Referral Facility: Specialist Interventions

• Health education and information on prevention and treatment of meningitis

• Testing for B. streptococcus when mother is at 36/37 weeks pregnant
• Prevent mother to child transmission of meningitis (Give antibiotics during labour to mothers who test positive for meningitis to prevent passing group B streptococcus to the newborn)
• Intrapartum prophylactic antibiotics in pregnant women who carry the risk of colonizing and hence risk of exposure to the neonate. (neonatal meningitis)

• Parenteral antibiotics
• Intravenous fluids
• Parenteral corticosteroids

• Health education and information on prevention and treatment of meningitis

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

• Parenteral antibiotics
• Intravenous fluids
• Anti-TB treatment for TB meningitis
• Antifungal treatment for fungal meningitis
• Parenteral corticosteroids

• Awareness campaign on causes, signs and symptoms of meningitis including prevention measures (IPC)
• Distribution of IEC materials
• Mobilisation for routine immunisation

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

• Parenteral antibiotics
• Intravenous fluids
• Anti-TB treatment for TB meningitis
• Antifungal treatment for fungal meningitis
• Parenteral corticosteroids

Create Awareness among adolescents; on meningitis and prevention measures Guidance on Good nutrition for adolescents Guidance on hygiene practices for adolescents to prevent meningitis

• Health workers training on meningitis & its management in adolescents

• Chemo prophylaxis for adolescents who are living in a household with one or more unvaccinated children younger than 48 months.
• Post exposure prophylaxis for adolescents who have had close contacts with someone with Meningitis

• Parenteral antibiotics
• Intravenous fluids
• Anti-TB treatment for TB meningitis
• Antifungal treatment for fungal meningitis
• Parenteral corticosteroids

• Health education on meningitis
• Create Awareness to adults on meningitis and prevention measures Guidance on Good nutrition for the adults
• Health workers training on meningitis & its management among the adults
• Guidance on hygiene practices for adults to prevent meningitis

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

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

• 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

• Awareness to mothers on whopping cough and prevention measures
• Guidance on Good nutrition for the mothers
• Guidance on hygiene practices Health workers education on whooping cough and its management

• Vaccination of pregnant women to prevent transmission to child

• Physical and Clinical examination
• Supportive management eg relieve pain and fever
• Administration of antibiotics
• Inpatient services
• ICU services for severely ill
• Follow up

• Health education and information to parents, families on immunization including vaccination schedule

• Isolate hospitalized patients
• Chemoprophylaxis to contacts (family and health workers)

• • Physical and Clinical examination
• Hospitalisation of infants
• Administration of antibiotics
• Monitoring /special attention to infants to prevent and manage any complications e.g apnea and pneumonia
• ICU services for severely ill
• Laboratory tests,B pertussis,culture, polymerase chain reaction (PCR), serologic testing, and direct fluorescent antibody (DFA) testing
• follow up

• Health education and information to parents, families on immunization including vaccination schedule

• Post exposure prophylaxis for close contacts

• Antibiotics if indicated
• Oral Vitamin A
• IV fluid for rehydration
• ICU services for severely ill

• Awareness to Adolescents and Adults on whopping cough and prevention measures
• Guidance on Good nutrition
• Guidance on hygiene practices
• Health workers education on whooping cough and its management

• Post exposure prophylaxis for close contacts

• Physical and clinical examination
• Outapttient services
• Anti-microbial therapy
• Supportive management eg relieve of pain and /or fever
• • Hospitalization for patients at risk of severe pertussis/and complications
• Laboratory tests,B pertussis, culture, polymerase chain reaction (PCR), serologic testing and direct fluorescent antibody (DFA) testing.
• Management of any complications e.g rib fracture, syncope, abdominal hernia or other complications from the severe, chronic cough
• ICU services for severe illness
• follow up

• Awareness to Adults on whopping cough and prevention measures
• Guidance on Good nutrition
• Guidance on hygiene practices
• Health workers education on whooping cough and its management

• Post exposure prophylaxis for close contacts

• Physical and clinical examination
• Outapttient services
• Anti-microbial therapy
• Supportive management eg relieve of pain and /or fever
• • Hospitalization for patients at risk of severe pertussis/and complications
• Laboratory tests,B pertussis, culture, polymerase chain reaction (PCR), serologic testing and direct fluorescent antibody (DFA) testing.
• Management of any complications e.g rib fracture, syncope, abdominal hernia or other complications from the severe, chronic cough
• ICU services for severe illness
• follow up

• 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

• Creation of awareness to mothers on encephalitis prevention measures
• Information/creation of awareness on healthy living
• Guidance on good nutrition for mothers 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

• 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

• Creation of awareness toparents/families on encephalitis prevention measures
• Information/creation of awareness on healthy living
• Guidance on good nutrition for children Training/sensitizing health workforce on encephalitis management

• Guidance /advise to families on importance of immunisation for the children
• Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus) ; Parasites such as Ticks control

• 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

• Creation of awareness to families, school going age children on encephalitis prevention measures
• Information/creation of awareness on healthy living
• Guidance on good nutrition for children Training/sensitizing health workforce on encephalitis management

• Guidance /advise to families on importance of immunisation for the children
• Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus) Parasites such as Ticks control

• 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

• Creation of awareness to the adolescents on encephalitis prevention measures
• Information/creation of awareness on healthy living
• Guidance on good nutrition for adolescents and the youths 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

• 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
• Initiate anti-viral treatment immediately

• Creation of awareness to adults on encephalitis prevention measures
• Information/creation of awareness on healthy living
• Guidance on good nutrition for adults Training/sensitizing health workforce on encephalitis management

• Guidance on vector control eg Vectors/mosquitos control (as a carrier for some of the virus arbovirus) ; Parasites such as Ticks control

• Physical and clinical examination
• Early recognition and treatment of encephalitis
• Imaging such as:
• Computerized Tomography CT
• Magnetic Resonance Imaging MRI
• Initiate anti-viral treatment immediately
• Initiate anti-microbial therapy including appropriate therapy for presumed bacterial meningitis (use antibiotics for acute bacterial meningitis
• Initiate specific regimen after determining the etiology of encephalitis
• For Viral encephalitis use of antiviral treatment.e.g. for herpes simplex virus /Antiviral medications e.g. Acyclovir
• Antimicrobial therapy targeting the identified infectious agent,
• Supportive care for severe encephalitis including: * Breathing assistance,
• Intravenous fluids adminstration
• Anti-inflammatory drugs administration
• Administration of Anticonvulsant medications
• Admissions for persons with encephalitis
• Management of any complications
• Prevention /or management of shock or hypertension
• Prevention/Management of seizures
• Management of hydrocephalus and increased intracranial pressure
• ICU services
• Laboartory diagnostic interventions for Encephalitis including:
• Blood and urine tests
• lumbar puncture (LP) -CSF culture
• Blood cultures for bacterial pathogens
• Serologic tests for Toxoplasma

• 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

• Guidance to mothers on measles prevention
• Guidance to pregnant women on proper nutrition
• Health workers training on management of measles in pregnant women

• Fetal monitoring
• Follow up of the newborns and manage any complications e.g. Low birth weight; babies born prematurely Immunoglobulin /measles antibodies administration for post exposure for Pregnant women

• Information and health education on VPDs and immunization

• Isolation of patients with measles to prevent spread
• Measles vaccination according to the national schedule

• Antibiotics
• Vitamin A
• Hydration
• Intensive care for severely ill

• Information and health education on VPDs and immunization

• Routine on schedule vaccination
• Vitamin A supplementation

• Antibiotics
• Oral Vitamin A
• IV fluid
• ICU services for severely ill

• Isolation of patients with measles to prevent spread

• Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus)

• Identify and manage any complications as per guidelines e.g. pneumonia,croup,diarrhea,malnutrition, otitis media,mouth ulcers,eye complications (conjunctivitis),laryngitis,febrile seizures,encephalitis

• Provide nutritional support

• Appropriate Antibiotics administration for any secondary infection e.g. pneumonia

• Responses for AEFI

• Intensive care services for adolescents with severe complications of measlesFollow up

• Relieve common symptoms of measles in adolescents ;

• Fever

• Cough

• Blocked nose

• Conjunctivitis

• sore mouth

• N/B Investigations-carry out necessary confirmatory tests for measles if need be (blood tests,throat swab; urine sample)

• Isolation of patients with measles to prevent spread

• Management of measles complications in adults including;-
• otitis media
• conjunctivitis
• pneumonia
• croup
• seizures
• encephalitis
• N/B Carry out necessary confirmatory tests for measles if need be (blood tests,throat swab; urine sample)
• Post exposure vaccination for unvaccinated contacts (within 72 hours of exposure to measles virus)

• Isolation of patients with measles to prevent spread

• Isolation of patients with measles to prevent spread

• Education for high risk reproductive age women on regular condom use with non-regular partners
• Education at ANC and CWC on symptoms of STIs and what to do if such symptoms occur

• Education for high risk reproductive age women on regular condom use with non-regular partners
• Education at ANC and CWC on symptoms of STIs and what to do if such symptoms occur

• Diagnostic tests
  - Swab test: Vaginal swab is cultured for identifying the causative of infection.
  - Antigen test: Rapid test in which antibody reacts with antigen forming a color on positive test.
  - DNA test: Nucleic acid from vaginal swab undergoes PCR to detect nucleic acid.
  - Wet prep: Fluid from vagina may be examined under microscope.
• Treatment with metronidazole or tindazole
• Treatmnet of sexual partners

• Screening of girls for evidence of sexual abuse 
• Investigation of victims of sexual abuse for Trichomoniasis 
• Examination and investigation of girls with persistent vaginal discharge for sexually transmitted infections 

• Diagnostic tests
  - Swab test: Vaginal swab is cultured for identifying the causative of infection.
  - Antigen test: Rapid test in which antibody reacts with antigen forming a color on positive test.
  - DNA test: Nucleic acid from vaginal swab undergoes PCR to detect nucleic acid.
  - Wet prep: Fluid from vagina may be examined under microscope.
• Treatment with metronidazole or tindazole
• Treatmnet of sexual partners

• Screening of high risk women for sexually transmitted infections
• Examination and investigation of female adolescents with persistent vaginal discharge for sexually transmitted infections

• Diagnostic tests
  - Swab test: Vaginal swab is cultured for identifying the causative of infection.
  - Antigen test: Rapid test in which antibody reacts with antigen forming a color on positive test.
  - DNA test: Nucleic acid from vaginal swab undergoes PCR to detect nucleic acid.
  - Wet prep: Fluid from vagina may be examined under microscope.
  - Urine test: For men, urine sample is tested to detect the presence of the parasite.
• Treatment with metronidazole or tindazole
• Treatmnet of sexual partners

