The article investigates the diagnostic capabilities and prevalence of chronic obstructive pulmonary disease (COPD) in primary care settings in northern Brazil. It highlights that COPD is often underdiagnosed and undertreated in resource-limited regions. The study involved 34 general practitioners a...nd used spirometry to evaluate their diagnostic accuracy compared to clinical assessments. Findings revealed significant discrepancies between GP diagnoses and spirometry results, with many false positives and negatives. The study underscores the need for better training and the use of spirometry to improve COPD diagnosis and case-finding in primary care, emphasizing the importance of targeted strategies to enhance healthcare outcomes in developing countries.
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For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE...CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
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Since 2002 the distribution of external funding to reproductive, maternal, newborn, and child health (RMNCH) has become more equitable and better targeted at the poorest countries and those experiencing the highest mortality. The aid envelope is not large enough or well enough concentrated to close ...gaps in domestic government fund ing between the poorest and middle income countries. Donors and governments of low and middle income countries should increase their investments for RMNCH . Donors should further concentrate their funds on the poorest countries and those with the highest maternal, newborn, and child mortality. Investment is also needed to close serious data and methodological gaps for assessing equity of financing between and within countries
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L’utilisation des services de santé de base est l’un des facteurs clefs favorisant une meilleure santé des populations. Conceptuellement, si la qualité des services est l’une des explications du niveau d’utilisation, cette étude a essayé de montrer aussi l’importance d’un ensemble d...’autres facteurs qui devraient être pris en compte pour améliorer la fréquentation des services de santé. Les résultats de cette étude indiquent que pour le dernier épisode de maladie, plus de 92% des malades ont recouru à différentes structures des soins modernes et 7,4% ont fait recours à la médecine traditionnelle. Pour la santé maternelle, l’utilisation des méthodes contraceptives est de 29.5% et 73% d’accouchements ont été assistés par un personnel qualifié. Parmi les 96% des femmes qui ont consulté les services de CPN pendant la grossesse, seulement 24% ont complété les quatre visites standards de CPN.
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A collection of resources on Covid-19 vaccines, including frequently asked questions, continuing medical education, published research, and commentary.
European Scientific Journal March 2015 edition vol.11, No.9 ISSN: 1857 – 7881 (Print) e - ISSN 1857- 7431
Objective: To describe the clinical, therapeutic and outcome aspects of emergency obstetric care at the University Hospital of Parakou in Benin
Am. J. Trop. Med. Hyg., 106 (Suppl 5), 2022, pp. 56–60. Lymphatic filariasis (LF) is a parasitic disease that is a major cause of chronic disability in the developing world. According to the 2021–2030 road map for neglected tropical diseases (NTDs) published by the World Health Organization (WHO...), the global goal for LF is elimination as a public health problem by 2030 through repeated rounds of mass drug administration (MDA). Critical components of any elimination program are monitoring and surveillance. Appropriate assessment tools and methods are needed for each stage of an elimination program; mapping to identify which areas require intervention, monitoring to assess the impact of interventions, and post-intervention surveillance to validate elimination or detect recrudescence.
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The article discusses the significant impact of chronic obstructive pulmonary disease (COPD) as a global health issue, with cigarette smoking as the main risk factor. However, in developing countries, the causes of COPD are often multifactorial, involving environmental tobacco smoke, biomass fuel sm...oke, dust, fumes, childhood illnesses, and tuberculosis (TB). Up to half of COPD patients in these regions are non-smokers. The article emphasizes that while smoking is crucial, other risk factors contribute significantly to COPD, particularly in low- and middle-income countries. It highlights the need for targeted research and public health strategies to address these diverse contributors to COPD, especially in Africa.
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Identificando o risco de acidente vascular cerebral e melhorando desfechos em pacientes com fibrilação atrial na América Latina
DOI: 10.1590/1516-3180.2015.0222110716
Sao Paulo Med J. 2016; 134(6):534-42
Background: Traumatic stress may arise from various incidents often leading to posttraumatic stress disorder (PTSD). The lifetime prevalence of PTSD is estimated at 1% – 2% in Western Europe, 6% – 9% in North America and at just over 10% in countries exposed to long-term
violence. In South Afri...ca, the lifetime prevalence for PTSD in the general population is estimated at 2.3%.
Aim: To examine the prevalence of posttraumatic stress symptomatology and related psychological functioning in a community sample of adolescents.
Setting: Low-socioeconomic communities in KwaZulu-Natal.
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Zule et al. Harm Reduction Journal (2018) 15:44 https://doi.org/10.1186/s12954-018-0249-3
Les infections associées aux soins sont les complications les plus fréquentes qui affectent les patients hospitalisés. L'hygiène des mains est la plus efficace des mesures préventives de ces infections. Cependant, l'observance à ce geste simple parmi les professionnels médico-soignants reste ...faible, souvent inférieure à 40 %. L'hygiène des mains est essentielle à la pratique des soins de tous les professionnels médico-soignants
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Free information about the Ebola virus and how best to treat it, is available from BMJ Best Practice [https://bestpractice.bmj.com/topics/en-gb/1210], the clinical support tool from BMJ, for clinicians working on the frontline in affected rural and urban regions of DR Congo. The information has bee...n reviewed and aligned with WHO guidance.
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New England Journal of Medicne NJM 2020 382, 22
You can download the video here https://medbox.org/document/how-to-obtain-a-nasopharyngeal-swab-specimen-video#GO
For health professionals located outside affected regions, online learning courses from BMJ Learning [http://learning.bmj.com/learning/module-intro/.html?moduleId=10058695] offer guidance on how to recognise who is most at risk and how to manage suspected cases of Ebola in primary care.