Interventions for 25 - 59 years

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Condition: Meningitis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on meningitis including prevention measures (IPC)
  • Distribution of IEC materials
  • Advocacy for proper sanitation and good housing Vaccination: meningococcal
  • Counselling on seeking early treatment for meningitis * Isolate individuals suspected with N. meningitis Clinical assessment for early recognition of need for referral
  • Physiotherapy services for adults with meningitis complications who may be referred back to communities from health facilities
  • Psychosocial support
Primary Care
  • Awareness campaign on causes, signs and symptoms of meningitis including prevention measures (IPC)
  • Distribution of IEC materials
  • Mobilisation for routine immunisation

Oral antimicrobials chemoprophylaxis for contacts Vaccination: meningococcal"

History and physical examination for meningitis Clinical assessment for early recognition of the need for referral Basic laboratory tests

Referral Facility: General
  • Awareness campaign on causes, signs and symptoms of meningitis including prevention measures (IPC)
  • Distribution of IEC materials

Oral antimicrobials chemoprophylaxis for contacts Vaccination: meningococcal

History and physical examination for meningitis Clinical assessment for early recognition of the need for referral Basic laboratory tests Lumbar puncture Systemic antibiotics for bacterial meningitis

  • Rehabilitation and follow up of adults with complications as a result of meningitis
  • Physical therapy to improve motor coordination and mobility
  • Occupational therapy to develop everyday skills
  • Hearing rehabilitation including provision of hearing aids Referral downwards to Primary care facilities for further or continued rehabilitation
  • Psycho social support for adults with meningitis and their family members
  • Counseling for adults with meningitis especially those who develop complications
Referral Facility: Specialist
  • Health education on meningitis
  • Create Awareness to adults on meningitis and prevention measures Guidance on Good nutrition for the adults
  • Health workers training on meningitis & its management among the adults
  • Guidance on hygiene practices for adults to prevent meningitis

Oral antimicrobials chemoprophylaxis for contacts "Vaccination: pneumococcal conjugate Vaccination: haemophilus influenzae type b (Hib) Vaccination: meningococcal"

History and physical examination for meningitis Basic laboratory tests Advanced laboratory tests Lumbar puncture Computed tomography (CT) scan Systemic antibiotics for bacterial meningitis

  • Rehabilitation and follow up of adults with complications as a result of meningitis
  • Physical therapy to improve motor coordination and mobility
  • Occupational therapy to develop everyday skills
  • Hearing rehabilitation including provision of hearing aids Referral downwards to Primary care facilities for further or continued rehabilitation
  • Psycho social support for adults with meningitis and their family members
  • Counseling for adults with meningitis especially those who develop complications
  • spiritual support
 
Condition: Whooping Cough
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Strengthen families and community-based awareness on whooping cough including prevention measures
  • Create knowledge among family members and communities on importance of vaccination and the vaccination schedule.
  • Knowledge on the importance of timely uptake of vaccine dose
  • Strengthen community health workers knowledge on whooping cough
  • Vaccination
  • One dose of Tdap for adults who have never received the vaccine
  • Good hygiene practices including hand hygiene
  • Cough and sneezing etiquette
  • Community Reporting systems on whopping cough
  • Avoiding close contact with people with whooping cough
  • Recognition of features of whooping cough - which include:
  • features of common cold:( i.e. Runny nose, Nasal congestion, Red, watery eyes, Fever), uncontrollable coughing)
  • Vomiting
  • A high-pitched "whoop" sound during breathing
  • Home remedies staying hydrated resting using a mist vaporizer practicing proper hand hygiene eating frequent small meals to avoid vomiting avoiding coughing triggers, such as smoke, strong chemicals,allergens
  • Monitoring for any worsening of the patient condition
  • Referrals to health facilities
Primary Care
  • Strengthen families and community-based awareness on whooping cough including prevention measures
  • Strengthen health workers knowledge on whooping cough
  • Knowledge on the importance of timely uptake of vaccine dose
  • Guidance on hygiene for adults
  • Guidance on good nutrition
  • Create knowledge among family members and communities on importance of vaccination and the vaccination schedule
  • Vaccination
  • One dose of Tdap for adults who have never received the vaccine
  • Post exposure prophylaxis for close contacts
  • Practicing proper hygiene including hand hygiene
  • Avoiding close contact with people with whooping cough
  • Cough and sneezing etiquette
  • Community Reporting systems on whopping cough
  • Clinical examination
  • Administration of antibiotics
  • Supportive management
  • Monitor for any complications
  • Referral to hospital for Management of any complications e.g rib fracture, syncope, abdominal hernia
Referral Facility: General
  • Awareness to Adults on whopping cough and prevention measures
  • Guidance on hygiene practices
  • Guidance on Good nutrition
  • Health workers education on whooping cough and its management
  • Post exposure prophylaxis for close contacts
  • Physical and Clinical examination
    • Outpatient services
  • Anti-microbial therapy
  • Supportive management
  • Management of any complications e.g rib fracture, syncope, abdominal hernia or other complications from the severe, chronic cough
  • Hospitalization for patients at risk of severe pertussis/and complication
  • Rweferral to specialised hospitals for further managemnet eg ICU services for severe illness
  • Laboratory tests,B pertussis, culture, polymerase chain reaction (PCR), serologic testing and direct fluorescent antibody (DFA) testing.
  • Follow up
  • Rehabilitation services depending on complications.
  • Physical rehabilitation
  • Psychosocial support
  • Counseling for adults with complications due to whooping cough
Referral Facility: Specialist
  • Awareness to Adults on whopping cough and prevention measures
  • Guidance on Good nutrition
  • Guidance on hygiene practices
  • Health workers education on whooping cough and its management
  • Post exposure prophylaxis for close contacts
  • Physical and clinical examination
  • Outapttient services
  • Anti-microbial therapy
  • Supportive management eg relieve of pain and /or fever
    • Hospitalization for patients at risk of severe pertussis/and complications
  • Laboratory tests,B pertussis, culture, polymerase chain reaction (PCR), serologic testing and direct fluorescent antibody (DFA) testing.
  • Management of any complications e.g rib fracture, syncope, abdominal hernia or other complications from the severe, chronic cough
  • ICU services for severe illness
  • follow up
  • Physical rehabilitation
  • Rehabilitation services depending on complications.
  • Counseling for adults with complications due to whooping cough
  • Psychosocial support
 
Condition: Encephalitis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness to families and communities on the disease and prevention measures
  • Information/creation of awareness on healthy living
  • Awareness creation on good nutrition
  • Provision of IEC materials
  • Awareness creation/education on animal handling and animal health e.g. dogs (rabies)
  • Information provision to the communities on the importance of immunization for children
  • Community health workers tarining on encehaplitis including on prevention measures
  • Vectors/mosquitos control (as a carrier for some of the virus arbovirus)
  • Parasites such as Ticks control
  • Recognition of features indicative of encephalitis including Fever, Aches in muscles,weakness,fits (Seizures),Muscle weakness,
  • Supportive and symptomatic management for the elderly suspected to have encephalitis awaiting referral including:
    • Encourage plenty of rest- Bed rest
    • Provision of Plenty of fluids
    • Use of Anti-inflammatory drugs -
    • Management of fever-sponging, use of anti pyretics -
    • Relieve pain/aches with pain medicines such as paracetamol
  • Urgent Referral of a patient suspected to have enephalitis to the nearest health facility
  • Continued Rehabilitation at community level and follow up of patients referred backwards from the health facilities (those who may have had complications)
  • Physical therapy to improve motor coordination
  • Occupational therapy to develop everyday skills
  • Community based rehabilitation
  • Speech therapy
  • Psycho-social support for adults with encephalitis and their families
  • Counselling
  • Psycho- therapy to learn coping strategies and new behavioral skills
  • Spiritual support
Primary Care
  • Create awareness to families and communities on the disease and prevention measures
  • Information on the importance of immunization for children
  • Information/creation of awareness on healthy living
  • Awareness on good nutrition
  • Provision of IEC materials
  • Awareness /education on animal handling and animal health e.g. dogs (rabies)
  • Training/sensitizing health workforce
  • Vectors mosquitos control (as a carrier for some of the virus arbovirus)
  • Parasites such as Ticks control
  • Clinical examination
  • Supportive and symptomatic management for encephalitis before urgent referral to hospital including:
  • Bed rest
  • Fluids therapy/Plenty of fluids
  • Management of fever using anti pyretics
  • Management if pain with analgesisc
  • Suction to remove secretions
  • Monitor for any danger signs e.g. lethargy; unconsciousness; convulsions
  • Referral of a pesron suspected to have encephalitis to the nearest hospital
  • Rehabilitation and follow up of patients referred backwards from the Hospitals
  • Physical therapy to improve motor coordination and mobility
  • Occupational therapy to develop everyday skills Referal downwards to community level for further community based rehabilitatuon
  • Psycho-social support for adults with encephalitis and their families
  • Counselling
  • Psycho- therapy to learn coping strategies and new behavioral skills
  • Spiritual support*
Referral Facility: General
  • Creation of awareness to adults on encephalitis prevention measures
  • Information/creation of awareness on healthy living
  • Guidance on good nutrition for adults
  • Training/sensitizing health workforce on encephalitis management
  • Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus) ; Parasites such as Ticks control
  • Early recognition and treatment of encephalitis
  • Initiate anti-viral treatment immediately
  • Initiate anti-microbial therapy including appropriate therapy for presumed bacterial meningitis (use antibiotics for acute bacterial meningitis
  • Initiate specific regimen after determining the etiology of encephalitis
  • For Viral encephalitis use of antiviral treatment.e.g. for herpes simplex virus /Antiviral medications e.g. Acyclovir
  • Antimicrobial therapy targeting the identified infectious agent,
  • Supportive care for severe encephalitis including: * Breathing assistance,
  • Intravenous fluids adminstration
  • Anti-inflammatory drugs administration
  • Administration of Anticonvulsant medications
  • Admissions for persons with encephalitis
  • Management of any complications
  • Prevention /or management of shock or hypertension
  • Prevention/Management of seizures
  • Management of hydrocephalus and increased intracranial pressure
  • ICU services
  • Laboartory diagnostic interventions for Encephalitis including:
  • Blood and urine tests - lumbar puncture (LP) -CSF culture - Blood cultures for bacterial pathogens - Serologic tests for Toxoplasma
  • Physical and clinical examination
  • Imaging such as: - Imaging such as Computerized Tomography CT - MRI
  • Computerized Tomography CT
  • Magnetic Resonance Imaging MRI
  • Follow-up therapy for complications of encephalitis
  • Physical therapy to improve motor coordination and function - Speech therapy - Occupational therapy to develop every day skills
  • Speech therapy
  • Referral downwards to primary care facilities for rehabilitation
  • Psycho-social support for adults with encephalitis and their families
  • Counselling
  • Psycho- therapy to learn coping strategies and new behavioral skills
Referral Facility: Specialist
  • Creation of awareness to adults on encephalitis prevention measures
  • Information/creation of awareness on healthy living
  • Guidance on good nutrition for adults Training/sensitizing health workforce on encephalitis management
  • Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus) ; Parasites such as Ticks control
  • Physical and clinical examination
  • Early recognition and treatment of encephalitis
  • Imaging such as:
  • Computerized Tomography CT
  • Magnetic Resonance Imaging MRI
  • Initiate anti-viral treatment immediately
  • Initiate anti-microbial therapy including appropriate therapy for presumed bacterial meningitis (use antibiotics for acute bacterial meningitis
  • Initiate specific regimen after determining the etiology of encephalitis
  • For Viral encephalitis use of antiviral treatment.e.g. for herpes simplex virus /Antiviral medications e.g. Acyclovir
  • Antimicrobial therapy targeting the identified infectious agent,
  • Supportive care for severe encephalitis including: * Breathing assistance,
  • Intravenous fluids adminstration
  • Anti-inflammatory drugs administration
  • Administration of Anticonvulsant medications
  • Admissions for persons with encephalitis
  • Management of any complications
  • Prevention /or management of shock or hypertension
  • Prevention/Management of seizures
  • Management of hydrocephalus and increased intracranial pressure
  • ICU services
  • Laboartory diagnostic interventions for Encephalitis including:
  • Blood and urine tests
  • lumbar puncture (LP) -CSF culture
  • Blood cultures for bacterial pathogens
  • Serologic tests for Toxoplasma
  • Follow-up therapy for complications of encephalitis
  • Referral downwards to primary care facilities for rehabilitation
  • Physical therapy to improve motor coordination and function
  • Speech therapy
  • Occupational therapy to develop every day skills
  • Psycho-social support for adults with encephalitis and their families
  • Counselling
  • Psycho- therapy to learn coping strategies and new behavioral skills
  • Spiritual support
 
Condition: Measles
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Families and community education on transmission and prevention of measles
  • Education on proper nutrition for adults
  • Health education on Proper sanitation
  • Promoting proper planning especially in urban areas to avoid over-crowding
  • Community health workers training on measles including prevention and recognition of measles in adults
  • Contact tracing
  • Quarantine for contacts
  • Recognition of features of measles in adults including cold-like symptoms, such as;-
  • a runny nose, sneezing and a cough
  • Sore, red eyes that may be sensitive to light
  • Fever
  • Small greyish-white spots on the inside of the cheeks
  • Watery eyes
  • Swollen eyelids
  • Body aches and pains
  • Home based care
  • Supportive management for adults with measles including;-
  • Provision of plenty of fluids to the adults
  • Encourage the adults with measles to rest
  • Proper nutrition for the adults with measles
  • Relieve fever-administer anti-pyretics when there is fever (paracetamol or brufen
  • Relieve aches/pain with paracetamol or Ibuprofen
  • Monitoring and recognition for any features indicating worsening of measles in adults and referral the features include;-
  • Shortness of breath
  • Coughing up blood
  • drowsiness
  • confusion
  • Fits (convulsions)
  • Referral to the health facilities
Primary Care
  • Information to Families and community education on transmission and prevention
  • Community education on;
  • proper nutrition
  • Proper sanitation
  • Promoting proper planning especially in urban areas to avoid over-crowding
  • Provision of IEC materials
  • Training/sensitizing health workforce on measles including its management
  • Contact tracing
  • Quarantine for contacts
  • Isolation for the patients with measles to contain the spread
  • Clinical examination and diagnosis of measles in adults based on key features (signs and symptoms) including cold-like symptoms,such as
  • a runny nose,sneezing and a cough
  • Sore, red eyes that may be sensitive to light
  • Fever
  • Small greyish-white spots on the inside of the cheeks
  • Watery eyes
  • Swollen eyelids
  • Body aches and pains
  • Supportive management for adults with measles including;
  • Provision of plenty of fluids to the adults
  • Proper nutrition for the adults with measles
  • Encourage the adults with measles to rest
  • Relieve fever-administer anti-pyretics when there is fever
  • Relieve aches/pain with analgesics
  • Monitoring and recognition for any complications/worsening of measles in adults and referral. The features include;
  • shortness of breath coughing up blood drowsiness confusion fits (convulsions)
  • Emergency care with an aim of stabilizing the adults with complications due to measles before referral
  • Referral of adults with measles complications to a hospital post exposure vaccination for unvaccinated contacts
Referral Facility: General
  • Isolation of patients with measles to prevent spread
  • Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus)
  • Management of measles complications in adults including;
  • otitis media,conjunctivitis, pneumonia, croup, seizures, encephalitis
  • N/B Carry out necessary confirmatory tests for measles if need be (blood tests,throat swab, urine sample)
Referral Facility: Specialist
  • Isolation of patients with measles to prevent spread
  • Management of measles complications in adults including;-
  • otitis media
  • conjunctivitis
  • pneumonia
  • croup
  • seizures
  • encephalitis
  • N/B Carry out necessary confirmatory tests for measles if need be (blood tests,throat swab; urine sample)
  • Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus)
 
Condition: Trichomoniasis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Referral of women with persistent vaginal discharge to next level for examination and treatment
  • Home based supervision of women with confirmed
  • Trichomoniasis diagnosis for treatment compliance
Primary Care
  • Screening of high risk women for sexually transmitted infections
  • Examination and investigation of women with persistent vaginal discharge for sexually transmitted infections
  • Treatment with oral metronidazole or tinidazole
  • Treatment of sex partners
Referral Facility: General
  • Screening of high risk women for sexually transmitted infections
  • Examination and investigation of women with persistent vaginal discharge for sexually transmitted infections
  • Diagnostic tests
    - Swab test: Vaginal swab is cultured for identifying the causative of infection.
    - Antigen test: Rapid test in which antibody reacts with antigen forming a color on positive test.
    - DNA test: Nucleic acid from vaginal swab undergoes PCR to detect nucleic acid.
    - Wet prep: Fluid from vagina may be examined under microscope.
    - Urine test: For men, urine sample is tested to detect the presence of the parasite.
  • Treatment with metronidazole or tindazole
  • Treatmnet of sexual partners
Referral Facility: Specialist
  • Screening of high risk women for sexually transmitted infections
  • Examination and investigation of women with persistent vaginal discharge for sexually transmitted infections
  • Diagnostic tests
    - Swab test: Vaginal swab is cultured for identifying the causative of infection.
    - Antigen test: Rapid test in which antibody reacts with antigen forming a color on positive test.
    - DNA test: Nucleic acid from vaginal swab undergoes PCR to detect nucleic acid.
    - Wet prep: Fluid from vagina may be examined under microscope.
    - Urine test: For men, urine sample is tested to detect the presence of the parasite.
  • Treatment with metronidazole or tindazole
  • Treatmnet of sexual partners
 
Condition: Tuberculosis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Social and behavioural change communication
  • Promote cough etiquette and cough hygiene
  • Create awareness on Tuberculosis risk factors and prevention methods
  • Social and behavioural change communication on tuberculosis
  • Mass media to raise awareness on tuberculosis and its prevention
  • Promote infection prevention control for TB
  • Contact tracing, screening and management
  • Isolation of confirmed or presumptive TB cases
  • Directly Observed Therapy (DOTs)
  • Referral of people with presumptive TB to next level
  • Referral of people living HIV for regular screening and possible TPT * Trace and follow up of defaulters
  • Directly Observed Therapy (DOTs) by family/community/CHAs to promote adherence
  • Self administrative therapy (SAT) to those with good adherence
  • Referral of presumptive TB cases to next level
  • Referral of people living HIV for regular screening and possible TPT * TB drugs refill
  • Trace and follow up of defaulters
  • Home-based self-management rehabilitation
  • Psychosocial support
  • Linkage with support groups
Primary Care
  • Promote cough etiquette and cough hygiene
  • Promote strong TB Infection control measures
  • Triage people with presumptive TB for “fast-track” or separation
  • Ensure rapid diagnosis and initiation of treatment
  • Improve room ventilation
  • Protect health care workers
  • TB preventive therapy
  • Physical and clinical examination
  • Confirmation of diagnosis using Chest X-ray and acid fast stain and culture of sputum
  • Treatment of confirmed TB cases with anti TB medication using Direct Observed Therapy (DOT )
  • Direct Observed Therapy (DOT) to promote adherence to medication
  • TB drugs refill
  • Sputum collection and specimen referral to labortaories within hospitals
  • Sputum smear -acid stain and culture of sputum
  • Monitoring of TB complications
  • Diagnosis confirmation using AFB,
  • Directly Observed Therapy (DOTs) by family/community/CHAs to promote adherence
  • Self administrative therapy (SAT) to those with good adherence
  • Referral of people with presumptive TB to next level
  • Referral of people living with HIV for regular TB screening
  • B Preventive Therapy
  • TB drugs refill
  • Trace and follow up of defaulters
Referral Facility: General
  • Promote cough etiquette and cough hygiene
  • Promote strong TB Infection control measures
  • Strong TB Infection control measures
  • Triage people with presumptive TB for “fast-track” or separation
  • Ensure rapid diagnosis and initiation of treatment
  • Improve room ventilation
  • Protect health care workers
  • TB preventive therapy
  • Directly Observed Therapy (DOTs)
  • Self-administrative therapy (SAT) to those with good adherence
  • ART therapy for TB/HIV co-infection
  • Referral of people living HIV for regular screening and possible TPT * TB drugs refill for SAT
  • Trace and follow up of defaulters
  • Manage adverse reactions and complications
  • Diagnosis confirmation using chest x-ray, AFB, GeneXpert
  • Directly Observed Therapy (DOTs) by family/community/CHAs to promote adherence
  • Self administrative therapy (SAT) to those with good adherence
  • Referral of people with presumptive TB to next level
  • Referral of people living HIV for regular screening and possible TPT * TB drugs refill
  • Trace and follow up of defaulters
  • Linkage to non-medical social support
  • Breathing exercise
Referral Facility: Specialist
  • Promote cough etiquette and cough hygiene
  • Promote strong TB Infection control measures
  • Strong TB Infection control measures
  • Triage people with presumptive TB for “fast-track” or separation
  • Ensure rapid diagnosis and initiation of treatment
  • Improve room ventilation
  • Protect health care workers
  • TB preventive therapy
  • Direct Observed Therapy (DOT)
  • Self-administered treatment (SAT)
  • Management of severe adverse infections and complications
  • Management of TB/HIV co-infection
  • ART therapy for TB/HIV co-infection
  • MDR/XDR TB management
  • Nutritional support and supplement
  • Management of complication
  • Linkage to non-medical social support
  • Breathing exercise
 
Condition: Syphilis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • General public education on condom use and maintaining one sexual partner
  • Home based supervision of men and women with confirmed Syphilis infection to comply with treatment and follow-up instructions
  • Referral of men and women with genital ulcers for syphilis screening

Physiotherapy support for people with residual neurological effects of neurosyphilis

Pain relief with non-opioid analgesics for patients with late or tertiary syphilis

Primary Care
  • Examination and reaginic tests of treated clients at 3, 6 and 12 months and annually until test is non-reactive
  • Men and women with genital ulcers should have VDRL Test
  • Men and women with positive VDRL or RPR test should have the FTA test
  • Screening of high risk women for sexually transmitted infections
  • Treatment with Penicillin Treatment of sex partners
  • Refer suspected cases of neurosyphilis to hospital for further investigation and treatment

Physiotherapy support for people with residual neurological effects of neurosyphilis

Pain relief with non-opioid analgesics for patients with late or tertiary syphilis

Referral Facility: General
  • Examination and reaginic tests of treated clients at 3, 6 and 12 months and annually until test is non-reactive
  • Men and women with genital ulcers should have VDRL Test
  • Men and women with positive VDRL/RPR test should have the FTA
  • For neurosyphilis, CSF testing every 6 months until CSF cell count is normal
  • Screening of high risk women for sexually transmitted infections

Treatment with PenicillinTreatment of sex partners

  • Specialist care for people with cardiovascular and other systemic residual effects of syphilis
  • Specialist physiotherapy and neurology care for people with residual neurologic effects of neurosyphilis
  • Pain relief with opioid and non-opioid analgesics for patients with late or tertiary syphilis
Referral Facility: Specialist
  • Examination and reaginic tests of treated clients at 3, 6 and 12 months and annually until test is non-reactive
  • Men and women with genital ulcers should have VDRL Test
  • Men and women with positive VDRL/RPR test should have the FTAFor neurosyphilis, CSF testing every 6 months until CSF cell count is normal
  • Screening of high risk women for sexually transmitted infections

Treatment with PenicillinTreatment of sex partners

  • Specialist care for people with cardiovascular and other systemic residual effects of syphilis
  • Specialist physiotherapy and neurology care for people with residual neurologic effects of neurosyphilis

Pain relief with opioid and non-opioid analgesics for patients with late or tertiary syphilis

 
Condition: Other STDs
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education on sexuality and safe sex practices
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Promote early health seeking behaviour distribute IEC materials,
  • Promote condoms use to prevent STIs
  • Promotion of stigma reduction

Counselling on STI prevention, risk reduction, and safer sex Promote and provide female condoms Promote and provide male condoms Vaccination: hepatitis B Risk assessment with sexual history and risk factors

Early recognition of need for referral

Primary Care
  • Education on sexuality and safe sex practices
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Promote early health seeking behaviour
  • Promotion of stigma reduction

Counselling on STI prevention, risk reduction, and safer sex Promote correct and consistent use of condoms Vaccination: hepatitis B Risk assessment with sexual history and risk factors

  • History and physical examination for STI and reproductive tract infections
  • Syndromic diagnosis and treatment of STIs
  • Counselling on partner notification, diagnosis and treatment
  • Information on treatment compliance and use of condom
  • Referral for management of complications of STIs Information on STIs and treatment compliance Provision of condom Referral for management of complications of STIs
Referral Facility: General
  • Education on sexuality and safe sex practices
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Promote early health seeking behaviour
  • Promotion of stigma reduction

Counselling on STI prevention, risk reduction, and safer sex Promote correct and consistent use of condoms Vaccination: hepatitis B Risk assessment with sexual history and risk factors

  • History and physical examination for STI and reproductive tract infections
  • Basic laboratory tests for STI
  • Etiologic diagnosis and treatment of STIs
  • Counselling on partner notification, diagnosis and treatment
  • Information on treatment compliance and use of condom
  • Referral for management of complications of STIs
Referral Facility: Specialist
  • Education on sexuality and safe sex practices
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Promote early health seeking behaviour
  • Promotion of stigma reduction

Counselling on STI prevention, risk reduction, and safer sex Promote correct and consistent use of condoms Vaccination: hepatitis B Risk assessment with sexual history and risk factors

  • History and physical examination for STI and reproductive tract infections
  • Point of care testing/GeneXpert
  • Advanced laboratory tests for STI including culture and sensitivity tests
  • Etiologic diagnosis and treatment of STIs
  • Counselling on partner notification, diagnosis and treatment
  • Information on treatment compliance and use of condom
 