• Screening of high risk women for sexually transmitted infections
• Examination and investigation of women with persistent vaginal discharge for sexually transmitted infections

• Diagnostic tests
  - Swab test: Vaginal swab is cultured for identifying the causative of infection.
  - Antigen test: Rapid test in which antibody reacts with antigen forming a color on positive test.
  - DNA test: Nucleic acid from vaginal swab undergoes PCR to detect nucleic acid.
  - Wet prep: Fluid from vagina may be examined under microscope.
  - Urine test: For men, urine sample is tested to detect the presence of the parasite.
• Treatment with metronidazole or tindazole
• Treatmnet of sexual partners

• Health education
• Create mass awareness on STIs /HIV/AIDs
• Sensitization on comprehensive sexuality education
• Health education on risk factors for STIs /HIV /AIDs
• Social and behavioural change communication
• Promote Condom use
• Promotion of HTS
• Promote early health seeking behaviour
• Promotion of stigma reduction
• Information Education Communication (IEC) materials distribution
• Condom and lubricants demonstration and distribution
• Strengthen health workers knowledge on STIs/HIV/AIDs through trainings
• Training on support for GBV

• Counseling and Testing for HIV of pregnant women
• Administration of antiretroviral drugs to babies born to HIV positive mothers
• Avoid breastfeeding of babies of HIV positive mothers if feasible
• Avoid mixed feeding of babies of HIV positive mothers
• Perform PCR test of babies of HIV positive mothers between birth and six weeks

• Physical and clinical examination
• Partner notification and expedited treatment for common STIs, /HIV
• Provider initiated counselling and testing
• HIV testing
• Diagnostics
  - Blood tests
  - CD4 count
  - Imaging -X-rays
  - Microscopy culture and sensitivity
• Syndromic management of STIs
• Clinical staging of HIV
• Chemotherapy for STIs that have progressed into cancer
• Radiotherapy for STIs that have progressed into cancer
• Defaulter tracking
• Management of opportunistic infections
  
  - Chronic diarrhoea
  - Oral Candidiasis
  -Oesophageal Candidiasis
  - Bacterial infections
  - PCP
  - Toxoplasmosis
  - TB
  - Extra pulmonary.
  - Cytomegalovirus Infection
  - Kaposi’s sarcoma
  - Lymphoma and other HIV related malignancies.
• Screening for TB and other opportunistic infections
• Management of TB co-infection
• Management of advanced HIV disease and complications
• Management of any complications
• Management for sexual violence cases and referral to support services 8 Treatment literacy /adherence counselling
• Supportive management
  - Nutritional support /Supplements
• Monitoring adherence to prescribed medications
• ART initiation services
• ART Monitoring
• ART refills
• Referral and linkages
• ICU care

• Health education and risk reduction counselling to parents

• Screen pregnant women for HIV
• ARV for HIV positive pregnant women
• ARV prophylaxis to HIV exposed infant
• Contraceptives

• First-line antiretroviral therapy
• Second-line antiretroviral therapy
• Manage moderate to severe adverse reactions * Viral load monitoring
• Management moderate to severe opportunistic infections
• Treat TB
• Manage co-morbidities
• Intensive care as clinically indicated

• Health education and risk reduction counselling to parents

• Screen pregnant women for HIV
• ARV for HIV positive pregnant women
• ARV prophylaxis to HIV exposed infant
• Contraceptives

• Second-line antiretroviral therapy
• Co-trimoxazole prophylaxis
• TB preventive therapy
• Manage severe adverse reactions * Viral load monitoring
• Management of severe opportunistic infections
• Treat TB
• Manage co-morbidities
• Intensive care as clinically indicated

• Health education and risk reduction counselling

• Provider-initiated HIV testing
• Screening blood for HIV
• Oral PrEP
• Dapivirine vaginal ring
• Injectable long-acting cabotegravir
• Post-exposure prophylaxis
• Treatment of STIs
• Voluntary male medical circumcision (VMMC)
• Substance abuse treatment
• Needle exchange program

• Second-line antiretroviral therapy
• Third-line antiretroviral therapy
• Co-trimoxazole prophylaxis
• TB preventive therapy
• Fluconazole pre-emptive therapy
• Manage severe adverse reactions * Viral load monitoring
• Management of severe opportunistic infections
• Treat TB
• Manage co-morbidities (viral hepatitis, NCDs)
• Intensive care as clinically indicated
• Linkage to care and non-medical support

• Health education and risk reduction counselling

• Provider-initiated HIV testing
• Screening blood for HIV
• Oral PrEP
• Dapivirine vaginal ring
• Injectable long-acting cabotegravir
• Post-exposure prophylaxis
• Treatment of STIs
• Voluntary male medical circumcision (VMMC)
• Substance abuse treatment
• Needle exchange program

• Third-line ARV
• Manage severe ADRs
• Viral load monitoring
• Treatment of severe opportunistic infections
• TB/HIV co-infection treatment
• Co-morbidities (viral hepatitis, NCDs) treatment
• ICU care as clinically indicated
• Linkage to care and non-medical support

• 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

• Promotion of multi-sectotral approach in addressing improving housing and sanitation to combat TB

• BCG vaccination at birth Advise pregnant women to avoid contact with people with persistent cough Investigate pregnant women with persistent cough for TB

• Physical and clinical examination
• Treatment with anti-TB medication
• Direct Observed Therapy (DOT) to promote adherence to medication
• Managment of TB/HIV co-infection
• Initiation of co-trimoxazole preventive therpay for TB/HIV co-ifection
• ART therapy for TB/HIV co-infection
• TB drugs refill
• Monitoring of TB complications
• Management of Multi -drug resistance TB
• Sputum smear /Stain and culture of sputum
• TB skin test
• HIV Counseling and Testing for confirmed TB cases

• 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)
• Manage severe adverse infections and complications
• Anti TB medication
• Anti MDR/XDR TB
• Intensive care as clinically indicated

• 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
• ICU care as clinically indicated
• Linkage to non-medical social support

• Advocacy for TB
• Distribution of IEC materials on TB
• Health education to communities on TB
• Promote use of personal protective equipment (PPE)
• Universal precaution for TB (eg. cough etiquette,
• Train health workers on TB

• Strong TB Infection control measures
• Triage people with presumptive TB for “fast-track” or separation
• Rapid diagnosis and initiation of treatment
• Improve room ventilation
• Protect health care workers

• Direct Observed Therapy (DOT)
• Self-administered treatment (SAT)
• Manage severe adverse infections
• Manage complications
• Manage HIV co-infection
• Manage MDR/XDR TB
• Nutritional support and supplement
• Intensive care as clinically indicated
• Linkage to non-medical social support

• Promote cough etiquette and cough hygiene
• Promote strong TB Infection control measures

• Strong TB Infection control measures
• Triage people with presumptive TB for “fast-track” or separation
• Ensure rapid diagnosis and initiation of treatment
• Improve room ventilation
• Protect health care workers
• TB preventive therapy

• Direct Observed Therapy (DOT)
• Self-administered treatment (SAT)
• Management of severe adverse infections and complications
• Management of TB/HIV co-infection
• ART therapy for TB/HIV co-infection
• MDR/XDR TB management
• Nutritional support and supplement
• Management of complication
• Linkage to non-medical social support

• 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

• Education for high risk reproductive age women on regular condom use with non-regular partners
• VDRL or RPR Testing for all pregnant women
• Pregnant women with positive VDRL or RPR test should have the FTA test

• Safe blood transfusion
• Screening pregnant women for syphilis
• Treatment of syphilis in pregnant women

• Examination and reaginic tests of treated clients at 3, 6 and 12 months and annually until test is non-reactive
• Screening of high risk women for sexually transmitted infections

• Safe blood transfusion
• Screening pregnant women for syphilis
• Treatment of syphilis in pregnant women

• Antibiotics
• Surgical repair of deformity

• Screening of girls for evidence of sexual abuse Girls with evidence of sexual abuse should be screened for sexually transmitted infections
• Girls with positive VDRL 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 Penicillin

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

Treatment with PenicillinTreatment of sex partners

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

Treatment with PenicillinTreatment of sex partners

• 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

• Education at ANC on symptoms of sexually transmitted infections and what to do in the event of occurrence of symptoms
• Education for high risk reproductive age women on regular condom use with non-regular partners
• 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

• Screening of high risk women for sexually transmitted infections
• Examination and investigation of pregnant women with STI symptoms

• Appropriate treatment for condition Concomitant treatment for Chlamydia and Gonorrhea
• Treatment of sex partners

Counselling on STI prevention, risk reduction, and safer sex Promote and provide female condoms Promote and provide male condoms Vaccination: human papillomavirus (HPV) Vaccination: hepatitis B

• History and physical examination for STI and reproductive tract infections
• Point of care testing/GeneXpert
• Advanced laboratory tests for STI including culture and sensitivity tests
• Etiologic diagnosis and treatment of STIs
• Counselling on partner notification, diagnosis and treatment
• Information on treatment compliance and use of condom

• Screening of high risk women for sexually transmitted infections
• Examination and investigation of adolescents with STI symptoms

• Appropriate treatment for condition Concomitant treatment for Chlamydia and Gonorrhea
• 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

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

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

• History and physical examination for STI and reproductive tract infections
• Point of care testing/GeneXpert
• Advanced laboratory tests for STI including culture and sensitivity tests
• Etiologic diagnosis and treatment of STIs
• Counselling on partner notification, diagnosis and treatment
• Information on treatment compliance and use of condom

• 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

• Education at ANC and CWC on symptoms of Gonococcal eye infection in neonates and what to do if such symptoms occur
• Education for high risk reproductive age women on regular condom use with non-regular partners

• Examination and investigation of pregnant women with offensive vaginal discharge for sexually transmitted infections
• Screening of high risk women for sexually transmitted infections
• Use 1% silver nitrate drops, 0.5% erythromycin or 1% tetracycline ointments or drops to asymptomatic babies of mothers with confirmed Gonorrhoea

• Concomitant treatment for ChlamydiaTreatment of sex partners
• Treatment of Gonococcal conjunctivitis in newborns with Tetracycline ointments or drops and saline irrigationSystemic treatment of newborns with Gonococcal conjunctivitis with IM Ceftriaxone
• Treatment with single dose of Ceftriaxone or Cefixime

