The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
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Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se...verely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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The disease burden caused by poor water, sanitation and hygiene is significant. For instance, soil transmitted helminthes (hookworm, roundworm, ringworm) infest approximately two billion people. Shistosomiasis infects and debilitates 200 million people. Trachoma, a disease related to poor sanitation... and hygiene which can cause blindness, infects five million people. However, the most serious health impact of poor WASH is diarrheal disease, particularly on children.
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The Panorama Perspectives: Conversations on Planetary Health report series aims to inspire new thinking, conversations, and engagement with planetary health and other integrated concepts. Collaboration and open knowledge sharing across sectors are necessary to solve the complex global health and dev...elopment problems of today. These reports are intended as practical tools, presenting actionable opportunities to advance planetary health.Each report expands on knowledge gathered from many sources, including analysis of publicly available reports and data; forums and events; group discussions; and individual conversations
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The World Heart Federation (WHF) Roadmap series covers a large range of cardiovascular conditions. These Roadmaps identify potential roadblocks and their solutions to improve the prevention, detection and management of cardiovascular diseases and provide a generic global framework available for loca...l adaptation. A first Roadmap on raised blood pressure was published in 2015. Since then, advances in hypertension have included the publication of new clinical guidelines (AHA/ACC; ESC; ESH/ISH); the launch of the WHO Global HEARTS Initiative in 2016 and the associated Resolve to Save Lives (RTSL) initiative in 2017; the inclusion of single-pill combinations on the WHO Essential
Medicines’ list as well as various advances in technology, in particular telemedicine and mobile health. Given the substantial benefit accrued from effective interventions in the management of hypertension and their potential for scalability in low and middle-income countries (LMICs), the WHF has now revisited and updated the ‘Roadmap for raised BP’ as ‘Roadmap for hypertension’
by incorporating new developments in science and policy. Even though cost-effective lifestyle and medical interventions to prevent and manage hypertension exist, uptake is still low, particularly in resource-poor areas. This Roadmap examined the roadblocks pertaining to both the demand side (demographic and socio-economic factors, knowledge and beliefs, social relations, norms, and
traditions) and the supply side (health systems resources and processes) along the patient pathway to propose a range of possible solutions to overcoming them. Those include the development of population-wide prevention and control programmes; the implementation of opportunistic screening and of out-of-office blood pressure measurements; the strengthening of primary care and a greater focus on task sharing and team-based care; the delivery of people-centred care and stronger patient and carer education; and the facilitation of adherence to treatment. All of the above are dependent upon the availability and effective distribution of good quality, evidencebased, inexpensive BP-lowering agents.
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The unmet need for palliative care in Cox’s Bazar
The policy brief focuses on four key areas for intervention - air pollution, energy, transport and food systems. Air pollution causes 7 million deaths annually, and is a leading cause of both NCDs and climate change, thus all interventions to reduce air pollution have a positive impact on both human... and planetary health. In the energy sector, transition from fossil fuels to renewable energy is if vital importance to improving health, with mortality rates due to coal-generated electricity 1,000 times higher than for wind-generated electricity.
Promoting active transport such as walking and cycling in place of motorised transport has the dual benefit of reducing both air pollution and physical activity. Livestock production alone accounts for 18% of greenhouse gas emissions, with added emissions from food which are highly process and transported over long distances, and thus locally sourced plant based diets both prevent NCDs and promote human and planetary health.
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Nature Medicine, https://doi.org/10.1038/s41591-021-01283-z
Sub-Saharan African Journal of Medicine: Year : 2014 | Volume : 1 | Issue : 1 | Page : 1-14
BMC Medicine (2015) 13:42 DOI 10.1186/s12916-014-0263-6
In the wake of the Covid‑19 Pandemic, parts of the public health system at increased risk of reduced efficiency include healthcare services for women and children. This in turn could reverse all the progress achieved over the years in reducing maternal and child mortality. In th...is study, an attempt has been made to assess the indirect effect of the pandemic on maternal and child health services in public health facilities.
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The growing understanding of how sequence information can contribute to improved public health is driving global investments in sequencing facilities and programmes. The falling cost and complexity of generating GSD provides opportunities for expanding sequencing capacity; however, challenges to wid...espread implementation remain. This document provides policy-makers and stakeholders with guidance on how to maximize the public health benefit of SARS-CoV-2 genomic sequencing activities in the short and long term as the pandemic continues to unfold. Practical considerations for the implementation of a virus genomic sequencing programme and an overview of the public health objectives of genomic sequencing are covered. This guidance focuses on SARS-CoV-2 but is applicable to other pathogens of public health concern.
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Guidelines for the use of oxygen in patients with COVID 19
The latest update (28 January 2021) includes the following addition and revision:
biosafety aspects for working with antigen-detecting rapid diagnostic test;
handling new variants of SARS-CoV-2 in the laboratory;
updated assay decontamination before disposal;
personal protectiv...e equipment (PPE) for specimen collection;
addressing chemical hazards and their safe disposal; and
the fourth edition of the WHO Laboratory Biosafety Manual (LBM4) is now available and the terminology in this guidance was aligned with the LBM4.
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The publication of the of the Antimicrobial Treatment Guidelines represents the
culmination of the efforts of the Antimicrobial Stewardship Program of ICMR to publish treatment guidelines for common syndromes in India. These guidelines are targeted for the health care settings. It aims to rationali...ze the usage of antibiotics on our Essential Medicines Formulary (EMF) and to establish consistency in the treatment of various infectious conditions.
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The new WHO guidelines provide recommended steps for safe phlebotomy and reiterate accepted principles for drawing, collecting blood and transporting blood to laboratories/blood banks.
This brief considers the rationale for shielding individuals at high risk of severe disease or death from COVID-19 in low- and middleincome countries. It provides an overview of proposed approaches to shielding, discusses the categories of individuals who may be identified for shielding, and outline...s the likely difficulties of these measures and ways to mitigate them.
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The focus of the current quarterly edition of Eurohealth (from the European Observatory on Health Systems and Policies) is Antimicrobial Resistance (AMR) and contains the following articles:
• Strengthening implementation of AMR national action plans
• Fostering clinical developmen...t and commercialisation of novel antibiotics
• Tackling AMR in the community
• Quantifying the benefits of vaccines in combating AMR
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The second edition of the joint WHO, WIPO and WTO
publication “Promoting Access to Medical Technologies
and Innovation: Intersections between public health,
intellectual property and trade” (the Trilateral Study),*
published in 2020, included a special insert mappi...ng the
challenges posed by the COVID-19 pandemic in relation
to the integrated health, trade and IP policy framework set
out in the study. The Trilateral Study and the special insert
were designed to serve as background reference for policy-
makers in the widest sense – lawmakers, government
officials, delegates to international organizations, non-
governmental organizations (NGOs) and researchers
who seek a comprehensive presentation of the full range
of issues, including institutions and legal concepts with
which they may be unfamiliar. It is also designed to serve
as a factual resource for the three organizations’ technical
cooperation activities.
This update revises the information contained in that
insert in the light of more recent developments as of
30 August 2021. Further updates will be made to reflect
subsequent developments.
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This policy brief identifies and explains the main reasons behind the rise of antimicrobial resistance (AMR) associated with improper use of antibiotics in the livestock sector. Focusing on the low- and middle- income country setting, this brief provides recommendations for a deliberated policy stra...tegy aimed to prevent healthcare crisis that could happen as a result of AMR.
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