Condition: HIV/AIDS
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Social and behavioural change communication
  • Peer-based HIV education
  • Health education and risk reduction counselling
  • Mass media on HIV awareness
  • Condom social marketing
  • Structural (policy, legal) interventions
  • Create awareness on STIs and HIV/AIDS risk factors and prevention methods
  • Social and behavioural change communication for parents
  • Mass media to raise awareness on HIV/AIDs and its prevention
  • Safe sexual practice including condom use
  • Avoiding harmful traditional practices including sharing needles
  • HIV Testing including HIV self-test
  • Avoiding harmful traditional practices including sharing needles
  • Consistent and correct use of condoms
  • HIV Testing including HIV self-test
  • Prevent gender-based violence
  • Support treatment adherence
  • Refills/Supply of antiretroviral
  • Trace loss to follow-ups
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
  • Social and behavioural change communication
  • Health education and risk reduction counselling
  • Provider-initiated HIV testing
  • Screening blood for HIV
  • Oral PrEP
  • Dapivirine vaginal ring
  • Injectable long-acting cabotegravir
  • Post-exposure prophylaxis
  • Treatment of STIs
  • Voluntary male medical circumcision (VMMC)
  • Substance abuse treatment
  • Needle exchange program
  • Avoiding harmful traditional practices including sharing needles
  • Consistent and correct use of condoms
  • HIV Testing including HIV self-test
  • Oral PrEP
  • Injectable PrEP
  • Prevent gender-based violence
  • Screening high risk groups for STI and HIV
  • Early treatment of STIs
  • Prevent gender-based violence
  • First-line antiretroviral therapy
  • Opportunistic infection prophylaxis
  • Patient follow-up
  • Adverse drug reactions (ADR) monitoring
  • Treatment of mild opportunistic infections
  • TB/HIV co-infection
  • Nutritional support
  • Adherence support
  • Referral to higher level for advanced HIV infection, severe adverse effects, complications and non-compliance
  • Assess and classify for HIV * Initiate combination ARVs
  • Monitor clinically, CD4, viral load
  • Manage opportunistic infections
  • Manage TB co-infection
  • Syndromic management of STIs
  • Supportive management (e.g., nutritional support and supplements etc)
  • Medication refills
  • Trace loss to follow-ups
  • Referral to higher level for severe adverse effects, complications and non-compliance
  • Self-management education
  • Physical exercise
  • Nutritional support
Referral Facility: General
  • Health education and risk reduction counselling
  • HIV Testing including HIV self-test
  • Oral PrEP
  • Injectable PrEP
  • Microbicides
  • Voluntary Medical Male Circumcision (VMMC)
  • Screening high risk groups for STI and HIV
  • Early treatment of STIs
  • Initiate combination ARVs * Monitor clinically, CD4, viral load
  • Management of opportunistic infections
  • Screening and management of latent TB infection and active TB co-infection
  • Syndromic management of STIs
  • Supportive management (e.g., nutritional support, etc)
  • Medication refills
  • Trace loss to follow-ups
  • Referral to higher level for severe adverse reactions, complications and non-compliance
  • Symptomatic relief for patients with untreatable advanced HIV diseases
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
  • Health education and risk reduction counselling
  • Provider-initiated HIV testing
  • Screening blood for HIV
  • Oral PrEP
  • Dapivirine vaginal ring
  • Injectable long-acting cabotegravir
  • Post-exposure prophylaxis
  • Treatment of STIs
  • Voluntary male medical circumcision (VMMC)
  • Substance abuse treatment
  • Needle exchange program
  • Initiate combination ARVs
  • Diagnose and manage advance HIV diseases
  • Monitor clinically, CD4, viral load, Chest X-ray, GeneXpert, culture etc
  • Management of opportunistic infections
  • Screening and management of LTBI, TB (DS & MDR) co-infection
  • Etiologic management of STIs
  • Supportive management (e.g., nutritional support, etc)
  • Medication refills
  • ICU care as clinically indicated
  • Linkage to care and non-medical support
  • Symptomatic relief for patients with untreatable advanced HIV diseases
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
 
Condition: Gonorrhoea
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • General public education on condom use and maintaining one sexual partner
  • Home based supervision of men and women with confirmed Gonococcal diagnosis for treatment compliance
  • Referral of women with offensive vaginal discharge to next level for examination and treatment
  • Referral of males with mucopurulent urethritis to next level for examination and treatment
  • Referral of women in reproductive age and men with infertility to hospitals for investigation and treatment
  • Referral of men with suspected urethral stricture to hospitals

Psychological support for people with infertility

Primary Care
  • Screening of high risk women for sexually transmitted infections
  • Examination and investigation of women with offensive vaginal discharge for sexually transmitted infections
  • Examination and investigation of males with mucopurulent urethritis for sexually transmitted infections
  • Treatment with single dose of Ceftriaxone or Cefixime
  • Concomitant treatment for ChlamydiaTreatment of sex partners
  • Referral of women in reproductive age and men with infertility to hospitals for investigation and treatment
  • Referral of men with suspected urethral stricture to hospitals

Psychological support for people with infertility

Referral Facility: General
  • Screening of high risk women for sexually transmitted infections
  • Examination and investigation of women with offensive vaginal discharge for sexually transmitted infections
  • Examination and investigation of males with mucopurulent urethritis for sexually transmitted infections
  • Treatment with single dose of Ceftriaxone or CefiximeConcomitant treatment for Chlamydia
  • Treatment of sex partners
Referral Facility: Specialist
  • Examination and investigation of males with mucopurulent urethritis for sexually transmitted infections
  • Screening of high risk women for sexually transmitted infectionsExamination and investigation of women with offensive vaginal discharge for sexually transmitted infections
  • Treatment with single dose of Ceftriaxone or Cefixime
  • Concomitant treatment for ChlamydiaTreatment of sex partners
 
Condition: Genital herpes
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Home based supervision of men and women with confirmed genital herpes treatment compliance
  • Referral of people with genital/perianal vesicles/ulcers to next level for examination and treatment
Primary Care
  • Treatment with Acyclovir, valacyclovir/famciclovir
  • Treatment of sex partners
Referral Facility: General
  • Screening of high risk women for sexually transmitted infections
  • Treatment with Acyclovir, valacyclovir or famciclovir
  • Treatment of sex partners
Referral Facility: Specialist

Screening of high risk women for sexually transmitted infections

Treatment with Acyclovir, valacyclovir or famciclovirTreatment of sex partners

 
Condition: Diarrhoeal diseases
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community-based awareness campaign
  • Mass media based awareness
  • Good sanitation and hygiene practices
  • Safe water supply
  • Oral rehydration salts (ORS) solution
  • Oral sugar-salt solution
  • Nutrient-rich foods
  • Zinc supplements
  • Immediate transfer of severe cases to a higher-level health care facility
Primary Care
  • Community-based awareness campaign
  • Mass media based awareness
  • Access to safe drinking water
  • Use of improved sanitation
  • Hand washing with soap
  • Oral rehydration salts (ORS) solution
  • Intravenous hydration
  • Antibiotics for bacterial infections
  • Zinc supplements
  • Nutrient-rich foods
  • Immediate transfer of severe or complicated cases to a higher-level health care facility
Referral Facility: General
  • Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc.
  • Distribution of IEC materials on enteric infections
  • Access to safe drinking water
  • Use of improved sanitation
  • Hand washing with soap
  • Intravenous hydration
  • Antibiotics to treat bacterial infections
  • Zinc supplements
Referral Facility: Specialist
  • Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc.
  • Distribution of IEC materials on enteric infections
  • Access to safe drinking water
  • Use of improved sanitation
  • Hand washing with soap
  • Intravenous hydration
  • Antibiotics to treat bacterial infections
  • Zinc supplements
 
Condition: Chlamydia
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Community health workers sensitization on chlamydia including prevention measures
  • General public education on condom use and maintaining one sexual partner
  • Education on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
  • Referral of adult women with offensive vaginal discharge to next level for examination and treatment
  • Referral of adult males with mucopurulent urethritis to next level for examination and treatment
  • Home based supervision of adult men and women with confirmed Chlamydia diagnosis for treatment compliance
  • Referral of women in reproductive age and men with infertility to hospitals for investigation and treatment (adult)
  • Referral of men with suspected urethral stricture to hospitals (adult)
  • Psychological support for people with infertility
Primary Care
  • Screening of high risk adult women for sexually transmitted infections
  • Examination and investigation of adult women with offensive vaginal discharge for sexually transmitted infections
  • Examination and investigation of adult men with mucopurulent urethritis for sexually transmitted infections
  • Physical and clinical examination
  • Diagnostics tests
    - Swab test for culturing or antigen testing for chlamydia especially in adult women
    - Urine culture-especially in adult men
  • Treatment of confirmed Chlamydia infection antibiotics
  • Guidance on avoidance of sex until completion of treatment course
  • Referral
  • Referral of women in reproductive age and men with infertility to hospitals for investigation and treatment (adult)
  • Referral of men with suspected urethral stricture to hospitals (adult)
  • Psychological support for people with infertility
Referral Facility: General
  • Screening of high risk adult women for sexually transmitted infections
  • Examination and investigation of adult women with offensive vaginal discharge for sexually transmitted infections
  • Examination and investigation of adult men with mucopurulent urethritis for sexually transmitted infections
  • Physical and clinical examination
  • Diagnostics tests
    - Swab test for culturing or antigen testing for chlamydia especially in women (adult women in this case)
    - Urine culture-especially in men (adult men in this case)
  • Treatment of confirmed Chlamydia infection antibiotics
  • Guidance on avoidance of sex until completion of treatment course
  • Referral
  • Investigation and treatment of men and women with infertility (adult)
  • Investigation and treatment of men with urethral stricture (adult)
  • Psychological support for people with infertility
Referral Facility: Specialist
  • Screening of high risk adult women for sexually transmitted infections
  • Examination and investigation of adult women with offensive vaginal discharge for sexually transmitted infections
  • Examination and investigation of adult men with mucopurulent urethritis for sexually transmitted infections
  • Physical and clinical examination
  • Diagnostics tests
    - Swab test for culturing or antigen testing for chlamydia especially in women (adult women in this case)
    - Urine culture-especially in men (adult men in this case)
  • Treatment of confirmed Chlamydia infection antibiotics
  • Guidance on avoidance of sex until completion of treatment course
  • Referral
  • Investigation and treatment of men and women with infertility (adult)
  • Investigation and treatment of men with urethral stricture (adult)
  • Psychological support for people with infertility
 
Condition: Dengue
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness and education On Dengue
  • Proper solid waste disposal and improved
  • Primary prevention through
  • Vector control against the mosquito using Indoor Residual
Primary Care
  • Community awareness and education On Dengue
  • Proper solid waste disposal and improved
  • use of mosquito repellents, mosquito bed nets, mosquito coils, protective clothing and regularly removing sources of stagnant water to prevent mosquito breeding
  • Community awareness and education On Dengue
  • Proper solid waste disposal and improved
  • use of mosquito repellents, mosquito bed nets, mosquito coils, protective clothing and regularly removing sources of stagnant water to prevent mosquito breeding
  • Able to conduct NS1 Ag, IgA and IgM antigens by rapid test
  • Able to conduct Overall assessment, diagnosis and identification of phase of severity
  • Management of non-severe dengue without warning signs by providing medical advice, supervising rest and drinking of plenty of fluids and prescribing of Paracetamol
Referral Facility: General
  • Community awareness and education On Dengue
  • Proper solid waste disposal and improved water storage practices, including covering of containers to prevent access by egg-laying female mosquitoes are among methods that are encouraged through community-based programmes
  • In addition to primary care interventions
  • Conduct virus isolation, genome detection, NS1 Ag, IgA and IgM antigens by rapid test, ELISA and in addition for IgA by IHS and neutralization assays.
  • Implement case management decisions for severe dengue with warning signs (Group B and C)including treatment of profound/compensated shock, electrolyte imbalances, metabolic acidosis, ensure glucose control, hemorrhagic complications
Referral Facility: Specialist

Community awareness and education On Dengue Proper solid waste disposal and improved water storage practices, including covering of containers to prevent access by egg-laying female mosquitoes are among methods that are encouraged through community-based programmes

Conduct virus isolation, genome detection, NS1 Ag, IgA and IgM antigens by rapid test, ELISA and in addition for IgA by IHS and neutralization assays. Implement case management decisions for severe dengue with warning signs (Group B and C)including treatment of profound/compensated shock, electrolyte imbalances, metabolic acidosis, ensure glucose control, hemorrhagic complications In addition to primary care interventions

 
Condition: Lymphatic filariasis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness and education of families and communities on Lymphatic Filariasis to promote positive attitudes towards people with disabilities
  • Primary prevention through
- Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
- Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
  • Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Primary prevention through
  • Improvement in community Water Sanitation and Hygiene (WASH)
  • Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Primary prevention through
  • Community screening of patients with scrotal swelling. Either the patient himself or a community health worker identifies scrotal swelling and the patient is referred or reports to a level II facility
  • Management of Acute dermatolymphangioadenitis with antibiotics, antipyretics, analgesics
  • Management of Lymphoedema and elephantiasis through limb washing and improved hygiene practices, wound care, foot care, wearing of suitable footwear, physiotherapy and exercise, and the application of antibacterial creams and antifungal creams
  • Tertiary prevention
  • Counseling
  • Occupational and physiotherapy
Primary Care
  • Community awareness and education
  • Education of families and communities on Lymphatic Filariasis
  • Promote positive attitudes towards people with disabilities
  • Primary prevention
- Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC) Secondary prevention measures
  • Diagnosis
  • Management of Lymphoedema and elephantiasis through limb washing and improved hygiene practices, wound care, foot care, wearing of suitable footwear, physiotherapy and exercise, and the application of antibacterial creams and antifungal creams
  • Management of Acute dermatolymphangioadenitis with Antibiotics, antipyretics, analgesics
  • Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
Referral Facility: General
  • Primary prevention
- Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
  • Secondary prevention measure:
- Diagnosis - Management of Acute dermatolymphangioadenitis with Antibiotics, antipyretics, analgesics
  • Management of Lymphoedema and elephantiasis through limb washing and improved hygiene practices, wound care, foot care, wearing of suitable footwear, physiotherapy and exercise, and the application of antibacterial creams and anti fungal creams
  • Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
  • Management of Hydrocele through surgery
  • Tertiary prevention
  • Counseling - Occupational and physiotherapy
Referral Facility: Specialist
  • Primary prevention
- Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
  • Secondary prevention measure:
- Diagnosis - Management of Acute dermatolymphangioadenitis with Antibiotics, antipyretics, analgesics
  • Management of Lymphoedema and elephantiasis through limb washing and improved hygiene practices, wound care, foot care, wearing of suitable footwear, physiotherapy and exercise, and the application of antibacterial creams and anti fungal creams
  • Management of Hydrocele through surgery
  • Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)
  • Counseling
  • Occupational and physiotherapy
  • Tertiary prevention
 
Condition: Diphtheria
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Families and community education on transmission and prevention of
  • Education on proper nutrition for adults
  • Proper sanitation
  • Promoting proper planning especially in urban areas to avoid over-crowding through multi sector al approach
  • Community health workers education on diphtheria including prevention measure
  • Vaccination-booster doses of diphtheria toxoid-containing vaccine for adolescents
  • Contact tracing
  • Quarantine for contacts
  • Recognition of features of Diphtheria in adults which include: _ sore throat, low fever and swollen glands in the neck, a thick coating in the throat or nose, hoarse voice
  • Supportive management for adults with Diphtheria - Plenty of rest
  • Recognition of features of worsening condition due to diphtheria –such as shortness of breath
  • Proper nutrition for adult with diphtheria
  • Referral to a health facility of adult with suspected diphtheria
Primary Care
  • Information/education on transmission and prevention of diphtheria
  • Creation of awareness on importance on immunization
  • Education on proper nutrition for adults
  • Provision of IEC materials through communities
  • Creation of awareness on good hygiene practices
  • Training/sensitizing health workforce on diphtheria and its management
  • Update/training of health care workers on immunization as recommended in national immunization schedules.
  • Active surveillance and early detection of diphtheria
  • Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
  • Monitor close contacts for signs and symptoms of diphtheria
  • Prophylactic antibiotics (penicillin/erythromycin) for close contacts
  • Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series
  • Recording and reporting of diphtheria cases through established reporting mechanisms
  • History and Clinical examination and diagnosis of diphtheria in adults
    -based on signs and symptoms of diphtheria - including - Fever
  • Supportive management to in adults with diphtheria to/Relieve common symptoms
  • Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen.
  • Provide nutritional support for the adults with diphtheria
  • Immunization with diphtheria toxoid vaccine for adults who have not been vaccinated or have not completed the appropriate course
  • Monitoring and recognition for any features of worsening of diphtheria s in adults which includes
  • Shortness of breath/breathing difficulties
  • Emergency care with an aim of stabilizing the adults with complications due to diphtheria before referral
  • Referral of adults with diphtheria to a hospital
Referral Facility: General
  • Guidance to adults on prevention of diphtheria
  • Education on importance of immunization
  • Guidance to adults on proper nutrition
  • Guidance to adults on hygiene practices
  • Health workers education on management of diphtheria among the adults
  • Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
    • Monitor close contacts for signs and symptoms of diphtheria
  • Prophylactic antibiotics (penicillin or erythromycin) for close contacts
  • Recording and reporting of diphtheria cases through established reporting mechanisms
  • Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series
  • Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
  • Monitor close contacts for signs and symptoms of diphtheria
  • Prophylactic antibiotics (penicillin or erythromycin) for close contacts
  • Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series
  • Recording and reporting of diphtheria cases through established reporting mechanisms
Referral Facility: Specialist
  • Guidance to adults on hygiene practices
  • Guidance to adults on prevention of diphtheria
  • Education on importance of immunization
  • Guidance to adults on proper nutrition
  • Health workers education on management of diphtheria among the adults
  • Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
    • Monitor close contacts for signs and symptoms of diphtheria
  • Prophylactic antibiotics (penicillin or erythromycin) for close contacts
  • Recording and reporting of diphtheria cases through established reporting mechanisms
  • Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series
  • Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
  • Monitor close contacts for signs and symptoms of diphtheria
  • Prophylactic antibiotics (penicillin or erythromycin) for close contacts
  • Recording and reporting of diphtheria cases through established reporting mechanisms
  • Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series
 
Condition: Acute Hepatitis B
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness creation on Hepatitis B transmission, prevention measures and treatment
  • Safer sex practices,
  • Barrier protective measures (condoms)
  • Avoiding harmful traditional practices and blood contaminated sharp objects
  • Provision of high caloric diet
  • Adequate of fluids
  • Restricted physical activity
  • Referral to next level health facility
Primary Care
  • Community awareness creation on Hepatitis B transmission, prevention measures and treatment
  • Provision of high caloric diet
  • Adequate fluids
  • Restricted physical activity
  • Avoid hepatotoxic drugs
  • Referral to next level health facility
Referral Facility: General
  • Awareness creation on Hepatitis B including transmission and prevention measures
  • Health Education on Hepatitis B
  • Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week
  • Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms)
  • Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items
  • Distribution of IEC materials on Heaptitis B
  • condom distribution
  • Promote testing for HBV and for HIV/AIDs
  • Provide Hepatitis B testing services.
  • Health workers training on Hepatitis B,including prevention measures
  • Hepatitis B Screening for adults at high Risk i.e. adults who live with someone who has hepatitis B, Health care workers, those with a sexually transmitted infection, including HIV, Men who have sex with men, Adults who have multiple sexual partners, those who inject illegal drugs or share needles and syringes, Adults with chronic liver disease, Adults with end-stage kidney disease, Adults planning to travel to an area of the world with a high prevalence of Hepatitis B
  • Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion
  • Hepatitis B vaccination for those at risk
  • Safe injection practices, including eliminating unnecessary and unsafe injections,
  • Avoid re-use of needles and syringes
  • Physical examination,Clinical examination and diagnosis of Hepatitis B
  • Supportive management for patients with Acute Hepatitis B - Provision of Healthy diet - Plenty of fluids - Encourage Exercises-
  • Encourage the patient with Hepatitis B to have Enough sleep/rest
  • Relieve of pain with painkillers
  • Admission for patient with severe Acute Hepatitis B
  • Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications
  • Monitoring and management of any complications including acute Liver failure
  • Follow up
  • Investigations
  • Blood tests to detect Hepatitis B surface antigen (HBsAg)
  • Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months - Test for Hepatitis A and C - Liver ultrasound - Liver Biopsy
Referral Facility: Specialist
  • Awareness creation on Hepatitis B including transmission and prevention measures
  • Health Education on Hepatitis B
  • Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week
  • Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms),
  • Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items
  • Distribution of IEC materials on Heaptitis B
  • condom distribution
  • Promote testing for HBV and for HIV/AIDs
  • Provide Hepatitis B testing services.
  • Health workers training on Hepatitis B,including prevention measures
  • Hepatitis B Screening for adults at high Risk i.e. adults who live with someone who has hepatitis B; Health care workers; those with a sexually transmitted infection, including HIV; Men who have sex with men; Adults who have multiple sexual partners; those who inject illegal drugs or share needles and syringes; Adults with chronic liver disease; Adults with end-stage kidney disease ; Adults planning to travel to an area of the world with a high prevalence of Hepatitis B
  • Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion
  • Safe injection practices, including eliminating unnecessary and unsafe injections,
  • Avoid re-use of needles and syringes Hepatitis B vaccination for those at risk
  • Physical examination
  • Clinical examination and diagnosis of Hepatitis B
  • Supportive management for patients with Acute Hepatitis B
  • Provision of Healthy diet
  • Plenty of fluids
  • Encourage Exercises-
  • Encourage the patient with Hepatitis B to have Enough sleep/rest
  • Relieve of pain with painkillers
  • Admission for patient with severe Acute Hepatitis B
  • Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications
  • Monitoring and management of any complications including acute Liver failure
  • Follow up
  • Investigations
  • Blood tests to detect Hepatitis B surface antigen (HBsAg)
  • Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months
  • Test for Hepatitis A and C -
  • Liver ultrasound-
  • Liver Biopsy
 
Condition: Hepatitis A
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on the benefits of immunization, particularly in high-risk individuals
  • Individuals and families education on the need for strict enteric precautions especially for individuals with HAV
  • Individuals, families and community education on proper hygiene measuresAdvice on Improved sanitation
  • Sensitize communities on use of clean, safe water
  • Community health workers training/sensitization on Hepatitis A including prevention measure
  • Reduce chances of infections and transmission to others through Observation of personal hygiene practices such as,
  • Regular hand-washing before meals and after going to the bathroom
  • Proper disposal of human waste within communities
  • Proper food hygiene including proper cooking/heating
  • Use clean safe water for drinking
  • Strict personal hygiene and hand washing to prevent faecal -oral transmission to others for those already infected
  • Proper cleaning of Contaminated surfaces/with disinfectant
  • Recognition of possible features of Hepatitis A including fever, malaise,loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine and yellowing of the skin and whites of the eyes
  • Referral to a health facility if symptoms worsen
  • Supportive Home remedies;
  • Plenty of rest
  • Plenty of fluids/hydration
  • Advice on avoidance of alcohol as these can worsen the effects of HAV on the liver
Primary Care
  • Create community awareness on Hepatitis A including risk factors
  • Create awareness on the benefits of immunization, particularly in high-risk individuals
  • Individuals education on the need for strict enteric precautions especially for individuals with HAV
  • Sensitize communities on use of clean, safe water,Individuals, families and community education on proper hygiene measures
  • Advice on Improved sanitation
  • Health workers education/sensitization on Hepatitis A , including prevention measures and management
  • Advice on the following to Reduce chances of infections and transmission to others;-
  • Proper hand hygiene
  • Proper food hygiene including proper cooking / heating
  • Use clean safe water for drinking
  • Strict personal hygiene and hand washing to prevent fecal -oral transmission to others for those already infected
  • Proper cleaning of Contaminated surfaces /with disinfectant
  • Hepatitis A Vaccine before exposure to targeted at risk groups;
  • Men who have sex with men
  • People who use illegal drugs
  • People with impaired immune systems or chronic liver disease
  • People with blood-clotting disorders who receive clotting factors
  • Physical and Clinical examination,Diagnosis of Hepatitis A based on signs and symptoms fever, malaise, loss of appetite, diarrhea, nausea, abdominal discomfort, dark-colored urine and yellowing of the skin and whites of the eyes
  • Relieve any symptom -fever, dehydration i.e.(no specific medicines except to relive symptoms)
  • Advice on home remedies;
  • Plenty of rest
  • Plenty of fluids/hydration
  • Monitor for any complications
  • Referal to a hospital
Referral Facility: General
  • Create awareness on Hepatitis A including risk factors
  • Provide Education on proper hygiene measuresAdvice on Improved sanitationSensitize communities on use of clean, safe water.
  • Create awareness on the benefits of immunization, particularly in high-risk individuals
  • Individuals education on the need for strict enteric precautions especially for individuals with HAV
  • Health workers training /sensitization on Hepatitis A , including prevention measures and management
  • Advice on personal hygiene, hand hygiene and proper food cooking Hepatitis A Vaccine before exposure to targeted at risk groups ;
  • Men who have sex with men
  • People who use illegal drugs
  • People with impaired immune systems or chronic liver disease
  • People with blood-clotting disorders who receive clotting factors
  • Physical and Clinical examination
  • Relieve any symptom -fever, dehydration i.e.(no specific medicines except to relive symptoms)
  • Investigations
  • Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood
  • Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA
  • Liver function tests
  • Test also for hepatitis B and C
  • Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)
Referral Facility: Specialist
  • Create awareness on Hepatitis A including risk factors
  • Create awareness on the benefits of immunization, particularly in high-risk individuals
  • Individuals education on the need for strict enteric precautions especially for individuals with HAV
  • Provide Education on proper hygiene measuresAdvice on Improved sanitationSensitize communities on use of clean, safe water.
  • Health workers training /sensitization on Hepatitis A , including prevention measures and management
  • Advice on personal hygiene; hand hygiene; proper food cooking
  • Hepatitis A Vaccine before exposure to targeted at risk groups
  • Men who have sex with men
  • People who use illegal drugs
  • People with impaired immune systems or chronic liver disease
  • People with blood-clotting disorders who receive clotting factors
  • Physical and Clinical examination
  • Relieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms )
  • Investigations -
  • Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood -
  • Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA
  • Liver function tests
  • Test also for hepatitis B and C
  • Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)
 
Condition: Hepatitis E
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on Hepatitis E disease,the transmission mode and preventive measures
  • Education on good hygiene practicesImprove access to clean and safe drinking waterStrategies to address poverty especially for resource poor areas
  • Improve access to good sanitation/including safe human waste disposal in communities including in congregate populations
  • Improve access to health services
  • Strategies to reduce overcrowding such as in refugee camps where sanitation and safe water supply pose special challenges Intersect oral collaboration to address social determinants of health e.g. Sanitation
  • Community health workers education/sensitization on Hepatitis E including prevention measures
  • Maintaining quality standards for public water supplies
  • Monitoring and Proper record keeping/reporting especially in out breaks situation.
  • Proper disposal of human waste /feaces
  • Maintaining individual hygiene practices
  • Consumption of clean safe water
  • Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases
  • Recognition of features indicative of Hepatitis E including initial mild fever, reduced appetite nausea and vomiting, abdominal pain, itching (without skin lesions), yellow colour of the skin and whiteness of the eyes, with dark urine and pale stools
  • Supportive treatment including - proper nutrition - Adequate rest - Relieving fever through use of pain killers
  • Referral to a health facility in case symptoms worsens
Primary Care
  • Create awareness on Hepatitis E disease,the transmission mode and preventive measure
  • Education on good hygiene practices
  • Improve access to clean and safe drinking waterStrategies to address poverty especially for resource poor areas
  • Improve access to good sanitation/including safe human waste disposal in communities including in congregate populations. Health workers education/sensitization on Hepatitis E including prevention measures and management
  • Improve access to health servicesStrategies to reduce overcrowding such as in refugee camps where sanitation and safe water supply pose special challenges
  • Intersectoral collaboration to address social determinants of health e.g. Sanitation
  • Health workers education/sensitization on Hepatitis E including prevention measures and management
  • Guidance/education on proper hygiene practices including:
  • Proper disposal of human waste/feaces
  • Consumption of clean safe water
  • Maintaining individual hygiene practices
  • Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases
  • Monitoring and Proper record keeping/reporting especially in out breaks situation
  • Physical and clinical examination,Diagnosis of Hepatitis E based on signs and symptoms including initial mild fever, reduced appetite nausea and vomiting,abdominal pain, itching (without skin lesions),jaundice,with dark urine and pale stools
  • Supportive treatment including;- proper nutrition - Adequate rest
  • Relieving fever through use of pain killers
  • Referral to a health facility in case symptoms worsens
Referral Facility: General
  • Create awareness on Hepatitis E disease, the transmission mode and preventive measures to the adults
  • Guidance on good hygiene practicesGuidance on use of clean and safe drinking water
  • Awareness on good sanitation/including safe human waste disposal in communities
  • Health workers education on Hepatitis E transmission, prevention and management
  • Guidance/education on proper hygiene practices including:
  • Proper disposal of human waste/feaces
  • Consumption of clean safe water
  • Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases
  • Maintaining individual hygiene practices
  • Monitoring and Proper record keeping/reporting especially in out breaks situation
  • Monitoring and management of any complications main one being fulminant hepatitis (acute liver failure)
  • N/b There is no specific treatment capable of altering the course of acute hepatitis E.; usually self-limiting disease
  • Supportive treatment including:
  • proper nutrition,
  • Adequate rest
  • relieving fever through use of pain killers
  • Physical and clinical examination
  • Diagnosis based on Strong link in appropriate epidemiology settings, e.g. when several cases occur in localities in known disease-endemic areas, or in settings with risk of water contamination.
  • Rule out hepatitis A
  • Blood tests for detection of specific IgM antibodies to the virus for definitive diagnosis.
Referral Facility: Specialist

Awareness on good sanitation /including safe human waste disposal in communitiesGuidance on good hygiene practicesGuidance on use of clean and safe drinking water Create awareness on Hepatitis E disease, the transmission mode and preventive measures to the adults Health workers education on Hepatitis E transmission, prevention and management

  • Guidance /education on proper hygiene practices including:
  • Proper disposal of human waste /feaces
  • Maintaining individual hygiene practices
  • Consumption of clean safe water
  • Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases
  • Monitoring and Proper record keeping/reporting especially in out breaks situation
  • Monitoring and management of any complications main one being fulminant hepatitis (acute liver failure)
  • N/b There is no specific treatment capable of altering the course of acute hepatitis E.; usually self-limiting disease
  • Supportive treatment including:
  • proper nutrition,
  • Adequate rest
  • relieving fever through use of pain killers
  • Physical and clinical examination
  • Diagnosis based on Strong link in appropriate epidemiology settings, e.g. when several cases occur in localities in known disease-endemic areas, or in settings with risk of water contamination.
  • Rule out hepatitis A
  • Blood tests for detection of specific IgM antibodies to the virus for definitive diagnosis.
 