• Systemic treatment of newborns with Gonococcal conjunctivitis with IM Ceftriaxone
• Treatment of Gonococcal conjunctivitis in newborns with Tetracycline and saline irrigation

• Examination and investigation of girls with offensive vaginal discharge for sexually transmitted infections
• Screening of girls for evidence of sexual abuse

• Examination and investigation of female adolescents with offensive vaginal discharge for sexually transmitted infections
• Examination and investigation of males with mucopurulent urethritis for sexually transmitted infections

• Examination and investigation of males with mucopurulent urethritis for sexually transmitted infections
• Screening of high risk women for sexually transmitted infectionsExamination and investigation of women with offensive vaginal discharge for sexually transmitted infections

• Treatment with single dose of Ceftriaxone or Cefixime
• Concomitant treatment for ChlamydiaTreatment of sex partners

Education for high risk reproductive age women on regular condom use with non-regular partners

Screening of high risk women for sexually transmitted infections

Screening of girls for evidence of sexual abuse

Screening of high risk women for sexually transmitted infections

Treatment with Acyclovir, valacyclovir or famciclovir Treatment of sex partners

Screening of high risk women for sexually transmitted infections

Treatment with Acyclovir, valacyclovir or famciclovirTreatment of sex partners

Screening of high risk women for sexually transmitted infections

Treatment with Acyclovir, valacyclovir or famciclovirTreatment of sex partners

• Education for high risk reproductive age women on regular condom use with non-regular partners
• Education at ANC and CWC on symptoms of chlamydia eye infection in neonates and what to do if such symptoms occur
• Training health workers on chlamydia including transmission, preventon measures and management

• Screening of high risk women for sexually transmitted infections
• Examination and investigation of pregnant women with offensive vaginal discharge for sexually transmitted infections

• Physical and clinical examination
• Diagnostics tests
  - Swab test for culturing or antigen testing for chlamydia especially in pregnant women
• Treatment of confirmed Chlamydia infection antibiotics
• Treatment of Chlamydia conjunctivitis in newborns with antibiotics (topical or systemic as indicated)
• Guidance on avoidance of sex until completion of treatment course
• Referral

• Physical and clinical examination
• Treatment of Chlamydia conjunctivitis in infants with antibiotics
• Referral as may be indicated

• Screening of girls for evidence of sexual abuse
• Examination and investigation of girls with offensive vaginal discharge for sexually transmitted infections

• Physical and clinical examination
• Diagnostics tests
  - Swab test for culturing or antigen testing for chlamydia especially in women (female adolescents in this case)
  - Urine culture-especially in men (male aldolescents in this case)
• Treatment of confirmed Chlamydia infection antibiotics
• Guidance on avoidance of sex until completion of treatment course
• Referral

• Screening of high risk adult women for sexually transmitted infections
• Examination and investigation of adult women with offensive vaginal discharge for sexually transmitted infections
• Examination and investigation of adult men with mucopurulent urethritis for sexually transmitted infections

• Physical and clinical examination
• Diagnostics tests
  - Swab test for culturing or antigen testing for chlamydia especially in women (adult women in this case)
  - Urine culture-especially in men (adult men in this case)
• Treatment of confirmed Chlamydia infection antibiotics
• Guidance on avoidance of sex until completion of treatment course
• Referral

• 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

• Improvement in community Water Sanitation and Hygiene (WASH)

• Health education and awareness craetion on Trachoma
• Education on personal hygiene including hand and facial hygiene /cleanliness
• Health workers training on Trachoma inckuding its management and prevention measures

• Improvement in community Water Sanitation and Hygiene (WASH)
• Preventive chemotherapy with Azithromycin (AZM) (starting from age 2) Primary prevention through
• screening communities for the presence of trachoma in children 1-9 years of age. (when over 10 % are found to have clinical disease the entire community is treated with antibiotics)

• Physical and clinical examination
• _ Medication --Chemotherapy with Azithromycin (AZM)
• Trichiasis surgery for trachoma

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

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

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

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

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

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

• Health education on prevention and treatment of diarrhoea

• Access to safe drinking water
• Use of improved sanitation
• Hand washing with soap

• Intravenous hydration
• Antibiotics to treat bacterial infections
• Zinc supplements

• Health education on prevention and treatment of diarrhoea

• Access to safe drinking water
• Use of improved sanitation
• Hand washing with soap

• Intravenous hydration
• Antibiotics to treat bacterial infections
• Zinc supplements

• Health education on prevention and treatment of diarrhoea

• Access to safe drinking water
• Use of improved sanitation
• Hand washing with soap

• Intravenous hydration
• Antibiotics to treat bacterial infections
• Zinc supplements

• Health education on prevention and treatment of diarrhoea

• Access to safe drinking water
• Use of improved sanitation
• Hand washing with soap

• Intravenous hydration
• Antibiotics to treat bacterial infections
• Zinc supplements

• Mass media to raise awareness on enteric infections including prevention measures (hygiene, IPC), sensitization, radio discussion, health talks, etc.
• Distribution of IEC materials on enteric infections

• Access to safe drinking water
• Use of improved sanitation
• Hand washing with soap

• Intravenous hydration
• Antibiotics to treat bacterial infections
• Zinc supplements

• 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

Community awareness and education on

• Onchocerciasis recognizing, responding to and referring cases of Severe Adverse Events (SAEs) following treatment with Mectizan to a designated health facility for clinical management of such cases. (Same for community distributors and all health personnel involved in the program)

Primary Prevention through

• Annual preventive chemotherapy with single dose of Ivermectin.

• Oral ivermectin
• Manage Mazzotti reaction

• workers education on diphtheria including its management in pregnant women
• Maternal education on diphtheria and prevention measures
• Maternal education on importance of immunization
• Creation of awareness on the importance of immunization
• Sensitization on proper hygiene practices

• ANC services
• Post-natal services
• Vaccination with Tdap during routine wellness visits to women and girls of childbearing age

• Provide nutritional support for the adults with diphtheria

• Clinical examination and diagnosis of diptheria in pregnant women
• Immunization with diphtheria toxoid vaccine for pregnant mothers
• Fetal monitoring
• Monitoring and Management of complications of diphtheria in pregnant women such as shortness of breath/breathing difficulties
• Management of neonates with low birth weights, preterm babies/as a result of diphtheria Supportive management to pregnant mothers with diphtheria to/Relieve common symptoms

• Relieve fever with anti pyretics/analgesics such as paracetamol and ibuprofen

• Guidance to parents on hygiene practices for children
• Guidance to parents on prevention of diphtheria among children
• Education on importance of immunization for the children
• Guidance to parents on proper nutrition for children
• Health workers education on management of diphtheria among children

• Identify close contacts such as caretakers, relatives, sexual contacts, friends; - Health care workers

• Monitor close contacts for signs and symptoms of diphtheria
• Prophylactic antibiotics (penicillin or erythromycin) for close contacts
• Recording and reporting of diphtheria cases through established reporting mechanisms
• Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series

• Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever
• Antitoxin treatment with DAT immediately diphtheria is strongly suspected in children under 5 years (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 children who have not been vaccinated/have not completed the appropriate course
• Isolation. Respiratory droplet isolation of children under 5s with respiratory diphtheria and contact precautions for under 5s children with cutaneous diphtheria
• Tests, nasal/pharyngeal swabs for culture
• 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

• Guidance to school children on prevention of diphtheria
• Education on importance of immunization
• Guidance to school children on hygiene practices
• Guidance to school children on proper nutrition
• Health workers education on management of diphtheria among primary school age children

• Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
• Monitor close contacts for signs and symptoms of diphtheria
• Prophylactic antibiotics (penicillin or erythromycin) for close contacts
• Recording and reporting of diphtheria cases through established reporting mechanisms
• Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series

• Tests, Nasal/pharyngeal swabs for culture

• Antitoxin treatment with DAT immediately diphtheria is strongly suspected in school age children (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 school age children who are immunised/have not completed the appropriate course
• Isolation. Respiratory droplet isolation of school age children 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
• Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever

• Guidance to adolescents on hygiene practices
• Guidance to adolescents on prevention of diphtheria
• Education on importance of immunization
• Guidance to adolescents on proper nutrition
• Health workers education on management of diphtheria among adolescents

• Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
• • Monitor close contacts for signs and symptoms of diphtheria
• Prophylactic antibiotics (penicillin or erythromycin) for close contacts
• Recording and reporting of diphtheria cases through established reporting mechanisms
• Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series

• Tests, nasal/pharyngeal swabs for culture

• Antitoxin treatment with DAT immediately diphtheria is strongly suspected in adolescents (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 adolescents who have not been immunized previously/have who had not completed the appropriate course<
• Isolation. Respiratory droplet isolation of adolescents 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/peripheral nerves
• Physical and Clinical examination and diagnosis of diphtheria in children under 5 years of age. -based on signs and symptoms of diphtheria including; - Fever

• Guidance to adults on hygiene practices
• Guidance to adults on prevention of diphtheria
• Education on importance of immunization
• Guidance to adults on proper nutrition
• Health workers education on management of diphtheria among the adults

• Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
• • Monitor close contacts for signs and symptoms of diphtheria
• Prophylactic antibiotics (penicillin or erythromycin) for close contacts
• Recording and reporting of diphtheria cases through established reporting mechanisms
• Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series

• Identify close contacts such as caretakers, relatives, sexual contacts, friends, Health care workers
• Monitor close contacts for signs and symptoms of diphtheria
• Prophylactic antibiotics (penicillin or erythromycin) for close contacts
• Recording and reporting of diphtheria cases through established reporting mechanisms
• Vaccination with diphtheria toxoid-containing vaccine for unvaccinated contacts and for Under-vaccinated contacts to complete their vaccination series

• 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

• Awareness among mothers on the importance on immunization
• Promote ANC attendance
• Education and awareness creation to mothers 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)
• Health workers training on Hepatitis B, including prevention measures

• Hepatitis B Vaccination for the pregnant women
• Routine Screening for Hepatitis B for the pregnant women
• Prevent mother to child transmission of Hepatitis B through; anti-retroviral prophylaxis
• Integration of hepatitis B testing and treatment of eligible pregnant women with the prevention of mother-to-child transmission of HIV and congenital syphilis with antenatal care service. ‘Triple elimination’ approach
• Hepatitis B vaccination for the newborn-preferably within 24 hours ( as it also help prevent mother to child transmission of Hepatitis B.)
• Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the mothers
• Safe injection practices, including eliminating unnecessary and unsafe injections,
• • Avoid re-use of needles and syringes.

