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Long Acting Muscarinic Antagonists (LAMA) such as tiotropium and glycopyrronium are used in the management of COPD1. They have been shown to improve lung function, quality of life and exercise tolerance. They have also been associated with reduced COPD-rel
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ated exacerbations, associated hospitalisations and duration of hospital stay. Both the South African Thoracic Society (SATS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD), guidelines recommend the use of long acting anticholinergic drugs (or long acting beta agonists) in moderate to very severe disease as defined by lung function (FEV1). The most up to date guideline, utilizing the GRADE methodology (European Respiratory Society guidelines of 2017), confirms their superiority over long acting β agonists (LABA) as monotherapy for COPD in that LAMA's have demonstrated greater efficacy in terms of exacerbation reduction, with similar safety profile.2 These recommnedations are supported by published peer-reviewed
evidence including individual papers and Cochrane reviews.
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Air pollution exposure—the (in)visible risk factor for respiratory diseases
Bălă, G.P.; Râjnoveanu, R.M.; Tudorache, E. et al.
Environmental Science and Pollution Research
(2021)
CC
There is increasing interest in understanding the role of air pollution as one of the greatest threats to human health worldwide. Nine of 10 individuals breathe air with polluted compounds that have a great impact on lung tissue. The nature of the r
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elationship is complex, and new or updated data are constantly being reported in the literature. The goal of our review was to summarize the most important air pollutants and their impact on the main respiratory diseases (chronic obstructive pulmonary disease, asthma, lung cancer, idiopathic pulmonary fibrosis, respiratory infections, bronchiectasis, tuberculosis) to reduce both short- and the long-term exposure consequences. We considered the most important air pollutants, including sulfur dioxide, nitrogen dioxide, carbon monoxide, volatile organic compounds, ozone, particulate matter and biomass smoke, and observed their impact on pulmonary pathologies. We focused on respiratory pathologies, because air pollution potentiates the increase in respiratory diseases, and the evidence that air pollutants have a detrimental effect is growing. It is imperative to constantly improve policy initiatives on air quality in both high- and low-income countries.
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Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We
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aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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BMC Infectious Diseases (2019) 19:832
Intestinal schistosomiasis is highly endemic in Tanzania and mass drug administration (MDA) using
praziquantel is the mainstay of the control program. However, the MDA program covers only school aged children
and does not include neither adult individuals nor
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other public health measures. The Ijinga schistosomiasis project
examines the impact of an intensified treatment protocol with praziquantel MDA in combination with additional
public health interventions. It aims to investigate the feasibility of eliminating intestinal schistosomiasis in a highly
endemic African setting using an integrated community-based approach.
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Currently, there are only two manufacturers with HIV POC diagnostic products prequalified by the World Health
Organization (WHO) and eligible for procurement through the United Nations. UNICEF concluded its last tender for
HIV EID and VL POC diagn
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ostic technologies in 2018 and awarded two manufacturers long-term arrangements
(LTAs) to supply WHO prequalified product
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This report is from the National study on living conditions among people
with disabilities carried out in Nepal in 2014-2015. The study was carried
out as a household survey with two-stage stratified sampling, including a screening/listing procedure using the Washington Group on Disability
Statis
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tics 6 questions, one Household questionnaire administered to
households with (Case HHs) and without disabled members (Control
HHs), one Individual Case questionnaire administered to individuals who were found to qualify as being disabled in the screening (Case
individuals), and an Individual Control questionnaire administered to
matched non-disabled individuals in the Control HHs (Control individuals). The study covers a range of indicators on level of living, such as socioeconomic indicators, economic activity, income, ownership and infrastructure, health (including reproductive health), access to health information, access to services, education, access to information, social participation, and exposure to discrimination and abuse (see all
questionnaires in Appendix).
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The report examines financing in the battle against malaria, focusing on the role of foreign aid. It analyzes whether or not a disease such as malaria can be controlled or eliminated in Africa without health aid. It also presents a theoretical model
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of the economics of malaria and shows how health aid can help avoid the “disease trap.” While calling for increased funding from international sources to fight malaria, it also recommends that African countries step up their own efforts, including on domestic resource mobilization. In 2016, governments of endemic countries contributed 31% of the estimated total of US $ 2.7 billion.
