WHO Regional Menu Of Essential Health Interventions

Condition: Meningitis

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Community health workers sensitization on meningitis including recognition of meningitis features among the elderly Create awareness to the elderly persons, their families and communities on meningitis and prevention measures Information/creation of awareness on healthy living for the elderly Awareness on good nutrition Provision of IEC materials Promote good hygiene practices including hand hygiene for the elderly	Practice good hygiene practices including cough, sneezing etiquette Hand washing with soap and water Hand washing with soap and water Limit the elderly contact with persons with meningitis	Recognition of danger signs of meningitis in the elderly which include, stiff neck, headache, neck and/or back pain, fever. Proper feeding Supportive therapy to an elderly person if immediate referral is not possible i.e. give fluids,Proper feeding,- Manage fever with medicine for fever such as paracetamol Urgent referral of elderly persons suspected to have meningitis to a health facility	Physiotherapy services for the elderly persons with meningitis complications who may be referred back to communities from health facilities	Psychosocial support counselling
Primary Care
Health workers education/sensitization on meningitis, prevention and management in the elderly persons. Create awareness to elderly persons and their families on meningitis and prevention measures Information/creation of awareness on healthy living for the elderly persons Guidance on good nutrition for the elderly Promote good hygiene practices including hand hygiene for the elderly	Post exposure prophylaxis for elderly persons in close contacts with someone with N.meningitidis Chemo prophylaxis for elderly persons living in a household with one or more unvaccinated children younger than 48 months.	Clinical examination and recognition of signs and symptoms (features) of meningitis in elderly persons including neck stiffness, neck and/or back pain, headache and feverThe priority at this level Urgent transfer to hospital is not possible (antibiotics should be given to any person with suspected bacterial meningitis) Emergency care with an aim of stabilizing the elderly person with meningitis before referral Emergency transfer of elderly persons suspected to have bacterial meningitis to a hopsital Administration of antibiotics to elderly person with meningitis if Supportive therapy to elderly person with meningitis as - use anti pyretics for fever - Use of analgesics for aches/pains - Physical examination		Psycho social support Counseling spiritual support
Referral Facility: General
Health Education on meningitis Health workers education on meningitis including its management in the elderly Create Awareness among the elderly and their families on meningitis and prevention measures Guidance on hygiene practices for the elderly to prevent meningitis Guidance on Good nutrition for the elderly	Post exposure prophylaxis for elderly persons who have had close contacts with someone with N.meningitidis Chemo prophylaxis for elderly persons living in a household with one or more unvaccinated children younger than 48 months	Clinical examination Physical examination Supportive treatment for elderly persons with meningitis including: Fluids/IV fluids therapy for elderly persons Relieve fever with anti-pyretics for elderly persons with fever due to meningitis Relieve aches/pains with analgesics for elderly persons with aches due to meningitis Provision of anti-emetics for elderly persons with vomiting due to meningitis Nutritional support for elderly persons with meningitis Long course therapy for tuberculous meningitis in elderly persons as per guidelines Treatment of non-infectious meningitis depending on the cause e.g. Use of corticosteroids for meningitis due to auto-immune diseases Treatment of specific cancer for cancer induced meningitis. Managmnet of all causes of meningitis as though they are bacterial meningitis until proven otherwise. Management of any complications of meningitis in elderly persons e.g. seizures, raised intra-cranial pressure. ICU services for management of meningitis complications in elderly persons		Psycho social support for elderly persons with meningitis and their family members or care givers Counseling for the elderly persons with meningitis and/with complications
Referral Facility: Specialist
Guidance on Good nutrition for the elderly Guidance on hygiene practices for the elderly to prevent meningitis Health Education on meningitis Create Awareness among the elderly and their families on meningitis and prevention measures Health workers education on meningitis including its management in the elderly	Post exposure prophylaxis for elderly persons who have had close contacts with someone with N.meningitidis Chemo prophylaxis for elderly persons living in a household with one or more unvaccinated children younger than 48 months	Clinical examination Physical examination Supportive treatment for elderly persons with meningitis including: Fluids /IV fluids therapy for elderly persons Relieve fever with anti-pyretics for elderly persons with fever due to meningitis Relieve aches /pains with analgesics for elderly persons with aches due to meningitis Provision of anti-emetics for elderly persons with vomiting due to meningitis Nutritional support for elderly persons with meningitis Long course therapy for tuberculous meningitis in elderly persons as per guidelines Treatment of non-infectious meningitis depending on the cause e.g. Use of corticosteroids for meningitis due to auto-immune diseases; Treatment of specific cancer for cancer induced meningitis. Managmnet of all causes of meningitis as though they are bacterial meningitis until proven otherwise. * * Management of any complications of meningitis in elderly persons e.g., seizures; raised intra-cranial pressure. ICU services for management of meningitis complications in elderly persons		Psycho social support for elderly persons with meningitis and their family members or care givers Counseling for the elderly persons with meningitis and /or with complications Spiritual support

Condition: Whooping Cough

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Strengthen 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	Booster vaccine Good hygiene practices including hand hygiene Avoiding close contact with people with whooping cough Cough and sneezing etiquette Community Reporting systems on whopping 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 Good nutrition eating frequent small meals to avoid vomiting avoiding coughing triggers, such as smoke, strong chemicals,allergens Home remedies staying hydrated resting using a mist vaporizer practicing proper hand hygiene 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 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 Guidance on hygiene for the elderly Strengthen health workers knowledge on whooping cough	Vaccination Tdap Post exposure prophylaxis for close contacts	Clinical examination Administration of antibiotics Supportive management Monitor for any complications Physical & Clinical examination Referral to hospital for Management of any complications e.g Rib fracture, syncope, abdominal hernia
Referral Facility: General
Awareness to elderly on whopping cough and prevention measures Guidance on hygiene practices Guidance on Good nutrition Health workers education on whooping cough 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 elderly patients with complications due to whooping cough
Referral Facility: Specialist
Awareness to elderly on whopping cough and prevention measures Guidance on Good nutrition Guidance on hygiene practices Health workers education on whooping cough 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 elderly patients with complications due to whooping cough Psychosocial support

Condition: Encephalitis

Health Promotion	Disease Prevention	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) 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 patients suspected to have encephalitis 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 elderly persons with encephalitis and their parents and families encephalitis Counselling Psycho- therapy to learn coping strategies and new behavioral skills Spiritual support
Primary Care
Awareness/education on animal handling and animal health e.g. dogs (rabies) 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 Training/sensitizing health workforceAwareness on good nutritionProvision of IEC materials 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 Adminstration of Anti-inflammatory drugs 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 Urgent 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 Referral downwards to communities for further/continued rehabilitation	Psycho-social support for elderly persons 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 elderly on encephalitis prevention measures Information/creation of awareness on healthy living Guidance on good nutrition for the elderly persons 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 - Magnetic Resonance Imaging MRI Imaging such as: - Computerized Tomography - CT - MRI	Follow-up therapy for complications of encephalitis Physical therapy to improve motor coordination anf function - Speech therapy Occupational therapy to develop every day skills Referral downwards to primary care facilities for rehabilitation	Psycho-social support for elderly persons with encephalitis and their families Counselling Psycho- therapy to learn coping strategies and new behavioral skills
Referral Facility: Specialist
Creation of awareness to elderly on encephalitis prevention measures Information/creation of awareness on healthy living Guidance on good nutrition for the elderly persons Training/sensitizing health workforce on encephalitis management	uidance 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 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 Imaging such as: Computerized Tomography CT Magnetic Resonance Imaging MRI	Follow-up therapy for complications of encephalitis Referral downwards to primary care facilities for rehabilitation Physical therapy to improve motor coordination anf function Speech therapy Occupational therapy to develop every day skills	Psycho-social support for elderly persons with encephalitis and their families Counselling Psycho- therapy to learn coping strategies and new behavioral skills Spiritual support

Condition: Measles

Health Promotion	Disease Prevention	Curative
Community Level
Information to Families and community education on transmission and prevention of measles Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding Community education on proper nutrition for the elderly Community health workers training on measles including prevention and recognition of measles in the elderly	Contact tracing Quarantine for close contacts	Recognition of features of measles in the elderly 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 elderly patients with measles:- Provision of plenty of fluids and Plenty of rest Proper nutrition Management of fever-administer anti-pyretics for fever Monitor for any worsening of measles in the elderly patient and refer Referral of elderly persons with severe measles to the health facilities
Primary Care
Information to Families and community education on transmission and prevention Community education on; proper nutrition Proper sanitation Provision of IEC materials Promoting proper planning especially in urban areas to avoid over-crowding 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 the elderly 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 elderly with measles including; Provision of plenty of fluids to the elder5ly Relieve fever-administer anti-pyretics when there is fever Relieve aches/pain with analgeith measlees Encourage the elderly with measles to rest Proper nutrition for the elderly with measles 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 elderly with complications due to measles before referral Referral of elderly with measles complications to a hospital post exposure vaccination for unvaccinated elderly persons
Referral Facility: General
	Isolation of patients with measles to prevent spread	Isolation of patients with measles to prevent spread
Referral Facility: Specialist
	Isolation of patients with measles to prevent spread	Isolation of patients with measles to prevent spread