• Supportive management
• Healthy diet
• Optimum fluids
• Enough sleep/rest
• Analgesics
• Admission for severe Acute Hepatitis B
• Anti-retroviral drugs for severe acute Hepatitis B
• Monitoring and management of any complications

Create awareness on the importance of Hepatitis B vaccination for the children Education and awareness creation among parents/c on Hepatitis B including transmission and prevention measures Guidance to parents on nutrition for the children Health workers training on Hepatitis B,including prevention measures among children Promote CWC attendance

• Hepatitis B Vaccination for under 5 years children not vaccinated at birth
• Screening for Hepatitis B for under 5s at risk ; those living with someone who has hepatitis B;
• Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion to the under 5s
• Safe injection practices, including eliminating unnecessary and unsafe injections,
• -Avoid re-use of needles and syringes

• Supportive management
• Healthy diet
• Optimum fluids
• Enough sleep/rest
• Pain relief
• Admission for severe Acute Hepatitis B
• Anti-retroviral drugs for severe acute Hepatitis B
• Monitoring and management of any complications

• Education and awareness creation on Hepatitis B including transmission and prevention measures
• Education on safe sex practices among the primary school age children
• Distribution of IEC materials on Hepatitis B through schools
• Health workers training on Hepatitis B,including prevention measures

• Hepatitis B Vaccination
• Safe injection practices, including eliminating unnecessary and unsafe injections,
• • Avoid re-use of needles and syringes
• Screening for Hepatitis B for primary school age children at risk, e.g. those living with someone who has hepatitis B;
• Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion

• 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

• 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 Vaccination
• Screening for Hepatitis B for adolescents at risk e.g those living with someone who has hepatitis B; those with multiple sexual partners; with STIs;
• 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

• Awareness creation on Hepatitis B including transmission and prevention measures
• Health Education on Hepatitis B
• Mass awareness campaigns through such days as World Hepatitis Day and World immunization Week
• Awareness creation on safer sex practices, including minimizing the number of partners and using barrier protective measures (condoms),
• Awareness creation on other risky behaviours such as illicit drugs and sharing needles and other sharp objects; no sharing personal items
• Distribution of IEC materials on Heaptitis B
• condom distribution
• Promote testing for HBV and for HIV/AIDs
• Provide Hepatitis B testing services.
• Health workers training on Hepatitis B,including prevention measures

• Hepatitis B Screening for adults at high Risk i.e. adults who live with someone who has hepatitis B; Health care workers; those with a sexually transmitted infection, including HIV; Men who have sex with men; Adults who have multiple sexual partners; those who inject illegal drugs or share needles and syringes; Adults with chronic liver disease; Adults with end-stage kidney disease ; Adults planning to travel to an area of the world with a high prevalence of Hepatitis B
• Screening all donated blood/Test all blood donations for hepatitis B to ensure blood safety before any transfusion
• Safe injection practices, including eliminating unnecessary and unsafe injections,
• Avoid re-use of needles and syringes Hepatitis B vaccination for those at risk

• Physical examination
• Clinical examination and diagnosis of Hepatitis B
• Supportive management for patients with Acute Hepatitis B
• Provision of Healthy diet
• Plenty of fluids
• Encourage Exercises-
• Encourage the patient with Hepatitis B to have Enough sleep/rest
• Relieve of pain with painkillers
• Admission for patient with severe Acute Hepatitis B
• Administer anti-retroviral drugs for severe acute Hepatitis B to prevent complications
• Monitoring and management of any complications including acute Liver failure
• Follow up
• Investigations
• Blood tests to detect Hepatitis B surface antigen (HBsAg)
• Serum immunoglobulin M (IgM)Test for Chronic Hepatitis B indicated by persistent Hepatitis B surface antigen for at least 6 months
• Test for Hepatitis A and C -
• Liver ultrasound-
• Liver Biopsy

• 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

• Advice to mothers on Hepatitis A including risk factors
• Mothers education on proper hygiene measures
• Sensitize mothers and families on use of clean, safe water
• Advice mothers proper human waste disposal -including for children
• Health workers training/sensitization on Hepatitis A , including prevention measures and management

• 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

• Physical and clinical examinationRelieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms )
• Relieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms )
• Investigations
• Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood
• Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA
• Liver function tests
• Test also for hepatitis B and C
• Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)

• Create awareness to mothers and families /communities on Hepatitis A including risk factors
• Families and community education on proper hygiene measures. Including for children
• Sensitize communities on use of clean, safe waterEducation to families on proper human waste disposal -including for children
• Health workers training /sensitization on Hepatitis A , including prevention measures and management

• Education/sensitization to families on Strict personal and hand hygiene
• Hepatitis A Vaccine for children older than 1 year especially children who live in communities where the number of HAV infections is unusually high or where there are periodic outbreaks of hepatitis A.

• Relieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms )
• Investigations -
• Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood -
• Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA
• Liver function tests
• Test also for hepatitis B and C
• Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)

• Create awareness through schools and communities on Hepatitis A including risk factors
• Sensitization of teachers and school communities
• Schools and community education on proper hygiene measuresAdvice on Improved sanitation
• Sensitize through schools and families on use of clean, safe water
• 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 advice and sensitization.
• 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.

• Physical and Clinical examination
• 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

• Create awareness on Hepatitis A including risk factors among the adolescents
• Create awareness on the benefits of immunization, particularly in high-risk individuals
• Individuals education on the need for strict enteric precautions especially for individuals with HAV
• Provide Education on proper hygiene measuresAdvice on Improved sanitationSensitize communities on use of clean, safe water
• Health workers training/sensitization on Hepatitis A , including prevention measures and management

• Advice on personal hygiene; hand hygiene; proper food cooking
• Hepatitis A Vaccine before exposure to targeted at risk grow
• Men who have sex with men
• People who use illegal drugs
• People with impaired immune systems or chronic liver disease
• People with blood-clotting disorders who receive clotting factors.

• Physical and Clinical examination
• Relieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms )
• Investigations -
• Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood -
• Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA
• Liver function tests
• Test also for hepatitis B and C
• Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)

• Create awareness on Hepatitis A including risk factors
• Create awareness on the benefits of immunization, particularly in high-risk individuals
• Individuals education on the need for strict enteric precautions especially for individuals with HAV
• Provide Education on proper hygiene measuresAdvice on Improved sanitationSensitize communities on use of clean, safe water.
• Health workers training /sensitization on Hepatitis A , including prevention measures and management

• Advice on personal hygiene; hand hygiene; proper food cooking
• Hepatitis A Vaccine before exposure to targeted at risk groups
• Men who have sex with men
• People who use illegal drugs
• People with impaired immune systems or chronic liver disease
• People with blood-clotting disorders who receive clotting factors

• Physical and Clinical examination
• Relieve any symptom -fever; dehydration i.e.(no specific medicines except to relive symptoms )
• Investigations -
• Blood test -To detect HAV-specific immunoglobulin G (IgM) antibodies in the blood -
• Reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA
• Liver function tests
• Test also for hepatitis B and C
• Monitor and management of complications the main one being fulminant hepatitis (acute liver failure)

• 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)

Create awareness on Hepatitis E disease, the transmission mode and preventive measures to the pregnant mothers Guidance on good hygiene practices for mothersGuidance on use of clean and safe drinking waterAwareness on good sanitation /including safe human waste disposal in communities Health workers education on Hepatitis E transmission, prevention and management

• 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*
• Admission/hospitalization for symptomatic pregnant women.
• 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.

Create awareness on Hepatitis E disease,the transmission mode and preventive measures to the parents Guidance on good hygiene practices for the childrenGuidance on use of clean and safe drinking waterAwareness on good sanitation /including safe human waste disposal in communities. Health workers education on Hepatitis E transmission, prevention and management

• Guidance /education on proper hygiene practices including:
• Proper disposal of human waste /feaces
• 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*
• Admissions for children who may develop severe Hepatitis E (usually due to co-infection with Hep.A)
• 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.

Guidance onProper disposal of human faecesMaintaining individual hygiene practicesConsumption of clean safe waterConsumption 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

• 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.

Create awareness on Hepatitis E disease, the transmission mode and preventive measures to the adolescents. Guidance on good hygiene practicesGuidance on use of clean and safe drinking waterAwareness on good sanitation/including safe human waste disposal in communities. Health workers education on Hepatitis E transmission, prevention and management

• Guidance /education on proper hygiene practices including:
• Proper disposal of human waste /feaces
• 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.

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

• Guidance /education on proper hygiene practices including:
• Proper disposal of human waste /feaces
• Maintaining individual hygiene practices
• Consumption of clean safe water
• Consumption of properly cooked meat and meat products (consumption of uncooked meat and meat products accounts for a small number of clinical cases
• Monitoring and Proper record keeping/reporting especially in out breaks situation

• Monitoring and management of any complications main one being fulminant hepatitis (acute liver failure)
• N/b There is no specific treatment capable of altering the course of acute hepatitis E.; usually self-limiting disease
• Supportive treatment including:
• proper nutrition,
• Adequate rest
• relieving fever through use of pain killers
• Physical and clinical examination
• Diagnosis based on Strong link in appropriate epidemiology settings, e.g. when several cases occur in localities in known disease-endemic areas, or in settings with risk of water contamination.
• Rule out hepatitis A
• Blood tests for detection of specific IgM antibodies to the virus for definitive diagnosis.

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.