Condition: Diabetes mellitus
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community engagement/sensitization on risk factors for diabetes mellitus and preventive measures such as weight control, regular exercise, healthy diet, and stress management

Community engagement [community sensitization on diabetes and risk factors, healthy diets, regular blood sugar testing, and exercise]. Provision of IEC/BCC materials

  • Lifestyle modifications, healthier diet, quitting smoking and alcohol, exercise.
  • Screen blood sugar through community screening services

Integrated counselling on healthy diet, physical activity, Encourage compliance with medications, and regular clinical check-ups and prevention of complications

  • Lifestyle management
  • Self-monitoring of blood glucose
  • Immediate transfer of suspected diabetes cases to a higher-level health care facility
  • Home-based self-management rehabilitation
  • Physical activity counselling and exercise training
  • Home based self management rehabilitation
  • Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan
  • Psychosocial support
  • Behavioural, mood, attitude, and emotional support to patients and family members
  • Enrolment to support groups
Primary Care
  • Health education on early identification of diabetes, early treatment and complication prevention

Community engagement [community sensitization on diabetes and risk factors, healthy diets, regular blood sugar testing, and exercise]. Provision of IEC/BCC materials

  • Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use
  • Regular monitoring of blood sugar levels in high risk patients
  • Diabetes-related foot examination

Integrated counselling on healthy diet, physical activity, Encourage compliance with medications, and regular clinical check-ups and prevention of complications

  • Lifestyle management
  • Oral antidiabetics
  • Monitoring glycaemic control Comprehensive diabetes care
  • Nicotine replacement
  • Availability of metformin for diabetes treatment
  • Self-management education
  • Physical activity counselling and exercise training
  • Provision and training in the use of assistive products

Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan

  • Physical, emotional, social and spiritual support based on cultural needs, values and preferences of patients and families
  • Enrolment to support groups
Referral Facility: General
  • Health education on early identification of diabetes, early treatment and complication prevention
  • Population wide reduction in daily salt consumption
  • Financial incentives to consume a healthy diet
  • Regular monitoring of blood sugar and HbA1C in high risk patients
  • Diabetes-related eye examination
  • Diabetes-related foot examination
  • Diabetes-related neuropathy examination
  • Diabetes-related kidney disease testing
  • Screening and treatment of CVD risk factors
  • Integration of hypertension and diabetes screening & treatment in HIV programs
  • Use of polypill for secondary CVD prevention in high risk candidates
  • Lifestyle management
  • Medical nutrition therapy
  • Oral glucose-lowering medications
  • Insulin
  • Monitoring glycaemic control
  • Detect and manage DM-specific complications

History and physical examination for diabetes mellitus Point of care testing Basic laboratory tests Advanced laboratory tests Condition-specific nutrition assessment and counselling Counselling on home glucose monitoring, and self-insulin administration. Provision of blood glucose monitoring device and test strips Diabetic foot examination Test for visual acuity Direct ophthalmoscopy Intravenous fluids Insulin treatment Oral hypoglycaemics Monitoring of acid base status

  • Self-management education
  • Physical activity counselling and exercise training
  • Provision and training in the use of assistive products

Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan

  • Physical, emotional, social assessment and support based on cultural needs, values and preferences of patients and families
  • Enrolment to support groups
Referral Facility: Specialist
  • Health education on early identification of diabetes, early treatment and complication prevention

Community engagement [community sensitization on diabetes and risk factors, healthy diets, regular blood sugar testing, and exercise]. Provision of IEC/BCC materials

  • Regular monitoring of blood sugar and HbA1C in high risk patients
  • Diabetes-related eye examination
  • Diabetes-related foot examination
  • Diabetes-related neuropathy examination Diabetes-related kidney disease testing
  • Lifestyle management
  • Medical nutrition therapy
  • Oral hypoglycaemic medications
  • Insulin
  • Monitoring glycaemic control
  • Detect and manage DM-specific complications

History and physical examination for diabetes mellitus Point of care testing Basic laboratory tests Advanced laboratory tests Condition-specific nutrition assessment and counselling Counselling on home glucose monitoring, and self-insulin administration. Provision of blood glucose monitoring device and test strips Diabetic foot examination Test for visual acuity Direct ophthalmoscopy Intravenous fluids Insulin treatment Oral hypoglycaemics Monitoring of acid base status

  • Self-management education
  • Physical activity counselling and exercise training
  • Provision and training in the use of assistive products
  • Physical, emotional, social assessment and support based on cultural needs, values and preferences of patients and families
  • Enrolment to support groups
 
Condition: Rabies
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Awareness creation on rabies and prevention measures including preventing dog bites.
  • Education on dog behavior and bite prevention
  • Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites and immediate care measures after a bite.
  • Community Health workers education on rabies ,prevention measures and its management
  • Eliminating rabies in dogs- through Vaccinating dogs
  • Advice and Referral to hospital for Pre-exposure immunization for adults in high-risk occupations such as, laboratory workers handling live rabies and rabies-related (lyssavirus) viruses and those whose profession brings them direct contact with animals e.g. wildlife rangers
  • Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly
  • Record keeping and reporting to the public health departments and veterinary departments
  • Recognition of animal bite exposures categorized as carrying a risk of developing rabies which include:if the biting mammal is a known rabies reservoir or vector species; the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound was contaminated by the animal’s saliva, the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable
  • First aid to an adult following a deep bite or scratch from an animal suspected to have rabies, through extensive wound washing—i.e Thorough flushing and washing of the wound for a minimum of 15 minutes with soap and water, detergent/anti septic’s such povidone iodin
  • Relive any pain with pain killers such as paracetamol
  • Immediate Referral to a health facility
  • Report/alert the veterinary services to remove the biting animal from the community/quarantined
Primary Care
  • Awareness creation on rabies and prevention measures including preventing dog bites.
  • Education on dog behavior and bite prevention
  • Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
  • Health workers education on rabies ,prevention measures and its management
  • Advice and Referral to hospital for Pre-exposure immunization for adults in high-risk occupations such as, laboratory workers handling live rabies and rabies-related (lyssavirus) viruses, and elderly whose profession brings them direct contact with animals e.g. wildlife rangers
  • Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly
  • Record keeping and reporting to the public health departments and veterinary departments.
  • Physical and clinical examination
  • Recognition and categorization of animal bite exposures categorized as carrying a risk of developing rabies which include: if the biting mammal is a known rabies reservoir or vector species; the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior; a wound or mucous membrane was contaminated by the animal’s saliva, the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable
  • Immediate post exposure prophylaxis through Extensive washing, flushing and local treatment of the bite wound or scratch
  • Relieve of any other symptoms such as pain with analgesics
  • Immediate Referral to a hospital for further management including Immunization of adults with rabies vaccine after exposure (PEP)
  • Integrated bite case management through alerting the veterinary services to remove the biting animal from the community/quarantined
Referral Facility: General
  • Awareness creation on rabies and prevention measures including preventing dog bites
  • Education on dog behavior and bite prevention
  • Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
  • Health workers training on rabies ,prevention measures and its management
  • Immunization of adults with rabies vaccine after exposure (PEP) or before exposure
  • Pre-exposure immunization is for adults in high-risk occupations such as; laboratory workers handling live rabies and rabies-related (lyssavirus) viruses and elderly whose profession brings them direct contact with animals e.g. wildlife rangers
  • Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims,with the goal to apply preventive measures accordingly
  • Record keeping and reporting to the public health departments and veterinary departments
  • Physical and clinical examination,
  • Recognition and categorization of animal bite exposures categorized as carrying a risk of developing rabies which include: if the biting mammal is a known rabies reservoir or vector species, the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound or mucous membrane was contaminated by the animal’s saliva; the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable
  • Immediate post exposure prophylaxis of all categorized exposures assessed as carrying a risk of developing rabies;
  • Extensive washing; flushing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure; Administration of rabies vaccine, the administration of rabies immunoglobulin (RIG), if indicated.
  • Relieve of any other symptoms such as pain with analgesics
  • Monitor and manage any complications depending on the two forms of rabies – such as cardiopulmonary arrest as a result of furious rabies or muscle paralysis and coma due to paralytic rabies
  • ICU services for patients with complications e.g. those in coma
  • Integrated bite case management/alert the veterinary services to remove the biting animal from the community/quarantined
Referral Facility: Specialist
  • Awareness creation on rabies and prevention measures including preventing dog bites
  • Education on dog behavior and bite prevention
  • Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
  • Health workers training on rabies ,prevention measures and its management
  • Immunization of adults with rabies vaccine after exposure (PEP) or before exposure
  • Pre-exposure immunization is for adults in high-risk occupations such as; laboratory workers handling live rabies and rabies-related (lyssavirus) viruses and elderly whose profession brings them direct contact with animals e.g. wildlife rangers
  • Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims,with the goal to apply preventive measures accordingly
  • Record keeping and reporting to the public health departments and veterinary departments
  • Physical and clinical examination,
  • Recognition and categorization of animal bite exposures categorized as carrying a risk of developing rabies which include: if the biting mammal is a known rabies reservoir or vector species, the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound or mucous membrane was contaminated by the animal’s saliva; the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable
  • Immediate post exposure prophylaxis of all cotegorized exposures assessed as carrying a risk of developing rabies;
    • Extensive washing ; flushing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure;
    • Administration of rabies vaccine
    • the administration of rabies immunoglobulin (RIG), if indicated.
  • Relieve of any other symptoms such as pain with analgesics
  • Monitor and manage any complications depending on the two forms of rabies – such as cardiopulmonary arrest as a result of furious rabies or muscle paralysis and coma due to paralytic rabies
  • ICU services for patients with complications e.g. those in coma
  • Integrated bite case management/alert the veterinary services to remove the biting animal from the community/quarantined
 
Condition: Yellow Fever
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Strengthen families and community-based awareness on Yellow Fever including transmission and prevention measures * Information and health education to parents, families and communities on Yellow Fever vaccination
  • Integrated vector control management (ITN, IRS, larva source management, etc.) * Vaccination: Yellow fever
  • Personal protective measures (mosquito repellent, long sleeved clothes)
  • Recognition of Yellow Fever symptoms
  • Supportive care (e.g., fever reduction, hydration, feeding, etc.)
  • Referrals to a health facility if symptoms worsen
Primary Care
  • Strengthen families and community-based awareness on Yellow Fever including transmission and prevention measures * Information and health education to parents, families and communities on Yellow Fever vaccination
  • Integrated vector control management (ITN, IRS, larva source management, etc.) * Vaccination: Yellow fever
  • Personal protective measures (mosquito repellent, long sleeved clothes)
  • Recognition of Yellow Fever symptoms
  • Supportive care (e.g., fever reduction, hydration, feeding, etc.)
  • Referrals to a health facility if symptoms worsen
  • Report immediately to local authorities
Referral Facility: General
  • Strengthen families and community-based awareness on Yellow Fever including transmission and prevention measures * Information and health education to parents, families and communities on Yellow Fever vaccination
  • Vaccination: Yellow fever

History and physical examination Basic laboratory tests Advanced laboratory tests Supportive care (e.g., fever reduction, hydration, feeding, etc.) IV fluid hydration Treat mild complications Refer if severe or not responding

Referral Facility: Specialist
  • Strengthen families and community-based awareness on Yellow Fever including transmission and prevention measures
  • Information and health education to parents, families and communities on Yellow Fever vaccination
  • Vaccination: Yellow fever

History and physical examination Basic laboratory tests Advanced laboratory tests Treat bacterial infections with antibiotics IV fluid for rehydration Manage complications such as liver and kidney failure Manage fever with antipyretics Nutritional support .

 
Condition: Acute Hepatitis C
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness to adults and families on Hepatitis C including transmission, risk factors and prevention measures
  • Mass awareness campaigns during health days such as World Hepatitis Day
  • Provision of education & comprehensive harm-reduction services to elderly who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence Health education on hepatitis C
  • Education on safe sex practices
  • Distribution of IEC materials
  • Community health workers sensitization on Hepatitis C, including transmission & prevention measures
  • Avoiding sharing personal care items that might have blood on them (razors, toothbrushes, nail clippers)
  • Safe handling and disposal of sharps and waste
  • Safe sex practices -prevention of exposure to blood during sex
  • Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver
  • Screening for Hepatitis C infection
  • Recognition of features indicative of Hepatitis C in adults including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes
  • Supportive Home therapies for adults with Hepatitis C including; proper nutrition - Plenty of fluids - plenty of rest - relieve pain
  • Referral to a health facility if symptoms worsens
  • Community Rehabilitation centers for Adults at risk e.g for provision comprehensive harm-reduction services to adults who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence
Primary Care
  • Create awareness to adults and families on Hepatitis C including transmission, risk factors and prevention measures
  • Mass awareness campaigns during health days such as World Hepatitis Day
  • Provision of education & comprehensive harm-reduction services to adults who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence health educatioN to adults on heaptitis C
  • Education to adults on safe sex practices
  • Distribution of IEC materials
  • Health workers training on Hepatitis C, including transmission, prevention measures
  • Primary prevention measures
  • Training of health personnel on heaptitis C
  • Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver
  • Safe handling and disposal of sharps and waste
  • Provision comprehensive harm-reduction services to Adults who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence
  • Injection safety -safe and appropriate use of health care injections
  • Safe handling and disposal of sharps and waste
  • Education /Guidance on Safe sex practices -prevent exposure to blood during sex
  • Screening, for hepatitis C infection
  • Physical and clinical examination
  • Diagnosis of hepatitis C in adults based on signs and symptoms including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes
  • Supportive therapies for adults with Hepatitis C including; - proper nutrition - fluids therapy - Plenty of rest - relieve of pain
  • Monitor for any complications
  • Referral to a hospital if symptoms worsens
Referral Facility: General
  • Create awareness to the adults and families on Hepatitis C including transmission, risk factors and prevention measures
  • Mass awareness campaigns during health days such as World Hepatitis Day
  • provision of education and comprehensive harm-reduction services to adults who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence;
  • Education to adults on safe sex practices
  • Distribution of IEC materuials on Hepatitis C
  • Health workers training on Hepatitis C, including transmission and prevention measures
  • Primary prevention measures
  • Injection safety -safe and appropriate use of health care injections
  • Safe handling and disposal of sharps and waste
  • Training of health personnel on hepatitis C
  • Guidance on Safe sex practices to prevent exposure to blood during sex; Secondary prevention measures
  • Screening for hepatitis C infection including to those at risk
  • Immunization with the hepatitis A and B vaccines for adults with hepatitis C infection to prevent coinfection from these hepatitis viruses and to protect their liver
Referral Facility: Specialist
  • Health workers training on Hepatitis C, including transmission & prevention measures
  • Mass awareness campaigns during health days such as World Hepatitis Day
  • Create awareness to the adults and families on Hepatitis C including transmission, risk factors and prevention measures
  • provision of education & comprehensive harm-reduction services to adults who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence;
  • Education to adults on safe sex practices
  • Distribution of IEC materuials on Hepatitis C
  • Primary prevention measures
    • Injection safety -safe and appropriate use of health care injections
    • Safe handling and disposal of sharps and waste
  • Training of health personnel on hepatitis C
  • Guidance on Safe sex practices to prevent exposure to blood during sex; Secondary prevention measures
  • Immunization with the hepatitis A and B vaccines for adults with hepatitis C infection to prevent coinfection from these hepatitis viruses and to protect their liver
 
Condition: Leprosy
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
Primary Care
  • Strengthening patient and community awareness of leprosy
  • Community Health education to raise suspicion of leprosy by the community members
  • Demand creation for community to seek early diagnosis and treatment
  • Community Capacity building on basic facts about leprosy, signs and symptoms and mode of transmission will improve early diagnosis and treatment
  • Community knowledge that leprosy disease is curable will reduce stigma and discrimination
  • Involving communities in actions for improvement of leprosy services
  • Multi-sectoral approach in addressing leprosy
  • Community Health workers sensitization on Leprosy
  • Avoidance of close and frequent contacts with persons with untreated leprosy
  • Community screening to identify presumptive leprosy cases
  • Early case detection through active case finding - Contact tracing
  • Strengthening surveillance for leprosy
  • Guidance on prompt start and adherence to treatment
  • Strengthening the reporting system for leprosy (health information systems for program monitoring and evaluation)
  • Physical and clinical examination
  • care for the patient with Leprosy including; Care of Eyes,care of hands and feet,guidance on voluntary muscle testing and sensory testing use of correct footwear
  • Presumptive diagnosis of Leprosy based on cardinal signs
  • Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch
  • Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve
  • Follow up
  • Guidance and Ensuring adherence to treatment, for known leprosy patients
  • Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs and eyes.
  • Referral to a hospital for definitive diagnosis and for further management
  • Supporting a known leprosy patient Ensure adherence to medicines
  • Promoting societal inclusion by addressing all forms of discrimination and stigma
  • Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services
  • Promoting coalition-building among persons affected by leprosy including self care groups such groups encourage each other on self care needs
  • Supporting community-based rehabilitation for people with leprosy-related disabilities
  • Working towards abolishing discriminatory laws and promote policies facilitating inclusion of persons affected by leprosy.
  • Psycho social and counseling support services for adults affected by leprosy and their families
Referral Facility: General
  • Strengthening patient and community awareness of leprosy
  • Community Health education to raise suspicion of leprosy by the community members
  • Demand creation for community to seek early diagnosis and treatment
  • Community Capacity building on basic facts about leprosy,signs and symptoms and mode of transmission will improve early diagnosis and treatment
  • Community knowledge that leprosy disease is curable will reduce stigma and discrimination
  • Involving communities in actions for improvement of leprosy services
  • Multi-sectoral approach in addressing leprosy
  • Health workers training on leprosy including prevention, diagnosis and management
  • Guidance to parents/families on ensuring the adults avoid close and frequent contacts with persons with untreated leprosy
  • Early case detection through active case finding Contact tracing
  • Surveillance for leprosy
  • Recording and reporting on leprosy (health information systems for program monitoring and evaluation)
  • Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities
  • physical and clinical examination
  • Presumptive diagnosis of Leprosy based on cardinal signs;
  • 1.Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch
  • 2.Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve
  • Guidance to the elderly leprosy patient on adherence to treatment,
  • Guidance/Advice to elderly patients with leprosy on self-care including Care of Eyes, care of hands and feet, guidance on voluntary muscle testing and sensory testing use of correct footwear
  • Management of Leprosy with Multidrug therapy (MDT)
  • Hospital admission
  • Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment
  • Guidance and Ensuring adherence to treatment for known leprosy patients
  • Promoting societal inclusion by addressing all forms of discrimination and stigma
  • Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services
  • Promoting coalition-building among persons affected by leprosy including self care groups –such groups encourage each other on self care needs
  • Supporting community-based rehabilitation for people with leprosy-related disabilities
  • Working towards abolishing discriminatory laws and promote policies facilitating inclusion of persons affected by leprosy.
  • Provide psycho social and counseling support services for adults affected by leprosy and their families
Referral Facility: Specialist
  • Strengthening patient and community awareness of leprosy
  • Community Capacity building on basic facts about leprosy,signs and symptoms and mode of transmission will improve early diagnosis and treatment
  • Demand creation for community to seek early diagnosis and treatment
  • Community Health education to raise suspicion of leprosy by the community members
  • Community knowledge that leprosy disease is curable will reduce stigma and discrimination
  • Involving communities in actions for improvement of leprosy services
  • Multi-sectoral approach in addressing leprosy
  • Health workers training on leprosy including prevention, diagnosis and management
    • Guidance on avoidance of close and frequent contacts with persons with untreated leprosy
  • Early case detection through active case finding
  • Contact tracing
  • Guidance on prompt start and adherence to treatment
  • Surveillance for leprosy
  • Recording and reporting on leprosy (health information systems for program monitoring and evaluation)
  • Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities
  • physical and clinical examination
  • Guidance to the elderly leprosy patient on adherence to treatment,
  • Guidance /Advice to patients with leprosy on self-care including Care of Eyes; care of hands and feet; guidance on voluntary muscle testing and sensory testing use of correct footwear
  • Presumptive diagnosis of Leprosy based on cardinal signs:
  • Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch *
  • Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve*
  • Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment
  • Management of Leprosy with Multidrug therapy (MDT)
  • Hospital admission
  • Prevention and management of disabilities.
  • Strengthening surveillance for antimicrobial resistance including laboratory network.
  • Promoting societal inclusion by addressing all forms of discrimination and stigma
  • Empowering persons affected by leprosy and strengthening their capacity to participate actively in leprosy services
  • Promoting coalition-building among persons affected by leprosy including self care groups –such groups encourage each other on self care needs
  • Supporting community-based rehabilitation for people with leprosy-related disabilities
  • Working towards abolishing discriminatory laws and promote policies facilitating inclusion of persons affected by leprosy.
  • Provide psycho social and counseling support services for adults affected by leprosy and their families
 
Condition: Ascariasis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Health education to adults and communities on ascariasis and prevention measures
  • Community,adult persons education on personal hygiene as well as proper disposal of human faeces
  • Community awareness on effective sewerage disposal systems
  • Promote through multi sectoral approach wastewater treatment before use for irrigation due to food grown in contaminated soil
  • Community Health workers training on ascariasis including prevention measures
  • Proper cleaning and cooking of food
  • Proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
  • Proper waste disposal/ not passing stool in the soil or outdoors
  • Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Promoting good nutrition for adults
  • Identification of features/signs indicative of ascariasis including; history of passage of a live worm, in faeces, abdominal pain while others may have cough, difficulty in breathing,fever
  • Supportive therapy including relieve of any abdominal pain with painkillers, nutritional support (proper nutrition)
  • Referral to health facility for definitive diagnosis and treatment
Primary Care
  • Health education to adults on ascariasis and prevention measures
  • Adult education on personal hygiene as well as proper disposal of human faecesAwareness on effective sewerage disposal systems
  • Health workers education on ascariasis including prevention measures and its management in adults
  • Guidance to adults on primary prevention measures incluidng;Proper cleaning and cooking of food
  • proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
  • Proper waste disposal/not passing stool in the soil or outdoors
  • Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Provide guidance on good nutrition for adults
  • Anthelmintic
  • Antispasmodics
  • Analgesics
Referral Facility: General
  • Health education to adults on ascariasis and prevention measures
  • Adult education on personal hygiene as well as proper disposal of human faeces
  • Awareness on effective sewerage disposal systems
  • Health workers training on ascariasis including prevention measures and its management in adults
  • Guidance to adults on primary prevention measures incluidng;
  • Proper cleaning and cooking of food
  • proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
  • Proper waste disposal/not passing stool in the soil or outdoors
  • Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Promote good nutrition for adults
  • Anthelmintic
  • Steroids for complication
  • Surgery for obstruction
Referral Facility: Specialist
  • Health education to adults on ascariasis and prevention measures
  • Adult education on personal hygiene as well as proper disposal of human faeces
  • bAwareness on effective sewerage disposal systems
  • Health workers training on ascariasis including prevention measures and its management in adults
  • Guidance to adults on primary prevention measures incluidng :

