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Most HBV-associated deaths among adults are secondary to infections acquired at birth or in the first five years of life.To extend the guideline for the prevention of mother-to-child transmission of the hepatitis B virus to include antiviral prophylaxis.The guideline was developed by the World Health Organization (WHO) in accordance with WHO standards. The summary was translated into German by employees of the WHO Collaborating Centre at Danube University Krems (Austria).In addition to the recommendation to test pregnant women for heptatitis B virus (HBV) and vaccinate newborns against hepatitis B as soon as possible after birth, two new recommendations have been formulated: pregnant women testing positive for HBV infection should receive tenofovir prophylaxis to prevent mother-to-child transmission of HBV. WHO recommends that in settings in which antenatal HBV DNA testing is not available, HBeAg testing can be used as an alternative to determine eligibility for tenofovir prophylaxis.Die meisten Hepatitis-B-Virus-assoziierten Todesfälle bei Erwachsenen sind die Folge von Infektionen, die diese bereits bei ihrer Geburt oder in den ersten fünf Lebensjahren erworben haben. ZIEL: Die Erweiterung der Leitlinie zur Prävention der Mutter-zu-Kind-Übertragung des Hepatitis-B-Virus um antivirale Prophylaxe.Die Leitlinie wurde von der Weltgesundheitsorganisation (WHO) gemäß WHO-Standards umgesetzt. Die Zusammenfassung wurde durch ein Team des WHO Collaborating Centre an der Donau-Universität Krems (Österreich) auf Deutsch übersetzt.Neben der Empfehlung, schwangere Frauen auf das Hepatitis-B-Virus (HBV) zu testen und Neugeborene so bald wie möglich nach der Geburt gegen Hepatitis B zu impfen, wurden zwei neue Empfehlungen formuliert: Schwangere, die positiv auf eine HBV-Infektion getestet werden, sollen eine Tenofovir-Prophylaxe erhalten. Die WHO empfiehlt in Settings, wo keine vorgeburtliche HBV-DNA-Bestimmung verfügbar ist, das Testen auf HBeAg als Alternative. Damit soll die Eignung für eine Tenofovir-Prophylaxe beurteilt werden.

Early childhood is a time during which a child's habits are formed and family lifestyle habits are open to changes and adaptations.This guideline provides recommendations on the amount of time during the 24 hours of a day that young children, under 5 years of age, should spend being physically active or sleeping for their health and wellbeing.The guideline was developed by the World Health Organization (WHO) in accordance with WHO standards. The summary was translated into German by employees of the WHO Collaborating Center at Danube University Krems (Austria).A day consists of sleep time, sedentary time and physical activity of light, moderate or vigorous intensity. Young children should have opportunities to participate in a range of developmentally appropriate, safe, enjoyable play-based physical activities.Die frühe Kindheit ist eine Zeit in der sich Verhaltensweisen formen und Familien für Änderungen des Lebensstils offen sind. ZIEL: Diese Leitlinie gibt Empfehlungen wie viele Stunden Kleinkinder unter 5 Jahren innerhalb von 24 Stunden körperlich aktiv sein oder schlafen sollen, um ihre Gesundheit und ihr Wohlbefinden zu fördern.Die Leitlinie wurde von der Weltgesundheitsorganisation (WHO) gemäß WHO-Standards umgesetzt. Die Zusammenfassung wurde von Mitarbeiter/innen des WHO Collaborating Centres an der Donau-Universität Krems (Österreich) auf Deutsch übersetzt.Jeder Tag besteht aus Schlafenszeit, niedrig-aktiven Phasen (Sitzen, Stehen, Liegen) und leichter, mäßiger oder kräftiger körperliche Aktivität. Kleine Kinder sollten die Möglichkeit haben, sich an entwicklungsgerechter, sicherer und spielbasierter körperlicher Aktivität zu beteiligen und nicht länger als eine Stunde am Stück von Bewegung abgehalten werden.