• Create awareness on diabetes including prevention measures among pregnant women
• Create awareness on health diets for the pregnant women
• Education to pregnant women, on importance of physical exercise
• Creation of awareness on avoidance risk factors such as on avoidance of tobacco use and harmful use of alcohol
• Health workers training on diabetes including management in pregnant women
• Promote ANC attendance

• Advice/guidance to pregnant women on maintaining healthy diet
• Guidance on a regular exercise routine
• Guidance on maintaining healthy body weight/guidance on weight loss

• Pre-natal screening for Gestational diabetes
• Management of Gestational diabetes and pre-existing diabetes through advice on Lifestyle change including.
• healthy balanced diet/nutritional therapy
• regular daily physical activity.
• Weight management depending on pregestational weight
• Medications/use of Insulin for treating hyperglycemia in gestational diabetes mellitus as it does not cross the placenta
• Management of pre-existing diabetes in pregnant women through use of insulin
• Monitoring and prevention of pre-eclampsia in pregnant women with diabetes (use low dose aspirin 60–150 mg/day
• Foetal monitoring
• Monitoring of the neonates blood sugar after delivery
• Postpartum Follow-up

• Create awareness to parents, families on type 1 diabetes
• Awareness creation on measures to prevent complications of type 1 diabetes among children
• Awareness creation on healthy diets for children, physical activity
• Health workers training on diabetes including type 1 diabetes and its management

• Interventions to prevent complications for type 1 diabetes including
• Helping the child maintain good blood sugar control
• Teaching the child the importance of eating a healthy diet and participating in regular physical activity
• Scheduling regular check-ups for the child with the health workers-including eye check up

• Physical and Clinical examination
• Random and fasting blood sugars for diagnosis of type 1 diabetes
• Advice to parents on healthy foods for the child with diabetes
• Guidance and encouraging Exercise regularly
• Screening for and management of blood lipid (to regulate cholesterol levels)
• screening for early signs of diabetes-related kidney disease and treatment
• Management of type 1 diabetes with insulin injection
• Recognition and management of acute diabetic emergencies (hypoglycaemeia and hyperglycaemia emergencies)
• Regular examination of the feet and management of any foot ulcers to prevent diabetic foot screening and treatment for retinopathy
• Monitoring and control of blood pressure
• Monitoring and management of any complications including
• Frequent blood sugar monitoring and blood glucose control
• Follow up

• Health education on early identification of diabetes, early treatment and complication prevention

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

• Healthy diet
• Physical activity
• Insulin
• Monitoring glycaemic control
• Prevent and treat diabetic ketoacidosis
• Monitor long-term complications
• Manage complications

• Health education on early identification of diabetes, early treatment and complication prevention

• Diabetes-related eye examination
• Diabetes-related foot examination
• Diabetes-related neuropathy examination
• Diabetes-related kidney disease testing

• Healthy diet
• Physical activity
• Insulin
• Monitoring glycaemic control
• Prevent and treat diabetic ketoacidosis
• Monitor long-term complications
• Manage complications

• 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

• 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

• Awareness creation on rabies and prevention measures including preventing dog bites.
• Education on dog behavior and bite prevention
• Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
• Health workers training on rabies,prevention measures and its management

• Immunization for mothers with rabies vaccine after exposure (PEP)
• Pre-exposure immunization for mothers in high-risk occupations such as, laboratory workers handling live rabies and rabies-related (lyssavirus) viruses and those whose profession brings them direct contact with animals e.g. wildlife rangers
• Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims, with the goal to apply preventive measures accordingly
• Record keeping and reporting to the public health departments

• 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 the pregnant women 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
• Foetal monitoring
• 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

• Awareness creation on rabies and prevention measures including preventing dog bites.
• Education on dog behavior and bite prevention
• Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
• Health workers training on rabies ,prevention measures and its management

• Immunization for children with rabies vaccine after exposure (PEP) or before exposure
• Immunization consideration for children living in, high rabies exposure risk areas ( As they play with animals, they may receive more severe bites, or may not report bites.)
• 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 under supervision of a physician
  • the administration of rabies immunoglobulin (RIG), if indicated.
• Relieve of any other symptoms such as pain with analgesics
• Admission services/inpatient services
• 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.

• Awareness creation on rabies and prevention measures including preventing dog bites.
• Education on dog behavior and bite prevention
• Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
• Health workers education on rabies ,prevention measures and its management

• Immunization of children with rabies vaccine after exposure (PEP) or before exposure
• Immunization consideration for children living in, high rabies exposure risk areas ( As they play with animals, they may receive more severe bites, or may not report bites)
• 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 categorised 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

• Awareness creation on rabies and prevention measures including preventing dog bites
• Education on dog behavior and bite prevention
• Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
• Health workers training on rabies,prevention measures and its management

• Immunization of adolescents with rabies vaccine after exposure (PEP) or before exposure
• Pre-exposure immunization is for adolescents in high-risk activities such as 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 categorised 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/quarantine the animal

• Awareness creation on rabies and prevention measures including preventing dog bites
• Education on dog behavior and bite prevention
• Increasing awareness of rabies prevention and control in communities including education and information on responsible pet ownership, how to prevent dog bites, and immediate care measures after a bite.
• Health workers training on rabies ,prevention measures and its management

• Immunization of adults with rabies vaccine after exposure (PEP) or before exposure
• Pre-exposure immunization is for adults in high-risk occupations such as; laboratory workers handling live rabies and rabies-related (lyssavirus) viruses and elderly whose profession brings them direct contact with animals e.g. wildlife rangers
• Joint contact tracing by veterinary and public health services to identify additional suspected rabid animals and human bite victims,with the goal to apply preventive measures accordingly
• Record keeping and reporting to the public health departments and veterinary departments

• Physical and clinical examination,
• Recognition and categorization of animal bite exposures categorized as carrying a risk of developing rabies which include: if the biting mammal is a known rabies reservoir or vector species, the exposure occurs in a geographical area where rabies is still present, the animal looks sick or displays abnormal behavior, a wound or mucous membrane was contaminated by the animal’s saliva; the bite was unprovoked, the animal has not been vaccinated, The vaccination status of the suspect animal is questionable
• Immediate post exposure prophylaxis of all cotegorized exposures assessed as carrying a risk of developing rabies;
  • Extensive washing ; flushing and local treatment of the bite wound or scratch as soon as possible after a suspected exposure;
  • Administration of rabies vaccine
  • the administration of rabies immunoglobulin (RIG), if indicated.
• Relieve of any other symptoms such as pain with analgesics
• Monitor and manage any complications depending on the two forms of rabies – such as cardiopulmonary arrest as a result of furious rabies or muscle paralysis and coma due to paralytic rabies
• ICU services for patients with complications e.g. those in coma
• Integrated bite case management/alert the veterinary services to remove the biting animal from the community/quarantined

• 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

• 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

• Vaccination with yellow fever vaccine for pregnant women during yellow fever out breaks when the risk of infection is high
• 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 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
• Isolation of infected individuals indoors or under mosquito netting to prevent further mosquito exposure and hence cut off the transmission
• Personal preventive measures such as clothing minimizing skin exposure and repellents to avoid mosquito bites
• 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

• 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

• Vaccination of children for life-long protection against yellow fever disease
• Vaccination for travelers going to yellow fever endemic areas
• Mass vaccination campaigns designed to increase coverage in countries at risk
• 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)
• Eliminating potential mosquito breeding sites to reduce risk of yellow fever transmission in urban areas ü 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
• 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

• 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

• Strengthen families and community-based awareness on Yellow Fever including transmission and prevention measures * Information and health education to parents, families and Communities on immunization including vaccination schedule for young children

• Vaccination: Yellow fever

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

• 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

• Vaccination for life-long protection against yellow fever disease
• 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)
• Eliminating 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

• 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

• Strengthen families and community-based awareness on Yellow Fever including transmission and prevention measures
• Information and health education to parents, families and communities on Yellow Fever vaccination

• Vaccination: Yellow fever

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

• 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

• Health workers training on Hepatitis C, including transmission ; prevention measures; and management
• Education to mothers on safe sex practices
• Provision of education & comprehensive harm-reduction services to mothers who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence
• Distribution of IEC materials
• Mass awareness campaigns during health days such as World Hepatitis Day
• Create awareness to mothers and families on Hepatitis C including transmission, risk factors and prevention measures

• Primary prevention measures
  • Injection safety -safe and appropriate use of health care injections
  • safe handling and disposal of sharps and waste
  • Education /guidance on Safe sex practices -prevent exposure to blood during sex
• Immunization with the hepatitis A and B vaccines to prevent coinfection from these hepatitis viruses and to protect their liver
• screening/ Testing of donated blood for HBV and HCV (as well as HIV and syphilis
• Screening, for hepatitis C infection for the pregnant women
• Screening for HCV to children born to mothers infected with HCV

• 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 pregnant women based on signs and symptoms
• Regular Monitoring for early diagnosis and management of any complications such as liver cirrhosis and liver cancer
• Supportive therapies pregnant women with Hepatitis C including
• proper nutrition;
• fluids therapy ;
• plenty of rest;
• relieve of pain
• Administration of Antiviral therapy

• Health workers training on Hepatitis C, including transmission, prevention measures and management
• Mass awareness campaigns during health days such as World Hepatitis Day
• Create awareness to parents and families on Hepatitis C including transmission, risk factors and prevention measures

• Primary prevention measures
  • Injection safety -safe and appropriate use of health care injections
  • Safe handling and disposal of sharps and waste
• Training of health personnel on hepatitis C
• Immunization with the hepatitis A and B vaccines for children with hepatitis C to prevent coinfection from these hepatitis viruses and to protect their liver
• Screening, for hepatitis C infection

• Physical and clinical examination
• Diagnosis of hepatitis C in children 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 children with Hepatitis C including
• proper nutrition;
• fluids therapy ;
• PLenty of rest;
• relieve of pain
• Monitor for any progression to Chronic Hepatitis C
• Follow up
• WHO -recommends Deferring anti-retroviral treatment for children aged less than 12 years with chronic HCV infection until 12 years of age

• Health workers trainings on Hepatitis C, including transmission; prevention measures and management
• Training/sensitizing school communities on Hepatitis C, including transmission; prevention measures
• Health education to school age children on hepatitsi C
  • Distribution of IEC materuials on Hepatitis C
• Mass awarenes creation on Heaptitis C eg through world hepatitis Day/ through schools ie. schools health programs

• Primary prevention measures
• Training of health personnel on hepatitis C
• Injection safety -safe and appropriate use of health care injections
• Safe handling and disposal of sharps and waste
• Immunization with the hepatitis A and B vaccines to children with hepatitis C infection to prevent coinfection from these hepatitis viruses and to protect their liver.