    • Proper cleaning and cooking of food
    • proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
    • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
    • Proper waste disposal/ not passing stool in the soil or outdoors
    • Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
    • Taking safety precautions like wearing gloves when handling soil/manure promote good nutrition for adults
  • Anthelmintic
  • Steroids for complication
  • Surgery for obstruction
 
Condition: Tetanus
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Awareness Creation among communities on Tetanus and preventive measures
  • Health education activities to increase community awareness of the importance of tetanus immunization
  • Distribution of IEC materials
  • Training the community Health workers on tetanus, including prevention measures/on vaccination/vaccination schedules/detection
  • Advice to adults on proper wound care
  • Proper care for minor Wounds-thorough cleaning of the wound and covering to prevent infections
  • Effective surveillance to identify areas or populations at high risk of neonatal tetanus
  • Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
  • Recognition of symptoms indicative of tetanus in adults including jaw cramping or the inability to open the mouth (lock jaw), muscle spasms often in the back, abdomen and extremities, sudden painful muscle spasms often triggered by sudden noises, trouble swallowing, seizures, Headache, fever and sweating
  • Immediate referral to a health facility of adults suspected to have tetanus
  • Home based/community based physical therapy rehabilitation for muscle movements
  • Psycho social support and counseling
  • Linkage to patient support groups
Primary Care
  • Awareness Creation among adults on Tetanus and preventive measures
  • Health education activities to increase awareness of the importance of tetanus immunization
  • Training Health care workers on Tetanus prevention measures and management among adults
  • Post exposure vaccination for adults with Tetanus Toxoid containing vaccine
  • Proper wound care for adults
  • Outreach activities in order to increase TT immunization coverage
  • Effective surveillance to identify areas or populations at high risk of tetanus
  • Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
  • Data keeping/monitoring the impact of interventions and reporting
    • Physical and clinical examination
  • Clinical diagnosis of tetanus based on Clinical features
  • Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning, or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in patients who are unable to recall a specific wound or injury.)
  • Relieve of other symptoms such as headache with analgesics, fever with anti pyretic
  • Proper wound care
  • Immediate referral of patient to a hospital for management
  • Physiotherapy, rehabilitation for muscle movements
    • Psycho social support and counseling
  • Linkage to patient support groups
Referral Facility: General
  • Awareness Creation among adults on Tetanus and preventive measures
  • Health education activities to increase awareness of the importance of tetanus immunization
  • Distribution of IEC materials
  • Training Health care workers on Tetanus prevention measures and management among adolescents
  • Advice to adults on proper wound care
  • Post exposure vaccination for adults with Tetanus Toxoid containing vaccine
  • Proper wound care for adults
  • Proper wound care for surgical and dental procedures
  • Effective surveillance to identify areas or populations at high risk of tetanus
  • Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
  • Data keeping/monitoring the impact of interventions and reporting
  • Physical and clinical examination
  • Clinical diagnosis of tetanus based on Clinical features
  • Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in adult patients who are unable to recall a specific wound or injury)*
  • Supportive therapy-Relieve of other symptoms such as headache with analgesics fever with anti pyretic
  • Immediate admission for adults with tetanus (Tetanus is a medical emergency)Immediate management with medicines human tetanus immune globulin (TIG)
  • Aggressive wound care for the adults with tetanus
  • Prevention and management of any complications
  • Management/control of muscle spasms
  • Administration of antibiotics
  • Tetanus Vaccination for the adults who have recovered from tetanus since infection with tetanus does not confer natural immunity
  • Referral to specialised hospitals for further managemnet eg Intensive care services to manage any complications/severe tetanus
  • Follow up
  • Physiotherapy, rehabilitation for muscle movements e.g swallowing and oral motor movements
  • Psycho social support and counseling
  • Linkage to patient support groups
Referral Facility: Specialist
  • Awareness Creation among adults on Tetanus and preventive measures
  • Health education activities to increase awareness of the importance of tetanus immunization
  • Distribution of IEC materials
  • Training Health care workers on Tetanus prevention measures and management among adolescents
  • Post exposure vaccination for adults with Tetanus Toxoid containing vaccine
  • Proper wound care for adults
  • Proper wound care for surgical and dental procedures
  • Effective surveillance to identify areas or populations at high risk of tetanus
  • Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
  • Data keeping/monitoring the impact of interventions and reporting
    • Physical and clinical examination
  • Clinical diagnosis of tetanus based on Clinical features
  • Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in adult patients who are unable to recall a specific wound or injury)
  • Supportive therapy-Relieve of other symptoms such as headache with analgesics fever with anti pyretic
  • Immediate admission for adults with tetanus (Tetanus is a medical emergency)Immediate management with medicines human tetanus immune globulin (TIG)
  • Aggressive wound care for the adults with tetanus
  • Prevention and management of any complications
  • Intensive care services to manage any complications/severe tetanus
  • Management/control of muscle spasms
  • Administration of antibiotics
  • Tetanus Vaccination for the adults who have recovered from tetanus since infection with tetanus does not confer natural immunity
  • Follow up
  • Physiotherapy, rehabilitation for muscle movements e.g swallowing and oral motor movements
  • Psycho social support and counseling
  • Linkage to patient support groups
 
Condition: Trichuriasis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Health education to adults and communities on trichuriasis and prevention measures
  • Community/adult persons education on personal hygiene as well as proper disposal of human faeces
  • Community awareness on effective sewerage disposal systems
  • Promote through multi sectoral approach wastewater treatment before use for irrigation due to food grown in contaminated soil.
  • Community Health workers training on trichuriasis including prevention measures
  • Proper cleaning and cooking of food
  • Practicing proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Avoiding consuming soil that may be contaminated with human feacal matter
  • Proper waste disposal-Not passing stool in the soil or outdoors
  • Avoidance of contact with soil that may be contaminated with human faeces
  • Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Promoting good nutrition for adults
  • Identification of features/signs indicative of trichuriasis including frequent, painful passage of stool that contains a mixture of mucus, water, and blood, abdominal pain The diarrhea typically has a pungent smell
  • Supportive therapy including relieve of any abdominal pain with painkillers, nutritional support (proper nutrition)
  • Referral to health facility for definitive diagnosis and treatment
Primary Care
  • Health education to adults on Trichuriasis and prevention measures
  • Adult education on personal hygiene as well as proper disposal of human faeces
  • Awareness on effective sewerage disposal systems
  • Health workers education on Trichuriasis including prevention measures and its management in adults
  • Guidance for the adults on proper cleaning and cooking of food
  • Guidance on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Guidance on Avoidance consuming or contact with soil that may be contaminated with human feacal matter
  • Proper waste disposal-Not passing stool in the soil or outdoors
  • Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Provide guidance on good nutrition for adults
  • Physical and clinical examination
  • Clinical diagnosis of Trichuriasis based on features such as including frequent, painful passage of stool that contains a mixture of mucus, water, and blood, abdominal distension, abdominal pain The diarrhea typically has a pungent smell
  • Supportive therapy including relieve of any abdominal pain with painkillers, nutritional support (proper nutrition)
  • Lab Diagnostic test-Stool sample for microscopy for identifying the trichuris eggs
  • Treatment using Anthelminthic medications such as albendazole and mebendazole
  • Follow up and prevention of complications e.g Anaemia
  • Referral to hospital for management of complications due to trichuriasis including iron deficiency anemia,rectal prolapse
Referral Facility: General
  • Health education to adults persons/families and communities on Trichuriasis and prevention measures
  • Adult education on personal hygiene as well as proper disposal of human faeces
  • Awareness on effective sewerage disposal systems
  • Health workers education on Trichuriasis including prevention measures and its management in adults
  • Guidance for the adults on proper cleaning and cooking of food
  • Guidance on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Guidance on Avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter
  • Proper waste disposal-Not passing stool in the soil or outdoors
  • Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Provide guidance on good nutrition for adults
  • physical and clinical examination
  • Clinical diagnosis of Trichuriasis, based on history of passage of a live worm in faeces, abdominal pain while others may have cough, difficulty in breathing or fever
  • Supportive therapy including relieve of any abdominal pain with painkillers, nutritional support (proper nutrition)
  • Diagnostic tests;
  • Microscopy–stool for identifying trichuris eggs
  • Endoscopy to see adult worms in GIT
  • Treatment using Anthelminthic medications such as albendazole and mebendazole<
  • Prevention and management of complications e.g Anaemia, rectal prolapse
Referral Facility: Specialist
    • Health education to adults persons/families and communities on Trichuriasis and prevention measures
      • Adult education on personal hygiene as well as proper disposal of human faeces
  • awareness on effective sewerage disposal systems
  • Health workers education on Trichuriasis including prevention measures and its management in adults
  • Guidance for the adults on proper cleaning and cooking of food
  • Guidance on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
  • Guidance on Avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter
  • Proper waste disposal-Not passing stool in the soil or outdoors
  • Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
  • Taking safety precautions like wearing gloves when handling soil/manure
  • Provide guidance on good nutrition for adults
  • Physical and clinical examination
  • Clinical diagnosis of Trichuriasis, based on history of passage of a live worm in faeces, abdominal pain while others may have cough, difficulty in breathing or fever
  • Supportive therapy including relieve of any abdominal pain with painkillers; nutritional support (proper nutrition)
  • Treatment using Anthelminthic medications such as albendazole and mebendazole
  • Diagnostic tests
  • Microscopy–stool for identifying trichuris eggs
  • Endoscopy to see adult worms in GIT
  • Prevention and management of complications e.g iron deficiency anaemia, rectal prolapse
 
Condition: Iodine deficiency
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education on nutritious and healthy eating
  • Education on nutritious and healthy eating
  • Examination during home visits for presence of goiter and signs of hypothyroidism
  • Follow up cases of iodine deficiency being managed at home to ensure compliance with treatment and advice
  • Refer people with suspected iodine deficiency next level for further assessment and management
Primary Care
  • Education on nutritious and healthy eating
  • Refer cases of iodine deficiency and cases of goiter to hospital for treatment
Referral Facility: General
  • Treat iodine deficiency cases with iodide with or without levothyroxine
  • Plan for surgery in cases with large goiters
Referral Facility: Specialist
  • Treat iodine deficiency cases with iodide with or without levothyroxine
  • Plan for surgery in cases with large goiters
 
Condition: Maternal conditions
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education on good nutrition for women and importance of antenatal care when pregnant
  • Education on importance of regular medical checkups to ensure that women are in good health before embarking on a pregnancy
Primary Care
  • Education on good nutrition for women and importance of antenatal care when pregnant
  • Provide general medical check-up service for women who are considering a pregnancy
  • Provide treatment for non-pregnant women who are found to have pre-existing medical conditions before becoming pregnant/pre-conceptual treatmnet/services
Referral Facility: General
Referral Facility: Specialist
 
Condition: Vitamin A deficiency
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education on nutritious and healthy eating
  • Recognition of symptoms that may be indicative of vitamin A defficeincy eg Dry and rough skin.; Eye inflammation affecting the eyelids, surrounding tissues, and even eyes
  • Guidance to adult on eating viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables.
  • Vitamin A supplemnts
  • Refer people with suspected Vitamin A deficiency next level for further assessment and management
  • Follow up cases of Vitamin A deficiency being managed at home to ensure compliance with treatment and advice
Primary Care
  • Education on nutritious and healthy eating
  • Physical and clinical assessmnet
  • Guidance to adults on eating viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables.
  • Treat Vitamin A deficiency with Vitamin A supplemnts
  • Treating underlying causes /conditions
  • Referrals to hospital
  • Follow up
Referral Facility: General
  • Physical and clinical assessmnet
  • Guidance to adults eating viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables.
  • Treat Vitamin A deficiency with Vitamin A supplemnts
  • Treating underlying causes /conditions
  • Follow up
Referral Facility: Specialist
  • Physical and clinical assessmnet
  • Guidance to adults on eating viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables.
  • Treat Vitamin A deficiency with Vitamin A supplemnts
  • Treating underlying causes /conditions
  • Follow up
 
Condition: Colon and rectum cancers
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community engagement [community sensitization on increasing dietary fibre and reducing red and processed meat consumption and alcoholic drinks as well as regular physical exercise
  • Community engagement and empowerment on cancer awareness and early health-seeking behaviour
  • Community leaders and advocates engagement to address cancer stigma and identification of barriers to accessing care
  • Healthy life style: Healthy diet (high fibre, low saturated fats), physical activity, weight management, and avoiding alcohol and tobacco use
  • Self-management education
  • Exercise and physical activity
  • Nutritional support
  • Home-based care with multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Primary Care
  • Dietary counselling on increasing dietary fibre and reducing red and processed food
Referral Facility: General
  • Dietary counselling on increasing dietary fibre and reducing red and processed food
  • Healthy life style: reducing weight gain and physical activity
  • Regular colorectal cancer screening to those with high risk
  • Appropriate management of infections
  • Early referral for additional procedures
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Referral Facility: Specialist
  • Regular colorectal cancer screening to those with high risk
  • Staging and grading
  • Chemotherapy
  • Targeted drug therapy
  • Immunotherapy
  • Surgery
  • Radiotherapy
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
 
Condition: Larynx cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Public education about dangers of smoking and alcohol use
  • Public education about dangers of smoking and alcohol use
  • Referral of people with neck masses (cervical lymph node swelling) to hospital for further examination
  • Referral of people with increasing hoarseness of voice to hospital for further assessment
  • Psychosocial support for people who have received treatment
  • Ensuring that treated people comply with follow up regime
  • Support of treated people in smoking and alcohol cessation
  • Non-opioid pain relief for people with advanced disease
Primary Care
  • Public education about dangers of smoking and alcohol use
Referral Facility: General
  • Assessment of people with increasing voice hoarseness for laryngeal cancer
  • Chemotherapy or radiation therapy
  • Surgery for disease with extra-laryngeal extension
  • Esophageal dilatation
  • Speech therapy
  • Opioid pain relief for people with advanced disease
Referral Facility: Specialist
  • Assessment of people with increasing voice hoarseness for laryngeal cancer
  • Chemotherapy or radiation therapy
  • Surgery for disease with extra-laryngeal extension
  • Esophageal dilatation
  • Speech therapy
  • Opioid pain relief for people with advanced disease
 
Condition: Leukemia
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Refer people with anaemia or easy bruising and bleeding or recurrent infection to next level for assessment
  • Refer people with anaemia or easy bruising and bleeding or recurrent infection to next level for assessment
  • Psychosocial support for people diagnosed with the disease
  • Supervision of people diagnosed with the condition for compliance with management
  • Home-based end of life care
  • Non-opioid pain relief
Primary Care
  • Refer people with anaemia or easy bruising and bleeding or recurrent infection where benign causes have been excluded to hospital for assessment
  • Psycho social support for people diagnosed with the condition
Referral Facility: General
  • Assess people with anaemia or easy bruising and bleeding or recurrent infection where benign causes have been excluded for leukaemia
  • Psycho social support for people diagnosed with the condition
  • Blood transfusion Treatment of infection Opioid pain relief
  • End of life support
Referral Facility: Specialist
  • Assess people with anaemia or easy bruising and bleeding or recurrent infection where benign causes have been excluded for leukaemia
  • Psycho social support for people diagnosed with the condition
  • Blood transfusion Treatment of infection Opioid pain relief
  • End of life support
 
Condition: Liver Cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Public education about dangers of alcohol use Public education on symptoms of liver disease
  • Ensuring that people with diagnosis of liver cancer comply with follow up regime
  • Psychosocial support for people who are being managed for liver cancer
  • Ensuring that people with diagnosis of liver cancer comply with follow up regime
  • Non-opioid pain relief for people with advanced disease
  • Provision of home-based end of life care
Primary Care
  • Referral of people with persistent dyspepsia to hospital for assessment
  • Referral of people with signs of liver disease to hospital for assessment
  • Referral of people with abdominal masses to hospital for assessment
  • Referral of people with weight loss to hospital for assessment
Referral Facility: General
  • Assessment of people with signs of liver disease and weight loss for liver cancer
  • Screening of blood and blood donors before transfusion
  • Liver Transplantation
  • Opioid pain relief for people with advanced disease
  • Provision of end of life care
Referral Facility: Specialist
  • Assessment of people with signs of liver disease and weight loss for liver cancer
  • Screening of blood and blood donors before transfusion
  • Liver Transplantation
  • Opioid pain relief for people with advanced disease
  • Provision of end of life care
 
Condition: Trachea, bronchus, lung cancers
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness on risk factors (smoking) and occupational and environmental exposure (e.g., goal mining, cement factories, etc.)
  • Mass media campaigns that educate the public about the harms of smoking/tobacco use and second hand smoke
  • Community engagement and empowerment on cancer awareness and early health-seeking behaviour
  • Community leaders and advocates engagement to address cancer stigma and identification of barriers to accessing care
  • Not starting smoking, or to quitting smoke and avoiding second hand smoke.
  • Healthy diet
  • Self-management education
  • Physical exercise
  • Nutritional support
  • Home-based care with multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Primary Care
  • Health education on early identification of signs and symptoms of respiratory tract cancers
  • Not starting smoking, or to quitting smoke and avoiding second hand smoke
  • Referral of people with cough, chest pain or weight loss to hospital for further assessment
Referral Facility: General
  • Assessment of people with cough, chest pain or weight loss for lung, tracheal or bronchial cancer
  • Appropriate management of infections
  • Referral to the next level for diagnostic workup and treatment
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Referral Facility: Specialist
  • Annual lung cancer screening with Low dose CT (LDCT) scan for high risk population
  • Counselling support to quit smoking
  • Staging and grading
  • Chemotherapy
  • Targeted drug therapy
  • Surgery
  • Radiotherapy
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members End-of-life care
 
Condition: Malignant skin melanoma
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Educate people with skin moles on need to monitor change in size and colour of mole
  • Educate people with skin moles on need to monitor change in size and colour of mole
  • Home based follow up of treated people for monitoring of recurrence
Primary Care
  • Refer people with changes in colour or size of skin moles to hospital for assessment
  • Home based follow up of treated people for monitoring of recurrence
Referral Facility: General
  • Assess people with non-sickle cell bone pain or pathological fractures for multiple myeloma
  • Surgical excision Adjuvant radiation therapy
  • Adjuvant interferon alfa
  • Treatment of complications
  • End of life support
Referral Facility: Specialist
  • Assess people with non-sickle cell bone pain or pathological fractures for multiple myeloma
  • Surgical excision Adjuvant radiation therapy
  • Adjuvant interferon alfa
  • End of life support
  • Treatment of complications
 
Condition: Multiple myeloma
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Refer people with non-sickle cell bone pain or pathological fractures to hospital for assessment
  • Monitoring of people being managed with disease to ensure treatment compliance
  • Psycho social support for people being managed with the disease
  • Home-based end of life support
Primary Care
Referral Facility: General
Referral Facility: Specialist
 
Condition: Nasopharynx cancer and other pharyngeal cancers
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Public education about ENT symptoms and need to report for examination with such symptoms
  • Public education about ENT symptoms and need to report for examination with such symptoms
  • Referral of people with neck masses (cervical lymph node swelling) to hospital for further examination
  • Referral of people with ENT symptoms to next level for assessment
  • Psychosocial support for people who have received treatment for nasopharynx cancer
  • Ensuring that treated people comply with follow up regime
  • Non-opioid pain relief for people with advanced disease
Primary Care
  • Public education about ENT symptoms and need to report for examination with such symptoms
  • Public education about ENT symptoms and need to report for examination with such symptoms
  • Referral of people with neck masses (cervical lymph node swelling) to hospital for further examination
  • Referral of people with persistent ENT symptoms to hospital
Referral Facility: General
  • Assessment of people with persistent ENT symptoms for ENT cancers
  • Chemotherapy and radiation therapy
  • Opioid pain relief for people with advanced disease
Referral Facility: Specialist
  • Assessment of people with persistent ENT symptoms for ENT cancers
  • Chemotherapy and radiation therapy
  • Opioid pain relief for people with advanced disease
 
Condition: Oesophagus cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Public education about dangers of smoking and alcohol use
  • Public education about dangers of smoking and alcohol use
  • Referral of people with neck masses (cervical lymph node swelling) to hospital for further examination
  • Referral of people with difficulty swallowing to hospital for further assessment
  • Psycho social support for people who have received treatment
  • Ensuring that treated people comply with follow up regime
  • Support of treated people in smoking and alcohol cessation
  • Non-opioid pain relief for people with advanced disease
Primary Care
  • Public education about dangers of smoking and alcohol use
  • Public education about dangers of smoking and alcohol use
  • Referral of people with neck masses (cervical lymph node swelling) to hospital for further examination
  • Referral of people with difficulty swallowing to hospital for further assessment
Referral Facility: General
  • Assessment of people with difficulty swallowing for oesophageal cancer
  • Surgery Chemotherapy
  • Radiation
  • Esophageal dilatation
  • Stents to maintain esophageal patency
  • Opioid pain relief for people with advanced disease
Referral Facility: Specialist
  • Assessment of people with difficulty swallowing for oesophageal cancer
  • Surgery Chemotherapy
  • Radiation
  • Esophageal dilatation
  • Stents to maintain esophageal patency
  • Opioid pain relief for people with advanced disease
 
Condition: Pancreas cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Referral of patients with weight loss and gastrointestinal symptoms to hospital for assessment
  • Psycho social support for people who have received treatment
  • Ensuring that treated people comply with follow up regime
  • Non-opioid pain relief for people with advanced disease
  • Provision of home-based end of life care
Primary Care
  • Referral of patients with weight loss and gastrointestinal symptoms to hospital for assessment
Referral Facility: General
  • Radiation therapy
  • Surgery Chemotherapy
  • Opioid pain relief for people with advanced disease
  • Provision of end of life care
Referral Facility: Specialist
  • Radiation therapy
  • Surgery Chemotherapy
  • Opioid pain relief for people with advanced disease
  • Provision of end of life care
 
Condition: Non-melanoma skin cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Educate people on need for hospital follow up for skin lesions and non-healing skin ulcers
  • Refer people with skin lesions on non-healing skin ulcers to next level for assessment
  • Home based follow up of treated people for monitoring of recurrence
Primary Care
  • Refer people with skin lesions on non-healing skin ulcers to next level for assessment
  • Home based follow up of treated people for monitoring of recurrence
Referral Facility: General
  • Adherence to any medication as prescribes
  • Advice to patient on monitoring the pattern of the headache/keeping a headache diary
  • Guidance on avoidance of headache triggers-such as caffeine
  • Guidance to patient on Practicing healthy behaviors Including;
  • Getting plenty of sleep,
  • Staying physically active,
  • Eating healthy meals and snacks,
  • Drinking plenty of water daily,
  • Management of stress.
  • Practicing relaxation techniques
  • Surgical excision
  • Radiation therapy for metastatic cases
Referral Facility: Specialist
  • Adherence to any medication as prescribes
  • Advice to patient on monitoring the pattern of the headache/keeping a headache diary
  • Guidance on avoidance of headache triggers-such as caffeine
  • Guidance to patient on Practicing healthy behaviors Including;
  • Getting plenty of sleep,
  • Staying physically active,
  • Eating healthy meals and snacks,
  • Drinking plenty of water daily,
  • Management of stress.
  • Practicing relaxation techniques
  • Radiation therapy for metastatic cases
  • Surgical excision
 
Condition: Stomach cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Healthy life style: healthy weight, physically active, no alcoholic drink or in moderation, no smoking, eat vegetables and fruits
  • Physical exercise
  • Nutritional support
  • Home-based care with multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Primary Care
  • Prompt treatment of ulcers and infections especially H. pylori
Referral Facility: General
  • Prompt treatment of ulcers and infections especially H. pylori
  • Appropriate management of infections
  • Referral to the next level for diagnostic workup and treatment
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Referral Facility: Specialist
  • Prompt treatment of ulcers and infections especially H. pylori
  • Staging and grading
  • Chemotherapy
  • Targeted drug therapy
  • Immunotherapy
  • Surgery
  • Radiotherapy
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members End-of-life care
 
Condition: Breast cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness on symptoms of breast cancer, importance of screening with regular breast exams and mammography
  • Community engagement and empowerment on cancer awareness and avoiding harmful traditional practice for breast cancer treatment
  • Community leaders and advocates engagement to address cancer stigma and identification of barriers to accessing care
  • Keep a healthy life style: healthy weight, physically active, no alcoholic drink or in moderation, no smoking, eat vegetables and fruits
  • Breasts self-examination
  • Immediate transfer of suspected cases to a higher-level health care facility
  • Physical exercise
  • Nutritional support
  • Home-based care with multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Primary Care
  • Health education on prevention and management of breast cancer
  • Keep a healthy life style: healthy weight, physically active, no alcoholic drink or in moderation, no smoking, eat vegetables and fruits and breast feed
  • Guidance on self-observance and taking note of any unusual symptoms e.g., nipple discharge, skin change, pitting, breast mass

Immediate transfer of suspected cases to a higher-level health care facility

  • Physical exercise
  • Nutritional support
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Referral Facility: General
  • Health education on prevention and management of breast cancer
  • Regular screening with mammogram
  • Immediate transfer of suspected cases to a higher-level health care facility
  • Physical exercise
  • Nutritional support
  • Cognitive behaviour therapy (CBT)
Referral Facility: Specialist
  • Regular screening with mammogram
  • Chemotherapy
  • Hormone therapy
  • Lumpectomy
  • Simple mastectomy
  • Radical mastectomy
  • Lymphadenectomy
  • Radiotherapy
  • Physical exercise
  • Nutritional support
  • Cognitive behaviour therapy (CBT)
 
Condition: Cervix uteri cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community engagement and empowerment on cancer awareness and early health-seeking behaviour
  • Community leaders and advocates engagement to address cancer stigma and identification of barriers to accessing care
  • Safe sexual practice
  • Correct and consistent use of condoms
  • HPV vaccination at earlier age
  • Early recognition of need for referral
  • Physical exercise
  • Nutritional support
  • Home-based care with multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Primary Care
  • Health education on prevention and management of cervical cancer
  • Safe sexual practice
  • Correct and consistent use of condoms
  • HPV vaccination at earlier age
  • Screening and treatment of precancerous lesions
  • Cryotherapy
  • Early referral of suspicious cases
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Referral Facility: General

Health education on prevention and management of cervical cancer

  • Screening and treatment of precancerous lesions
  • History and physical examination for cervical cancer
  • Cervical cancer screening using HPV-test or Visual inspection with acetic acid (VIA)
  • Treatment of precancerous lesions with Cryotherapy and/or LEEP
  • Early recognition of need for referral
  • Physical exercise
  • Nutritional support
  • Multi-disciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
Referral Facility: Specialist
  • Health education on prevention and management of cervical cancer
  • Screening and treatment of precancerous lesions
  • Chemotherapy
  • Simple hysterectomy
  • Radical hysterectomy
  • Targeted drug therapy
  • Immunotherapy Radiotherapy
  • Physical exercise
  • Nutritional support
  • Hospital-based care with multidisciplinary team with access to opiates and essential supportive medicines
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
  • Linkage to address financial well-being of patients and family members
  • End-of-life care
 
Condition: Corpus uteri cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Social Marketing campaigns instituted towards generating empathy and promotion social inclusion of those who have completed a treatment cycle
  • Promotion of manufacturing of prosthetics, post-Surgical treatment
  • Set up publicly owned-and-run hospices
  • Promote private sector participation in setting up hospices and palliative care centres
Primary Care
  • Routine Endometrial sampling
  • Early Detection through clinical awareness, colposcopy and endometrial biopsy.
  • Prompt referral for hospital care for those with results positive for malignancies
  • Provision of Clinical Psychology services as part of Primary Care for clients who have completed treatment cycles
  • Set up publicly run hospices to collaborate with Primary Care Centers
Referral Facility: General
  • Clinical Breast Examinations (CBE) during consultations and Physical Examinations
  • Breast Ultrasound scans for pathologies elicited from CBE
  • Advanced Imaging – Co
  • Genetic screening to pick up mutations in Breast Cancer genes
  • Stage I – Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy)
  • Stages II and III – Pelvic Radiation and Chemotherapy. Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy) may also be done
  • Stage IV – Surgery, Chemotherapy, Radiotherapy and Hormonal Therapy may be used in various combinations
  • Institute Specialist teams to offer Multidisciplinary care in Clinical Psychology, Dietetics and Physiotherapy
Referral Facility: Specialist
  • Breast Ultrasound scans for pathologies elicited from CBE
  • Advanced Imaging – Co
  • Clinical Breast Examinations (CBE) during consultations and Physical Examinations
  • Genetic screening to pick up mutations in Breast Cancer genes
  • Stage I – Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy)
  • Stages II and III – Pelvic Radiation and Chemotherapy. Surgery (Total Hysterectomy with Bilateral Salpingo-OOphrectomy and Pelvic and Para-aortic lymphadenectomy) may also be done
  • Stage IV – Surgery, Chemotherapy, Radiotherapy and Hormonal Therapy may be used in various combinations
  • Institute Specialist teams to offer Multidisciplinary care in Clinical Psychology, Dietetics and Physiotherapy
 
Condition: African trypanosomiasis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • IEC on African trypanosomiasis to all age cohorts
  • The main approaches to controlling African trypanosomiasis are to reduce the reservoirs of infection and the presence of the tsetse fly.