During the COVID-19 pandemic, many health-related questions require rapid answers. In the Competence Network Public Health COVID-19, founded by representatives of several scientific societies in March 2020, rapid reviews are often conducted to generate evidence-based answers that are useful for policy makers. The aim of this paper is to reflect on the practical experience with rapid reviews in the context of the Competence Network Public Health. Methods for high-quality and practicable implementation of rapid reviews were developed, which are particularly helpful for rapid evidence generation based on observational studies.Using the 8-step approach proposed by Tricco et al. [1], we describe the acute challenges that have arisen in the Public Health Competence Network COVID-19 while conducting rapid reviews on public health-related issues related to the COVID-19-pandemic. The 8 steps are: 1. conceptualization of the research question, 2. literature search, 3. title/abstract and full text screening, 4. data extraction, 5. risk of bias assessment, 6. evidence synthesis, 7. dissemination, 8. update. We develop a methodological approach for conducting rapid reviews by expert consensus of the members (n=42 as of 01/28/2021) of the Rapid Reviews Working Group in the Competence Network Public Health COVID-19.A standardized approach is presented that closely follows the approach of the Cochrane Rapid Reviews Methods Group and takes into account the special requirements of etiological - but often also ecological - observational studies on COVID-19.The proposed approach for conducting rapid reviews can form an important basis for evidence-based policy advice - certainly beyond questions related to COVID-19. Flexible and rapid funding concepts should be made available for the short-term realization of methodologically high-quality rapid reviews on emerging questions. Scientific cooperation in conducting rapid reviews needs to be expanded, and more methodologically high-quality approaches such as prospective meta-analyses should be used.ZIEL: Im Zuge der COVID-19-Pandemie benötigen viele gesundheitsrelevante Fragestellungen rasche Antworten. Im Kompetenznetz Public Health zu COVID-19, das im März 2020 von Vertreter:innen mehrerer wissenschaftlicher Fachgesellschaften gegründet wurde, werden vielfach Rapid Reviews erstellt, um rasch evidenzbasierte, für politische Entscheidungsträger:innen nutzbare Antworten zu generieren. Ziel dieses Beitrags ist es, die praktischen Erfahrungen bei der Durchführung von Rapid Reviews im Rahmen des Kompetenznetzes Public Health zu reflektieren. Auf dieser Grundlage sollen Methoden zur qualitativ hochwertigen und praktikablen Durchführung von Rapid Reviews entwickelt werden, die insbesondere auch zur raschen Evidenzgenerierung auf der Grundlage von Beobachtungsstudien anwendbar sind.Unter Nutzung des von Tricco et al. [1] vorgeschlagenen 8-schrittigen Vorgehens werden die aktuellen Herausforderungen beschrieben, die sich im Kompetenznetz Public Health zu COVID-19 bei der Durchführung von Rapid Reviews zu Public Health-bezogenen Fragen der COVID-19-Pandemie ergeben haben. Die 8 Schritte lauten: 1. Formulierung der Fragestellung, 2. Literatursuche, 3. Titel-Abstract- und Volltextsichtung, 4. Datenextraktion, 5. Risk of Bias-Bewertung, 6. Evidenzsynthese, 7. Dissemination, 8. Aktualisierung. Zudem werden Lösungsvorschläge im Expert:innenkonsens der Mitglieder (n=42 zum 28.01.2021) der Querschnitts-AG Rapid Reviews des Kompetenznetzes Public Health zu COVID-19 entwickelt.Vorgelegt und zur Diskussion gestellt wird ein standardisiertes Vorgehen, das sich eng an das Vorgehen der Cochrane Rapid Reviews Methods Group anlehnt und den besonderen Anforderungen von ätiologisch orientierten, häufig auch ökologischen Beobachtungsstudien zu COVID-19 Rechnung trägt.Das vorgeschlagene Vorgehen bei der Durchführung von Rapid Reviews kann – ggf. über Fragestellungen zu COVID-19 hinaus – eine wichtige Grundlage einer evidenzbasierten Politikberatung bilden. Zur kurzfristigen Realisierung von methodisch hochwertigen Rapid Reviews zu neuen Fragestellungen sollten flexible und kurzfristig aktivierbare Förderkonzepte bereitgestellt werden. Wissenschaftliche Kooperationen bei der Durchführung von Rapid Reviews sollten ausgebaut werden, dabei sollten verstärkt methodisch hochwertige Ansätze wie bspw. prospektive Metaanalysen Anwendung finden.