Condition: Tuberculosis

Health Promotion	Disease Prevention	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 TB Prevention Therapy (TPT) Isolation of confirmed or presumptive TB cases	Referral of people with presumptive TB to next level Referral of people living HIV for regular screening and possible TPT Direct observation of patients 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	Directly Observed Therapy (DOTs) Self-administrative therapy (SAT) to those with good adherence Referral of people living HIV for regular screening and possible TPT * TB drugs refill for SAT Trace and follow up of defaulters Referral of people with adverse reactions and complications
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	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 Referral of people with adverse reactions and complications	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	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 diagnosis and management Nutritional support and supplement Management of complication Linkage to non-medical social support	Breathing exercise

Condition: Syphilis

Health Promotion	Disease Prevention	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 partne	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	Treatment with PenicillinTreatment 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
	Men and women with genital ulcers should have VDRL Test Men and women with positiveVDRL or RPR test should have the FTA test Examination and reaginic tests of treated clients at 3, 6 and 12 months and annually until test is non-reactive For neurosyphilis, CSF testing every 6 months until CSF cell count is normal	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	Screening of children for sexual abuse during home visits by Community Health Workers Pain relief with opioid and non-opioid analgesics for patients with late or tertiary syphilis Referral of children suspected to be victims of sexual abuse to the next level for examination and needed treatment Referral of suspected cases of sexual abuse to appropriate authorities
Referral Facility: Specialist
	Men and women with genital ulcers should have VDRL Test Men and women with positiveVDRL or RPR test should have the FTA test Examination and reaginic tests of treated clients at 3, 6 and 12 months and annually until test is non-reactive For neurosyphilis, CSF testing every 6 months until CSF cell count is normal	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	Screening of children for sexual abuse during home visits by Community Health Workers Pain relief with opioid and non-opioid analgesics for patients with late or tertiary syphilis Referral of children suspected to be victims of sexual abuse to the next level for examination and needed treatment Referral of suspected cases of sexual abuse to appropriate authorities

Condition: Other STDs

Health Promotion	Disease Prevention	Curative
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 Sensitization of traditional healers and community leaders. promote substance use cessation Promote early health seeking behaviour distribute IEC materials, promote condoms use to prevent STIs Educate communities on sex and sexual education for guidance to prevent risk factors Promotion of stigma reduction Training of community Health Workers on STI	General public education on condom use and maintaining one sexual partner	Home based supervision of men and women with confirmed STI diagnosis for treatment compliance Referral of women with STI symptoms to next level for examination and treatment Referral of males with urethral discharge or other STI symptoms to next level for examination and treatment
Primary Care
	Examination and investigation of men and women for STI symptoms	Education at ANC on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
Referral Facility: General
	Examination and Investigation of men and women with STI symptoms	Appropriate treatment for condition Concomitant treatment for Chlamydia and Gonorrhoea Treatment of sex partners Conduct investigative laboratory tests Such as chlamydia, RPR test for syphilis Syndromic management of STIs with microscope according to guidelines Develop National STI and mentoring program to support clinicians on-site with diagnosis, treatment, record keeping and greater integration of STI and HIV services Promote regular inquiries of STI symptoms at ANC and general outpatient visits, using the syndromic method of STI management.
Referral Facility: Specialist
	Conduct Clinical examination of reproductive system Screening of high risk women for sexually transmitted infections Examination and investigation of men and women for STI symptoms Conduct follow up to high-risk groups, such as youths and commercial sex workers and prisoners Awareness and sensitization about HTS Assess further complications and manage conditions Introduce mechanism on a regular check-up and follow up mechanism Training health workers on complex complications of STI	Appropriate treatment for condition Concomitant treatment for Chlamydia and Gonorrhoea Treatment of sex partners Microscopy culture and sensitivity Radiotherapy and chemotherapy for STIs that have progressed into cancer Surgical procedures where necessary. Medical imaging such as CT scan, MRI, ultrasound Perform Excisional biopsy

Condition: HIV/AIDS

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Social and behavioural change communication	Safe sexual practice including condom use Avoiding harmful traditional practices including sharing needles HIV Testing including HIV self-test	Adherence support 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
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	HIV Testing including HIV self-test Oral PrEP Injectable PrEP Post-exposure prophylaxis Screening high risk groups for STI and HIV Early treatment of STIs	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	Self-management education Physical exercise Nutritional support
Referral Facility: General
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	HIV Testing including HIV self-test Oral PrEP Injectable PrEP Post-exposure prophylaxis Screening high risk groups for STI and HIV Early treatment of STIs	First-line antiretroviral therapy Second-line antiretroviral therapy Manage moderate to severe adverse reactions * Viral load monitoring Treat moderate to severe OIs Treat TB/HIV co-infection Manage co-morbidities (viral hepatitis, NCDs) Referral to higher level for to non-responders		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
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	HIV Testing including HIV self-test Oral PrEP Injectable PrEP Post-exposure prophylaxis Screening high risk groups for STI and HIV Early treatment of STIs	Second-line antiretroviral therapy Third-line antiretroviral therapy Manage severe adverse reactions * Viral load monitoring Management of severe opportunistic infections Treat TB/HIV co-infection Manage co-morbidities (viral hepatitis, NCDs) Intesive care as clinically indicated		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 Linkage to care and non-medical support

Condition: Gonorrhoea

Health Promotion	Disease Prevention	Curative
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	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 Gonococcal diagnosis for treatment compliance Referral of women with offensive vaginal discharge to next level for examination and treatmentReferral of males with mucopurulent urethritis to next level for examination and treatment
Primary Care
	Examination and investigation of males with mucopurulent urethritis for sexually transmitted infections Examination and investigation of women with offensive vaginal discharge for sexually transmitted infections	Referral of newborns with purulent conjunctivitis to hospital for treatment Treatment with single dose of Ceftriaxone or Cefixime Concomitant treatment for Chlamydia Treatment of sex partners
Referral Facility: General

Referral Facility: Specialist

Condition: Genital herpes

Health Promotion	Disease Prevention	Curative
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 or 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	Curative
Community Level
Community-based awareness campaign Mass media based awareness	Good sanitation and hygiene practices Safe water supply Danger signs recognition Preventive zinc supplements	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	Guidance and counselling on good sanitation, hygiene and use of safe water supply Early identification of danger signs Preventive zinc supplements	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	Vaccination: rotavirus Vaccination: typhoid	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	Vaccination: rotavirus Vaccination: typhoid	Intravenous hydration Antibiotics to treat bacterial infections Zinc supplements

Condition: Chlamydia

Health Promotion	Disease Prevention	Curative
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 sensisitization 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 elderly women with offensive vaginal discharge to next level for examination and treatment Referral of elderly males with mucopurulent urethritis to next level for examination and treatment Home based supervision of elderly men and women with confirmed Chlamydia diagnosis for treatment compliance
Primary Care
	Examination and investigation of elderly women with offensive vaginal discharge for sexually transmitted infections Examination and investigation of elderly 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 elderly women - Urine culture-especially in elderly men Treatment of confirmed Chlamydia infection antibiotics Guidance on avoidance of sex until completion of treatment course Referral
Referral Facility: General
	Examination and investigation of elderly women with offensive vaginal discharge for sexually transmitted infections Examination and investigation of elderly 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 (elderly women in this case) - Urine culture-especially in men (elderly men in this case) Treatment of confirmed Chlamydia infection antibiotics Guidance on avoidance of sex until completion of treatment course Referral
Referral Facility: Specialist
	Examination and investigation of elderly women with offensive vaginal discharge for sexually transmitted infections Examination and investigation of elderly 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 (elderly women in this case) - Urine culture-especially in men (elderly men in this case) Treatment of confirmed Chlamydia infection antibiotics Guidance on avoidance of sex until completion of treatment course Referral