  • Primary prevention emasures *

  • Fly control measures

  • clear bushes.

  • Use insect repellent,

  • vector control using a multisectoral appraoch

  • use of Protective clothings: Wear long-sleeved shirts and pants of medium-weight material in neutral colors that blend with the background environment. (Tsetse flies are attracted to bright or dark colors, and they can bite through lightweight clothing).

  • Inspection of places before entry eg cars --since the flies are attracted to bright lights eg car lights

  • The use of trypanotolerant breeds for livestock farming should be considered if the disease is widespread.

  • Fly control is another option but is difficult to implement.

  • screening -The card agglutination test for trypanosomiasis T. b. gambiense (CATT) is a serologic screening test used for population screening

  • Screening of people at risk helps identify patients at an early stage.

Primary Care
Referral Facility: General
    • Physical and clinical examinaton
  • *Experienced staff to conduct clinical assessment For T.b. gambiense **
  • Treatment under direct observation either through outpatient or as inpatients
  • Admission/inpatient services
  • Treatmnet with relevant medication first-line treatment or second line treatmnet aas indicated
  • Management of relapses
  • Mananagement of nay complications eg reduce the risk of encephalopathy
  • Management of any adverse drug effects- eg Encephalopathy gastrointestinal and skin reactions, pyrexia, and peripheral neuropathy.
  • Diagnostic tests
  • Microscopy of fresh blood chancre fluid or lymph node aspirate
  • Microscopy of celebral spinal fluid (CSF) (wet preparation)
Referral Facility: Specialist
  • First-line treatment
  • Second line treatment
  • Management of relapses
  • Management of complications
  • Management of adverse drug effects
 
Condition: Malaria
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community mobilization and engagement on malaria prevention and control
  • Mass media on malaria prevention measures
  • Community mobilization and engagement on malaria risk reduction, prevention and control and early treatment seeking
  • Create mass awareness on malaria using social media, mass media, print media, public gatherings
  • Social and behavioural change communication
  • Promote the use of Information Education Communication (IEC) materials
  • Improve CHW knowledge on malaria * School based education on malaria prevention
  • Integrated vector control management (e.g., ITN, IRS, larva source management etc
  • Intermittent preventive treatment for pregnant women (IPTp)
  • Oral antimalarial treatment
  • Immediate transfer of severe or unresponsive cases to a higher-level health care facility
  • Diagnosis confirmation for malaria parasites using rapid diagnostic tests
  • Treatment of uncomplicated P. falciparum malaria based on national guidelines * Management of fever using oral antipyretics * Follow up on malaria treatment adherence
  • Refer unresponsive or severe cases to the next level
Primary Care
  • Health education on early identification of malaria symptoms and early treatment
  • Early identification and treatment of malaria
  • Insecticide treated bed net for malaria cases
  • Oral antimalarial treatment
  • Intramuscular antimalarial empiric therapy for initial phase treatment of severe malaria * Immediate transfer of severe or unresponsive cases to a higher-level health care facility
Referral Facility: General
  • Health education on early identification of malaria symptoms and early treatment
  • Early identification and treatment of malaria
  • Insecticide treated bed net for malaria cases
  • Intravenous antimalarial for treatment of severe malaria
  • IV Glucose
  • IV anticonvulsants
  • Blood and blood product transfusion
  • Immediate transfer of unresponsive or complicated cases to a higher-level health care facility
Referral Facility: Specialist
  • Health education on early identification of malaria symptoms and early treatment
  • Early identification and treatment of malaria
  • Insecticide treated bed net for malaria cases
  • Intravenous antimalarial for severe malaria
  • IV Glucose
  • IV anticonvulsants * Blood and blood product transfusion
  • Haemodialysis for acute kidney injury
  • Intensive care for cerebral malaria
 
Condition: Schistosomiasis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Improvement in community Water Sanitation and Hygiene (WASH)
  • Preventive chemotherapy with Praziquantel (PZQ)
  • Preventive chemotherapy with Praziquantel (PZQ) for 12 -14-year olds and for those above, only for persons at risk whicjh may include groups with occupations involving contact with infested water, such as fishermen, farmers, irrigation workers, or women in their domestic tasks, to entire communities living in endemic areas
  • Vector control
  • It is recommended that pre-school children should be treated for schistosomiasis within child-health services where their weight is monitored, they are immunized, dewormed and given micronutrient supplements
Primary Care
  • IEC for all age cohorts
  • Schistosomiasis,
  • Hygiene
  • Preventive chemotherapy with Praziquantel (PZQ)
  • Preventive chemotherapy with Praziquantel (PZQ) for 12 -14-year olds and for those above, only for persons at risk whicjh may include groups with occupations involving contact with infested water, such as fishermen, farmers, irrigation workers, or women in their domestic tasks, to entire communities living in endemic areas
  • Vector control
  • It is recommended that pre-school children should be treated for schistosomiasis within child-health services where their weight is monitored, they are immunized, dewormed and given micronutrient supplements
  • Medication --use of Praziquantel
  • Microscopic examination of stool and urine samples for parasites eggs
  • Physical and clinical examination
Referral Facility: General
Referral Facility: Specialist
 
Condition: Echinococcosis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Improved water sanitation and hygiene in the community
  • Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)
  • Public education campaigns on prevention
    - Limit the areas where dogs are allowed
    - Prevent animals from consuming meat infected with cysts
    - Do not allow dogs to feed on rodents and other wild animals
    - Avoid contact with wild animals such as foxes, coyotes and stray dogs
    - Do not encourage wild animals to come close to your home or keep them as pets
    - Prevent dogs from feeding on the carcasses of infected sheep
    - Control stray dog populations
    - Restrict home slaughter of sheep and other livestock
    - Do not consume any food or water that may have been contaminated by fecal matter from dogs
    - Wash your hands with soap and warm water after handling dogs, and before handling food
    - Teach children the importance of washing hands to prevent infection
    - Periodic deworming of domestic carnivores (dogs etc.) with praziquantel (at least 4 times per year)
    - Vaccination of sheep with an E. granulosus recombinant antigen (EG95)
  • A programme
  • Treatment
    - Both albendazole 10 to 15 mg/kg body weight per day (max 800 mg orally in two doses) and, as a second choice for treatment, mebendazole 40-50 mg/kg body weight per day continuously for several months have been highly effective.
Primary Care
  • Diagnosis  
    - Ultrasonography imaging is the technique of choice for the diagnosis of both cystic echinococcosis and alveolar echinococcosis in humans.
  • Treatment  
    - Both albendazole 10 to 15 mg/kg body weight per day (max 800 mg orally in two doses) and, as a second choice for treatment, mebendazole 40-50 mg/kg body weight per day continuously for several months have been highly effective  
    - Percutaneous treatment of the hydatid cysts with the PAIR (Puncture, Aspiration, Injection, Re-aspiration) technique
Referral Facility: General
  • Improved water sanitation and hygiene in the community
  • Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)
Referral Facility: Specialist
  • Improved water sanitation and hygiene in the community
  • Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)
 
Condition: Cysticercosis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
Primary Care
Referral Facility: General
  • Widespread Improvement of water, sanitation and hygiene conditions
    - Strict meat inspection
  • Health education
    - Identification and treatment of tapeworm carriers
    - Cooking pork and beef well
    - Avoid foods that might be contaminated by human faeces.
  • Food handlers should be educated in good handwashing practices
  • Anthelminthic therapy using albendazole (conventional dosage 15 mg/kg/day in 2 divided doses for 15 days) may be superior to praziquantel (50 mg/kg/day for 15 days) for the treatment of neurocysticercosis
  • Co-administration of corticosteroids that cross the blood brain barrier (e.g. dexamethasone) is used to mitigate these effects
  • Treatment of edema, intracranial hypertension or hydrocephalus, which may include ventricular shunt or other neurosurgical procedures.
Referral Facility: Specialist
  • Widespread Improvement of water, sanitation and hygiene conditions
    - Strict meat inspection
  • Health education
    - Identification and treatment of tapeworm carriers
    - Cooking pork and beef well
    - Avoid foods that might be contaminated by human faeces.
  • Food handlers should be educated in good handwashing practices
  • Anthelminthic therapy using albendazole (conventional dosage 15 mg/kg/day in 2 divided doses for 15 days) may be superior to praziquantel (50 mg/kg/day for 15 days) for the treatment of neurocysticercosis
  • Co-administration of corticosteroids that cross the blood brain barrier (e.g. dexamethasone) is used to mitigate these effects
  • Treatment of edema, intracranial hypertension or hydrocephalus, which may include ventricular shunt or other neurosurgical procedures
 
Condition: Asthma
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on triggers/ risk factors of asthma and preventive measures * Multi sectoral approach to ensure clean environments
  • Avoidance of aeroallergen
  • Avoidance of direct or passive exposure to cigarette smoke
  • Counselling on recognition of symptoms
  • Guidance to patient on how to monitor their breathing and how to recognize warning signs
  • Guidance on use of medication as prescribed
  • Recognition of danger signs and referral to the next higher level
Primary Care
  • Health education on triggers/ risk factors of asthma and preventive measures
  • Avoidance of aeroallergen
  • Avoidance of direct or passive exposure to cigarette smoke
  • Vaccination: influenza
  • Vaccination: pneumonia
  • Short-acting beta-2 agonist.
  • Inhaled steroids
  • Long-acting beta-2 agonists
  • Buteyko or yoga breathing techniques
Referral Facility: General
  • Health education on triggers/ risk factors of asthma and preventive measures
  • Vaccination: influenza
  • Vaccination: pneumonia
  • Short-acting bronchodilator,
  • Low-dose inhaled corticosteroid (ICS)
  • Long-acting bronchodilator (LABA)
  • Long-acting muscarinic agonist (LAMA)
  • Oxygen supplementation
  • Bilevel Positive Airway Pressure (BiPAP)
Referral Facility: Specialist
  • Health education on triggers/ risk factors of asthma and preventive measures
  • Vaccination: influenza
  • Vaccination: pneumonia
  • Short-acting bronchodilator,
  • Low-dose inhaled corticosteroid (ICS)
  • Long-acting bronchodilator (LABA)
  • Long-acting muscarinic agonist (LAMA)
  • Oxygen supplementation
  • Bilevel Positive Airway Pressure (BiPAP
 
Condition: Eating disorders
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Awareness creation to communities on eating disorders, early recognition and how to prevent them
  • Distribution of IEC materials on eating disorders
  • Community health workers education on eating disorders, including prevention measures
  • Early identification and referral for treatment for persons with eating disorder
  • Promoting healthy balanced diets/healthy eating for the adults
  • Promoting healthy exercises
  • Social support systems for at community level
  • Guidance and support on effective ways of coping with emotions
  • Early Recognition of signs indicative of eating disorder such as eating extremely small amounts of food or severely overeating,This may be coupled with weakness, fatigue, weight loss
  • Recognition of signs of any concurrent mental ailments as indicated by signs such as nervousness, withdrawal, trouble sleeping
  • Encourage elderly to eat healthy diets/Guidance on Diet /Nutrition counseling
  • Encourage elderly to do healthy exercise moderation /reducing excessive exercises
  • Referral to a health facility for elderly patients with eating disorder and any associated ailments for further management
  • Family & Community social support systems where people can share their feelings
Primary Care
  • Awareness creation to adults, families on eating disorders and how to prevent them
  • Education to health workers on eating disorders, prevention measures and management
  • Early identification and treatment of any eating disorder among adults
  • Education to adults on effective ways of coping with emotions
  • Education and guidance to adults on health exercises
  • Guidance to adults on healthy balanced diets/healthy eating including body image
  • Advisory on exercises/exercise moderation/reducing excessive exercises
  • Recognition of any concurrent mental ailments like depression and anxiety disorders.
  • Clinical and physical examination
  • Early detection and management of eating disorders
  • Diet education and advice/Nutrition counseling
  • Monitoring and recognition of any complications associated with eating disorders such as obesity, diabetes,
  • Referral to a hospital for adult patient with severe eating disorder and any complications for further management
  • Counselling services for adult patients with eating disorder and their families
  • Linkage of adult patients with eating disorder to Self-help/support groups
Referral Facility: General
  • Awareness creation to adults, families on eating disorders and how to prevent them
  • Training health workers on eating disorders, prevention measures and management
  • Early identification and treatment of any eating disorder among adults
  • Education to adults on effective ways of coping with emotions
  • Education and guidance to adults on health exercises
  • Guidance to adults on healthy balanced diets/healthy eating including body image
  • Early detection and treatment of eating disorders
  • Assessment mental and social well being
  • Multi-disciplinary treatment approach involving psychiatrists, psychologists, physicians, dieticians or nutritional advisers, social workers,
  • Diet education and advice/Nutrition counseling
  • Medical nutrition therapy
  • Advisory on exercises/exercise moderation/reducing excessive exercises
  • Psychological interventions
  • Cognitive behavioral therapy to help the patient control their thoughts
  • Behavioral therapy focusing on assisting patient to gain control and change unwanted behaviors
  • Medications
  • Management of concurrent mental ailments like depression and anxiety disorders.
  • Monitoring and management of any complications associated with eating disorders such as obesity, diabetes, hypertension (high blood pressure) and heart disease.
  • Hospitalization for more serious cases.
  • Follow up
  • Counselling services for adult patients with eating disorder
  • Family therapy
  • Linkage of adult patients with eating disorder to Self-help/support groups
Referral Facility: Specialist
  • Awareness creation to adults, families on eating disorders and how to prevent them
  • Training health workers on eating disorders, prevention measures and management
  • Early identification and treatment of any eating disorder among adults
  • Education to adults on effective ways of coping with emotions
  • Education and guidance to adults on health exercises
  • Guidance to adults on healthy balanced diets/healthy eating including body image
  • Advisory on exercises/exercise moderation/reducing excessive exercises
  • Psychological interventions
  • Cognitive behavioral therapy to help the patient control their thoughts
  • Behavioral therapy focusing on assisting patient to gain control and change unwanted behaviors
  • clinical and physical examination
  • Early detection and treatment of eating disorders
  • Assessment mental and social well being
  • Hospitalization for more serious cases.
  • Follow up
  • Medical nutrition therapy
  • Medications
  • Management of concurrent mental ailments like depression and anxiety disorders.
  • Monitoring and management of any complications associated with eating disorders such as obesity, diabetes, hypertension (high blood pressure) and heart disease.
  • Multi-disciplinary treatment approach involving psychiatrists, psychologists, physicians, dieticians or nutritional advisers, social workers,
  • Diet education and advice/Nutrition counseling
  • Counselling services for adult patients with eating disorder
  • Family therapy
  • Linkage of adult patients with eating disorder to Self-help/support groups
 
Condition: Periodontal disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on oral health including periodontal disease to the communities
  • Increase knowledge and practices among the public through community programmes
  • Fully integrating oral health into community health programmes.
  • Community Health workers training on periodontal disease including prevention measures
  • Daily oral hygiene measures to prevent periodontal disease including brushing properly on a regular basis (at least twice daily), Flossing daily
  • Using an antiseptic mouthwash, Chlorhexidine gluconate-based mouthwash
  • Adoption of healthy lifestyles such as no smoking or cessation of smoking, use of healthy balanced diets
  • Regular dental check-ups
  • Community level screening for periodontal disease
  • Recognition of symptoms indicative of periodontal disease such as bleeding gums, drifted or loose teeth or a complaint of bad breath
  • Good oral hygiene/oral hygiene instructions including brushing and flossing
  • Guidance on healthy diet/good nutrition
  • Use of antiseptic mouth washes as a temporary primary oral hygiene measure
  • Relieve of symptoms such as pain with analgesics
  • Referral to a health facility for management of adult with periodontal disease
Primary Care
  • Education to the adults on periodontal disease and prevention measures
  • Health workers training on periodontal disease including prevention and management in adults
  • Guidance on good oral hygiene practices including brushing
  • Guidance to patient on their role in improving periodontal health.
  • Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation .
  • Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis
  • Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease
  • Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy
  • Screen adults for periodontal diseases at every routine examination
  • Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth
  • Treatment planning and Patient education on the treatment
  • Guidance to patient on their role in improving periodontal health.
  • Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support)
  • Use of mouth washes as a temporary primary orla hygiene measure
  • Ensure that the patient is motivated to achieve and maintain effective plaque removal.
  • Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances
  • Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemiicrobials
  • Use of analgesics where there is pain
  • Referral for the adult patient with periodontal disease to a hospital for further management including managemnet of any underlyng conditions
Referral Facility: General
  • Early treatment/management of predisposing conditions such as diabetes cardiovascular disease as a preventive measure
  • Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis
  • Guidance on good oral hygiene practices including brushing
  • Guidance to patient on their role in improving periodontal health.
  • Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation
  • Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease
  • Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy
  • Screen adults for periodontal diseases at every routine examination.
  • Education to the adults on periodontal disease and prevention measures
  • Health workers education on periodontal disease including prevention and management in adults
  • Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth
  • Diagnostics including;
    • Study models for diagnostics especially of gingival recession
    • Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession
    • Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs
  • Treatment planning and Patient education on the treatment choice
  • Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support)
  • Use of mouth washes as a temporary primary oral hygiene measure
  • Removal of plaque and calculus including supragingival debridement and root surface instrumentation
  • Ensure that the patient is motivated to achieve and maintain effective plaque removal.
  • Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances
  • Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials
  • Use of analgesics where History and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every there is pain
  • Advanced treatment through periodontal surgery to prevent more bone loss
  • Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease
  • Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
Referral Facility: Specialist
  • Early treatment/management of predisposing conditions such as diabetes cardiovascular disease as a preventive measure
  • Advice/guidance on control of diabetes as Poorly controlled diabetes enhances the signs and symptoms of gingivitis and periodontitis
  • Guidance on good oral hygiene practices including brushing
  • Guidance to patient on their role in improving periodontal health.
  • Guidance on avoidance of factors that predispose to periodontal disease including the effect of smoking on their oral health and general health and assist them on smoking cessation
  • Information and guidance to patient on the benefits of a healthy, balanced diet to their oral health including prevention of periodontal disease
  • Advice on frequent visits for dental prophylaxis and or supportive periodontal therapy
  • Screen adults for periodontal diseases at every routine examination.
  • Education to the adults on periodontal disease and prevention measures
  • Health workers education on periodontal disease including prevention and management in adults
  • Physical, clinical and full periodontal assessment involving charting of recession, probing depths, bleeding on probing and mobility for every tooth
  • Diagnostics including;
    • Study models for diagnostics especially of gingival recession
    • Use of clinical photographs calibrated by inclusion of a probe to monitor gingival recession
    • Use of Radiographs (x-rays) to determine the extent of periodontal disease and for treatment planning. These include periapical radiographs & or panoramic radiographs
  • Treatment planning and Patient education on the treatment choice
  • Oral Hygiene instructions modelled on patient behaviour change strategies (TIPPS-talk, instruct, practice, plan, support)
  • Use of mouth washes as a temporary primary oral hygiene measure
  • Removal of plaque and calculus including supragingival debridement and root surface instrumentation
  • Ensure that the patient is motivated to achieve and maintain effective plaque removal.
  • Management of Local Plaque-retentive Factors e.g. crowded teeth, partial dentures, bridgework, orthodontic appliances
  • Antimicrobial Medication; Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials
  • Use of analgesics where there is pain
  • Advanced treatment through periodontal surgery to prevent more bone loss
  • Management of any underlying conditions such as diabetes /cardiovascular disease that predisposes to periodontal disease
  • Supportive periodontal therapy-long term program of Follow up and check ups after successful periodontal treatment
 
Condition: Migraine
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education and awareness creation/information to communities on headache prevention measures
  • Community awareness on healthy behaviours Including; getting plenty of sleep, staying physically active, eating healthy meals and snacks, drinking plenty of water, management of stress, practicing relaxation techniques
  • Lifestyle modifications,
  • Avoidance of triggers
  • Healthy coping mechanisms
  • Analgesics for mild headaches
  • Identify warning features of serious headaches
  • Referral to higher levels of serious headaches
  • Relaxation therapy e.g massage therapy to relive migraine
  • Counselling and patient education on use and adherence to the medication according to the prescription
Primary Care
Referral Facility: General
Referral Facility: Specialist
 
Condition: Parkinson disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Health education/ Awareness creation among the elderly and communities on Parkinson disease and related conditions
  • Advocacy programs on parkinsonism
  • Encourage elderly persons to Exercise regularly to reduce the risk of Parkinson's disease
  • Advice on other preventive measures such as;
  • Avoidance of exposure to pesticides and herbicides
  • Use of vitamins such as Vitamin C and E* *Advice on diet/use of balance diet
  • Recognition of cardinal signs of parkinsonism including slowness of movement; tremor, stiffness or rigidity and postural instability or difficulty in walking
  • Advice on diet/use of balance diet
  • Monitoring any indication of progression or severity of the disease
  • Pain relief and exercise
  • Encourage adherence to medication
  • Referral to a health facility for management
  • Encourage Regular Physical Exercise programs for adults persons with early onset Parkinsonism disease to improve mobility and flexibility
  • Generalized relaxation techniques such as gentle rocking to improve flexibility
  • Psychosocial support and counselling for the adult patient with early onset parkinsonism and to the family to address factors such as loss of function and jobs, depression, fear
  • Stress management for both patient and families
Primary Care
  • Education to the elderly and communities on Parkinson and related conditions
  • Encourage elderly persons to Exercise regularly to reduce the risk of Parkinson's disease
  • Advice on other preventive measures such as Avoidance of exposure to pesticides and herbicides
  • Use of vitamins such as Vitamin C and E
  • Identification of at-risk patients
  • Encourage /Advice on adherence to medication
  • Monitoring for any complications arising including difficulties in swallowing; urine incontinence; breathing complications
  • Stabilize patient in case on any complications e.g.patient with difficulties in breathing before referral to a hospital
  • Referral for a patient with parkinsonism to a hospital for further management
  • Regular Physical Exercise programs for elderly persons with Parkinsonism disease to improve mobility and flexibility
  • Physiotherapy
  • Generalized relaxation techniques such as gentle rocking to improve flexibility
  • Speech and language therapy
  • Occupational therapy
  • Regular Physical Exercise programs for adults with early onset Parkinsonism disease to improve mobility and flexibility
  • Generalized relaxation techniques such as gentle rocking to improve flexibility
  • Palliative care to improve quality of life for both the person with Parkinson's and the family by
  • Providing relief from the symptoms such as pain for the patient
  • Stress relief for the patient and families
  • Provide emotional support/counselling to address factors such as loss of function and jobs, depression, fear

  • Palliative care serves an important role in addressing goals of care.