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Psychological first aid for schools: Field operations guide, 2nd Edition
Brymer M., Taylor M., Escudero P., Jacobs A., Kronenberg M., Macy R., Mock L., Payne L., Pynoos R., & Vogel J.
National Child Traumatic Stress Network (NCTSN) & National Center for PTSD
(2012)
C2
National Child Traumatic Stress Network National Center for PTSD | The field of school safety and emergency management has evolved significantly over the past decade. Tragically, acts of violence, natural disasters, and terrorist attacks have taught us many lessons. We also know that other types of
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emergencies can impact schools, including medical emergencies, transportation accidents, sports injuries, peer victimization, public health emergencies, and the sudden death of a member of the school community. We now recognize the need for school emergency management plans that are up-to-date and take an “all-hazards” approach with clear communication channels and procedures that effectively reunite parents and caregivers with students. We have also learned that preparing school administrators, teachers, and school partnering agencies before a critical event is crucial for effective response, the value of ongoing training and emergency exercises, and that having intervention models that address the public health, mental health, and psychosocial needs of students and staff is essential to a safe school environment and the resumption of learning.
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Guidelines.
The guidelines set out essential actions that humanitarian actors must take in order to effectively identify and respond to the needs and rights of persons with disabilities who are most at risk of being left behind in humanitarian settings.
The recommended actions in each chapter pl
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ace persons with disabilities at the centre of humanitarian action, both as actors and as members of affected populations. They are specific to persons with disabilities and to the context of humanitarian action and build on existing and more general standards and guidelines.
These are the first humanitarian guidelines to be developed with and by persons with disabilities and their representative organizations in association with traditional humanitarian stakeholders. Based on the outcomes of a comprehensive global and regional multi-stakeholder consultation process, they are designed to promote the implementation of quality humanitarian programmes in all contexts and across all regions, and to establish and increase both the inclusion of persons with disabilities and their meaningful participation in all decisions that concern them.
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The National Action Plan for Combating Antibiotic-Resistant Bacteria (CARB), 2020-2025, presents
coordinated, strategic actions that the United States Government will take in the next five years to improve the health and wellbeing of all Americans
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by changing the course of antibiotic resistance.
This Plan is based on the U.S. Government’s 2014 National Strategy for CARB, and builds on the first National Action Plan released in 2015 by expanding evidence-based activities that have already been shown to reduce antibiotic resistance, such as optimizing the use of antibiotics in human and animal health settings.
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The outbreak of COVID-19 comes with unpredictable primary and secondary impacts on vulnerable and food-insecure populations across the world. Mortality and morbidity appear to be most acute for elderly people, and those with underlying health
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conditions. At the same time, the widely anticipated economic downturn could have a more devastating effect on the world’s poor than the virus itself
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Sudan recorded the first COVID-19 case on 13 March 2020 and, at the beginning of July, the Federal Ministry of Health had confirmed that nearly 10,000 people had contracted the virus, including over 600 who died from the disease across the country.
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Although more than 70 per cent of the confirmed cases are in the Khartoum area, COVID-19 has spread throughout the country, with the highest numbers recorded in the central and eastern states. With extremely low testing capacity — around 800 samples per day, the lowest in the region — the official figures of confirmed cases likely underestimate the extent of the pandemic and the actual situation is unknown.
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Published OnlineJuly 14, 2021https://doi.org/10.1016/S2214-109X(21)00164-9. New Lancet research offers the first comprehensive analysis of the growing footprint of noncommunicable and injury-related neurological disorders to India’s overall diseas
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e burden.
Takeaways from 1990 to 2019 In terms of total disability adjusted life years:
• The share of noncommunicable neurological disorders doubled from 4% to 8.2%.
• Injury-related neurological disorders increased from 0.2% to 1.1%
• The contribution of communicable neurological disorders decreased from 4.1% to 1.1%
• Stroke, epilepsy, cerebral palsy, and headache disorders were among the largest contributors to DALYs.