Condition: Dengue

Health Promotion	Disease Prevention	Curative
Community Level
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.	Primary prevention through Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Environmental manipulation such as frequent emptying and cleaning, by scrubbing, of water-storage vessels, flower vases and desert room coolers, cleaning of gutters, sheltering stored tyres from rainfall, recycling or proper disposal of discarded containers and tyres, management of plants close to homes that collect water in the leaf axils, street cleansing and draining of drainage system Environmental modification such as installation of a reliable piped water supply to communities, including household connections Installing mosquito screening on windows, doors and other entry points, and using mosquito nets while sleeping during daytime. Use of larvicides, adulticides (2-3 times annually) use of Indoor residual spraying (IRS) and insecticide treated nets (ITN) Mosquito-proofing of water-storage containers Breeding and distribution of biological control organisms such as native larvivorous fish and predatory copepods, into water-storage containers, open freshwater wells, concrete irrigation ditches and industrial tanks, wells etc.
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 Supervising rest and drinking of plenty of fluids and prescribing of Paracetamol Management of non-severe dengue without warning signs by providing medical advice,
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	Curative	Rehabilitative
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 anti fungal creams Management of Acute dermatolymphangioadenitis with Antibiotics, antipyretics, analgesics	Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)	Tertiary prevention Counsellin - Occupational and physiotherapy
Referral Facility: General
	Primary prevention Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC) Secondary prevention measure 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 anti fungal creams Management of Acute dermatolymphangioadenitis with Antibiotics, antipyretics, analgesics	Management of Hydrocele through surgery Single dose preventive chemotherapy with Albendazole (Alb), Ivermectin (IV) or Diethylcarbamazine (DEC)	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	Curative
Community Level
Information to Families and community education on transmission and prevention of diphtheria Awareness creation on hygiene measures Community education on proper nutrition for the elderly Proper sanitation Promoting proper planning especially in urban areas to avoid over-crowding Community health workers education on diphtheria including prevention measures	Vaccination-booster doses of diphtheria toxoid-containing vaccine for adolescents Contact tracing Quarantine for contacts	Recognition of features of Diphtheria in the elderly 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 the elderly with Diphtheria - Plenty of rest Proper nutrition for elderly with diphtheria Recognition of features of worsening condition due to diphtheria –such as shortness of breath Referral to a health facility of the elderly 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 elderly Creation of awareness on good hygiene practices Provision of IEC materials Training/sensitizing health workforce on diphtheria and its management	Physical and Clinical examination and diagnosis of diphtheria in the elderly based on signs and symptoms of diphtheria; including - Fever Supportive management to elderly with diphtheria to /Relieve common symptoms Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen Provide nutritional support for the elderly with diphtheria Immunization with diphtheria toxoid vaccine for elderly who have not been vaccinated or have not completed the appropriate course Monitoring and recognition for any features of worsening of diphtheria s in elderly which includes,shortness of breath/breathing difficulties Emergency care with an aim of stabilizing the elderly with complications due to diphtheria before referral Referral of elderly persons with diphtheria to a hospital
Referral Facility: General
Guidance to elderly on prevention of diphtheria Education on importance of immunization Guidance to elderly on proper nutrition Guidance to the elderly on hygiene practices Health workers education on management of diphtheria among elderly	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 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	Tests, Nasal/pharyngeal swabs for culture Physical and Clinical examination and diagnosis of diphtheria in the elderly -based on signs and symptoms of diphtheria; including - Fever Antitoxin treatment with DAT immediately diptheria is strongly suspected in the elderly (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for elderly who had not completed the appropriate course Isolation. Respiratory droplet isolation of elderly patients with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions
Referral Facility: Specialist
Guidance to elderly on prevention of diphtheria Education on importance of immunization Guidance to elderly on proper nutrition Guidance to the elderly on hygiene practices Health workers education on management of diphtheria among elderly	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 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	Tests, Nasal/pharyngeal swabs for culture Physical and Clinical examination and diagnosis of diphtheria in the elderly -based on signs and symptoms of diphtheria; including - Fever Antitoxin treatment with DAT immediately diptheria is strongly suspected in the elderly (without waiting for lab results) Antibiotic treatment (penicillin or erythromycin) to eliminate the bacteria and toxin production Immunization with diphtheria toxoid vaccine during convalescence for elderly who had not completed the appropriate course Isolation. Respiratory droplet isolation of elderly patients with respiratory diphtheria and contact precautions for those with cutaneous diphtheria Monitor and management of any diphtheria complications such as obstruction of the airways, systemic diphtheria -to the heart, kidney or peripheral nerves Emergency management for diphtheria complication such as airway obstructions

Condition: Acute Hepatitis B

Health Promotion	Disease Prevention	Curative
Community Level
Community awareness creation on Hepatitis B transmission, prevention measures and treatment		Provision of high caloric diet Adequate of fluids Restricted physical activity Referral to next level health facility
Primary Care
Awareness creation on Hepatitis B including transmission and prevention measures 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 Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Health Education on Hepatitis B Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week Distribution of IEC materials on Heaptitis B condom distribution Health workers training on Hepatitis B,including prevention measures	Hepatitis B screening and Vaccination for elderly at risk including People who frequently require blood or blood products - Dialysis patients - Recipients of solid organ transplantation - People in prisons - People who inject drugs - Household and sexual contacts of people with chronic HBV infection, - Elderly with multiple sexual partners, Healthcare workers and others who may be exposed to blood and blood products through their work - Travelers who have not completed their HBV series, who should be offered the vaccine before leaving for endemic areas Safe injection practices, including eliminating unnecessary and unsafe injections, Avoid re-use of needles and syringes.	Recognition of features on Hepatitis B infection in the elderly such as yellowing of the skin and eyes (jaundice),dark urine, tiredness, nausea, vomiting and abdominal pain Supportive management Provision of Healthy diet to the elderly with hepatitis B-Plenty of fluids- Encourage Exercises Encourage the elderly with suspected Hepatitis B to have Enough sleep/rest Monitoring for any complications/worsening of the symptoms Relieve of pain with painkillers such as paracetamol Referral to a hospital
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 Promote testing for HBV and for HIV/AIDs Provide Hepatitis B testing services. Distribution of IEC materials on Heaptitis B condom distribution Health workers training on Hepatitis B,including prevention measures	Hepatitis B Screening for elderly 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 Hep B Hepatitis B vaccination for elderly at risk 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	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 elderly 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 Hep B Hepatitis B vaccination for elderly at risk 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

Condition: Hepatitis A

Health Promotion	Disease Prevention	Curative
Community Level
Create community awareness on Hepatitis A including risk factors; Individuals and families education on the need for strict enteric precautions especially for individuals with HAV Create awareness on the benefits of immunization, particularly in high-risk individuals Individuals, families and community education on proper hygiene measuresAdvice on Improved sanitation Sensitize communities on use of clean, safe water Community health workers education/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. 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 Referral to a health facility if symptoms worsen
Primary Care
Create community awareness on Hepatitis A including risk factors Individuals, families and community education on proper hygiene measures Advice on Improved sanitation Sensitize 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 the following to Reduce chances of infections and transmission to others through; 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 worsening of the condition/any complications Referral 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 individual. 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	Reduce chances of infections and transmission to others through; 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. 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 relieve 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 individual. Individuals education on the need for strict enteric precautions especially for individuals with HAV Provide Education on proper hygiene measures Advice on Improved sanitationSensitize communities on use of clean, safe water. Health workers training /sensitization on Hepatitis A , including prevention measures and management	Reduce chances of infections and transmission to others through; 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. 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 relieve 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	Curative
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 water Strategies 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 challengesIntersectoral 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/tepid sponging Referral to a health facility in case symptoms worsens
Primary Care
Create awareness on Hepatitis E disease, the transmission mode and preventive measures Education on good hygiene practices Improve access to clean and safe drinking water Improve access to good sanitation/including safe human waste disposal in communities including in congregate populations Improve access to health services Intersectoral collaboration to address social determinants of health e.g. Sanitation Strategies to reduce overcrowding such as in refugee camps where sanitation and safe water supply pose special challenges Health workers education /sensitization on Hepatitis E including prevention measures and management	Guidance/education; - Proper disposal of human waste/feaces - proper hygiene practices including: 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	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
Awareness on good sanitation /including safe human waste disposal in communitiesGuidance on good hygiene practices Create awareness on Hepatitis E disease, the transmission mode and preventive measures to the elderly 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.
Referral Facility: Specialist
Awareness on good sanitation /including safe human waste disposal in communitiesGuidance on good hygiene practices Create awareness on Hepatitis E disease, the transmission mode and preventive measures to the elderly 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	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	Lifestyle modifications, healthier diet, quitting smoking and alcohol, exercise. Screen blood sugar through community screening services	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	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	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	Lifestyle management Oral antidiabetics Monitoring glycaemic control Comprehensive diabetes care	Self-management education Physical activity counselling and exercise training Provision and training in the use of assistive products	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	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 glucose-lowering medications Insulin Monitoring glycaemic control Detect and manage DM-specific complications	Self-management education Physical activity counselling and exercise training Provision and training in the use of assistive products	Emotional and psychosocial support
Referral Facility: Specialist
Health education on early identification of diabetes, early treatment and complication prevention	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	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	Curative
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 training on rabies ,prevention measures and its management	Eliminating rabies in dogs- through Vaccinating dogs Advice and Referrals to hospitals for Pre-exposure immunization for elderly 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	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 the elderly 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 iodine 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/to quarantine the animal
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 training on rabies , prevention measures and its management	Advice and Referral to hospital for Pre-exposure immunization for elderly 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	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 elderly 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 behaviour 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 elderly with rabies vaccine after exposure (PEP) or before exposure Pre-exposure immunization is for elderly in high-risk occupations such as, laboratory workers handling live rabies and rabies-related (lysavirus) 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 behaviour 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 elderly with rabies vaccine after exposure (PEP) or before exposure Pre-exposure immunization is for elderly in high-risk occupations such as, laboratory workers handling live rabies and rabies-related (lysavirus) 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