Referral Facility: General
  • Awareness creation among adults and communities on parkinsonism disease including early onset parkinsonism disease
  • Advocacy programs on parkinsonism
  • Health workers training on parkinsonism and its management
  • Encourage elderly persons to Exercise regularly to reduce the risk of Parkinson's disease
  • Advice on other preventive measures such as
  • Avoidance of exposure to pesticides and herbicides
  • Use of vitamins such as Vitamin C and E
  • Medical history and neurological examination
  • Diagnosis through neuro-imaging -MRI
  • Symptomatic treatment
  • Diet therapy/guidance on balanced diet
  • Use of medication such as levodopa
  • Surgery for deep brain stimulation has been used to reduce motor symptoms in severe cases where drugs are ineffective.
  • Monitoring the disease progression and management of any complications arising
  • Management of difficulties in swallowing/feeding e.g., through use of feeding tube
  • Managing breathing complications e.g., through use of non-invasive ventilator, and tracheostomy.
  • Management of Urine incontinence
  • Management of constipation, pain, blood pressure
  • Management of secondary causes of parkinsonism’s such as stroke
  • Regular Physical Exercise programs for elderly persons with Parkinsonism disease to improve mobility and flexibility
  • Physiotherapy services for elderly with parkinsonians improve mobility, gait, speed, flexibility
  • Generalized relaxation techniques such as gentle rocking to improve flexibility
  • Speech therapy-Lee Silverman Voice treatment
  • Occupational therapy to promote health and quality of life by helping elderly persons with the disease to participate in as many of their daily living activities as possible.
  • Palliative care to improve quality of life for both the person with Parkinson's and the family by
  • providing relief from the symptoms such as pain for the patient
  • Stress relief for the patient and families ,
  • Psychosocial and emotional support/counselling to address factors such as loss of function and jobs, depression, fear
Referral Facility: Specialist
  • Awareness creation among adults and communities on parkinsonism disease including early onset parkinsonism disease
  • Advocacy programs on parkinsonism
  • Health workers training on parkinsonism and its management
  • Encourage elderly persons to Exercise regularly to reduce the risk of Parkinson's disease
  • Advice on other preventive measures such as
  • Avoidance of exposure to pesticides and herbicides
  • Use of vitamins such as Vitamin C and E
  • Medical history and neurological examination
  • Diagnosis through neuro-imaging -MRI
  • Symptomatic treatment
  • Diet therapy/guidance on balanced diet
  • Use of medication such as levodopa
  • Surgery for deep brain stimulation has been used to reduce motor symptoms in severe cases where drugs are ineffective.
  • Monitoring the disease progression and management of any complications arising
  • Management of difficulties in swallowing/feeding e.g., through use of feeding tube
  • Managing breathing complications e.g., through use of non-invasive ventilator, and tracheostomy.
  • Management of Urine incontinence
  • Management of constipation, pain, blood pressure
  • Management of secondary causes of parkinsonism’s such as stroke
  • Regular Physical Exercise programs for elderly persons with Parkinsonism disease to improve mobility and flexibility
  • Physiotherapy services for elderly with parkinsonians improve mobility, gait, speed, flexibility
  • Generalized relaxation techniques such as gentle rocking to improve flexibility
  • Speech therapy-Lee Silverman Voice treatment
  • Occupational therapy to promote health and quality of life by helping elderly persons with the disease to participate in as many of their daily living activities as possible.
  • Palliative care to improve quality of life for both the person with Parkinson's and the family by
  • providing relief from the symptoms such as pain for the patient
  • Stress relief for the patient and families ,
  • Psychosocial and emotional support/counselling to address factors such as loss of function and jobs, depression, fear
 
Condition: Hookworm disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education and awareness creation among adults/communities on hookworm disease including prevention measures
  • Public health education about proper hygiene
  • Awareness creation on improving sanitation including proper waste disposal to reduce the risk of infection
  • Provision of IEC materials on hook worm disease
  • Multisectoral approach in addressing the risk factors of hook worm dieses including improving sanitation, access to clean water and income status of communities
  • Community health workers education on hookworm disease and prevention measures
  • Guidance to adults/communities on preventive measures including
  • Drinking safe water
  • Properly cleaning and cooking food
  • Practicing proper handwashing/hand hygiene
  • Using a barrier to prevent the skin surfaces from touching the soil eg use of gloves , shoes while gardening
  • Avoiding consuming soil that may be contaminated with hookworm
  • Proper human waste disposal-Not passing stool in the soil or outdoors
  • Treating pet dogs and cats for hookworm/deworming pets
  • Recognition of signs of hookworm infestation including rash at the site of initial infection e.g. on the palm or soles; itchiness at the site; creeping eruptions on lower limbs or upper trunk (depending on site of entry of the larvae)
  • Guidance to the patient on Improving nutrition to address any deficiency of nutrients due to the worms (e.g. Iron; Protein;)
  • Symptomatic treatment e.g. relief of fever if present;
  • Referral to a health facility for management of pregnant women with hookworm disease.
Primary Care
  • Education and awareness creation among adults/communities on hookworm disease including prevention measures
  • Public health education about proper hygiene
  • Awareness creation on improving sanitation including proper waste disposal to reduce the risk of infection
  • Provision of IEC materials on hook worm disease
  • Health workers training on hookworm disease, prevention measures and its management
  • Advice to adults on use of safe Drinking water
  • Advice on Properly cleaning and cooking food
  • Advice on use of barrier to prevent the skin from getting in contact with the soil especially in areas that may have feaces in the soil e.g. use of shoes, gloves when gardening
  • Guidance to under 5s on proper handwashing /hand hygiene
  • Guidance to parents/families on proper human waste including the children waste
  • Diagnostic test—Examination of stool sample to identify hookworm eggs
  • Nutrition Support/advice to address any deficiency of nutrients due to the worms (e.g. Iron; Protein;)
  • Administration of anthelminthic drugs (e.g. mebendazole; albendazole) to adults with hook worm disease
  • Management of larvae in the skin ( Topical administration of anthelminthic e.g. .Thiabendazole to destroy the larvae in the skin.
  • Monitor for any worsening of hookworm disease including complications such as anemia
  • Referral to a hospital for further management including management of complications
Referral Facility: General
  • Education and awareness creation to the adults on hookworm disease including prevention measures
  • Education about proper hygiene
  • Education on proper waste disposal to reduce the risk of infection
  • Health workers training on hookworm disease, prevention measures and its management
  • Advice to adults on use of safe Drinking water
  • Advice on Properly cleaning and cooking food
  • Advice on use of barrier to prevent the skin from getting in contact with the soil especially in areas that may have feaces in the soil e.g. use of shoes, gloves when gardening
  • Guidance on proper handwashing/hand hygiene
  • Guidance on proper human waste disposal
  • Nutrition support/therapy to address any deficiency of nutrients due to the worms (e.g. Iron, Protein)
  • Administration of anthelminthic drugs (e.g. mebendazole; albendazole) to adults with hook worm disease
  • Management of larvae in the skin (Topical administration of anthelminthic e.g. .Thiabendazole to destroy the larvae in the skin.
  • Local cryotherapy to destroy the hookworms while still in the skin
  • Management of anemia and its complications (use of iron supplements, vitamin C. Folic acid and vitamin B12 supplements) Diagnostic tests
  • Examination of a stool sample to identify hookworm eggs
  • Blood tests to check for anemia and nutritional deficiencies
  • Chest X-ray to check lung involvement in hookworm infection.
Referral Facility: Specialist
  • Education and awareness creation to the adults on hookworm disease including prevention measures
  • Education about proper hygiene
  • Education on proper waste disposal to reduce the risk of infection
  • Health workers training on hookworm disease, prevention measures and its management
  • Advice to adults on use of safe Drinking water
  • Advice on Properly cleaning and cooking food
  • Advice on use of barrier to prevent the skin from getting in contact with the soil especially in areas that may have feaces in the soil e.g. use of shoes, gloves when gardening
  • Guidance on proper handwashing/hand hygiene
  • Guidance on proper human waste disposal
  • Nutrition support/therapy to address any deficiency of nutrients due to the worms (e.g. Iron, Protein)
  • Administration of anthelminthic drugs (e.g. mebendazole; albendazole) to adults with hook worm disease
  • Management of larvae in the skin (Topical administration of anthelminthic e.g. .Thiabendazole to destroy the larvae in the skin.
  • Local cryotherapy to destroy the hookworms while still in the skin
  • Management of anemia and its complications (use of iron supplements, vitamin C. Folic acid and vitamin B12 supplements) Diagnostic tests
  • Examination of a stool sample to identify hookworm eggs
  • Blood tests to check for anemia and nutritional deficiencies
  • Chest X-ray to check lung involvement in hookworm infection.
 
Condition: Lower respiratory tract infections (LRTI)
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on respiratory tract infections including prevention measures
  • Distribution of IEC materials on lower respiratory tract infections
  • Advocacy for proper sanitation and good housing
  • Good hygiene practices including hand washing
  • Avoidance of smoking within the household
  • Avoidance of secondary exposure to smoke
  • Avoidance of biomass combustion (particularly indoor cooking fires) and
  • Avoidance of air pollutants
  • First-line antibiotic treatment
  • Immediate transfer of unresponsive or sever cases to a higher-level health care facility
Primary Care
  • Health education on LRTI prevention measures and early treatment
  • Good hygiene practices including hand washing
  • Counselling and guidance on avoidance of smoking within the household and secondary exposure to smoke
  • Immunizations, e.g., Pneumococcal, influenza, COVID
  • First-line antibiotic treatment
  • Immediate transfer of unresponsive or sever cases to a higher-level health care facility
Referral Facility: General
  • Health education on LRTI prevention measures and early treatment
  • Immunizations, e.g; Pneumococcal, influenza, COVID
  • IV/IM antibiotics
  • Oxygen supplementation
  • IV fluids

Post-pneumonia pulmonary rehabilitation

Referral Facility: Specialist
  • Health education on LRTI prevention measures and early treatment
  • Immunizations, e.g., Pneumococcal, influenza, COVID
  • IV/IM antibiotics
  • Oxygen supplementation
  • IV fluids
  • Intensive care for severe disease

Post-pneumonia pulmonary rehabilitation

 
Condition: Non-migraine headache
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Education and awareness creation/information to communities on headaches including prevention measures
  • Community Health worker training on headaches prevention, recognition and management at the community level
  • Guidance to patient on Practicing healthy behaviors. Including
  • getting plenty of sleep,
  • Staying physically active,
  • Eating healthy meals and snacks,
  • Drinking plenty of water daily,
  • Management of stress.
  • Practicing relaxation techniques
  • Advice to patient on monitoring the pattern of the headache/keeping a headache diary
  • Guidance on avoidance of headache triggers-such as caffeine
  • Adherence to any medication as prescribes
  • Recognition of features indicative of non-migraine headache including, Mild to moderate, non-pulsating pain on both sides of the head; Pain that's not worsened by physical activity, one sided headache (headaches not accompanied by nausea or vomiting, as is often the case with migraine
  • Drinking plenty of water
  • Use of over the counter pain killers such as ibuprofen
  • keeping a headache diary to study the patterns of the headache and associated symptoms
  • Guidance to patient on relaxation techniques including;
  • Heat therapy, such as applying warm compresses or taking a warm shower
  • Massage
  • Meditation
  • Neck stretching
  • Relaxation exercises
  • Identify warning features of serious headaches such as vomiting, blurred vision
  • Referral to a health facility for management of serious headaches
Primary Care
  • Provide information to on headaches their prevention measures and their treatment.
  • Health workers training on the different types on non migraine head aches, their prevention and treatment measures
  • Guidance to patient on Practicing healthy behaviors Including;
  • Getting plenty of sleep,
  • Staying physically active,
  • Eating healthy meals and snacks,
  • Drinking plenty of water daily,
  • Management of stress.
  • Practicing relaxation techniques
  • Advice to patient on monitoring the pattern of the headache/keeping a headache diary
  • Guidance on avoidance of headache triggers-such as caffeine
  • Adherence to any medication as prescribes
  • Physical and clinical examination
  • Diagnosis of headaches based on the history and clinical features
  • Guidance to patient on keeping a headache diary to study the patterns of the headache and associated symptoms
  • Medication-use of analgesics such as ibuprofen
  • Guidance to patient on relaxation techniques including;
  • Heat therapy, such as applying warm compresses or taking a warm shower
  • Massage
  • Meditation
  • Neck stretching
  • Relaxation exercises
  • Identify warning features of serious headaches or headaches due to underlying conditions such as new headache in a patient with cancer, HIV, headache with motor weakness could indicate stroke,
  • Referral to a hospital for management of serious headaches or headaches due to other underlying conditions
Referral Facility: General
  • Provide information to on headaches their prevention measures and their treatment.
  • Health workers training on the different types on non migraine head aches, their prevention and treatment measures
  • Physical and clinical examination
  • Identify and distinguish the different types of non-migraine headaches based the clinical features including;
  • For tensional headache, usually mild or moderate, more generalized and typically described as pressure or tightness
  • For cluster headache, severe headache strictly unilateral around the eye, red and watering eyes with running or blocked nostrils and marked agitation
  • Medication over use headache-usually due to chronic use of medication mainly for migraine or tension headache (usually diagnosed if symptoms improve within 2 months of medicine withdrawal)
  • Encourage patient to keep a headache diary to study the patterns of the headache and associated symptoms
  • Medication -use of analgesics such as ibuprofen
  • Guidance to patient on relaxation techniques including;
  • heat therapy, such as applying warm compresses or taking a warm shower
  • Massage
  • Meditation
  • Neck stretching
  • Relaxation exercises
  • Identify warning features of serious headaches or headaches due to underlying conditions such as new headache in a patient with cancer, HIV, headache with motor weakness could indicate stroke,
  • Management of any underlying conditions causing headaches
  • Patients follow up
Referral Facility: Specialist
  • Provide information to on headaches their prevention measures and their treatment.
  • Health workers training on the different types on non migraine head aches, their prevention and treatment measures
  • Physical and clinical examination
  • Identify and distinguish the different types of non-migraine headaches based the clinical features including;
  • For tensional headache, usually mild or moderate, more generalized and typically described as pressure or tightness
  • For cluster headache, severe headache strictly unilateral around the eye, red and watering eyes with running or blocked nostrils and marked agitation
  • Medication over use headache-usually due to chronic use of medication mainly for migraine or tension headache (usually diagnosed if symptoms improve within 2 months of medicine withdrawal)
  • Encourage patient to keep a headache diary to study the patterns of the headache and associated symptoms
  • Medication -use of analgesics such as ibuprofen
  • Guidance to patient on relaxation techniques including;
  • heat therapy, such as applying warm compresses or taking a warm shower
  • Massage
  • Meditation
  • Neck stretching
  • Relaxation exercises
  • Identify warning features of serious headaches or headaches due to underlying conditions such as new headache in a patient with cancer, HIV, headache with motor weakness could indicate stroke,
  • Management of any underlying conditions causing headaches
  • Patients follow up
 
Condition: Ischaemic (Coronary) Heart Disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community engagement/sensitization on risk factors for ischaemic heart disease and preventive measures such as regular exercise, healthy diet, and stress management]
  • Integrated counselling on healthy diet, physical activity, weight management, alcohol and tobacco use
  • Daily low-dose aspirin for secondary prevention
  • Screening and treatment of CVD risk factors
  • Immediate transfer of suspected cases to a higher-level health care facility
  • Home-based self-management rehabilitation
  • Physical activity counselling and exercise training
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
  • Health education on risk factors for ischaemic heart disease and preventive measures including stress management
  • Display patient friendly IEC/BCC materials
  • Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use
  • Daily low-dose aspirin for secondary prevention
  • Screening and treatment of CVD risk factors
  • Oral antiplatelet therapy for acute chest pain
  • Immediate transfer of suspected cases to a higher-level health care facility
  • Physical activity counselling and exercise training
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
  • Health education on risk factors for ischaemic heart disease and preventive measures including stress management Provision of patient friendly IEC/BCC materials
  • Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use
  • Daily low-dose aspirin for secondary prevention
  • Screening and treatment of CVD risk factors
  • Thrombolytic drugs
  • Oxygen supplementation and ventilation support
  • Antiplatelet drugs (e.g. Aspirin)
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Lipid lowering medications (statins)
  • Beta blockers,
  • Calcium channel blockers
  • Therapeutic lifestyle modification
  • Stabilization and referral of acute complications
  • Physical activity counselling and exercise training
  • Occupational therapy
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
  • Health education on risk factors for ischaemic heart disease and preventive measures including stress management
  • Display patient friendly IEC/BCC materials
  • Guidance on healthy eating i.e.eating balanced healthy diets –low fat and Low sodium intake
  • Guidance on Physical activities and physical exercises
  • Advice on the need for adequate rest-including adequate sleep
  • Avoidance of smoking tobacco
  • Cessation of alcohol use
  • Maintaining a healthy body weight
  • Monitor blood pressure and cholesterol levels
  • Early detection and management of other medical conditions as a preventive measure including;
  • Management of coronary heart disease
  • Management of high blood pressure,
  • Early treatment of diabetes mellitus
  • Early screening
  • Early initiation of thrombolysis
  • Oxygen supplementation and ventilation support
  • Antiplatelet drugs (e.g. Aspirin)
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Lipid lowering medications (statins)
  • Calcium channel blockers
  • Mechanical thrombectomy
  • Blood pressure management
  • Cardiac catheterization and stent insertion
  • Physical activity counselling and exercise training
  • Provision and training in the use of assistive products
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
 
Condition: Peptic Ulcers
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness to the communities/families on peptic ulcer disease including prevention measure
  • Provision of IEC materials on Peptic ulcers disease
  • Community health workers training on peptic ulcers disease; its prevention and remedies at community level
  • Cessation of smoking
  • Stoppage/avoidance of alcohol to avoid increase in acid in the stomach
  • Stress management
  • Diet control—avoidance of spicy foods
  • Hand hygiene to prevent infections
  • Reduce intake of pain relivers or take medication with meals.
  • Recognition of symptoms indicative of peptic ulcers including, burning stomach pain, bloating or belching, vomiting, weight loss or poor appetite.
  • Cessation of tobacco smoking
  • Stoppage of alcohol
  • Stoppage of use of NSAIDs
  • Taking fluids
  • Proper nutrition
  • Referral to a health facility
Primary Care
  • Create awareness to the communities/families on peptic ulcer disease including prevention measure
  • Provision of IEC materials on Peptic ulcers disease
  • Community health workers training on peptic ulcers disease, its prevention and remedies at community level
  • Cessation of smoking
  • Stoppage/avoidance of alcohol to avoid increase in acid in the stomach
  • Stress management
  • Diet control—avoidance of spicy foods
  • Hand hygiene to prevent infections
  • Reduce intake of pain relivers or take medication with meals.
  • Physical and clinical examination
  • Guidance on Cessation of tobacco smoking
  • Guidance/advice on Stoppage of alcohol
  • Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs
  • Fluids therapy
  • Guidance on diet
  • Medication to reduce acidity
  • Referral to a hospital
Referral Facility: General
  • Create awareness to the communities/families on peptic ulcer disease including prevention measure
  • Provision of IEC materials on Peptic ulcers disease
  • Community health workers training on peptic ulcers disease, its prevention and remedies at community level
  • Cessation of smoking
  • Stoppage/avoidance of alcohol to avoid increase in acid in the stomach
  • Stress management
  • Diet control—avoidance of spicy foods
  • Hand hygiene to prevent infections
  • Reduce intake of pain relivers or take medication with meals.
  • Physical and clinical examination
  • Diagnostic tests including;
    • Endoscopy
    • X-rays/barium swallow.
    • Blood tests for antibodies due to H.pylori
    • Urea breath test,
    • Stool for signs of the bacteria
    • Biopsy of the stomach
  • Cessation of tobacco smoking
  • Stoppage of alcohol
  • Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs
  • Fluids therapy
  • Combination therapy to eradicate H.Pylori bacteria
  • Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker
  • Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding, Perforation, peritonitis.Cancer
  • Management of anemia due to bleeding complication
  • Blood transfusion if ulcers bleeding is severe
  • Surgical interventions e.g. endoscopy with open surgery for bleeding ulcers
  • Follow up
Referral Facility: Specialist
  • Create awareness to the communities/families on peptic ulcer disease including prevention measure
  • Provision of IEC materials on Peptic ulcers disease
  • Community health workers training on peptic ulcers disease, its prevention and remedies at community level
  • Cessation of smoking
  • Stoppage/avoidance of alcohol to avoid increase in acid in the stomach
  • Stress management
  • Diet control—avoidance of spicy foods
  • Hand hygiene to prevent infections
  • Reduce intake of pain relivers or take medication with meals.
  • Physical and clinical examination
  • Diagnostic tests including;
    • Endoscopy
    • X-rays/barium swallow.
    • Blood tests for antibodies due to H.pylori
    • Urea breath test,
    • Stool for signs of the bacteria
    • Biopsy of the stomach
  • Cessation of tobacco smoking
  • Stoppage of alcohol
  • Stoppage of use of NSAIDs for ulcers caused by taking NSAIDs
  • Fluids therapy
  • Combination therapy to eradicate H.Pylori bacteria
  • Medication to decrease stomach acidity - proton pump inhibitor (PPI) or an H2 blocker
  • Follow up, prevention and management of Peptic ulcer complications including Gastrointestinal bleeding, Perforation, peritonitis.Cancer
  • Management of anemia due to bleeding complication
  • Blood transfusion if ulcers bleeding is severe
  • Surgical interventions e.g. endoscopy with open surgery for bleeding ulcers
  • Follow up
 
Condition: Dental Caries
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness on dental caries and prevention measures
  • Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions
  • Multi-sectoral approach in ensuring access to clean safe water
  • Community water fluoridation
  • Community dental outreach services
  • Training community health workers on dental caries including prevention measures
  • Oral hygiene through regular cleaning of teeth -tooth brushing and flossing
  • Diet modification -use of low sugar diets
  • Use of fluoridated tooth pastes
  • Avoidance of tobacco use.
  • Avoidance of alcohol use
  • Screening for early detection of dental caries
  • Recognition of signs of dental caries including pain and difficulty with eating holes in teeth
  • Pain relief with pain medications such as paracetamol and ibuprofen
  • Recognition of symptoms of complications of dental caries including swelling of the tissue around the tooth, tooth loss and infection or abscess formation
  • Referral to a health facility for management
Primary Care
  • Community awareness on dental caries and prevention measures
  • Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions
  • Multi-sectoral approach in ensuring access to clean safe water
  • Community water fluoridation
  • Community dental outreach services
  • Training health workers on dental caries including prevention measures
  • Oral hygiene education
  • Advice on oral hygiene -teeth brushing and flossing
  • Advice on healthy diets -avoidance of sugars
  • Tobacco and alcohol cessation programs
  • Early screening for dental caries
  • Oral Hygiene instructions
  • Relieve of pain with analgesics
  • Monitor any complications of caries including development of abscesses
  • Monitor and manage for any complication such as gum inflammations and dental abscesses
  • Referral to a hospital for further management
Referral Facility: General
  • Community awareness on dental caries and prevention measures
  • Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions
  • Multi-sectoral approach in ensuring access to clean safe water
  • Community water fluoridation
  • Community dental outreach services
  • Training health workers on dental caries including prevention measures
  • Oral hygiene education
  • Advice on oral hygiene -teeth brushing and flossing
  • Advice on healthy diets -avoidance of sugars
  • Tobacco and alcohol cessation programs
  • Application of topical fluorides/application of fluorides to prevent caries
  • Application of sealants
  • Early screening for dental caries
  • Investigations including dental x-rays
  • Relieve of pain with analgesics
  • Use of Local anesthetics, in some cases to relieve pain during or following treatment or to relieve anxiety during treatment.
  • Use of topical fluoride to promote remineralization for small lesions
  • Dental restorations -Dental fillings for carious lesions using amalgam or composite fillings
  • Repair or replacement of fillings where necessary
  • Dental extractions
  • Endodontic therapy/Root canal treatment
  • Use of Crown in extensive caries with little tooth structure left
  • Monitor and manage any complication as a result of dental caries such as dental abscesses, gum inflammations
  • Follow up
  • Provision of dentures
Referral Facility: Specialist
  • Community awareness on dental caries and prevention measures
  • Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions
  • Multi-sectoral approach in ensuring access to clean safe water
  • Community water fluoridation
  • Community dental outreach services
  • Training health workers on dental caries including prevention measures
  • Oral hygiene education
  • Advice on oral hygiene -teeth brushing and flossing
  • Advice on healthy diets -avoidance of sugars
  • Tobacco and alcohol cessation programs
  • Application of topical fluorides/application of fluorides to prevent caries
  • Application of sealants
  • Early screening for dental caries
  • Investigations including dental x-rays
  • Relieve of pain with analgesics
  • Use of Local anesthetics, in some cases to relieve pain during or following treatment or to relieve anxiety during treatment.
  • Use of topical fluoride to promote remineralization for small lesions
  • Dental restorations -Dental fillings for carious lesions using amalgam or composite fillings
  • Repair or replacement of fillings where necessary
  • Dental extractions
  • Endodontic therapy/Root canal treatment
  • Use of Crown in extensive caries with little tooth structure left
  • Monitor and manage any complication as a result of dental caries such as dental abscesses, gum inflammations
  • Follow up
  • Provision of dentures
 
Condition: Rheumatic Heart Disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Awareness creation among the communities/families on Rheumatic Heart disease including prevention measures
  • Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions
  • Distribution of IEC materials on RHD
  • Promote multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living
  • Advocacy for Improved access health services including to oral health care, access to life saving heart surgery
  • Community health workers training on RHD
  • Population wide reduction in daily salt consumption
  • Financial incentives to consume a healthy diet
  • Reduction of sugar consumption
  • Mass media campaign on salt reduction
  • Tax reduction on fruit & vegetables and tax increase on fats & sugar
  • Taxation of junk food
  • Front of pack - Traffic Light Labeling of nutrition on processed foods
  • Legislation to limit trans fats in processed food
  • Food product reformulation with less sodium
  • Higher consumption of grain-based foods, seafood, fruits and vegetables and lower consumption of meat, dairy, fats
  • Tobacco price increase
  • Guidance on healthy hygiene practice for adults
  • Seek treatment early for adults with sore throat or any infections
  • Teaching/guidance on Good oral hygiene practices for the adults
  • Adherence to antibiotics medication including completion of doses as
  • Good nutrition/healthy diet
  • Community based management of hypertension
  • Screening and treatment of CVD risk factors
  • Mobile technology enabled community based CVD risk assessment and mitigation
  • Integration of hypertension screening and treatment program into community services
  • Use of polypill for secondary CVD prevention in high risk candidates
  • Recognition of symptoms indicative of RHD including fever, painful joints especially knees ankles, elbows and wrists, pain that moves between different joints, fatigue, jerky uncontrollable body movements, nodules under the skin near joints and/or a non-itchy rash
  • Relive of pain with pain killers
  • Relieve of fever
  • Proper nutrition for the adult with RHD
  • Ensure adherence to any prescribed medicines such as antibiotics
  • Recognition of symptoms indicative of worsening of the condition such as complaints of chest pain, shortness of breath, swelling of the stomach, hands or feet
  • Early Referral to a health facility
  • Home based self management rehabilitation
  • Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan
  • Psychosocial support and counselling to reduce stress associated with the prolonged treatment or admission
  • Linkage with social and support services
Primary Care
  • Information to the adults on Rheumatic Heart disease including prevention measures
  • Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions
  • Distribution of IEC materials on RHD
  • Advocacy for a multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living
  • Advocacy for Improved access health services including to oral health care, access to life saving heart surgery
  • Health workers training on RHD
  • Population wide reduction in daily salt consumption
  • Financial incentives to consume a healthy diet
  • Information to adults on healthy hygiene practices
  • Promoting good nutrition for the adults
  • Good oral hygiene practices
  • Advice to adults on the need to ensure
  • Adherence to antibiotics medication
  • Early identification and treatment of streptococcal infections with antibiotics such as penicillin to
  • Early identification and treatment of Rheumatic fever to reduce the likelihood of Rheumatic Heart disease
  • Screening and treatment of CVD risk factors
  • Integration of hypertension and diabetes screening & treatment in HIV programs
  • Use of polypill for secondary CVD prevention in high risk candidates
  • Complete Physical and clinical examination
  • Relive pain
  • Relive fever
  • Management of inflammation with anti-inflammatory medications such as aspirin
  • Antibiotic prophylaxis to prevent recurrent infection with Group A streptococcus. -use/Benzathine penicillin G
  • Recognition of any signs and symptoms indicating severe or complications of RHD eg severe chest pain, feet oedema
  • Referral to a hospital
  • Nicotine replacement
  • Availability of metformin for diabetes treatment

Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan

  • Psychosocial support and counselling for the adults with RHD for any psychological trauma due to the long nature of treatment
Referral Facility: General
  • Information to the adults on Rheumatic Heart disease including prevention measures
  • Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions
  • Distribution of IEC materials on RHD
  • Advocacy for a multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living
  • Advocacy for Improved access health services including to oral health care, access to life saving heart surgery
  • Health workers training on RHD
  • Population wide reduction in daily salt consumption
  • Financial incentives to consume a healthy diet
  • Information adults on healthy hygiene practices
  • Promoting good nutrition for the adults
  • Good oral hygiene practices
  • Advice to adults on the need to ensure
  • Adherence to antibiotics medication
  • Early identification and treatment of streptococcal infections with antibiotics such as penicillin to
  • Early identification and treatment of Rheumatic fever to reduce the likelihood of Rheumatic Heart disease
  • Screening and treatment of CVD risk factors
  • Integration of hypertension and diabetes screening & treatment in HIV programs
  • Use of polypill for secondary CVD prevention in high risk candidates
  • Complete Physical and clinical examination
  • Diagnostics -tests including;
    • Throat swab culture for evidence of streptococcus infection
    • Blood tests
    • Echocardiogram (echo)-. check the heart's chambers and valves.
    • Electrocardiogram (ECG)-.To test the strength and timing of the electrical activity of the heart.
    • Chest x-rays
    • Cardiac MRI
  • Management of pain
  • Management of fever
  • Management of inflammation with anti-inflammatory medications such as aspirin or corticosteroids
  • Antibiotic prophylaxis to prevent recurrent infection with Group A streptococcus. -use/Benzathine penicillin G
  • Early identification and treatment of ARF, as well as interventions to prevent recurrences of ARF and therefore reduce the likelihood of RHD.-use of antibiotics,
  • Admission to manage severe cases /complications
  • Management of heart failure or heart rhythm abnormalities heart failure e.g. with diuretics, beta blockers
  • Prevention and management of clotting with blood thinners
  • Anti-coagulants
  • Surgical interventions including Cardiac catheterization to repair damaged valves
  • ICU services for severely ill patients e.g. post-surgery
  • Follow up

Availability of metformin for diabetes treatment

Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan

  • Psychosocial support and counselling for adults with RHD for any psychological trauma due to the long nature of treatment
Referral Facility: Specialist
  • Information to the adults on Rheumatic Heart disease including prevention measures
  • Awareness creation on risk factors of Rheumatic heart disease such as overcrowding, poor sanitary conditions
  • Distribution of IEC materials on RHD
  • Advocacy for a multi-sectoral approach in promoting improvement in environmental conditions such as housing conditions, improving the standards of living
  • Advocacy for Improved access health services including to oral health care, access to life saving heart surgery
  • Health workers training on RHD
  • Population wide reduction in daily salt consumption
  • Financial incentives to consume a healthy diet
  • Information adults on healthy hygiene practices
  • Promoting good nutrition for the adults
  • Good oral hygiene practices
  • Advice to adults on the need to ensure
  • Adherence to antibiotics medication
  • Early identification and treatment of streptococcal infections with antibiotics such as penicillin to
  • Early identification and treatment of Rheumatic fever to reduce the likelihood of Rheumatic Heart disease
  • Complete Physical and clinical examination
  • Diagnostics -tests including;
    • Throat swab culture for evidence of streptococcus infection
    • Blood tests
    • Echocardiogram (echo)-. check the heart's chambers and valves.
    • Electrocardiogram (ECG)-.To test the strength and timing of the electrical activity of the heart.
    • Chest x-rays
    • Cardiac MRI
  • Management of pain
  • Management of fever
  • Management of inflammation with anti-inflammatory medications such as aspirin or corticosteroids
  • Antibiotic prophylaxis to prevent recurrent infection with Group A streptococcus. -use/Benzathine penicillin G
  • early identification and treatment of ARF, as well as interventions to prevent recurrences of ARF and therefore reduce the likelihood of RHD.-use of antibiotics,
  • Admission to manage severe cases /complications
  • Management of heart failure or heart rhythm abnormalities heart failure e.g. with diuretics, beta blockers
  • Prevention and management of clotting with blood thinners
  • Anti-coagulants
  • Surgical interventions including Cardiac catheterization to repair damaged valves
  • ICU services for severely ill patients e.g. post-surgery
  • Follow up

Availability of metformin for diabetes treatment

  • Psychosocial support and counselling for adults with RHD for any psychological trauma due to the long nature of treatment
 
Condition: Upper Respiratory Tract Infections
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Awareness creation on upper respiratory tract infections including prevention measures
  • Distribution of IEC materials on URTI
  • Multi-sectoral approach in ensuring proper environmental sanitation including good housing
  • Community Health workers training on URTI including prevention measures and management at community level
  • Proper nutrition for adults
  • Good Hand hygiene practices
  • Avoidance of smoking/exposure to secondary smoking
  • Vitamin supplementation
  • Seek treatment early for any upper respiratory tract infection
  • Recognition of symptoms indicative of upper respiratory tract infections including fever, cough, headache, nasal congestion, runny nose and sneezing, sore throat, red waterly or sore eyes
  • Relieve of pain with pain killers such as paracetamol
  • Relieve of fever
  • Proper nutrition
  • Plenty of fluids for the patient
  • Plenty of rest
  • Vitamins - such as Vitamin C
  • Referral to a health facility for further management
Primary Care
  • Information on upper respiratory tract infections including prevention measures
  • Distribution of IEC materials on URTI
  • Promote Multi-sectoral approach in ensuring proper environmental sanitation including good housing
  • Health workers training on URTI including prevention measures and its management
  • Guidance/advice on Proper nutrition for the adults
  • Promote Good Hand hygiene practices
  • Guidance on smoking cessation/avoidance to exposure to secondary smoking
  • Vitamin supplementation
  • Early treatment for any upper respiratory tract infection
  • Guidance on adherence to medication including completion of antibiotic dosage
  • Hydration/fluids therapy
  • Management of Nasal congestion/use of decongestants/e.g. pseudoephedrine
  • Management of pain -Analgesics e.g. paracetamol and NSAIDs)
  • Management of fever
  • Management of allergies – use of antihistamines e.g.chlorpheniramine
  • Antibiotics therapy e.g. co*amoxiclav
  • Management of cough- use of mucolytics
  • Vitamin C
  • Zinc gluconate
  • Follow up, prevention of complications such as otitis media, compromised airways
  • Referral to hospital for further management or management of any complications
Referral Facility: General
  • Information on upper respiratory tract infections including prevention measures
  • Distribution of IEC materials on URTI
  • Promote Multi-sectoral approach in ensuring proper environmental sanitation including good housing
  • Health workers training on URTI including prevention measures and its management
  • Guidance/advice on Proper nutrition for the adults
  • Promote Good Hand hygiene practices
  • Guidance on smoking cessation/or avoidance to exposure to secondary smoking
  • Vitamin supplementation
  • Early treatmnet for any upper respiratory tract infection
  • Guidance on adherence to medication including completion of antibiotic dosage
  • Diagnostic tests including culture and sensitivity, radiological examination (X-rays, CT scans)
  • Hydration/fluids therapy
  • Management of Nasal congestion/use of decongestants/e.g.pseudoephedrine
  • Management of pain -Analgesics e.g. paracetamol and NSAIDs)
  • Management of fever
  • Management of allergies – use of antihistamines e.g. chlorpheniramine
  • Antibiotics therapy e.g. co*amoxiclav
  • Management of cough- use of mucolytics
  • Vitamin C
  • Zinc gluconate
  • Humidified hot air
  • Follow up, prevention and management of complications such as otitis media, compromised airways
Referral Facility: Specialist
  • Information on upper respiratory tract infections including prevention measures
  • Distribution of IEC materials on URTI
  • Promote Multi-sectoral approach in ensuring proper environmental sanitation including good housing
  • Health workers training on URTI including prevention measures and its management
  • Guidance/advice on Proper nutrition for the adults
  • Promote Good Hand hygiene practices
  • Guidance on smoking cessation/or avoidance to exposure to secondary smoking
  • Vitamin supplementation
  • Early treatmnet for any upper respiratory tract infection
  • Guidance on adherence to medication including completion of antibiotic dosage
  • Diagnostic tests including culture and sensitivity, radiological examination (X-rays, CT scans)
  • Hydration/fluids therapy
  • Management of Nasal congestion/use of decongestants/e.g.pseudoephedrine
  • Management of pain -Analgesics e.g. paracetamol and NSAIDs)
  • Management of fever
  • Management of allergies – use of antihistamines e.g. chlorpheniramine
  • Antibiotics therapy e.g. co*amoxiclav
  • Management of cough- use of mucolytics
  • Vitamin C
  • Zinc gluconate
  • Humidified hot air
  • Follow up, prevention and management of complications such as otitis media, compromised airways
 
Condition: Cardiomyopathy - Myocarditis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Information to patients/families/communities on cardiomyopathy including prevention measures
  • Provision of IEC materials
  • Advocacy for patients with cardiomyopathy including for availability of services
  • Community Health workers training on cardiomyopathy including prevention measures
  • Living healthy lifestyle including:
  • Avoiding the use of alcohol
  • Controlling high blood pressure, high cholesterol and diabetes
  • Eating a healthy diet
  • Getting regular exercise
  • Getting enough sleep
  • Reducing stress
  • Recognition of signs indicative of cardiomyopathy such as breathlessness, Swelling of the legs, ankles and feet, Bloating of the abdomen due to fluid buildup, Cough while lying down, Fatigue, Dizziness, and fainting
    • First aid
  • Referral to a health facility for management
  • Community based rehabilitation programs for persons with stroke
  • Home based rehabilitation services
  • Psychosocial support for the adults with cardiomyopathy and their families to prevent anxiety, depression, and stress, That may be associated with living with the condition
  • Joining a patient support group
  • Seeking support from family and friends
Primary Care
  • Information to patients/families/communities on cardiomyopathy including prevention measures
  • Provision of IEC materials
  • Advocacy for patients with cardiomyopathy including for availability of services Health workers training on cardiomyopathy
  • Guidance on Living a healthy lifestyle including;
  • Avoiding the use of alcohol
  • Controlling high blood pressure, high cholesterol and diabetes
  • Eating a healthy diet
  • Getting regular exercise
  • Getting enough sleep
  • Reducing stress
  • Physical and clinical examination
  • Recognition of signs indicative of cardiomyopathy such as breathlessness, Swelling of the legs, ankles and feet
  • Stabilize the patient e.g the breathing
  • Referral to a hospital for management
  • Physical rehabilitation/physical exercises to restore the motor functions
  • Psychosocial support for patient with cardiomyopathy and their families to prevent anxiety, depression and stress that may be associated with having the condition
  • Joining a patient support group
  • Seeking support from family and friends
Referral Facility: General
  • Information to patients/families/communities on cardiomyopathy including prevention measures
  • Provision of IEC materials
  • Advocacy for patients with cardiomyopathy including for availability of services
  • Health workers training on cardiomyopathy
  • Guidance on Living a healthy lifestyle including;
  • Avoiding the use of alcohol
  • Controlling high blood pressure, high cholesterol and diabetes
  • Eating a healthy diet
  • Getting regular exercise
  • Getting enough sleep
  • Reducing stress
  • Physical and clinical examination
  • Diagnostic including;
  • Chest X-ray.
  • Blood tests
  • cardiac CT scans
  • Medications e.g for blood pressure;
  • Referral to specilised hospitals for specialsied management including of any complications
  • Follow up
  • Rehabilitation to help regain motor skills and coordination.
  • Occupational, therapy to help the patient participate in gainful occupation
  • Physical therapy/exercises for motor function
  • Speech therapy to help regain lost speech
  • Therapy to help regain sensory function
  • Psychosocial support for the patient with cardiomyopathy and their families to prevent anxiety, depression, and stress that may be associated with having the condition and/or the complications
  • Joining a patient support group
  • Seeking support from family and friends
Referral Facility: Specialist
  • Information to patients/families/communities on cardiomyopathy including prevention measures
  • Provision of IEC materials
  • Advocacy for patients with cardiomyopathy including for availability of services
  • Health workers training on cardiomyopathy
  • Guidance on Living a healthy lifestyle including;
  • Avoiding the use of alcohol
  • Controlling high blood pressure, high cholesterol and diabetes
  • Eating a healthy diet
  • Getting regular exercise
  • Getting enough sleep
  • Reducing stress
  • Physical and clinical examination
  • Diagnostic including;
  • Chest X-ray.
  • Echocardiogram.
  • Electrocardiogram
  • Treadmill stress test
  • Cardiac catheterization for (biopsy)
  • Cardiac CT scan
  • Blood tests
  • Medications e.g for blood pressure;
  • Surgical interventions -eg implanting devices such as pacemaker, septal myectomy
  • Prevention and management of complications of cardiomyopathy including heart failure, blood clots, heart valves problems
  • ICU care
  • Follow up
  • Occupational, therapy to help the patient participate in gainful occupation
  • Speech therapy to help regain lost speech
  • Physical therapy/exercises for motor function
  • Rehabilitation to help regain motor skills and coordination.
  • Therapy to help regain sensory function
  • Psychosocial support for the patient with cardiomyopathy and their families to prevent anxiety, depression, and stress that may be associated with having the condition and/or the complications
  • Joining a patient support group
  • Seeking support from family and friends
 
Condition: Chronic Obstructive Pulmonary Disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create awareness on risk factors and preventive measures of COPD * Multi sectoral approach to ensure clean environments
  • Avoidance of tobacco smoking (including second-hand smoke),
  • Avoidance of occupational exposure to dusts, fumes or chemicals
  • Avoiding air pollution and allergens
  • Avoidance of solid fuel based indoor air pollution
  • Smoking cessation
  • Short-acting beta2-agonists (SABAs)
  • Immediate transfer of severe cases to a higher-level health care facility
  • Home-based self-management rehabilitation
  • Breathing exercise
  • Non-pharmacological treatment to relieve the discomfort of shortness of breath or anxiety
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
  • Regular patients’ education on smoking cessation and treatment adherence
  • Guidance and counselling on risk of smoking and second hand smoke
  • Counselling support to quit smoking
  • Vaccination: pneumonia and COVID
  • Annual influenza vaccination
  • Smoking cessation
  • Short-acting beta2-agonists (SABAs)
  • Long-acting beta2-agonists (LABA)
  • Inhaled corticosteroids (ICS
  • Immediate transfer of severe cases to a higher-level health care facility
  • Pulmonary Rehabilitation: exercise, dietary advice, disease education, psychological intervention, behavioural intervention
  • Pharmacological and non-pharmacological treatment to relieve the discomfort of shortness of breath or anxiety
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
  • Regular patients’ education on smoking cessation and treatment adherence
  • Guidance and counselling on risk of smoking and second hand smoke
  • Counselling support to quit smoking
  • Vaccination: pneumonia, influenza and COVID
  • Annual influenza vaccination
  • Smoking cessation
  • Short-acting beta2-agonists (SABAs)
  • Long-acting beta2-agonists (LABA)
  • Short-acting antimuscarinic agents (SAMA)
  • Long-acting antimuscarinic agents (LAMA)
  • Inhaled corticosteroids (ICS)
  • Systemic glucocorticoids
  • Antibiotics
  • Pulmonary Rehabilitation: exercise, dietary advice, disease education, psychological intervention, behavioural intervention
  • Pharmacological and non-pharmacological treatment to relieve the discomfort of shortness of breath or anxiety
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
  • Raise awareness among the communities on COPD
  • Advocacy for creation of more healthy environments, especially for poor and disadvantaged populations;
  • Advocacy on reducing the risk factors such as tobacco smoking and exposure to second-hand smoke,
  • Distribution of IEC materials
  • Health workers training on COPD
  • Guidance and counselling on smoking cessation and treatment adherence
  • Smoking cessation
  • Short-acting beta2-agonists (SABAs)
  • Long-acting beta2-agonists (LABA)
  • Short-acting antimuscarinic agents (SAMA)
  • Long-acting antimuscarinic agents (LAMA)
  • Inhaled corticosteroids (ICS)
  • Systemic glucocorticoids
  • Phosphodiesterase-4 (PDE4) inhibitors
  • Antibiotics
  • Pulmonary Rehabilitation: exercise, dietary advice, disease education, psychological intervention, behavioural intervention
  • Pharmacological and non-pharmacological treatment to relieve the discomfort of shortness of breath, anxiety, fear and depression
 
Condition: Hypertensive heart disease
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community engagement/sensitization on risk factors for Hypertension and preventive measures such as weight control, regular exercise, healthy diet, and stress management
  • Healthy life style: healthy weight, physically active, no alcoholic drink or in moderation, no smoking, eat vegetables and fruits
  • Integration of hypertension screening and treatment program into community services
  • Tobacco cessation
  • Decreased alcohol use
  • Increased physical activity
  • Referral to the next level health facility
  • Home-based self-management rehabilitation
  • Physical exercise
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
  • Patient education on the risks of uncontrolled blood pressure and treatment compliance
  • Screening and treatment of CVD risk factors
  • Tobacco cessation
  • Decreased alcohol use
  • Increased physical activity
  • Low sodium diet
  • Thiazide diuretics
  • Self-management education
  • Physical exercise
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
  • Patient education on the risks of uncontrolled blood pressure and treatment compliance
  • Screening and treatment of CVD risk factors
  • Tobacco cessation
  • Decreased alcohol use
  • Increased physical activity
  • Low sodium diet
  • Thiazide diuretics
  • Angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers
  • Calcium channel blockers
  • Self-management education
  • Physical exercise
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
  • Patient education on the risks of uncontrolled blood pressure and treatment compliance
  • Screening and treatment of CVD risk factors
  • Tobacco cessation
  • Decreased alcohol intake
  • Increased physical activity
  • Low sodium diet
  • Thiazide diuretics
  • Angiotensin-converting enzyme inhibitors/ angiotensin receptor blockers
  • Calcium channel blockers
  • Self-management education
  • Physical exercise
  • Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
 
Condition: COVID-19
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Promote hand washing facilities
  • Promote use of face masks
  • Promote maintenance of physical and social distance
  • Screening of vulnerable groups
  • Active case finding in the community
  • Conduct routine and mass Vaccination
  • Promote vaccination for travelers where applicable
  • surveillance and testing
  • Recording and reporting
  • Promote hand washing facilities
  • Promote use of face masks
  • Promote maintenance of physical and social distance
  • Community Quarantine facilities
  • Community based isolation centers
  • Notification
  • Vaccine: COVID 19
  • Wash hands with running water and soap following all contact with sick persons or their immediate environment.
  • Avoid direct contact with body fluids, particularly oral or respiratory secretions or stool of the patient.
  • Avoid sharing toothbrushes, eating utensils, dishes, drinks, towels, washcloths or bed linen with the sick person.
  • Persons with symptoms should remain at home until their symptoms are resolved based on either clinical and/or laboratory findings.
  • All household members should be considered contacts and their health should be monitored.
  • Keep physical distance of at least 1 metre apart from others, even if they don’t appear to be sick.
  • Wear a properly fitted mask when physical distancing is not possible or when in poorly ventilated settings.
  • Surveillance and Point of care test
  • Community Quarantine
  • Eating balanced diet
  • Isolation and referral to next level
  • Home based self management rehabilitation
  • Psychosocial support to patient and family members/care givers
  • Counselling support
  • Spiritual support
Primary Care
  • Health Education on COVID-19 disease
  • Awareness creation including on transmission and prevention measures
  • Promoting vaccination
  • Promoting Multi sectoral approach in control of COVID-19
  • Distribution of IEC materials
  • Health workers training on COVID-19 including its prevention and management
  • Screening of vulnerable groups
  • Promote hand washing facilities
  • Promote use of face masks
  • Promote maintenance of physical and social distance
  • Conduct routine and mass Vaccination for protection against diseases through.
  • Requirement for travelers to provide certificate of proof of vaccination for PHEICs in line with the International Health Regulations (IHR),
  • Monitoring and reporting on Adverse Events Following Immunization (AEFI)
  • Surveillance
  • Screening incoming and out-going travelers for COVID -19 ( a public health emergencies of international concern)
  • Proper Infection Prevention measures (IPC)
  • Use of personal protective equipment (PPE) eg personal medical masks,gown,gloves, eye protection
  • Provision of points of entry isolation of ill travelers (including Port Health)
  • Quarantine at health centers
  • Isolation of COVID-19 patients.
  • Recording and reporting COVID-19 to health departments
  • Vaccine: COVID 19
  • Wash hands with running water and soap following all contact with sick persons or their immediate environment.
  • Avoid direct contact with body fluids, particularly oral or respiratory secretions or stool of the patient.
  • Avoid sharing toothbrushes, eating utensils, dishes, drinks, towels, washcloths or bed linen with the sick person.
  • Persons with symptoms should remain at home until their symptoms are resolved based on either clinical and/or laboratory findings.
  • All household members should be considered contacts and their health should be monitored.
  • Keep physical distance of at least 1 metre apart from others, even if they don’t appear to be sick.
  • Wear a properly fitted mask when physical distancing is not possible or when in poorly ventilated settings.
  • Psychosocial support to patient and family members/care givers
  • Spiritual support
  • Addition of person-centered care services to usual care in chronic heart failure or COPD for individualised health plan
  • Psychosocial support to patient and family members/care givers
  • Spiritual support
Referral Facility: General
  • Health Education on COVID -19 disease
  • Awareness creation including on transmission and prevention measures
  • Promoting vaccination
  • Promoting Multi sectoral approach in control of COVID-19
  • Distribution of IEC materials
  • Health workers training on COVID-19 including its prevention and management
  • Screening of vulnerable groups
  • Promote hand washing facilities
  • Promote use of face masks
  • Promote maintenance of physical and social distance
  • Vaccination for life-long protection
  • Mass vaccination campaigns designed to increase coverage
  • Vaccination for travelers
  • Conduct disease surveillance
  • Requirement for travelers to provide certificate of vaccine in line with the International Health Regulations (IHR)
  • Proper Infection Prevention and control (IPC) measures
  • Monitoring and reporting on Adverse Events Following Immunization (AEFI)
  • Recording and reporting on to the next level
  • Notification
  • Isolation of persons with COVID-19 disease
  • Screening and treatment of CVD risk factors
  • Physical examination
  • Perform triage and clinical assessment,Check vital signs,temperature, respiratory rate,pulse, blood pressure, mental status (AVPU) and pulse oximetry.
  • Supportive treatment aimed at relieving symptoms including Relive pain and fever
  • Monitoring and specific management of the disease depending on the severity
  • Management of airways for patient with severe disease
  • Oxygen therapy for patient with severe disease
  • Medication for patient with severe or critical covid-19 including administration of corticosteroids,anti coagulants
  • Blood pressure control
  • Blood sugar monitoring and control
  • Antibiotics for any secondary bacterial infections
  • Management for any complication due to AEFI
  • Referral to specilised hospitals for ICU services for endotracheal intubation and mechanical ventilation in cases of respiratory complications
  • Follow up
  • Diagnostics /investigations
  • Polymerase Chain reaction test (PCR test) for COVID
  • Blood test
  • Chest Xrays
  • Ultra-sound

History and physical examination Clinical assessment for early recognition of need for referral Advanced laboratory tests Basic laboratory tests Supplemental oxygen Basic imaging (Ultrasound, X-ray) Treat bacterial infections with antibiotics Oral or IV fluid for rehydration Oral or IM antipyretics Oral or IV or IM steroids Manage complications such as liver and kidney failure Mechanical ventilation (non-invasive) Antiviral medications Immunomodulators

  • Physiotherapy services
  • Physical exercises

Pulmonary rehabilitation for post-pneumonia

  • Psychosocial support to patient and family members/care givers
  • counselling for patients with COVID-19 and their families
  • Spiritual support
Referral Facility: Specialist
  • Health Education on COVID -19 disease
  • Awareness creation including on transmission and prevention measures
  • Promoting vaccination
  • Promoting Multi sectoral approach in control of COVID-19
  • Distribution of IEC materials
  • Health workers training on COVID-19 including its prevention and management
  • Screening of vulnerable groups
  • Promote hand washing facilities
  • Promote use of face masks
  • Promote maintenance of physical and social distance
  • Vaccination for life-long protection
  • Mass vaccination campaigns designed to increase coverage
  • Vaccination for travelers
  • Conduct disease surveillance
  • Requirement for travelers to provide certificate of vaccine in line with the International Health Regulations (IHR)
  • Proper Infection Prevention and control (IPC) measures
  • Monitoring and reporting on Adverse Events Following Immunization (AEFI)
  • Recording and reporting on to the next level
  • Notification
  • Isolation of persons with COVID-19 disease
  • Conduct routine and mass Vaccination
  • Active case finding in the community
  • Education on infection prevention control, including cough etiquette
  • Physical examination
  • Perform triage and clinical assessment,Check vital signs,temperature, respiratory rate,pulse, blood pressure, mental status (AVPU) and pulse oximetry.
  • Supportive treatment aimed at relieving symptoms including Relive pain and fever
  • Monitoring and specific management of the disease depending on the severity
  • Management of airways for patient with severe disease
  • Oxygen therapy for patient with severe disease
  • Medication for patient with severe or critical covid-19 including administration of corticosteroids,anti coagulants
  • Blood pressure control
  • Blood sugar monitoring and control
  • Antibiotics for any secondary bacterial infections
  • Management for any complication due to AEFI
  • Dialysis for kidney failure
  • ICU services for endotracheal intubation and mechanical ventilation in cases of respiratory complications
  • Diagnostics /investigations
  • Polymerase Chain reaction test (PCR test) for COVID
  • Blood test
  • Chest Xrays
  • CT scan
  • Ultra-sound