• Physical and clinical examination
• Diagnosis of hepatitis C in children 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 children with Hepatitis C including
• proper nutrition;
• fluids therapy ;
• PLenty of rest;
• relieve of pain
• Monitor for any progression to Chronic Hepatitis C
• Follow up
• n/b WHO -recommends Deferring anti-retroviral treatment for children aged less than 12 years with chronic HCV infection until 12 years of age

• Health workers training on Hepatitis C, including transmission & ; prevention measures
• Create awareness to adolescents 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 adolescents who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence;
• Education to adolescents on safe sex practices
• Distribution of IEC materuials on Hepatitis C

• Training of health personnel on hepatitis C
• Guidance /eduvation on Safe sex practices -prevent 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
• Primary prevention measures
  • Injection safety -safe and appropriate use of health care injections
  • Safe handling and disposal of sharps and wastencluding 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
• Regular Monitoring for early diagnosis and management of any complications such as liver cirrhosis and liver cancer
• 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

• Health workers training on Hepatitis C, including transmission & prevention measures
• Mass awareness campaigns during health days such as World Hepatitis Day
• Create awareness to the adults and families on Hepatitis C including transmission, risk factors and prevention measures
• provision of education & comprehensive harm-reduction services to adults who inject drugs including sterile injecting equipment and effective and evidence-based treatment of dependence;
• Education to adults on safe sex practices
• Distribution of IEC materuials on Hepatitis C

• Primary prevention measures
  • Injection safety -safe and appropriate use of health care injections
  • Safe handling and disposal of sharps and waste
• Training of health personnel on hepatitis C
• Guidance on Safe sex practices to prevent exposure to blood during sex; Secondary prevention measures
• Immunization with the hepatitis A and B vaccines for adults with hepatitis C infection to prevent coinfection from these hepatitis viruses and to protect their liver

• 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

• 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
• Health workers education on leprosy including prevention, diagnosis and management
• Multi-sectoral approach in addressing leprosy
• 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

• • 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
• 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.
• Management of Leprosy with Multidrug therapy (MDT)
• Hospital admission
• Strengthening surveillance for antimicrobial resistance including laboratory network.

• 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-sect oral approach in addressing leprosy
• Health workers training on leprosy including prevention, diagnosis and management

• 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*
• Prevention and management of disabilities.
• Hospital admission
• Management of Leprosy with Multidrug therapy (MDT)
• Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment
• Strengthening surveillance for antimicrobial resistance including laboratory network.
• Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities

• Strengthening patient and community awareness of leprosy
• Community Health education to raise suspicion of leprosy by the community members
• Multi-sectoral approach in addressing leprosy
• Health workers traiing 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
• 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*
• Hospital admission
• Management of Leprosy with Multidrug therapy (MDT)
• Prevention and management of disabilities.
• Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment
• Strengthening surveillance for antimicrobial resistance including laboratory network.

• 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 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 education to raise suspicion of leprosy by the community members
• 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
• 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.
• Management of Leprosy with Multidrug therapy (MDT)
• Hospital admission
• Strengthening surveillance for antimicrobial resistance including laboratory network.

• Strengthening patient and community awareness of leprosy
• Community Capacity building on basic facts about leprosy,signs and symptoms and mode of transmission will improve early diagnosis and treatment
• Demand creation for community to seek early diagnosis and treatment
• Community Health education to raise suspicion of leprosy by the community members
• Community knowledge that leprosy disease is curable will reduce stigma and discrimination
• Involving communities in actions for improvement of leprosy services
• Multi-sectoral approach in addressing leprosy
• Health workers training on leprosy including prevention, diagnosis and management

• • Guidance on avoidance of close and frequent contacts with persons with untreated leprosy
• Early case detection through active case finding
• Contact tracing
• Guidance on prompt start and adherence to treatment
• Surveillance for leprosy
• Recording and reporting on leprosy (health information systems for program monitoring and evaluation)
• Conducting basic and operational research in all aspects of leprosy and maximize the evidence base to inform policies, strategies and activities

• physical and clinical examination
• Guidance to the elderly leprosy patient on adherence to treatment,
• Guidance /Advice to patients with leprosy on self-care including Care of Eyes; care of hands and feet; guidance on voluntary muscle testing and sensory testing use of correct footwear
• Presumptive diagnosis of Leprosy based on cardinal signs:
• Definite loss of sensation in a pale (hypo pigmented) or reddish skin patch *
• Thickened or enlarged peripheral nerve with loss of sensation and/or weakness of the muscles supplied by that nerve*
• Follow up and prevention of complications including progressive and permanent damage to the skin, nerves, limbs, and eyes through early diagnosis and early treatment
• Management of Leprosy with Multidrug therapy (MDT)
• Hospital admission
• Prevention and management of disabilities.
• Strengthening surveillance for antimicrobial resistance including laboratory network.

• 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.

• Health education to pregnant women on ascariasis and prevention measures
• Pregnant women education on personal hygiene as well as proper disposal of human faeces
• Health workers education on ascariasis including prevention measures and management

• Guidance to pregnant women 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 Promoting good nutrition for pregnant women

• Anthelmintic
• Steroids for complication
• Surgery for obstruction

• Health education to parents/families on ascariasis and prevention measures in children
• Families/parents education on personal hygiene as well as proper disposal of human faeces including children fecal matter
• Health workers training on ascariasis including prevention measures and its management in children

• Guidance parents/children 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 Promoting good nutrition for children

• Anthelmintic
• Steroids for complication
• Surgery for obstruction

• Health education to primary school age children on ascariasis and prevention measures
• School children education on personal hygiene as well as proper disposal of human faeces
• School health programs/outreaches
• Health workers training on ascariasis including prevention measures and management among school children

• Guidance to parents and children on primary prevention measures incluidng :

• • Proper cleaning and cooking of food
• • proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
• • Proper waste disposal/ not passing stool in the soil or outdoors
• • Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
• • Taking safety precautions like wearing gloves when handling soil/manure promote good nutrition for school age children

• Anthelmintic
• Steroids for complication
• Surgery for obstruction

• Health education for adolescents on ascariasis and prevention measures
• Adolescents education on personal hygiene as well as proper disposal of human faeces
• Health workers education on ascariasis including prevention measures and management among the adolescents

• Guidance to adolescents on primary prevention measures incluidng :

• • Proper cleaning and cooking of food
• • proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
• • Proper waste disposal/ not passing stool in the soil or outdoors
• • Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
• • Taking safety precautions like wearing gloves when handling soil/manure promote good nutrition for adolescents

• Anthelmintic
• Steroids for complication
• Surgery for obstruction

• Health education to adults on ascariasis and prevention measures
• Adult education on personal hygiene as well as proper disposal of human faeces
• bAwareness on effective sewerage disposal systems
• Health workers training on ascariasis including prevention measures and its management in adults

• Guidance to adults on primary prevention measures incluidng :

• • Proper cleaning and cooking of food
• • proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• • Avoidance of consuming or contact with soil that may be contaminated with human feacal matter
• • Proper waste disposal/ not passing stool in the soil or outdoors
• • Wash, peel, or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
• • Taking safety precautions like wearing gloves when handling soil/manure promote good nutrition for adults

• Anthelmintic
• Steroids for complication
• Surgery for obstruction

• 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

• Awareness Creation among mothers on Tetanus and preventive measures
• Education and awareness creation on safe delivery to the mothers
• Creation of awareness on importance of infant/child vaccination and on vaccination schedule
• Health education activities to increase awareness of the importance of tetanus immunization
• Training the ANC Health care providers on tetanus on vaccination and cold chain management
• Training Health workers on safe delivery methods
• Training Health care workers on Tetanus, prevention measures and management

• Advice to mothers on Regular ANC attendance
• Clean delivery practices
• Maternal immunization against Tetanus (Tetanus toxoid vaccination)
• Proper wound care
• Proper wound care for surgical and dental procedures
• Proper cord care during delivery
• Data keeping/monitoring the impact of interventions and reporting
• Effective surveillance to identify areas or populations at high risk of neonatal tetanus and maternal tetanus

• • Physical and clinical examination
• Clinical diagnosis of tetanus based on Clinical features
• For neonatal tetanus–an illness occurring in an infant who has the normal ability to suck and cry in the first 2 days of life, but who loses this ability between days 3 and 28 of life and becomes rigid or has spasms
• Non-neonatal tetanus ( in this case affecting the mothers)requires at least one of the following signs; a sustained spasm of the facial muscles in which the person appears to be grinning, or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in patients who are unable to recall a specific wound or injury)
• Relieve of other symptoms such as headache with analgesics, fever with anti pyretic
• Immediate admission for mothers with tetanus/neonates with neonatal tetanus (Tetanus is a medical emergency)
• Immediate management with medicines human tetanus immune globulin (TIG)
• Aggressive wound care for the mothers with tetanus
• Management/control of muscle spasms
• Administration of antibiotics
• Tetanus Vaccination for the mothers who have recovered since infection with tetanus does not confer natural immunity ** Prevention and management of any complications such as respiratory failure
• Intensive care services to mange severe tetanus/any complications eg for ventilation
• Follow up

• Awareness Creation among parents and families on Tetanus and preventive measures
• Creation of awareness on importance of infant/child vaccination and on vaccination schedule

• Immunization with tetanus-toxoid-containing vaccines (TTCV), which are included in routine immunization programmes
• Proper wound care for the under 5s
• Proper wound care for surgical and dental procedures
• Data keeping/monitoring the impact of interventions and reporting
• Effective surveillance to identify areas or populations at high risk of tetanus
• Outreach activities in order to increase TT immunization coverage

• • 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 children whose parents /families are unable to recall a specific wound or injury)*
• Relieve of other symptoms such as headache with analgesics, fever with anti pyretic
• Immediate admission for under 5 with tetanus(Tetanus is a medical emergency)
• Immediate management with medicines human tetanus immune globulin (TIG)
• Aggressive wound care for the under 5 with tetanus
• Prevention and management of any complications such as respiratory failure
• Intensive care services to manage any complications/severe tetanus e.g for ventilation
• Management/control of muscle spasms
• Administration of antibiotics
• Tetanus Vaccination for the under 5 since infection with tetanus does not confer natural immunity
• Follow up

• • Awareness Creation among school going age children on Tetanus and preventive measures
• Health education activities to increase awareness of the importance of tetanus immunization
• Distribution of IEC materials
• Training Health care workers on Tetanus prevention measures and management among adolescents

• Post exposure vaccination for school going age children with Tetanus Toxoid containing vaccine
• Proper wound care for the school going age children
• Proper wound care for surgical and dental procedures
• Effective surveillance to identify areas or populations at high risk of tetanus
• Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
• Data keeping/monitoring the impact of interventions and reporting

• • Physical and clinical examination

• Clinical diagnosis of tetanus based on Clinical features

• Non-neonatal tetanus)requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in patients who are unable to recall a specific wound or injury)*

• Relieve of other symptoms such as headache with analgesics, fever with anti pyretic

• Immediate admission for school age child with tetanus(Tetanus is a medical emergency)

• Immediate management with medicines human tetanus immune globulin (TIG)

• Aggressive wound care for the school age child with tetanus

• Prevention and management of any complications such as respiratory failure

• Intensive care services to manage any complications/severe tetanus eg for ventilation

• Management/control of muscle spasms

• Administration of antibiotics

• Tetanus Vaccination for the school age child who has recovered from tetanus since infection with tetanus does not confer natural immunity