Condition: Yellow Fever

Health Promotion	Disease Prevention	Curative
Community Level
Education and awareness creation on yellow fever including transmission and prevention measures Education on the need for yellow fever vaccination Education on vector /mosquito control measures Distribution of IEC materials Community health workers training on yellow fever including prevention measures	Promote Vaccination for life-long protection against yellow fever disease through Mass vaccination campaigns designed to increase coverage in countries at risk Promote vaccination for travelers going to yellow fever endemic areas Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low. Requirement for travelers to provide certificate of yellow fever vaccine in line with the International Health Regulations (IHR) Eliminating potential mosquito breeding sites to reduce risk of yellow fever transmission Vector surveillance targeting Aedes aegypti and other Aedes species to inform where there is a risk of an outbreak and hence inform vector control activities, human disease surveillance and testing Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites. Recording and reporting on yellow fever to health departments	Recognition of features indicative of yellow fever including fever, headache, yellowing of the skin and eyes, muscle pain, nausea, vomiting and fatigue Relieve symptoms through - Relieve fever through use medicines such as paracetamol Relieve pain through use of painkillers such as paracetamol Give fluids to the patient Referral to a health facility for further management
Primary Care
Education and awareness creation on yellow fever including transmission and prevention measures Education on the need for yellow fever vaccination Education on vector/mosquito control measures Distribution of IEC materials Mass awareness campaigns on yellow fever Health workers training on yellow fever including prevention measures	Vaccination for life-long protection against yellow fever disease for elderly after careful risk assessment Mass vaccination campaigns designed to increase coverage in countries at risk Vaccination for travelers going to yellow fever endemic areas Yellow fever disease surveillance and Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Requirement for travelers to provide certificate of yellow fever vaccine in line with the International Health Regulations (IHR) > Working with communities to Eliminate potential mosquito breeding sites to reduce risk of yellow fever transmission in urban areas Vector surveillance targeting Aedes aegypti and other Aedes species to inform where there is a risk of an outbreak and hence inform vector control activities; human disease surveillance and testing Guidance on Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites Monitoring and reporting on Adverse Events Following Immunization (AEFI) Recording and reporting on yellow fever to health departments	Physiacl examination clinical diagnosis based on the patient's signs and symptoms, the travel history (when and where), the related travel activities and vaccine history Supportive treatment aimed at relieving symptoms including; - Relive pain - Management of fever - Hydration Monitoring for any complications/severity of the disease Stabilize the patient with complications due to yellow fever before referral e.g. administration of oxygen Monitoring, supportive management for any Adverse Events Following Immunization (AEFI) with Yellow fever Vaccine Referral to a hospital for a patient with severe yellow fever and for those with complications due to AEFI for further management
Referral Facility: General
Education and awareness creation on yellow fever including transmission and prevention measures Education on the need for yellow fever vaccination Education on vector/mosquito control measures Distribution of IEC materials Health workers training on yellow fever including prevention measures and its management	Vaccination for life-long protection against yellow fever disease for elderly after careful risk assessment Mass vaccination campaigns designed to increase coverage in countries at risk vaccination for travelers going to yellow fever endemic areas Yellow fever disease surveillance and Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Guidance on Personal preventive measures such as clothing minimizing skin exposure and use of repellents to avoid mosquito bites Monitoring and reporting on Adverse Events Following Immunization (AEFI) Isolation of infected individuals indoors or under mosquito netting to prevent further mosquito exposure and hence cut off the transmission Recording and reporting on yellow fever to health departments	Physiacl examination clinical diagnosis based on the patient's signs and symptoms, the travel history (when and where), the related travel activities and vaccine history Supportive treatment aimed at relieving symptoms including Relive pain and fever Monitoring and specific management of the disease depending on the severity including Oxygen administration Intravenous fluid administration for dehydration Blood pressure control -medications to increase collection/blood_pressure in cases of circulatory collapse transfusion of blood products in cases of severe bleeding Antibiotics for secondary bacterial_infections Management for any complication due to AEFI with yellow fever vaccine Diagnostic Tests- Blood tests to detect the virus in the early stages of the disease or demonstrate the presence of virus-specific antibodies (IgM and IgG) in late stages of yellow fever. Referral to specialised hospital for further managemnent eg for dialysis ; ICU services as may be indicated
Referral Facility: Specialist
Education and awareness creation on yellow fever including transmission and prevention measures ** Education on the need for yellow fever vaccination Education on vector /mosquito control measures Distribution of IEC materials Health workers training on yellow fever including prevention measures and its management	Vaccination for life-long protection against yellow fever disease for elderly after careful risk assessment Mass vaccination campaigns designed to increase coverage in countries at risk vaccination for travelers going to yellow fever endemic areas Yellow fever disease surveillance and Prompt recognition and control of outbreaks using mass immunization in high-risk areas where vaccination coverage is low Guidance on Personal preventive measures such as clothing minimizing skin exposure and use of repellents to avoid mosquito bites Isolation of infected individuals indoors or under mosquito netting to prevent further mosquito exposure and hence cut off the transmission Monitoring and reporting on Adverse Events Following Immunization (AEFI) Recording and reporting on yellow fever to health departments	Physical examination clinical diagnosis based on the patient's signs and symptoms, the travel history (when and where), the related travel activities and vaccine history Supportive treatment aimed at relieving symptoms including Relive pain and fever Monitoring and specific management of the disease depending on the severity including Oxygen administration Intravenous fluid administration for dehydration Blood pressure control -medications to increase collection/blood_pressure in cases of circulatory collapse · transfusion of blood products in cases of severe bleeding Antibiotics for secondary bacterial_infections_ ICU services for endotracheal intubation and mechanical ventilation in cases of respiratory failure Management for any complication due to AEFI with yellow fever vaccine Diagnostic Tests;- Blood tests to detect the virus in the early stages of the disease or demonstrate the presence of virus-specific antibodies (IgM and IgG) in late stages of yellow fever. Follow up