History and physical examination Clinical assessment for early recognition of need for referral Advanced laboratory tests Basic laboratory tests Supplemental oxygen Basic imaging (Ultrasound, X-ray) Treat bacterial infections with antibiotics Oral or IV fluid for rehydration Oral or IM antipyretics Oral or IV or IM steroids Manage complications such as liver and kidney failure Mechanical ventilation (non-invasive) Antiviral medications Immunomodulators

  • Physiotherapy services
  • Physical exercises
  • Psychosocial support to patient and family members/care givers
  • counselling for patients with COVID-19 and their families
  • Spiritual support
 
Condition: Cancer
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Removal of exposure to smoking and second hand smoke
  • Higher consumption of grain-based foods, seafood, fruits and vegetables and lower consumption of meat, dairy, fats
  • Reduction of tax for fruits & vegetables and increasing tax on fats & sugars
  • Cancer awareness raising
  • Combined prevention of behavioral risk factors
  • HPV cytology screening
  • Basic palliative care
  • Extended palliative care
Primary Care
  • HPV cytology screening
Referral Facility: General
  • HPV cytology screening
Referral Facility: Specialist
  • HPV cytology screening
 
Condition: Preventive Chemotherapy (PC) NTDs
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children faecal matter
  • Observation of good hygiene practices in food preparation
  • Provision of portable water to homes and communities
  • Early recognition of danger signs by the family members
  • Early health seeking behaviour
  • Mass drug administration
  • Identification of features/signs indicative
  • Relief of any abdominal pain
  • Oral rehydration with oral fluids,
  • Treatment for prevalent NTDs
  • Referral to health facility for definitive diagnosis and treatment
Primary Care
  • Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children faecal matter
  • Periodical deworming to eliminate infecting worms,
  • Health education to prevent re-infection,
  • Access to safe water, adequate sanitation and hygiene
  • Mass drug administration (MDA) for lymphatic filariasis (LF), onchocerciasis, schistosomiasis, trachoma, soil-transmitted helminth (STH) infections (ascariasis, hookworm, and trichuriasis)
  • Monitor adverse events during MDA
  • Counselling on to clean and disinfect commonly used surfaces
  • Confirm diagnosis with laboratory tests
  • Relief of any abdominal pain
  • Oral rehydration
  • Treatment for prevalent NTDs
  • Follow up and prevention of complications e.g. anaemia
  • Referral to hospital for management of complications
Referral Facility: General
  • Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter and protection from insect bites
  • Periodical deworming to eliminate infecting worms,
  • Health education to prevent re-infection,
  • Improved sanitation to reduce soil contamination with infective eggs. * Counselling on to clean and disinfect commonly used surfaces
  • Integrated vector control
  • Antigen detection (ICT) or microfilaria detection (microscopy) in whole blood, for LF
  • Nodule detection using rapid techniques and skin snip for onchocerciasis
  • Detection of eggs in urine or stool
  • Eyelid examination for follicular inflammation (TF)
  • Relief of any abdominal pain
  • Oral rehydration with oral fluids,
  • Specific treatment for NTDs
  • Follow up and prevention of complications e.g., anaemia
  • Referral to hospital for management of complications
Referral Facility: Specialist
  • Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter
  • Periodical deworming to eliminate infecting worms,
  • Health education to prevent re-infection,
  • Improved sanitation to reduce soil contamination with infective eggs.
  • Antigen detection (ICT) or microfilaria detection (microscopy) in whole blood, for LF
  • Nodule detection using rapid techniques and skin snip for onchocerciasis
  • Detection of eggs in urine or stool
  • Eyelid examination for follicular inflammation (TF)
  • Oral rehydration with oral fluids,
  • Nutritional support (proper nutrition)
  • Administer treatment for NTDs
  • Prevention and management of any complications
  • Follow up for children including those who may have cognitive delays
  • Surgical interventions for complications, Trichiasis, lymphedema, eye complication
 
Condition: Viral Hepatitis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level

Community engagement [community sensitization on transmission and prevention for hepatitis B and C, safe sex practices, condom use, harmful traditional practices, sharing of sharp objects, tattoos, IV drug use and needle sharing]

  • Promote testing for Hepatitis B and C
  • Provision of IEC/BCC materials
  • Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week
  • Avoiding harmful traditional practices including sharing needles and unsafe tattoo
  • Vaccination: Hepatitis B
  • Consistent and correct use of condoms

Clinical assessment for early recognition of need for referral

Primary Care
  • Provision of IEC/BCC materials
  • Promote testing for Hepatitis B and C Sensitization of the community on preventive measures on hepatitis B and C
  • Avoiding harmful traditional practices including sharing needles and unsafe tattoo
  • Vaccination: Pentavalent vaccine
  • Consistent and correct use of condoms

History and physical examination for viral hepatitis Condition specific counselling Oral antipyretics for acute hepatitis infection Oral hydration for acute viral hepatitis Intravenous fluids Clinical assessment for early recognition of need for referral.

Referral Facility: General

counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use

  • Avoiding harmful traditional practices including sharing needles and unsafe tattoo
  • Vaccination: Hepatitis B
  • Consistent and correct use of condoms
  • Post exposure prophylaxis
  • Safe blood transfusion practice

History and physical examination for viral hepatitis Point of care testing Basic laboratory tests Advanced laboratory tests Basic imaging e.g., ultrasound Condition specific counselling Oral antivirals for HBV Vaccination: HBIG Oral pan genotypic antivirals for HCV cure

Referral Facility: Specialist

Provision of IEC/BCC materials Promote testing for Hepatitis B and C Sensitization of the community on preventive measures on hepatitis B and C

  • Avoiding harmful traditional practices including sharing needles and unsafe tattoo
  • Vaccination: Hepatitis B
  • Consistent and correct use of condoms
  • Post exposure prophylaxis
  • Safe blood transfusion practice

History and physical examination for viral hepatitis Point of care testing Basic laboratory tests Advanced laboratory tests Basic imaging e.g., ultrasound Condition specific counselling Oral antivirals for HBV Vaccination: HBIG Oral pan genotypic antivirals for HCV cure Management of liver failure

 
Condition: Ebola
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level

Counselling about handwashing with soap Counselling on WASH services (use of safe water supply; sanitation and hygiene)

  • Vaccination: Ebola virus disease
  • Reduce risk of wildlife-to-human transmission by avoiding contact with infected fruit bats, monkeys, apes, forest antelope or porcupines and the consumption of their raw meat * Reduce risk of human-to-human transmission by avoiding direct or close contact with people with Ebola symptoms, particularly with their bodily fluids
  • Safe and dignified burial of the dead
  • Identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days,
  • Separate the healthy from the sick to prevent further spread,
  • Good hygiene and maintaining a clean environment.
  • Safe sex practice for men who have survived Ebola disease
  • Frequent ANC attendance of pregnant women who have survived Ebola disease
  • Report suspected cases accordingly * Referral to the next level
Primary Care

Counselling about handwashing with soap Counselling on WASH services (use of safe water supply; sanitation and hygiene)

  • Vaccination: Ebola virus disease
  • Reduce risk of wildlife-to-human transmission by avoiding contact with infected fruit bats, monkeys, apes, forest antelope or porcupines and the consumption of their raw meat * Reduce risk of human-to-human transmission by avoiding direct or close contact with people with Ebola symptoms, particularly with their bodily fluids
  • Safe and dignified burial of the dead
  • Identifying people who may have been in contact with someone infected with Ebola and monitoring their health for 21 days,
  • Separate the healthy from the sick to prevent further spread,
  • Good hygiene and maintaining a clean environment.
  • Safe sex practice for men who have survived Ebola disease
  • Frequent ANC attendance of pregnant women who have survived Ebola disease
  • Report suspected cases accordingly
  • Rapid antigen detection tests
  • Referral to the next level
Referral Facility: General

Counselling about handwashing with soap Counselling on WASH services (use of safe water supply; sanitation and hygiene)

  • Vaccination: Ebola virus disease
  • Safe and dignified burial of the dead

History and physical examination Rapid antigen detection tests Basic laboratory test Advanced laboratory test Ultrasound Oral salts for Ebola virus disease Rehydration with oral or intravenous fluids Management of specific symptoms Treat bacterial infections with antibiotics Blood and blood product transfusion Supplemental oxygen Monoclonal antibody treatments Mechanical ventilation Counselling to ensure safer sexual practices

Referral Facility: Specialist

Counselling about handwashing with soap Counselling on WASH services (use of safe water supply; sanitation and hygiene)

  • Vaccination: Ebola virus disease
  • Safe and dignified burial of the dead

Automated or semi-automated nucleic acid tests (NAT) Rehydration with oral or intravenous fluids Management of specific symptoms Treat bacterial infections with antibiotics Manage complications such as liver and kidney failure Blood and blood product transfusion Supplemental oxygen Monoclonal antibody treatments Mechanical ventilation Counselling to ensure safer sexual practices

 
Condition: Appendicitis
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level

Community engagement [community sensitization on symptoms of surgical emergencies when to seek care] Community engagement [community sensitization on healthy diet, fluid intake, risk factors and symptoms of ileus and obstruction]

  • Integrated counselling on healthy diet, physical activity, weight management, and alcohol and tobacco use
  • Counselling on seeking care for abdominal pain and mass
  • Health education on recognition of signs and symptoms in postoperative patients

Early recognition of need for referral and appropriate referral

Primary Care

Community engagement [community sensitization on healthy diet, fluid intake, risk factors and symptoms of obstruction]

Integrated counselling on healthy diet (high fibre and low saturated fat), physical activity, weight management, and alcohol and tobacco use Condition-specific nutrition assessment and counselling

  • Assess for risk factors for obstruction (History of abdominal/Pelvic surgery, hernia)

History and physical examination Early recognition of need for referral

Referral Facility: General

Community engagement [community sensitization on healthy diet, fluid intake, risk factors and symptoms of obstruction]

Integrated counselling on healthy diet (high fibre and low saturated fat), physical activity, weight management, and alcohol and tobacco use Condition-specific nutrition assessment and counselling

  • Assess for risk factors for obstruction (History of abdominal/Pelvic surgery, hernia)
  • History and physical examination for gastrointestinal diseases Point of care testing Basic laboratory tests Basic imaging: Ultrasound Pharmacological intervention as clinically indicated including electrolytes, fluids, analgesic
  • Non-surgical reduction of intestinal obstruction
  • Laparotomy
  • Surgical procedures for appendicitis, mechanical bowel obstruction
Referral Facility: Specialist
  • History and physical examination for gastrointestinal diseases Point of care testing Basic laboratory tests Basic imaging: Ultrasound Pharmacological intervention as clinically indicated including electrolytes, fluids, analgesic
  • Non-surgical reduction of intestinal obstruction
  • Laparotomy Surgical procedures for appendicitis, mechanical bowel obstruction
 
Condition: Renal Injury (acute renal failure)
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level

*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs]

  • Provision of IEC/BCC materials
  • Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol
  • Adequate hydration
  • Avoid nephrotoxic medicines and traditional herbs
  • Monitor blood pressure, sugar and cholesterol levels through community screening services
  • Provide dietary advice including avoidance of high sodium and excessive protein intake;
  • Advice on blood glucose and blood pressure control
  • Early recognition of kidney disease symptoms of need for referral
Primary Care

*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs]

  • Provision of IEC/BCC materials
  • Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol
  • Adequate hydration
  • Avoid nephrotoxic medicines and traditional herbs
  • Monitor blood pressure, sugar and cholesterol levels through community screening services
  • Provide dietary advice including avoidance of high sodium and excessive protein intake
  • Advice on blood glucose and blood pressure control
  • Early recognition of kidney disease symptoms of need for referral
Referral Facility: General

*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs]

  • Provision of IEC/BCC materials
  • Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol
  • Adequate hydration
  • Avoid nephrotoxic medicines and traditional herbs
  • Monitor blood pressure, sugar and cholesterol levels through community screening services
  • History and physical examination
  • Basic laboratory tests
  • Advance laboratory tests
  • Basic imaging: x-ray, ultrasound,
  • Advanced imaging: CT scan, MRI
  • Therapeutic lifestyle modifications
  • Appropriate management of infections and other febrile illnesses
  • Pharmaceutical management to prevent or decrease the rate of progression to end-stage renal disease
  • Optimal management of comorbidities such as diabetes and other cardiovascular diseases
  • Statin therapy to reduce the risk of cardiovascular events
  • Avoid or reduce nephrotoxic medications
  • Monitor and manage CKD complications including: anaemia, electrolyte imbalance, and malnutrition
  • Early referral for peritoneal dialysis or haemodialysis
Referral Facility: Specialist

*Community engagement [community sensitization on kidney disease and risk factors, healthy diets, exercise, hydration, appropriate medication use especially NSAIDs]

  • Provision of IEC/BCC materials
  • Healthy, balanced diet and exercise to control blood sugar, blood pressure and cholesterol
  • Adequate hydration
  • Avoid nephrotoxic medicines and traditional herbs
  • Monitor blood pressure, sugar and cholesterol levels through community screening services
  • History and physical examination
  • Basic laboratory tests
  • Advance laboratory tests
  • Basic imaging: x-ray, ultrasound,
  • Advanced imaging: CT scan, MRI
  • Therapeutic lifestyle modifications
  • Appropriate management of infections and other febrile illnesses
  • Pharmaceutical management to prevent or decrease the rate of progression to end-stage renal disease
  • Optimal management of comorbidities such as diabetes and other cardiovascular diseases
  • Statin therapy to reduce the risk of cardiovascular events
  • Avoid or reduce nephrotoxic medications
  • Monitor and manage CKD complications including: anaemia, electrolyte imbalance, and malnutrition
  • Early referral for peritoneal dialysis or haemodialysis
  • Renal replacement therapy
 
Condition: Sickle cell anemia/disorder
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community engagement [community sensitization on screening for sickle cell disease, myths associated with sickle cell disease]
  • Community education and awareness regarding the transmission of disease, stigma related to disease and carrier states, and informing the community about appropriate prevention options * Community education and sensitization with links to civil society organizations, parents’ groups, schools, and school clubs
  • Sensitize and use local governance structures to establish community-based intervention program
  • Marriage counselling for genetics for carriers of haemoglobin disorders
  • Counselling on avoidance of triggers for vaso-occlusive crisis
  • Counselling on disease management and warning signs and when to seek treatment Vaccination: pneumococcal conjugate
  • Recognition of danger signs and referral for management
Primary Care
  • Community engagement [community sensitization on screening for sickle cell disease, myths associated with sickle cell disease]
  • Community education and awareness regarding the transmission of disease, stigma related to disease and carrier states, and informing the community about appropriate prevention options * Community education and sensitization with links to civil society organizations, parents’ groups, schools, and school clubs
  • Sensitize and use local governance structures to establish community-based intervention program
  • Genetic counselling for carriers of haemoglobin disorders, including premarital counselling
  • Education patients and caregivers about sickle cell disease including on warning signs and what to do in acute conditions before coming to the hospital.
  • Adequate hydration by teaching the patients to drink enough fluids to make their urine clear
  • Prophylaxis for infection, pneumococcal vaccines, oral penicillin, use of insecticide treated bed nets, and anti-malaria
  • Folate supplementation with folic acid
  • History and physical examination for sickle cell disease
  • Screening for sickle cell disease using rapid point of care test
  • Condition-specific nutrition assessment and counselling
  • Incentive spirometer to help improve lung function
  • Routine malaria chemoprophylaxis
  • non-steroidal anti-inflammatory drugs (NSAIDs) for relieving the inflammatory component of infarctive (vaso-occlusive) bone pains
  • Oral antibiotics to prevent and treat invasive pneumococcal diseases
  • Pulse oximetry to reliably estimate arterial oxygen saturation
  • Referral (for acute complication and for initial diagnosis)
Referral Facility: General
  • Community engagement [community sensitization on screening for sickle cell disease, myths associated with sickle cell disease]
  • Community education and awareness regarding the transmission of disease, stigma related to disease and carrier states, and informing the community about appropriate prevention options * Community education and sensitization with links to civil society organizations, parents’ groups, schools, and school clubs
  • Sensitize and use local governance structures to establish community-based intervention program
  • Genetic counselling for carriers of haemoglobin disorders, including premarital counselling
  • Education patients and caregivers about sickle cell disease including on warning signs and what to do in acute conditions before coming to the hospital.
  • Adequate hydration by teaching the patients to drink enough fluids to make their urine clear
  • Prophylaxis for infection, pneumococcal vaccines including Hep. B, oral penicillin, use of insecticide treated bed nets, and anti-malaria
  • Folate supplementation with folic acid
  • History and physical examination for sickle cell disease
  • Screening for sickle cell disease using rapid point of care test
  • Condition-specific nutrition assessment and counselling
  • History and physical examination *Basic and advanced laboratory tests
  • Investigations such as X-ray, Electrocardiogram (ECG)
  • Incentive spirometry for sickle cell disease
  • Chemoprophylaxis for sickle cell disease
  • Oral hydroxyurea for prevention of vaso-occlusive crises
  • Oral or intravenous fluid rehydration
  • Supplemental oxygen
  • Analgesics for pain relief
  • Antibiotics for bacterial infections
  • Blood and blood product transfusion
  • Referral to the next higher level
Referral Facility: Specialist
  • Community engagement [community sensitization on screening for sickle cell disease, myths associated with sickle cell disease]
  • Community education and awareness regarding the transmission of disease, stigma related to disease and carrier states, and informing the community about appropriate prevention options * Community education and sensitization with links to civil society organizations, parents’ groups, schools, and school clubs
  • Sensitize and use local governance structures to establish community-based intervention program
  • Adequate hydration by teaching the patients to drink enough fluids to make their urine clear
  • Prophylaxis for infection, pneumococcal vaccines including Hep. B, oral penicillin, use of insecticide treated bed nets, and anti-malaria
  • Folate supplementation with folic acid
  • History and physical examination for sickle cell disease
  • Condition-specific nutrition assessment and counselling
  • Basic and advanced laboratory tests
  • Investigations such as X-ray, Electrocardiogram (ECG)
  • Incentive spirometry for sickle cell disease
  • Chemoprophylaxis for sickle cell disease
  • Oral hydroxyurea for prevention of vaso-occlusive crises
  • Oral or intravenous fluid rehydration
  • Supplemental oxygen
  • Analgesics for pain relief
  • Antibiotics for bacterial infections
  • Blood and blood product transfusion
  • Splenectomy for splenic sequestration crisis
  • Red cell exchange transfusion
 
Condition: Idiopathic epilepsy
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Provide information and awareness creation on seizures disorders including Epilepsy, its recognition and prevention measures
  • Education to prevent stigma and discrimination
  • Prevention and seeking treatment early for febrile infections such as malaria, other viral/bacterial infections
  • Prevent head injury to prevent post-traumatic epilepsy
  • Knowing and avoiding seizure triggers such as sleep deprivation, alcohol, flashing lights, stress, etc
  • Early recognition of signs of seizures disorders
  • Relieve of any pain due to physical injuries as a result of seizures through use of pain management
  • First aid on any other complication due to seizures e.g., burns
  • Referral to a health facility for management
Primary Care
  • Provide information and awareness creation on seizures disorders including Epilepsy, its recognition and prevention measures
  • Education to prevent stigma and discrimination
  • Prevention and seeking treatment early for febrile infections such as malaria, other viral/bacterial infections
  • Prevent head injury to prevent post-traumatic epilepsy
  • Knowing and avoiding seizure triggers such as sleep deprivation, alcohol, flashing lights, stress, etc
  • History and physical examination for epilepsy
  • Anti-seizure medications (ASMs)
Referral Facility: General
  • History and physical examination for epilepsy
  • Point of care testing
  • Special diet (ketogenic diet)
  • Basic laboratory tests
  • Lumbar puncture
  • Condition specific nutrition assessment and counselling
  • Anti-seizure medications (ASMs) Monitor therapeutic drug level

Psychoeducation and psychosocial support (including for patient’s carers)

Referral Facility: Specialist
  • History and physical examination for epilepsy
  • Point of care testing
  • Basic laboratory tests
  • Advanced imaging; Magnetic resonance imaging (MRI), Computed tomography (CT) scan
  • Lumbar puncture
  • Electroencephalography (EEG)
  • Condition specific nutrition assessment and counselling
  • Special diet (ketogenic diet)
  • Anti-seizure medications (ASMs)
  • Monitor therapeutic drug level
  • Vagus nerve stimulation therapy
  • Surgery for poorly responding to ASMs
 
Condition: Oral Conditions
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Community awareness on dental caries, periodontal disease and prevention measures
  • Fully integrating oral health into community health programmes.
  • Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions
  • Multi-sectoral approach in ensuring access to clean safe water
  • Oral health education to the community by Teeth savers
  • Community water fluoridation

Counselling on daily oral hygiene including toothbrushing with fluoride toothpaste, flossing daily Counselling on nutrition, food safety, and healthy diet

  • Community level screening for oral diseases
  • Counselling on the use of Kola nuts
  • History and intraoral examination
  • Provide disinfectant mouthwash
  • Referral to a health facility for management of oral diseases
  • Screening, treatment of minor oral conditions
Primary Care
  • Community awareness on dental caries, periodontal disease and prevention measures
  • Fully integrating oral health into community health programmes.
  • Multi sectoral approach in addressing socio-cultural determinants such as poor living conditions
  • Multi-sectoral approach in ensuring access to clean safe water
  • Oral health education to the community by Teeth savers
  • Community water fluoridation

Counselling on daily oral hygiene including toothbrushing with fluoride toothpaste, flossing daily Counselling on nutrition, food safety, and healthy diet

  • Community level screening for oral diseases
  • School based screening for oral diseases
  • Counselling on the use of Kola nuts

History and intraoral examination Provide disinfectant mouthwash Application of fluoride varnish on tooth surface Silver diamine fluoride application Counselling on use of saline mouthwash Oral analgesics for oral diseases Oral antibiotics for dental abscess

  • Referral for management of oral diseases
Referral Facility: General

History and intraoral examination Provide disinfectant mouthwash Application of fluoride varnish on tooth surface X-ray Counselling on use of saline mouthwash Oral analgesics for oral diseases Oral antibiotics for dental abscess Dental extraction Incision and drainage Atraumatic restorative treatment Filling dental caries using advanced procedures Silver diamine fluoride application

  • Monitor and manage any complications
  • Fixing of dentures
Referral Facility: Specialist

History and intraoral examination Provide disinfectant mouthwash Application of fluoride varnish on tooth surface Basic imaging: X-ray Counselling on use of saline mouthwash Incision and drainage Atraumatic restorative treatment Filling dental caries using advanced procedures Silver diamine fluoride application

  • Endodontic therapy/Root canal treatment
  • Use of crowns and bridges in extensive caries with little tooth structure left
  • Monitor and manage any complications
  • Fixing of dentures
 
Condition: Eye Conditions
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level

Community awareness on the importance of early and regular comprehensive eye examinations

Counselling on adherence to treatment regimen for chronic eye diseases Counselling to promote good eye health practices and prevention strategies Counselling and education on importance of spectacle compliance

Early identification of eye conditions and refer

Primary Care

Community awareness on the importance of early and regular comprehensive eye examinations

Counselling on adherence to treatment regimen for chronic eye diseases Counselling to promote good eye health practices and prevention strategies Counselling and education on importance of spectacle compliance

Screening and diagnosis of eye diseases and vision impairment Test for visual acuity Visual field assessment Torchlight examination (external eye assessment)

Referral Facility: General

Management of refractive error, amblyopia and strabismus Patching for the treatment of amblyopia Provide spectacles Spectacle correction - presbyopia Topical cycloplegic drugs for the treatment of amblyopia

Referral Facility: Specialist

Management of refractive error, amblyopia and strabismus Strabismus surgery Patching for the treatment of amblyopia Provide spectacles Spectacle correction - presbyopia Topical cycloplegic drugs for the treatment of amblyopia Management of ocular cancer Intravenous chemotherapy for retinoblastoma Surgery for retinoblastoma Focal laser therapy for ocular cancer Cryotherapy for ocular cancer

 
Condition: Family planning
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Create mass awareness on family planning using social media, mass media, print media, public gatherings
  • Social and behavioural change communication
  • Promote the use of Information Education Communication (IEC) materials
  • Improve health workers knowledge on family planning * Male involvement in family planning

Counselling on family planning, with all available contraceptive methods Provide condoms Oral hormonal contraceptive for family planning and contraception Emergency contraceptive pills

Primary Care
  • Health education on family planning
  • Create mass awareness on family planning using social media, mass media, print media, public gatherings
  • Social and behavioural change communication
  • Promote the use of Information Education Communication (IEC) materials
  • Improve health workers knowledge on family planning
  • Male involvement in family planning

History and physical examination HIV testing for contraceptive services Basic laboratory tests Point of care testing Counselling on family planning methods Oral hormonal contraceptive for family planning and contraception Injectable hormonal contraceptive method Oral hormonal medications for emergency contraception Counselling on post-partum and post-abortion contraceptives Vaginal ring Fertility-awareness based methods Intrauterine devices (IUD)

Referral Facility: General

History and physical examination for contraception and family planning HIV testing for contraceptive services Basic laboratory tests Counselling on family planning, with all available barrier and contraceptive methods Oral hormonal contraceptive for family planning and contraception Insertion and removal of sub-dermal contraceptive implant Insertion and removal of intrauterine devices (IUD) Female sterilization Male sterilization

Referral Facility: Specialist

Insertion and removal of sub-dermal contraceptive implant Insertion and removal of intrauterine devices (IUD) Female sterilization Male sterilization

 
Condition: Menopause
Health Promotion Disease Prevention Diagnostic Curative Rehabilitative Palliative
Community Level
  • Sensitization of religious leaders and other stakeholder on sexual health
  • Services to increase physical activity
  • Education on avoiding the use of drugs for sexuality

Provision of menstrual care products

Primary Care
  • Counselling on menstruation and menopause
  • Sensitization of religious leaders and other stakeholder on sexual health

History and physical examination for menstrual health problems Counselling on menstrual disorders including menopause Management of anaemia related to heavy menstrual bleeding Counselling on respectful and equal gender relations and rights Clinical assessment for sexual dysfunction and other sexual health complications Referral for severe menstrual disorders

Referral Facility: General
Referral Facility: Specialist