• Follow up

• Awareness Creation among adolescents on Tetanus and preventive measures
• Health education activities to increase awareness of the importance of tetanus immunization
• Distribution of IEC materials
• Training Health care workers on Tetanus prevention measures and management among adolescents

• Post exposure vaccination for adolescents with Tetanus Toxoid containing vaccine
• Proper wound care for the adolescents
• Proper wound care for surgical and dental procedures
• Effective surveillance to identify areas or populations at high risk of tetanus
• Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
• Data keeping/monitoring the impact of interventions and reporting

• • Physical and clinical examination
• Clinical diagnosis of tetanus based on Clinical features
• Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning, or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in adolescents who are unable to recall a specific wound or injury)**
• Supportive therapy-Relieve of other symptoms such as headache with analgesics, fever with anti-pyretic
• Immediate admission for adolescents with tetanus (Tetanus is a medical emergency)
• Immediate management with medicines human tetanus immune globulin (TIG)
• Aggressive wound care for the adolescents with tetanus
• Prevention and management of any complications such as respiratory failure
• Intensive care services to manage any complications/severe tetanus eg for ventilation
• Management/control of muscle spasms
• Administration of antibiotics
• Tetanus Vaccination for the adolescents who have recovered from tetanus since infection with tetanus does not confer natural immunity
• Follow up

• Awareness Creation among adults on Tetanus and preventive measures
• Health education activities to increase awareness of the importance of tetanus immunization
• Distribution of IEC materials
• Training Health care workers on Tetanus prevention measures and management among adolescents

• Post exposure vaccination for adults with Tetanus Toxoid containing vaccine
• Proper wound care for adults
• Proper wound care for surgical and dental procedures
• Effective surveillance to identify areas or populations at high risk of tetanus
• Effective tetanus vaccination monitoring system including immunization register, personal vaccination cards
• Data keeping/monitoring the impact of interventions and reporting

• • Physical and clinical examination
• Clinical diagnosis of tetanus based on Clinical features
• Non-neonatal tetanus requires at least one of the following signs: a sustained spasm of the facial muscles in which the person appears to be grinning or painful muscular contractions. And with a history of injury or wound, tetanus (but may also occur in adult patients who are unable to recall a specific wound or injury)
• Supportive therapy-Relieve of other symptoms such as headache with analgesics fever with anti pyretic
• Immediate admission for adults with tetanus (Tetanus is a medical emergency)Immediate management with medicines human tetanus immune globulin (TIG)
• Aggressive wound care for the adults with tetanus
• Prevention and management of any complications
• Intensive care services to manage any complications/severe tetanus
• Management/control of muscle spasms
• Administration of antibiotics
• Tetanus Vaccination for the adults who have recovered from tetanus since infection with tetanus does not confer natural immunity
• Follow up

• 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

• Health education to pregnant women on Trichuriasis and prevention measures
• Pregnant women education on personal hygiene as well as proper disposal of human faeces
• Health workers training on Trichuriasis including prevention measures and management

• Guidance to pregnant women on proper cleaning and cooking of food
• Teaching on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• Teaching/advice on Avoidance consuming or getting into contact with soil that may be contaminated with human feacal matter
• Advice mothers on Proper waste disposal-Not passing stool in the soil or outdoors
• Advice on Washing, peeingl or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure<
• • Advice on safety precautions like wearing gloves when handling soil/manure
• Promoting good nutrition for pregnant women

• Physical and clinical examination
• Clinical diagnosis of Trichuriasis, 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 any complications due to Trichuriasis e.g Viatmin A deficiency, anaemia, rectal prolapse

• Families/parents education on personal hygiene as well as proper disposal of human faeces including children fecal matter
• Health education to parents/families on Trichuriasis and prevention measures in children
• Health workers education on Trichuriasis including prevention measures and its management in children

• Guidance to parents on Proper cleaning and cooking of food for the under 5s
• Teaching children on proper handwashing/good hand hygiene practices
• Teaching children on avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter
• Guidance to children on Proper waste disposal-Not passing stool in the soil or outdoors
• Guidance to parents to 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 before giving children
• Taking safety precautions for children like wearing gloves when handling soil/manure
• Promoting good nutrition for children

• Anthelmintic

• Health education to primary school age children on Trichuriasis and prevention measures
• School children education on personal hygiene as well as proper disposal of human faeces
• School health programs/outreaches
• Deworming of school children
• Health workers training on Trichuriasis including prevention measures and management among school children

• Guidance to parents on proper cleaning and cooking of food for school age children
• Guidance to school age children on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• Guidance on Avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter
• Proper waste disposal-Not passing stool in the soil or outdoors
• Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
• Taking safety precautions like wearing gloves when handling soil/manure
• Provide guidance on good nutrition for school age children

• Anthelmintic

• Health education for adolescents on Trichuriasis and prevention measures
• • Adolescents education on personal hygiene as well as proper disposal of human faeces
• Health workers training on Trichuriasis including prevention measures and management among the adolescents

• Guidence to adolescents on proper cleaning and cooking of food
• Guidance adolescents on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• Guidance on Avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter
• Proper waste disposal-Not passing stool in the soil or outdoors
• Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
• Provide guidance on good nutrition for adolescents

• Physical and clinical examination
• Clinical diagnosis of Trichuriasis, based on history of passage of a live worm in faeces, abdominal pain while others may have cough, difficulty in breathing or fever
• Supportive therapy including relieve of any abdominal pain with painkillers; nutritional support (proper nutrition)
• Treatment using Anthelminthic medications such as albendazole and mebendazole
• Diagnostic tests

• Microscopy–stool for identifying trichuris eggs
• Endoscopy to see adult worms in GIT

• Prevention and management of complications e.g iron deficiency anaemia, rectal prolapse

• • Health education to adults persons/families and communities on Trichuriasis and prevention measures
• • • Adult education on personal hygiene as well as proper disposal of human faeces
• awareness on effective sewerage disposal systems
• Health workers education on Trichuriasis including prevention measures and its management in adults

• Guidance for the adults on proper cleaning and cooking of food
• Guidance on proper handwashing/good hand hygiene practices before handing food and after handling soil/manure
• Guidance on Avoidance of consuming or getting into contact with soil that may be contaminated with human feacal matter
• Proper waste disposal-Not passing stool in the soil or outdoors
• Wash, peel or cook all raw vegetables and fruits before eating, particularly those that have been grown in soil that has been fertilized with manure
• Taking safety precautions like wearing gloves when handling soil/manure
• Provide guidance on good nutrition for adults

• Physical and clinical examination
• Clinical diagnosis of Trichuriasis, based on history of passage of a live worm in faeces, abdominal pain while others may have cough, difficulty in breathing or fever
• Supportive therapy including relieve of any abdominal pain with painkillers; nutritional support (proper nutrition)
• Treatment using Anthelminthic medications such as albendazole and mebendazole
• Diagnostic tests

• Microscopy–stool for identifying trichuris eggs
• Endoscopy to see adult worms in GIT

• Prevention and management of complications e.g iron deficiency anaemia, rectal prolapse

• 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

• create awareness on birth aspyxia
• Health Education to pregnanct women on birth asphyxia
• Health education to pregancnt women on the need for ANC
• promote eraly health seeking behaviour
• Educate pregnant women on the need for facility births attended by a skilled birth attendant
• Dstribution of IEC materails
• Strengten health workers knowledge on birth asphyxia including management

• Promote ANC attendance
• Promote early initaion of breastfeeding
• promote good maternal nutrition/including nutrition supplementation
• clean and safe delivery
• Infection prevention cand control practices
• Full assessment of all newborns with Apgar score
• Monitoring quality of care and instituting remedial measures
• Timely referall for mothers

• Physical and clinical examination
• ManagEment of neonates with birth asphyxia as per IMCI guidelines
• Antibiotics therapy for neonates with possible severe bacterial infections
• Neonatal resuscitation
• • Dry neonate and place supine under overhead warmer
• *Suctioning of airways
• • Tactile stimulation to encourage spontaneous breathing
• Oxygen therapy,
• • Bag-mask ventilation (Ambu bag) for non-responsive neonates
• • Chest compression if heart rate does not improve
• Encourage kangaroo mother care /or kangaroo father care
• Nutritional support
• Encourage breastfeeding
• ICU Services -eg for life support where indfdicated
• Tests
• Blood tests -eg blood gases
• • Ultrasound
• CT scan
• MRI
• Electro-encephalogram EEG

• Health Education to pregnant women to create awareness on birth asphyxia
• Health education to pregnant women on the need for regular ANC and skilled birth attendance
• Promote early health seeking behaviour
• Strengthen health workers knowledge on birth asphyxia including management

• Educate pregnant women to deliver at health facility by skilled birth attendant * Full assessment of all newborn with Apgar score
• Monitoring quality of care and instituting remedial measures
• Timely referral for mothers
• Use partograph for labour monitoring.
• Ensure supportive 2nd stage management based on foetal and maternal condition.
• Manage pre-eclampsia correctly.