Condition: Acute Hepatitis C

Health Promotion	Disease Prevention	Curative	Rehabilitative
Community Level
Create awareness to the elderly 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 the elderly including fever, fatigue, decreased appetite, nausea, vomiting, abdominal pain, joint pain and yellowing of skin and the whites of the eyes Referral to a health facility if symptoms worsens Supportive Home therapies for the elderly persons 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 elderly at risk e.g for provision comprehensive harm-reduction services to elderly who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence.
Primary Care
Create awareness to the elderly and families on Hepatitis C including transmission, risk factors and prevention measures Provision of education & comprehensive harm-reduction services to elderly who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence - Education to elderly on hepatitis C and prevention measures - Education on safe sex parctices - Distribution of IEC materials Mass awreness campaigns during world heptitis day Health workers education 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 personnelon hepatitis C Guidance on Safe sex practices -prevent exposure to blood during sex Provision comprehensive harm-reduction services to elderly who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence Screening, for hepatitis C infection Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver	Physical and clinical examination Diagnosis of hepatitis C in elderly 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 the elderly 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 elderly and families on Hepatitis C including transmission, risk factors and prevention measures provision of education & comprehensive harm-reduction services to elderly who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence; Education to elderly on safe sex practices Distribution of IEC materuials on Hepatitis C Mass awareness campaigns during health days such as World Hepatitis Day Health workers training on Hepatitis C, including transmission & amp prevention measures	Primary prevention measures,Injection safety -safe and appropriate use of health care injections Safe handling and disposal of sharps and waste Education on Safe sex practices prevent exposure to blood during sex Training of health personnel on hepatitis C Screening, for hepatitis C infection in elderly including to those at risk Immunization with the hepatitis A and B vaccines to elderly with hepatis C to prevent coinfection from these hepatitis viruses and to protect their liver	Physical and clinical examination,Diagnostic tests Diagnosis of hepatitis C in elderly based on signs and symptoms Supportive therapies to elderly with Hepatitis C including proper nutrition, fluids therapy,Adequate rest - relieve pain Serological tests for anti-HCV antibodies (hepatitis C antibody test) Monitoring for progression to Chronic Hepatitis C Administration of Antiviral therapy (use of pan-genotypic direct-acting antivirals (DAAs) for chronic HCV) after careful assessment Regular Monitoring for early diagnosis and management of any complications such as liver cirrhosis and liver cancer Nucleic acid test for HCV ribonucleic acid (RNA) to confirm chronic infection
Referral Facility: Specialist
Health workers training on Hepatitis C, including transmission & amp; prevention measures Mass awareness campaigns during health days such as World Hepatitis Day Create awareness to the elderly and families on Hepatitis C including transmission, risk factors and prevention measures provision of education & comprehensive harm-reduction services to elderly who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence; Education to elderly 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 Education on Safe sex practices prevent exposure to blood during sex Training of health personnel on hepatitis C Immunization with the hepatitis A and B vaccines to elderly with hepatis C to prevent coinfection from these hepatitis viruses and to protect their liver Screening, for hepatitis C infection in elderly including to those at risk	Physical and clinical examination Diagnostic tests Serological tests for anti-HCV antibodies (hepatitis C antibody test) Nucleic acid test for HCV ribonucleic acid (RNA) to confirm chronic infection Diagnosis of hepatitis C in elderly based on signs and symptoms Supportive therapies to elderly with Hepatitis C including proper nutrition; fluids therapy Adequate rest; relieve pain Monitoring for progression to Chronic Hepatitis C Administration of Antiviral therapy (use of pan-genotypic direct-acting antivirals (DAAs) for chronic HCV) after careful assessment Regular Monitoring for early diagnosis and management of any complications such as liver cirrhosis and liver cancer

Condition: Leprosy

Health Promotion	Disease Prevention	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 Surveillance for leprosy Guidance on prompt start and adherence to treatment Recording and reporting on leprosy (health information systems for program monitoring and evaluation	Identification of a presumptive leprosy case based on signs including presence of pale (lighter than normal skin) or Hypo pigmented skin patches, Numbness in the hands and feet, Weakness and difficulty in normal movement of fingers/thumb/wrist/toes/ankles or eyelids,Painless injuries, blisters, burns or ulcers in hands and feet, presence of deformities such as clawing of fingers/thumb, clawing of toes or inability to close eyes properly Guidance/Advice to the elderly patient on self care including Care of Eyes, care of hands and feet; guidance on voluntary muscle testing and sensory testing use of correct footwear Referral of a patient suspected to have Leprosy to a health facility for management Supporting a known leprosy patient to 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 the elderly affected by leprosy and their families
Referral Facility: General
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 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; 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 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 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 Prevention and management of disabilities. Management of Leprosy with Multidrug therapy (MDT) Hospital admission Follow up for patients Strengthening surveillance for antimicrobial resistance including laboratory network. Guidance and Ensuring adherence to treatment for known leprosy patients	Promoting societal inclusion by addressing all forms of discrimination and stigma Work with communities to Empower 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	Provide psycho social and counseling support services for elderly persons 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 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 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 Prevention and management of disabilities. Hospital admission Management of Leprosy with Multidrug therapy (MDT) Follow up for patients Strengthening surveillance for antimicrobial resistance including laboratory network.	Promoting societal inclusion by addressing all forms of discrimination and stigma Work with communities to Empower 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	Provide psycho social and counseling support services for elderly persons affected by leprosy and their families

Condition: Ascariasis

Health Promotion	Disease Prevention	Curative
Community Level
Health education to elderly persons/families and communities on ascariasis and prevention measures Community,family and elderly 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 effective sewerage disposal and wastewater treatment before use for irrigation due to food grown in contaminated soil Community Health workers education on ascariasis including prevention measures	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 faecal matter Community-based deworming campaigns	Antispasmodics Analgesics Nutritional support (proper nutrition) Referral to health facility for definitive diagnosis and treatment
Primary Care
Awareness on effective sewerage disposal systems Elderly persons education on personal hygiene as well as proper disposal of human faeces Health education to elderly persons/families and communities on ascariasis and prevention measures Health workers education on ascariasis including prevention measures	Guidance to the elderly and their families 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 guidance on good nutrition for the elderly	Anthelmintic Antispasmodics Analgesics
Referral Facility: General
Health education to elderly persons/families and communities on ascariasis and prevention measures Elderly persons 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	Guidance for the elderly on primary prevention measures incluidng, Proper cleaning and cooking of food roper 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	Anthelmintic Steroids for complication Surgery for obstruction
Referral Facility: Specialist
Health education to elderly persons/families and communities on ascariasis and prevention measures Elderly persons education on personal hygiene as well as proper disposal of human faeces Awareness on effective sewerage disposal systems Health workers education on ascariasis including prevention measures	Guidance for the elderly 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	Anthelmintic Steroids for complication Surgery for obstruction

Condition: Tetanus

Health Promotion	Disease Prevention	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 elderly 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 the elderly 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 for an elderly person 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 elderly 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 elderly	Post exposure vaccination for elderly with Tetanus Toxoid containing vaccine Proper wound care for the elderly 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, 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 to the mother/or neonate hospital for management	Physiotherapy, rehabilitation for muscle movements	Psycho social support and counseling Linkage to patient support groups
Referral Facility: General
Awareness Creation elderly 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 elderly	Post exposure vaccination for elderly with Tetanus Toxoid containing vaccine Proper wound care for the elderly Proper wound care for surgical and dental procedures Effective surveillance to identify areas/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 elderly patients who are unable to recall a specific wound or injury) Supportive management-Relieve of other symptoms such as headache with analgesics fever with anti pyretic Immediate admission for the elderly person with tetanus(Tetanus is a medical emergency) Immediate management with medicines human tetanus immune globulin (TIG) Aggressive wound care for the elderly with tetanus Prevention and management of any complications such as respiratory failure Refferal to specialised hospitals for further managemnet eg Intensive care services to manage any complications/severe tetanus Follow up of elderly patients with tetanus	Physiotherapy, rehabilitation for muscle movements e.g swallowing and oral motor move	Psycho social support and counseling Linkage to patient support groups
Referral Facility: Specialist
Awareness Creation elderly 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 elderly	Post exposure vaccination for elderly with Tetanus Toxoid containing vaccine Proper wound care for the elderly Proper wound care for surgical and dental procedures Effective surveillance to identify areas/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 elderly patients who are unable to recall a specific wound or injury)* Supportive management-Relieve of other symptoms such as headache with analgesics fever with anti pyretic Immediate admission for the elderly person with tetanus(Tetanus is a medical emergency) Immediate management with medicines human tetanus immune globulin (TIG) Aggressive wound care for the elderly with tetanus Prevention and management of any complications such as respiratory failure Intensive care services to manage any complications/severe tetanus Management/control of muscle spasms Administration of antibiotics Tetanus Vaccination for the elderly who have recovered from tetanus since infection with tetanus does not confer natural immunity Follow up of elderly patients with tetanus	Physiotherapy, rehabilitation for muscle movements e.g swallowing and oral motor move	Psycho social support and counseling Linkage to patient support groups

Condition: Trichuriasis

Health Promotion	Disease Prevention	Curative
Community Level
Health education to elderly persons/families and communities on trichuriasis and prevention measures Communitt/family and elderly 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 effective sewerage disposal and wastewater treatment before use for irrigation due to food grown in contaminated soil Community Health workers education 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 Avoidance of contact with soil that may be contaminated with human faeces Avoiding consuming 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 the elderly	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 elderly persons/families and communities on Trichuriasis and prevention measures Elderly persons education on personal hygiene as well as proper disposal of human faeces Awareness on effective sewerage disposal systems Health workers training on Trichiuris including its management and prevention measures	Guidance for the elderly 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 the elderly	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) Treatment using Anthelminthic medications such as albendazole and mebendazole Microscopy for identifying trichuris eggs Follow up and prevention of complications e.g anaemia, rectal prolapse Referral to hospital for management of complications due to trichuriasis including iron deficiency anemia, rectal prolapse.
Referral Facility: General
Health education to elderly persons/families and communities on Trichuriasis and prevention measures Elderly persons education on personal hygiene as well as proper disposal of human faeces Awareness on effective sewerage disposal systems Health workers training on Trichuriasis including prevention measures	Guidance for the elderly on proper cleaning and cooking of food Guidance on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure 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 the elderly	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. anaemia, rectal prolapse
Referral Facility: Specialist
Health education to elderly persons/families and communities on Trichuriasis and prevention measures Elderly persons education on personal hygiene as well as proper disposal of human faeces Awareness on effective sewerage disposal systems Health workers training on Trichuriasis including prevention measures	Guidance for the elderly on proper cleaning and cooking of food Guidance on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure Taking safety precautions like wearing gloves when handling soil/manure Guidance on food hygiene ----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 Provide guidance on good nutrition for the elderly	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 Anaemia, rectal prolapse