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Event-based surveillance (EBS) is defined as the organized collection, monitoring, assessment and interpretation of mainly unstructured ad hoc information regarding health events or risks, which may represent an acute risk to
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health. Both indicator-based and event-based surveillance components serve the early warning and response (EWAR) function of the public health surveillance system. The Framework for Event-based Surveillance offers guidance to public health practitioners seeking to implement EBS at each administrative level in healthier countries.
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Buruli ulcer caused by Mycobacterium ulcerans is a neglected tropical disease characterized by extensive ulceration involving predominantly the upper and lower limbs of patients. The disease is common in rural tropical communities in West and Central Africa, where access to proper
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health care is limited. Pathogenesis of the characteristic painless ulcers is linked to the elaboration by M. ulcerans of a lipid toxin called mycolactone that has potent cytopathic, immunosuppressive, and analgesic effects on a host of cells in cutaneous tissues. Mycolactone is known to profoundly inhibit secretion of a plethora of proteins that are essential for wound healing. Even though a combination antibacterial therapy of streptomycin and rifampicin for 8 weeks is effective for treatment, it relies on good and appropriate wound management to prevent secondary bacterial infections and improve healing. Evidence-based interventions for wound care in Buruli ulcer disease are often lacking and have relied on expert advice and recommendations. Surgical interventions are limited to debridement of necrotic tissue and grafting of extensive ulcers, usually after antibiotic therapy. Patients’ rehabilitation is an important component of care to reduce disabilities associated with the disease and proper integration into the community after treatment.
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Conflicts and disasters, including pandemics, affect women and men in all their diversity differently, and women and girls often suffer the most. Crisis-related hardships combine and compound pre-existing disadvantages, for example, they often cause
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women’s working conditions to worsen while increasing their overall workload and care responsibilities. At the same time, crises can give rise to changes that enable women to take up roles that were previously available only to men, and crises can open opportunities to address existing gender-based discrimination and violations of rights.
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In 2014, an estimated 40 million women of reproductive age were infected with Schistosoma haematobium, S. japonicum and/or S. mansoni. In both 2003 and 2006, the World Health Organization (WHO) recommended that all schistosome-infected pregnant and
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breastfeeding women be offered treatment, with praziquantel, either individually or during treatment campaigns. In 2006, WHO also stated the need for randomized controlled trials to assess the safety and efficacy of such treatment. Some countries have yet to follow the recommendation on treatment and many programme managers and pregnant women in other countries remain reluctant to follow the recommended approach.
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2nd edition. The Event-based Surveillance Framework is intended to be used by authorities and agencies responsible for surveillance and response. This framework serves as an outline to guide stakeholders interested in implementing event-based surveillance (EBS) using a multisectoral, One
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Health approach. You can download the Training Manual and Framework in Arabic, English, French, and Portuguese
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Atherosclerotic lower-extremity peripheral artery disease (PAD) is increasingly recognized as an important cause of cardiovascular morbidity and mortality that affects more than 230 million people worldwide. Traditional cardiovascular risk factors, including advanced age, smoking, and diabetes, are
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strongly linked to an increase risk of PAD. Although PAD has been historically underappreciated compared to coronary artery disease and stroke, greater attention on PAD in recent years has led to important new epidemiologic insights in the areas of thrombosis, inflammation, dyslipidemia, and microvascular disease. In addition, the concept of polyvascular disease, or clinically-evident atherosclerosis in multiple arterial beds, is increasingly identified as a particularly malignant cardiovascular disease worthy of special clinical attention and further study. It is noteworthy that PAD may increase the risk of adverse outcomes in similar or even greater magnitude than coronary disease or stroke. In this review, we highlight important new advances in the epidemiology of PAD with a particular focus on polyvascular disease, emerging biomarkers, and differential risk pathways for PAD compared to other atherosclerotic diseases.
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This report describes efforts in nine countries, supported by the 2gether 4 SRHR programme and other partners, highlighting the results achieved and learning on improving the health and wellbeing of adolescent and young mothers and their families. K
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ey insights include the importance of responsive service delivery and social support as well as service provision across sectors.
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