Despite considerable progress in the fight against tuberculosis, it is still the most deadly bacterial infectious disease worldwide. Every year, up to 10 million people worldwide still die of tuberculosis. The World Health Assembly has set itself the goal of reducing the number of tuberculosis deaths by 90% and the number of new infections by 80% by 2030. Prevention and infection control measures in public health facilities and wherever the risk of transmission of the tuberculosis bacterium "Mycobacterium tuberculosis" is high are especially important.The aim of the guideline is to provide updated and evidence-based recommendations for public health measures to prevent the spread of the tuberculosis bacterium in clinical settings and in tuberculosis management.The World Health Organization (WHO) developed these recommendations according to the methods outlined in the WHO handbook for guideline development. This publication is a summary of the most important aspects of this guideline translated into German by members of the WHO Collaborating Centre at the Danube University Krems (Austria).This guideline takes into account the current evidence base and provides recommendations and comments on the implementation of tuberculosis prevention and control measures at the level of health care institutions and at the national level.Trotz beachtlicher Fortschritte im Kampf gegen Tuberkulose, stellt diese nach wie vor die am häufigsten zum Tode führende bakterielle Infektionskrankheit weltweit dar. Jedes Jahr versterben weltweit nach wie vor bis zu 10 Mio. Menschen an Tuberkulose. Die World Health Assembly hat es sich zum Ziel gesetzt die Zahl der Tuberkulose-Toten bis zum Jahr 2030 um 90% zu senken, die Zahl der Neuansteckungen um 80%. Hierbei sollte besonderes auf Maßnahmen zur Prävention und Infektionskontrolle in öffentlichen Gesundheitseinrichtungen und überall dort, wo das Übertragungsrisiko für das Tuberkulose-Bakterium „Mycobacterium tuberculosis“ hoch ist, gesetzt werden.Ziel ist es aktualisierte und evidenzbasierte Empfehlungen für Public Health Maßnahmen zu geben, um die Ausbreitung des Tuberkulose-Bakteriums im klinischen Setting und im Tuberkulose-Management vorzubeugen.Die Leitlinie wurde von der Weltgesundheitsorganisation (WHO) gemäß der im WHO Handbuch zur Leitlinienentwicklung empfohlene Methode umgesetzt. Die vorliegende Publikation fasst die wichtigsten Punkte der Leitlinie zusammen und wurde von Mitarbeiterinnen und Mitarbeitern des WHO Collaborating Centre an der Donau-Universität Krems (Österreich) auf Deutsch übersetzt.Diese Leitlinie berücksichtigt die aktuelle Studienlage und gibt Empfehlungen und Anmerkungen zur Umsetzung von Tuberkuloseprävention- und kontrolle auf Ebene von Gesundheitseinrichtungen sowie auf nationaler Ebene.

The aim of this paper is to describe a conceptual framework for how to consider health equity in the Grading Recommendations Assessment and Development Evidence (GRADE) guideline development process.Consensus-based guidance developed by the GRADE working group members and other methodologists. This is a German translation of the original paper published in English.We developed consensus-based guidance to help address health equity when rating the certainty of synthesized evidence (i.e., quality of evidence). When health inequity is determined to be a concern by stakeholders, we propose five methods for explicitly assessing health equity: (1) include health equity as an outcome; (2) consider patient-important outcomes relevant to health equity; (3) assess differences in the relative effect size of the treatment; (4) assess differences in baseline risk and the differing impacts on absolute effects; and (5) assess indirectness of evidence to disadvantaged populations and/or settings.The most important priority for research on health inequity and guidelines is to identify and document examples where health equity has been considered explicitly in guidelines. Although there is a weak scientific evidence base for assessing health equity, this should not discourage the explicit consideration of how guidelines and recommendations affect the most vulnerable members of society.

To provide guidance on how systematic review authors, guideline developers, and health technology assessment practitioners should approach the use of the risk of bias in nonrandomized studies of interventions (ROBINS-I) tool as a part of GRADE's certainty rating process.The study design and setting comprised iterative discussions, testing in systematic reviews, and presentation at GRADE working group meetings with feedback from the GRADE working group.We describe where to start the initial assessment of a body of evidence with the use of ROBINS-I and where one would anticipate the final rating would end up. The GRADE accounted for issues that mitigate concerns about confounding and selection bias by introducing the upgrading domains: large effects, dose-effect relations, and when plausible residual confounders or other biases increase certainty. They will need to be considered in an assessment of a body of evidence when using ROBINS-I.The use of ROBINS-I in GRADE assessments may allow for a better comparison of evidence from randomized controlled trials (RCTs) and nonrandomized studies (NRSs) because they are placed on a common metric for risk of bias. Challenges remain, including appropriate presentation of evidence from RCTs and NRSs for decision-making and how to optimally integrate RCTs and NRSs in an evidence assessment.