Condition: Iodine deficiency

Health Promotion	Disease Prevention	Curative
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: Protein-energy malnutrition

Health Promotion	Disease Prevention	Curative
Community Level
Education of families on healthy nutrition for the elderly	Education of families on healthy nutrition for the elderly	Follow up cases of protein energy malnutrition being managed at home to ensure compliance with treatment and advice
Primary Care
		Educate caregivers on feeding of the elderly through provision of practical examples using local foods Refer severe cases of protein energy malnutrition to hospital for further management Treat mild to moderate cases with balanced oral diet Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide with multivitamin supplement Provide treatment to correct other specific deficiencies Treat any underlying conditions
Referral Facility: General
		Educate caregivers on feeding of the elderly through provision of practical examples using local foods Provide with multivitamin supplement Provide treatment to correct other specific deficiencies Refer severe cases of protein energy malnutrition to hospital for further management Treat mild to moderate cases with balanced oral diet Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide with multivitamin supplement Treat any underlying conditions
Referral Facility: Specialist
		Educate caregivers on feeding of the elderly through provision of practical examples using local foods Provide with multivitamin supplement Provide treatment to correct other specific deficiencies Refer severe cases of protein energy malnutrition to hospital for further management Treat mild to moderate cases with balanced oral diet Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide with multivitamin supplement Treat any underlying conditions

Condition: Vitamin A deficiency

Health Promotion	Disease Prevention	Curative
Community Level
Education on nutritious and healthy eating	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 elderly 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 elderly 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
Referral Facility: Specialist
		Physical and clinical assessmnet Guidance to elderly patient 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	Curative	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	Recognition of danger symptoms and signs for early referral
Primary Care
	Dietary counselling on increasing dietary fibre and reducing red and processed food
Referral Facility: General
		Appropriate management of infections Early referral for additional procedures
Referral Facility: Specialist
		Staging and grading Chemotherapy Targeted drug therapy Immunotherapy Surgery Radiotherapy	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

Condition: Larynx cancer

Health Promotion	Disease Prevention	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	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
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	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	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	Healthy life style: healthy weight, physically active, no alcoholic drink or in moderation, no smoking, eat vegetables and fruits		Family or caregiver educational training	Non-opioid analgesia for effective control of mild to moderate pain Symptomatic non-pharmacological treatment 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 chronic viral hepatitis
Referral Facility: General
	Prompt treatment of chronic viral hepatitis	Appropriate management of infections Referral to the next level for diagnostic workup and treatment		Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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
	Assessment of people with signs of liver disease and weight loss for liver cancer Screening of blood and blood donors before transfusion	Surgery Ablation Embolization Radiotherapy Chemotherapy Liver transplantation		Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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: Trachea, bronchus, lung cancers

Health Promotion	Disease Prevention	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	Support smoking cessation Early identification of symptoms and referral	Self-management education Physical exercise Nutritional support
Primary Care
	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	Support smoking cessation Early identification of symptoms and referral Follow up care of treated patients
Referral Facility: General
		Appropriate management of infections Referral to the next level for diagnostic workup and treatment
Referral Facility: Specialist
		Staging and grading Chemotherapy Targeted drug therapy Surgery Radiotherapy		Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families Opioid pain relief for people with advanced disease Provision of end-of-life care

Condition: Malignant skin melanoma

Health Promotion	Disease Prevention	Curative	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	Home-based end of life support
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	Curative	Rehabilitative
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
Primary Care

Referral Facility: General

Referral Facility: Specialist

Condition: Nasopharynx cancer and other pharyngeal cancers

Health Promotion	Disease Prevention	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		Psycho social 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	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	Healthy life style: healthy weight, physically active, no alcoholic drink or in moderation, no smoking, eat vegetables and fruits		Physical exercise Nutritional support	Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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 oesophageal cancer	Guidance on health life style
Referral Facility: General
	Guidance on health life style	Appropriate management of infections Referral to the next level for diagnostic workup and treatment	Physical exercise Nutritional support	Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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
	Assessment of people with difficulty swallowing for oesophageal cancer	Endoscopic resection Chemotherapy Targeted drug therapy Immunotherapy Surgery Radiotherapy	Physical exercise Nutritional support	Palliative systemic therapy for those locally advanced unresectable or metastatic disease End-of-life care*

Condition: Pancreas cancer

Health Promotion	Curative	Rehabilitative	Palliative
Community Level
	Referral of patients with weight loss and gastrointestinal symptoms to hospital for assessment	Ensuring that treated people comply with follow up regime Psycho social support for people who have received treatment	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	Curative
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
		Surgical excision Radiation therapy for metastatic cases
Referral Facility: Specialist
		Radiation therapy for metastatic cases Surgical excision

Condition: Stomach cancer

Health Promotion	Disease Prevention	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	Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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		Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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
	Assessment of people with persistent dyspepsia for stomach cancer	Staging and grading Chemotherapy Targeted drug therapy Immunotherapy Surgery Radiotherapy		Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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	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			Non-opioid analgesia for effective control of mild to moderate pain Symptomatic non-pharmacological treatment 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

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
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	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
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
Referral Facility: General
Health education on prevention and management of cervical cancer	Screening and treatment of precancerous lesions	Cryotherapy Loop electrosurgical excision procedure (LEEP) Intra-cavitary brachytherapy
Referral Facility: Specialist
		Chemotherapy Simple hysterectomy Radical hysterectomy Targeted drug therapy Immunotherapy Radiotherapy	Physical exercise Nutritional support	Opioid analgesia for effective control of moderate-to-severe pain Symptomatic non-pharmacological treatment 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	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
		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	Curative
Community Level
IEC on African trypanosomiasis to all age cohorts	Vector control against the mosquito using Indoor Residual Spraying (IRS) and use of Insecticide Treated Nets (ITN) Use of personal repellents and protective clothing
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 treatmnet Management of relapses Management of complications Management of adverse drug effects

Condition: Malaria

Health Promotion	Disease Prevention	Curative
Community Level
Community mobilization and engagement on malaria prevention and control Mass media on malaria prevention measures	Insecticide-treated nets (ITNs) Indoor residual spraying (IRS) Larvicidal Environmental management	Oral antimalarial treatment Immediate transfer of severe or unresponsive cases to a higher-level health care facility
Primary Care
Community mobilization and engagement on malaria prevention and control Mass media campaign on malaria prevention and early treatment	Guidance on the use of malaria prevention measures	Oral antimalaria treatment Intramuscular antimalarials 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
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	Integrated vector control management (ITN, IRS, larva source management, etc.)	Intravenous antimalarial 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
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	Integrated vector control management (ITN, IRS, larva source management, etc.)	Intravenous antimalarial IV Glucose IV anticonvulsants * Blood and blood product transfusion Haemodialysis for acute kidney injury Intensive care unit for cerebral malaria

Condition: Schistosomiasis

Health Promotion	Disease Prevention	Curative
Community Level
	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 Improvement in community Water Sanitation and Hygiene (WASH) Preventive chemotherapy with Praziquantel (PZQ) `* Vector control	Treatment Praziquantel 40 mg/kg body weight
Primary Care
IEC for all age cohorts Schistosomiasis, Hygiene	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	Medication --use of Praziquantel Microscopic examination of stool and urine samples for parasites eggs Blood serologic tests Physical and clinical examination
Referral Facility: General

Referral Facility: Specialist

Condition: Echinococcosis

Health Promotion	Disease Prevention	Curative
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
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 - Vaccination of sheep with an E. granulosus recombinant antigen (EG95) A programme	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	Curative
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: Alzheimer disease and other dementias

