evolve in line with solid scientific evidence concerning their effectiveness. The volume opens with an overview of the technical basis for the guidelines, which aim to help health workers reach quick and accurate decisions based on clinical signs and symptoms. Two subsequent papers report on field evaluations of the guidelines in Africa, one in an area with seasonal malaria and the second in an area with high malaria transmission. In both studies, health workers using the guidelines as the basis for case management performed well when compared with paediatricians, whose clinical diagnosis was supported by laboratory investigations and radiology.

The training course was evaluated in two studies, which were designed to determine how well the course trained workers to assess, classify, and treat ill children, and to suggest improvements in the course material and teaching procedures. Other studies investigated the extent to which use of the guidelines resulted in the accurate assessment and classification of cases, and correct referral to hospital. The remaining studies considered whether specific clinical signs used in the guidelines were adequate for reaching a correct diagnosis of protein-energy malnutrition and moderate or severe anaemia. The final paper summarizes lessons from these studies, which confirm that use of the guidelines enables health workers in first-level facilities to manage a very high proportion of clinical problems quickly and correctly. Use of the guidelines and the training course in individual countries requires adaptation to specific epidemiological situations and health system environments. WHO has developed a detailed guide to facilitate this process.


The Management and Prevention of Diarrhoea
Practical Guidelines
Third edition

1993, v + 50 pages [C, E, F, R, S]
ISBN 92 4 154454 6
Sw.fr. 12.-/US $10.80; in developing countries: Sw.fr. 8.40
Order no. 1153230

How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions

The third edition of a practical guide for teaching health workers how to assess diarrhoea and dehydration, treat cases effectively, and convince community members to adopt preventive practices. Didactic in its approach, the manual uses simple language supported by abundant charts, tables, checklists, and illustrations to help readers absorb information and acquire the full range of essential skills.

The book opens with a clear explanation of what diarrhoea is, why dehydration is so dangerous, and how a child with diarrhoea should and should not be treated. The second section, devoted to home treatment, elaborates three basic rules for helping mothers and other family members treat diarrhoea in the home. Of particular practical value are sections designed to teach health workers how to assess and treat patients. Instructions for assessment are presented through a list of questions to ask, conditions to investigate, and signs to observe, followed by a detailed assessment chart and illustrative examples of how the chart works in practice. The section on treatment provides step-by-step instructions for the preparation of a solution from oral rehydration salts, and sets out three detailed plans, correlated with columns in the assessment chart, for the treatment of diarrhoea, dehydration, and severe dehydration. The guide also outlines the treatment of dysentery and cholera, and discusses what health workers can do to help prevent diarrhoea by making community members aware of preventive practices and encouraging their adoption. A checklist of essential points to remember concludes the book.

"... clear and simple ... a very useful book for family practice in developing countries..."
— Family Practice


The Rational Use of Drugs in the Management of Acute Diarrhoea in Children

1990, iv + 71 pages [C, E, F, S from PAHO]
ISBN 92 4 156142 4
Sw.fr. 14.-/US $12.60; in developing countries: Sw.fr. 9.80
Order no. 1150355

How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions Provides authoritative information essential to those concerned with improving the rational use of drugs in the management of acute diarrhoea in infants and young children and with tackling the immense problems posed by the prescribing of clinically useless and potentially dangerous drugs. The book gathers the information needed to argue against the widespread use of medicines that have no established clinical benefits, are frequently harmful, and may delay or replace effective treatment measures.

Drugs judged effective are dealt with concisely in a table listing four first-choice antimicrobials, and six alternatives, useful in the management of cholera, shigella dysentery, amoebiasis, and giardiasis. Apart from these cases of specific etiology, readers are informed that antidiarrhoeal drugs and antiemetics should never be used for children, as none has any proven practical value and some are frankly dangerous. This statement is substantiated through a review of data on eleven antidiarrhoeal drugs widely used in paediatric practice. The book concludes that none of these preparations has any documented benefits, some actually prolong diarrhoea, and others have been shown to produce severe and sometimes fatal side-effects. The book further concludes that the continued production, promotion, and sale of these preparations for paediatric practice cannot be justified.

"...offers objective assessments of drugs that are widely misused ... will be important everywhere, but vitally so in developing countries..."
— The Lancet


Guidelines for Cholera Control

1993, vi + 61 pages [C, E, F, S*]
ISBN 92 4 154449 X
Sw.fr. 15.-/US $13.50; in developing countries: Sw.fr. 10.50
Order no. 1150398


How to obtain WHO publicationsWHO publications and documents - in multiple languages - are available for free download from the WHO Library database. Printed copies can be ordered from the WHO Bookshop, which offers discounts on orders from developing countries. The Bookshop also offers priced subscriptions to periodicals, book series and thematic packages.WHO Library database | WHO Bookshop | Subscriptions

Sets out the facts and advice needed to guide public health actions in response to an outbreak of cholera. Noting that the introduction of cholera into a country cannot be prevented, the book stresses the many things that can be done to prepare the health services, educate the general public, save the lives of patients, and prevent the further spread of an outbreak. The objective is to help managers of national diarrhoeal disease control programmes and non-governmental agencies to make the most effective decisions, whether concerning the selection of medical supplies or the emergency response to an epidemic. Throughout, emphasis is placed on the importance of safe water, scrupulous personal hygiene, and careful food preparation as the most effective preventive measures. Readers are also alerted to public health interventions, such as vaccination, mass chemoprophylaxis, and cordon sanitaire, which are ineffective, wasteful, and therefore to be discouraged. The opening chapters describe what national programmes should do to be prepared for an outbreak of cholera, outline the actions to take at the earliest stage of an outbreak, and provide guidelines for the management of patients, including advice on the use of oral rehydration therapy and antibiotics. The remaining chapters cover measures for preventing the spread of an outbreak, the epidemiological investigation of an outbreak, the role of the laboratory, and long-term preventive activities. The second part, which consists of five annexes, provides brief advice on the construction of a ventilated improved pit latrine, followed by a detailed step-by-step guide to the management of cholera patients, a selection of sample health education messages, and nine rules for safe food preparation to prevent cholera. The book concludes with guidelines describing a simple and rapid method for the isolation and identification of Vibrio cholerae O1 in diarrhoeal stools.

updated: 24 April, 2014

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