Breastfeeding is one of the foundations of child health, development, and survival. Despite extensive evidence that lack of breastfeeding is associated with higher mortality rates and other long-term negative health outcomes, less than half of all babies under the age of 6 months are breastfed worldwide. Breastfeeding counselling is one of the key interventions, to improve breastfeeding rates.The objective of this guideline is to give recommendations on how to implement breastfeeding counselling to improve breastfeeding practices.This guideline was developed by the World Health Organization (WHO) according to the methods outlined in the WHO handbook for guideline development. This publication is a summary of the most important aspects of this guideline translated into German by members of the WHO Collaborating Centre at the Danube University Krems (Austria).This guideline is based on current evidence and gives recommendations and makes comments on the implementation of breastfeeding counselling, such as frequency, timing, or mode and provider of breastfeeding counselling to improve breastfeeding practices. The scope of the guideline is limited to this intervention.Stillen ist eine wichtige Grundlage für die Gesundheit und Entwicklung eines Kindes, in manchen Teilen der Welt auch für das Überleben eines Kindes. Trotz umfangreicher Belege dafür, dass Nicht-Stillen global mit erhöhter Mortalität und langfristigen gesundheitsschädlichen Auswirkungen assoziiert ist, werden weniger als die Hälfte aller Kinder weltweit in den ersten 6 Monaten ausschließlich gestillt. Stillberatung ist eine maßgebliche Intervention, um die Stillraten zu erhöhen.Ziel dieser Leitlinie ist es, Empfehlungen zur Umsetzung von Stillberatung zu geben, um die Stillpraktiken von Müttern zu verbessern.Die Leitlinie wurde von der Weltgesundheitsorganisation (WHO) gemäß der im WHO-Handbuch zur Leitlinienentwicklung empfohlenen Methode umgesetzt. Die vorliegende Publikation umfasst die wichtigsten Aspekte der Leitlinie und wurde vom WHO Collaborating Centre an der Donau-Universität Krems (Österreich) auf Deutsch übersetzt.Diese Leitlinie berücksichtigt die aktuelle Evidenz und gibt Empfehlungen und Anmerkungen zur Umsetzung von Stillberatung, wie bspw. zur Häufigkeit, zum optimalen Zeitpunkt, oder zur Art und zu den Anbietern von Stillberatung, um Stillpraktiken zu verbessern. Der Umfang der Leitlinie ist auf diese Umsetzungs-Details beschränkt.

To provide guidance for guideline developers on how to consider health equity at key stages of the guideline development process.Literature review followed by group discussions and consensus building.The key stages at which guideline developers could consider equity include setting priorities, guideline group membership, identifying the target audience(s), generating the guideline questions, considering the importance of outcomes and interventions, deciding what evidence to include and searching for evidence, summarizing the evidence and considering additional information, wording of recommendations, and evaluation and use. We provide examples of how guidelines have actually considered equity at each of these stages.Guideline projects should consider the aforementioned suggestions for recommendations that are equity sensitive.

This article introduces the rationale and methods for explicitly considering health equity in the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology for developing clinical, public health, and health system guidelines. This article is a German translation of the original version published in English.We searched for guideline methodology articles, conceptual articles about health equity, and examples of guidelines that considered health equity explicitly. We held three meetings with GRADE Working Group members and invited comments from the GRADE Working Group listserve.We developed three articles on incorporating equity considerations into the overall approach to guideline development, rating certainty, and assembling the evidence base and evidence to decision and/or recommendation.Clinical and public health guidelines have a role to play in promoting health equity by explicitly considering equity in the process of guideline development.

The Austrian periodic health examination (PHE) was introduced in 1974 as a health insurance benefit and was redesigned for the last time in 2005. Therefore, the aim of this work was to revise the scientific basis of the PHE using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. We updated the scientific evidence of examinations and consultations that are currently part of the PHE and searched and integrated new examinations. We assessed the expectations of the population towards the PHE in three focus groups. A panel of experts developed evidence-based recommendations for the revised PHE. They formulated 26 recommendations on 20 target diseases or risk factors. In comparison to the previous PHE, the panel added screening for abdominal aortic aneurysm, osteoporotic fracture risk, and chronic kidney disease to the recommendations, while screening for asymptomatic bacteriuria, screening for iron deficiency/pernicious anaemia, and risk identification of glaucoma should no longer be included.

In healthcare, the processes, criteria, and evidence that decision makers use to reach their judgments often remain unclear. Decision makers sometimes neglect important criteria, give undue weight to criteria, or do not use the best available evidence to inform their judgments. Thus, the GRADE (Grading of Recommendations Assessment, Development and Evaluation) working group developed a system to support transparent decision making. The purpose of the Evidence-to-Decision (EtD) framework is to help people use evidence in a structured and transparent way to inform decisions in the context of clinical recommendations, coverage decisions, and health system, or public health recommendations and decisions. EtD frameworks include the formulation of the question, an assessment of the evidence, and drawing conclusions. EtD frameworks inform users of recommendations about judgments that were made and the evidence supporting these judgments by making the basis for decisions transparent to target audiences. EtD frameworks also facilitate dissemination of recommendations.