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Awareness creation among the communities on memory loss including prevention measures	Mental exercise Engagement in intellectual activities Regular social interactions Healthy life style	Referral to a health facility for further management	Home based physical exercise	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Primary Care
Regular patient education on staying active, identification of symptoms of dementia early	Guidance and counselling on mental exercise including engagement in intellectual activities	Psychosocial therapy –including behavioural therapy Referral to a health facility for further management	Cognitive training and rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: General
Regular patient education on staying active, identification of symptoms of dementia early	Guidance and counselling on mental exercise including engagement in intellectual activities.	Cholinesterase inhibitors Psychosocial therapy Behavioural therapy Cognitive stimulation	Cognitive training and rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families
Referral Facility: Specialist
Regular patient education on staying active, identification of symptoms of dementia early	Guidance and counselling on mental exercise including engagement in intellectual activities	Cholinesterase inhibitors and memantine Psychosocial therapy – including behavioural therapy Psychoeducation	Cognitive training and rehabilitation	Emotional, social, spiritual assessment and support based on cultural needs, values and preferences of patients and families

Condition: Asthma

Health Promotion	Disease Prevention	Curative
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	Short-acting beta-2 agonist.
Primary Care
Health education on triggers/ risk factors of asthma and preventive measures	Avoidance of indoor, outdoor asthma triggers and smoking Avoidance of exposure to exhaust fumes or other types of pollution Vaccination against influenza and pneumonia to prevent trigger flare ups	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	Curative	Rehabilitative	Palliative
Community Level
Awareness creation to communities on eating disorders and how to prevent them Counselling services for elderly persons with eating disorder Family therapy Linkage of elderly with eating disorder to Self-help/support groups Encourage elderly with eating disorder to attend social activities Distribution of IEC materials on eating disorders Community health workers education on eating disorders, including prevention measures	Early identification and referral for treatment for elderly persons with eating disorder Promoting healthy balanced diets/healthy eating for the elderly Social support systems for elderly persons at community level Guidance and support to elderly persons 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 Encourage elderly to eat healthy diets/ Guidance on Diet/Nutrition counseling Encourage elderly to do healthy exercises/exercise moderation /reducing excessive exercises Recognition of signs of any concurrent mental ailments as indicated by signs such as nervousness, withdrawal, trouble sleeping 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 elderly, 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 an eating disorder among the elderly Education to elderly on effective ways of coping with emotions Education and guidance to elderly on health exercises Guidance to elderly on healthy balanced diets/healthy eating including body image	Advisory on exercises/exercise moderation/reducing excessive exercises Clinical examination Early detection and treatment of eating disorders Diet education and advice/Nutrition counseling Early detection and management of eating disorders Recognition of any concurrent mental ailments like depression and anxiety disorders. Monitoring and recognition of any complications associated with eating disorders such as obesity, diabetes Referral to a hospital for elderly patients with severe eating disorder and any complications for further management	Physical rehabilitation program to enhance mobility and endurance for the elderly persons with eating disorders	Counselling services for elderly persons with eating disorder Family therapy Linkage of elderly with eating disorder to Self-help/support groups Encourage elderly with eating disorder to attend social activities.
Referral Facility: General
Awareness creation to elderly, 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 an eating disorder among the elderly Education and guidance to elderly on health exercises Education to elderly on effective ways of coping with emotions Guidance to elderly 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	physical rehabilitation program to enhance mobility and endurance for the elderly persons with eating disorders	Counselling services for elderly persons with eating disorder Family therapy Linkage of elderly with eating disorder to Self-help/support groups Encourage elderly with eating disorder to attend social activities
Referral Facility: Specialist
Awareness creation to elderly, 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 an eating disorder among the elderly Education and guidance to elderly on health exercises Education to elderly on effective ways of coping with emotions Guidance to elderly on healthy balanced diets/healthy eating including body image	History and clinical examination 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	physical rehabilitation program to enhance mobility and endurance for the elderly persons with eating disorders	Counselling services for elderly persons with eating disorder Family therapy Linkage of elderly with eating disorder to Self-help/support groups Encourage elderly with eating disorder to attend social activities

Condition: Periodontal disease

Health Promotion	Disease Prevention	Curative
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 elderly person with periodontal disease
Primary Care
Education to the elderly and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in elderly patients	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 elderly persons for periodontal diseases at every routine examination.	Physcal, 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 choice 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 oral hygiene measure Use of mouth washes as a temporary primary oral hygiene measure Ensure that the patient is motivated to achieve and maintain effective plaque removal. Antimicrobial Medication, Local antimicrobials, including disinfectants such as chlorhexidine and systemic antimicrobials Use of analgesics where there is pain Referral to a hospital for further management of an elderly person with periodontal disease
Referral Facility: General
Education to the elderly and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in elderly patients	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 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 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 elderly persons 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 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
Referral Facility: Specialist
Education to the elderly and their families on periodontal disease and prevention measures Health workers training on periodontal disease including prevention and management in elderly patients	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 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 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 elderly persons 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 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 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	Curative	Rehabilitative	Palliative
Community Level
Education and awareness creation/information to the elderly on migraine headache, prevention measures Community Health worker training on migraine, prevention , recognition and management at the community level	Advice on lifestyle factors to avoid and specific migraine triggers to reduce the frequency of attacks including, Irregular or skipped meals, Irregular or too little sleep, A stressful lifestyle, Excessive caffeine consumption, Lack of exercise, Obesity Encourage patients to participate actively in their treatment and to employ self-management principles including; self-monitoring to identify factors influencing migraine managing migraine triggers effectively pacing activity to avoid triggering or exacerbating migraine maintaining a lifestyle that does not worsen migraine practicing relaxation techniques maintaining good sleep hygiene developing stress management skills improving communication skills to talk effectively about pain with family and others	Identify features of migraine in elderly including headache with nausea; light sensitivity, patients with recurrent moderate or severe headaches, bilateral (on both sides) headache that interferes with patient activities; Supportive therapy such as ensuring the patient has adequate rest, adequate sleep; regular meals Give pain relieving medicines such as paracetamol/ibuprofen Use nondrug therapies such as relaxation therapies, physiotherapy/massage Monitoring for any indication of worsening of the condition Referral of elderly with worsening migraine to a health facility for further management	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
	Advice on lifestyle factors to avoid and specific migraine triggers to reduce the frequency of attacks including, irregular or skipped meals, irregular or too little sleep, a stressful lifestyle, excessive caffeine consumption, lack of exercise, obesity Encourage patients to participate actively in their treatment and to employ self-management principles including; self-monitoring to identify factors influencing migraine managing migraine triggers effectively pacing activity to avoid triggering or exacerbating migraine maintaining a lifestyle that does not worsen migraine practicing relaxation techniques maintaining good sleep hygiene developing stress management skills improving communication skills to talk effectively about pain with family and others
Referral Facility: General