• History and physical examination
• Dry neonate and place supine under overhead warmer
• Antibiotics therapy for neonates with possible severe bacterial infections
• Neonatal resuscitation including oxygen therapy
• Suctioning of airways
• Tactile stimulation to encourage spontaneous breathing
• Bag-mask ventilation (Ambu bag) for non-responsive neonates
• Chest compression if heart rate does not improve
• Encourage kangaroo mother care /or kangaroo father care
• ICU Services -e.g. for life support where indicated
• Laboratory tests e.g. blood gases analysis,
• Imaging modalities such as ultrasound, CT scan, MRI
• Electroencephalogram (EEG)

• Clinical examination
• Physical examination
• Nutritional support
• antibitics terapy where indicated
• safe transportation of small babies
• Encourage KFC and /or KMC
• ICU support where indicated
• Laboratory services /invstigations that include but are not limited to:
• blood film microscopy,
• blood group and cross-match,
• blood chemistry, CSF and stool and urine microscopy, gram stain,
• Imaging modalities including
• x-ray
• ultra-sound
• MRI

• Educate pregnant women on the need for facility births attended by a skilled birth attendant

• Check the mother for adequate pelvis, correlate maternal height to pelvis size to identify those in high risk (narrow pelvis, big babies, etc.) * Ultrasound examination for gestational age, foetal presentation and foetal weight for early identification

• Admit to SBCU for intensive care management
• Imaging modalities including x-ray, ultrasound, MRI and CT scan
• Laboratory investigations as indicated * Blood grouping and transfusion if indicated

• Education of pregnant women on infant and child feeding

• Exclusive breastfeeding

• Treat iodine deficiency cases with iodide with or without levothyroxine
• Plan for sugery for pregnant women with large goiters after delivery

• Treat iodine deficiency cases with iodide with or without levothyroxine

• Treat iodine deficiency cases with iodide with or without levothyroxine

• Treat iodine deficiency cases with iodide with or without levothyroxine
• Plan for surgery in cases with large goiters

• Treat iodine deficiency cases with iodide with or without levothyroxine
• Plan for surgery in cases with large goiters

• Treat iodine deficiency cases with iodide with or without levothyroxine
• Plan for surgery in cases with large goiters

• Education of mothers and other care givers about signs and symptoms of neonatal infection
• Education of mothers on improtance of exclusive breastfeeding
• Education of mothers and other care givers and good hygienic practices
• Education of mothers and other care givers on umbilical cord care

• Start neonates with foul smelling amniotic fluid at birth with antibiotics for anaerobic infections (Clindamycin or Metronidazole)
• Full blood count, Blood urine and CSF cultures for all neonates with suspicion of sepsis  
• Refer neonates with suspicion of sepsis to next level if facilities for full investigations are not available 

• Start treatment with ampicillin or penicillin G plus an aminoglycoside Add Cefotaxime if meningitis is suspected
• Treat with appropriate antibiotics based on culture resultsLaboratory services that include but are not limited to Blood
• Nutritional support.
• Early initiation and exclusive breastfeeding.
• Neonatal High dependency unit services
• Neonatal ICU services

• Education of mothers and other caregivers about signs and symptoms of neonatal infection using job aides
• Education of mothers on importance of facility delivery, exclusive breastfeeding, good hygienic practices, care of the umbilical cord.

• Training of health workers on the nine steps on essential newborn care to prevent neonatal sepsis

• Antibiotics
• IV hydration
• Oxygen support
• Blood products transfusion
• Vasopressor agents

• Education of pregnant women on infant and child feeding

• Health education on timely complementary feeding and good hygiene practices

• Educate mothers on feeding of children through provision of practical examples using local foods
• Treat existing infections in severe cases Provide macronutrients for severe cases by appropriate means (orally, feeding tube, nasogastric tube, gastrostomy tube)
• Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide children with multivitamin supplement
• Treat mild to moderate cases with balanced oral diet Correct fluid and electrolyte imbalances for severe cases
• Provide lactose free liquid oral food supplements if solid food cannot be adequately ingested Provide children with multivitamin supplement

• Health education on timely complementary feeding and good hygiene practices

• F-75 and F-100 therapeutic milks
• Ready-to-use therapeutic food (RUTF)
• Vitamin A supplementation
• Folic acid
• Deworming
• Antibiotics
• Measles vaccination
• Antimalarial
• Local foods for complementary feeding and nutrition

• 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

• Health education to communities and to mothers on preterm birth complications including prevention measures
• Education of pregnant women on signs and symptoms of labor
• Education of pregnant women on what to do when signs and symptoms of labor occur
• Provision of antenatal care for all pregnant women with screening for pre-eclampsia and other risk factors for preterm labor
• Education on Kangaroo mother care and Kangaroo Father care

• Clinical and physical examination
• Administration of tocolytic agents to women 34 weeks or less in early preterm labour
• Administration of corticosteroids to women in preterm labour who are 34 weeks or less
• Neonatal resuscitation for preterm deliveries by a qualified personeel (neonatologist)
• Nutritional support for premature babies
• High dependency unit services for premature babies
• Neonatal ICU services for premature babies
• Transfer all preterm babies to neonatal intensive care unit after delivery for assessment

• Physical and Clinical examination
• Assessment and follow up of preterm neonates for complications of prematurity
• Appropriate treatment of any detected complications of prematurity * Intravenous or gavage feeding of preterm neonates born before 34 weeks
• Gradual transition of preterm neonates from intravenous or gavage feeding to breastfeeding
• Education of mothers on care of preterm neonates  including Kangaroo Mother Care
• Use of Kangaroo Mother Care especially in hospitals without neonatal intensive care facilities and during period of observation before discharge

• Family involvement in the routine care of preterm or low-birth-weight infants in health-care facilities

• Manage pre-eclampsia correctly
• Corticosteroids
• Tocolytics
• Magnesium sulphate

• Immediate Kangaroo mother care (KMC)
• Expressed mother’s own milk feeding by cups, nasogastric tubes
• Enteral iron supplementation
• Continuous positive airway pressure (CPAP) therapy
• Caffeine or other methylxanthines (aminophylline or theophylline)

• Education of pregnant women on infant and child feeding

• Exclusive breastfeeding

• Physical and clinical assessmnet
• Guidance to parents/families on feeding child with 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

• Periodic vitamin A supplementation

• Vitamin A
• Vitamin A-rich foods

• Physical and clinical assessmnet
• Guidance to adolescents 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

• Physical and clinical assessmnet
• Guidance to adults on eating viatmin A rich foods eg eg, liver, beef, oily fish, chicken, eggs, fortified milk, carrots, mangoes, sweet potatoes and leafy green vegetables.
• Treat Vitamin A deficiency with Vitamin A supplemnts
• Treating underlying causes /conditions
• Follow up

• 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

• Health education on recognition of risk factors, signs and symptoms of colon and rectal cancer and leading healthy life style

• Regular colorectal cancer screening to those with high risk

• Staging and grading
• Chemotherapy
• Targeted drug therapy
• Immunotherapy
• Surgery
• Radiotherapy

• Health education on recognition of risk factors, signs and symptoms of colon and rectal caner

• Staging and grading
• Chemotherapy
• Targeted drug therapy
• Immunotherapy
• Surgery
• Radiotherapy

• Chemotherapy
• Targeted therapy
• Immunotherapy
• Bone marrow or Stem cell transplantation
• Radiotherapy

• Chemotherapy
• Targeted therapy
• Immunotherapy
• Bone marrow or Stem cell transplantation
• Radiotherapy

• Health education on early identification of signs and symptoms of leukaemia

• Chemotherapy
• Targeted therapy
• Immunotherapy
• Bone marrow or Stem cell transplantation
• Radiotherapy

• Assess people with anaemia or easy bruising and bleeding or recurrent infection where benign causes have been excluded for leukaemia

• Assess people with anaemia or easy bruising and bleeding or recurrent infection where benign causes have been excluded for leukaemia

• Health education on early identification of signs and symptoms of respiratory tract cancers

• Annual lung cancer screening with Low dose CT (LDCT) scan for high risk population
• Counselling support to quit smoking

• Staging and grading
• Chemotherapy
• Targeted drug therapy
• Surgery
• Radiotherapy

• Annual lung cancer screening with Low dose CT (LDCT) scan for high risk population
• Counselling support to quit smoking

• Staging and grading
• Chemotherapy
• Targeted drug therapy
• Surgery
• Radiotherapy

• Health education on recognition of risk factors, signs and symptoms of stomach caner

• Prompt treatment of ulcers and infections especially H. pylori

• Staging and grading
• Chemotherapy
• Targeted drug therapy
• Immunotherapy
• Surgery
• Radiotherapy

• Health education on recognition of risk factors, signs and symptoms of stomach caner

• Assessment of people with persistent dyspepsia for stomach cancer

• Staging and grading
• Chemotherapy
• Targeted drug therapy
• Immunotherapy
• Surgery
• Radiotherapy

• Guidance on Preventive measures which involves healthy habits such as:
• Eat healthy and nutritious food
• Avoidance of alcohol
• exercises
• Visit doctor for regular examination
• screening for Breast cancer eg through physical examination
• Guidance on self breast examination

Health education on prevention and management of breast cancer

• Regular screening with mammogram

• Health education on prevention and management of breast cancer

• Regular screening with mammogram

• Create awreness on cervix-uteri cancer; risk factors and preventon measure
• Health and Wellness education on
• diet management,
• regular exercise, weight management,
• reduced exposure to radiation,
• reducing alcohol intake and
• avoiding smoking or exposure to tobacco smoke
• Reproductive health education on the benefit safe sex practices including use of condoms

• Guidance on primary prevention measures incluing :
• safe sex practices (use of condom)
• avoidance of smoking (benzyenes are known to damage the cervix)
• Guidance on self observance and taking note of any unusual symptoms eg bleeding between periods; abnormal discharge
• HPV vaccine
• Routine cervical cancer screening

• Create awareness on cervix-uteri cancer, risk factors and prevention measures
• Health and Wellness education on
• diet management,
• regular exercise, weight management,
• reduced exposure to radiation,
• reducing alcohol intake and
• avoiding smoking or exposure to tobacco smoke
• Reproductive health education on the benefit safe sex practices including use of condoms

• Guidance on primary prevention measures incluing :
• Absitence from sex for the aldolesents or safe sex practices (use of condom)
• avoidance of smoking (benzyenes are known to damage the cervix)
• Guidance on self observance and taking note of any unusual symptoms eg bleeding between periods; abnormal discharge
• HPV vaccination

• Health education on prevention and management of cervical cancer

• Screening and treatment of precancerous lesions

• Health education on prevention and management of cervical cancer

• Screening and treatment of precancerous lesions

• Health education on early identification of malaria symptoms and early treatment

• Early identification and treatment of malaria
• Insecticide treated bed net for malaria cases

• Early identification and treatment of malaria
• Insecticide treated bed net for malaria cases

• Health education on early identification of malaria symptoms and early treatment

• Early identification and treatment of malaria
• Insecticide treated bed net for malaria cases

• Health education on early identification of malaria symptoms and early treatment

• Early identification and treatment of malaria
• Insecticide treated bed net for malaria cases

• Health education on early identification of malaria symptoms and early treatment

• Early identification and treatment of malaria
• Insecticide treated bed net for malaria cases

• 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.)

• Health education to parents, families and communities on NTDs prevention measures such as personal hygiene as well as proper disposal of human faeces including children fecal matter

• Periodical deworming to eliminate infecting worms,
• Health education to prevent re-infection,
• Improved sanitation to reduce soil contamination with infective eggs.
• Mass drug administration to infected community

• 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

• Improved water sanitation and hygiene in the community

• Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)

• Improved water sanitation and hygiene in the community

• Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)

• Improved water sanitation and hygiene in the community

• Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)

• Improved water sanitation and hygiene in the community

• Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)

• Improved water sanitation and hygiene in the community

• Hygiene in the slaughtering of livestock (including the proper destruction of infected offal)