Referral Facility: Specialist

Condition: Edentulism

Health Promotion	Disease Prevention	Curative	Palliative
Community Level
Awareness creation among the population on oral health including prevention of dental conditions that lead to loss of teeth Mass awareness campaigns on healthy lifestyles including on good nutrition Awareness creation on good oral hygiene Integration of oral health program into community health programmes. Health educaton/ Guidance on preventive measures including: appropriate diet and good nutrition Practising good oral hygiene Avoidance of tobacco smoking Advice on seeking treatment early for other dental conditions that lead to edentulism including dental caries, periodontal diseases, trauma, and oral cancer. Avoidance of lifestyle behavior that affects general health such as tobacco use, excessive alcohol consumption and poor dietary choices which are associated with increased risk of periodontal disease, dental caries which lead to edentulism (loss of all teeth) Training/sensitising community helth workers on dental caries including preventon measures	Gudance on primary prevention measures including: Good nutrition Practicing good oral hygiene Avoidance of tobacco smoking Advice on seeking treatment early for other dental conditions that lead to edentulism including dental caries, periodontal diseases, trauma, and oral cancer. Avoidance of lifestyle behavior that affects general health such as tobacco use, excessive alcohol consumption and poor dietary choices which are associated with increased risk of periodontal disease, dental caries which lead to edentulism (loss of all teeth)	Nutritional support for edentulous elderly patients Oral hygiene measures for edentulous patients including keeping the lips, cheeks, alveolar ridge and tongue clean in order to avoid health complications Use of mouth wash Dentures care for edentulous patients with dentures already (cleaning the complete dentures) Referral of edentulous elderly persons to a health facility for dentures	Psychosocial support to edentulous patients to adjust to the dentures and nutritional requirements
Primary Care
Awareness creation among the population on oral health including prevention of dental conditions that lead to loss of teeth Mass awareness campaigns on healthy lifestyles including on good nutrition Awareness creation on good oral hygiene Integration of oral health program into community health programmes. Multi-sectoral approach in provision of safe drinking water Health workers training oral health; prevention edentulism and its management	Guidance on primary prevention measures Appropriate diet and good nutriton Practicing good oral hygiene Avoidance of tobacco smoking Advice on seeking treatment early for other dental conditions that lead to edentulism including dental caries, periodontal diseases, trauma and oral cancer. Avoidance of lifestyle behavior that affects general health such as tobacco use, excessive alcohol consumption and poor dietary choices which are associated with increased risk of periodontal disease, dental caries which lead to edentulism. Outreach services to the community including essential oral health care	Physical and clinical examination Guidance on healthy Nutritional for edentulous elderly patients including vitamins supplementation Oral hygiene instructions for edentulous patients including advice on keeping the lips, cheeks, alveolar ridge and tongue clean in order to avoid health complications Use of mouth wash Guidance on use and care of Dentures for edentulous patients with dentures already (cleaning the complete dentures) Management of any conditions due to use of dentures such as mucosal changes: traumatic ulcers, denture stomatitis, candida infection, angular chelitis and soft tissue hyperplasia. Referral of edentulous elderly persons to a hospital for dentures (for those with no dentures)	Psychosocial support to edentulous patients to adjust to the dentures and nutritional requirements
Referral Facility: General
Awareness creation among the population on oral health including prevention of dental conditions that lead to loss of teeth Mass awareness campaigns on healthy lifestyles including on good nutrition Awareness creation on good oral hygiene Health workers training ooral health, prevention edentulism and its management Multi-sectoral approach in provision of safe drinking water Integration of oral health program into community health programmes.	Guidance on primary prevention measures Appropriate diet and good nutriton Practicing good oral hygiene Avoidance of tobacco smoking Advice on seeking treatment early for other dental conditions that lead to edentulism including dental caries, periodontal diseases, trauma and oral cancer. Avoidance of lifestyle behavior that affects general health such as tobacco use, excessive alcohol consumption and poor dietary choices which are associated with increased risk of periodontal disease, dental caries which lead to edentulism.	Physical and clinical examination Complete dentures as replacement of teeth in edentulous elderly i.e. Complete Removable acrylic dentures Digitally fabricated complete dentures Tooth retained over denture Dental implants/implant supported prosthesis for edentulous elderly patients Management of any conditions due to use of dentures such as mucosal changes: traumatic ulcers, denture stomatitis, candida infection, angular chelitis and soft tissue hyperplasia. Management of other cormobidities associated with being edentulous includng poor dietray habits and nutritional intake; increased risk of hypertension and coronary artery disease. Nutritional support including vitamins supplementation Patient education on use of the dentures Radigraphc examination --Orthopantomography (OPG) Recall and Follow up	Psychosocial support to edentulous patients to adjust to the dentures and nutritional requirements
Referral Facility: Specialist
Awareness creation among the population on oral health including prevention of dental conditions that lead to loss of teeth Mass awareness campaigns on healthy lifestyles including on good nutrition Awareness creation on good oral hygiene Health workers training ooral health, prevention edentulism and its management Multi-sectoral approach in provision of safe drinking water Integration of oral health program into community health programmes.	Guidance on primary prevention measures Appropriate diet and good nutriton Practicing good oral hygiene Avoidance of tobacco smoking Advice on seeking treatment early for other dental conditions that lead to edentulism including dental caries, periodontal diseases, trauma and oral cancer. Avoidance of lifestyle behavior that affects general health such as tobacco use, excessive alcohol consumption and poor dietary choices which are associated with increased risk of periodontal disease, dental caries which lead to edentulism.	Physical and clinical examination Complete dentures as replacement of teeth in edentulous elderly i.e. Complete Removable acrylic dentures Digitally fabricated complete dentures Tooth retained over denture Dental implants/implant supported prosthesis for edentulous elderly patients Management of any conditions due to use of dentures such as mucosal changes: traumatic ulcers, denture stomatitis, candida infection, angular chelitis and soft tissue hyperplasia. Management of other cormobidities associated with being edentulous includng poor dietray habits and nutritional intake; increased risk of hypertension and coronary artery disease. Nutritional support including vitamins supplementation Patient education on use of the dentures Radigraphc examination --Orthopantomography (OPG) Recall and Follow up	Psychosocial support to edentulous patients to adjust to the dentures and nutritional requirements

Condition: Parkinson disease

Health Promotion	Disease Prevention	Curative	Rehabilitative	Palliative
Community Level
Integrated media and public education campaigns to avoid stigmatizing perceptions of PD and to create awareness on symptoms and initiation of treatment	Health life style: regular Exercise, healthy diet etc. Avoidance of exposure to pesticides and herbicides	Referral to a health facility for management Monitor progression of disease severity	Support for self-management and family carers	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
Primary Care
Provide educational materials for better diagnosis, communicating the diagnosis and follow-up care, including support	Guidance and counselling on promotion of healthy behaviour (exercise and diet)	Referral to a health facility for further management	Occupational therapy Physical therapy Speech therapy Strength training, gait and balance training and hydrotherapy	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
Referral Facility: General
Provide educational materials for better diagnosis, communicating the diagnosis and follow-up care, including support	Guidance and counselling on promotion of healthy behaviour (exercise and diet)	Dopaminergic medications Non-dopaminergic medications	Occupational therapy Physical therapy Speech therapy Strength training, gait and balance training and hydrotherapy	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
Referral Facility: Specialist
Provide educational materials for better diagnosis, communicating the diagnosis and follow-up care, including support	Guidance and counselling on promotion of healthy behaviour (exercise and diet)	Dopaminergic medications Non-dopaminergic medications Levodopa-carbidopa enteral suspension Deep brain stimulation	Occupational therapy Physical therapy Speech therapy Strength training, gait and balance training and hydrotherapy	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

Condition: Hookworm disease

Health Promotion	Disease Prevention	Curative
Community Level
Education and awareness creation among elderly/families/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 elderly/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 to the elderly on hookworm disease including prevention measures Public health Education about proper hygiene Education on proper waste disposal to reduce the risk of hookworm infection Provision of IEC materials on hookworm disease Health workers training on hookworm disease, prevention measures and its management	Advice to elderly 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 elderly 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 elderly on hookworm disease including prevention measures Education about proper hygiene Education on proper waste disposal to reduce the risk of hookworm infection Health workers training on hookworm disease, prevention measures and its management	Advice to elderly 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	Diagnosis based of the different clinical entities of hookworm disease i.e. Classic hookworm disease (gastrointestinal (GI) infection), Cutaneous larva migrans and Eosinophilic enteritis 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 elderly persons 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 elderly on hookworm disease including prevention measures Education about proper hygiene Education on proper waste disposal to reduce the risk of hookworm infection Health workers training on hookworm disease, prevention measures and its management	Advice to elderly 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	Diagnosis based of the different clinical entities of hookworm disease i.e. Classic hookworm disease (gastrointestinal (GI) infection), Cutaneous larva migrans and Eosinophilic enteritis 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 elderly persons 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	Curative	Palliative
Community Level
Create awareness on respiratory tract infections including prevention measures (hand feeding, bottle feeding) 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 Use of cleaner liquid fuels Use of solid fuel stoves WASH activities including clean drinking water, sanitation and hygiene Counselling about household indoor air pollution Counselling on seeking early treatment for respiratory infections Vaccination: seasonal influenza Vaccination: COVID-19	First-line antibiotic treatment Immediate transfer of unresponsive or sever cases to a higher-level health care facility Syndromic diagnosis of lower respiratory tract infection (LRTI) and management with oral antimicrobials Oral antipyretics Oral hydration * Clinical assessment for early recognition of need for referral
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 Secondary level Vaccination: seasonal influenza Vaccination: COVID-19	First-line antibiotic treatment Immediate transfer of unresponsive or sever cases to a higher-level health care facility Facility based case management Standard of care (hospitalization+ low-flow oxygen and antibiotics)
Referral Facility: General
Health education on LRTI prevention measures and early treatment	Vaccination: seasonal influenza Vaccination: COVID-19	Antibiotics Oxygen supplementation IV fluids History and physical examination for lower respiratory infections Clinical assessment for early recognition of need for referral Basic laboratory tests Advanced laboratory tests Basic imaging (Ultrasound, X-ray) Treatment for acute lower respiratory tract infections Intravenous fluids Supplemental oxygen Mechanical ventilation	Post-pneumonia pulmonary rehabilitation
Referral Facility: Specialist
Health education on LRTI prevention measures and early treatment	Immunizations, e.g., Pneumococcal, influenza, COVID	Antibiotics Oxygen supplementation IV fluids Management of complications	Post-pneumonia pulmonary rehabilitation

Condition: Non-migraine headache

Health Promotion	Disease Prevention	Curative
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 headacheas, their prevention and treatment measures	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	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