Coronavirus disease 2019 has a mild disease course in children and adolescents. Chronic respiratory conditions, including asthma, have been suggested as risk factors; however, asthma in children is highly variable in both triggers and severity.
During the pandemic, pediatric asthma services limite...d consultations and established virtual clinics. However, respondents perceived their patients’ asthma control to be retained or even improved, while treatment adherence was considered increased. Children with asthma were not disproportionately affected by coronavirus disease 2019.
Trigger avoidance and treatment adherence can rapidly improve asthma control in children, even under lockdown pressure. Children/adolescents with asthma do not appear to need additional prophylactic measures from coronavirus disease 2019 when asthma is well-treated. This article analyses the effect of COVID-19 on Asthma in children, providing information for management guidelines.
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Key facts
- A healthy diet helps to protect against malnutrition in all its forms, as well as noncommunicable diseases (NCDs), including diabetes, heart disease, stroke and cancer.
- Unhealthy diet and lack of physical activity are leading global risks to health.
- Healthy dietary practices start... early in life – breastfeeding fosters healthy growth and improves cognitive development, and may have longer term health benefits such as reducing the risk of becoming overweight or obese and developing NCDs later in life.
- Energy intake (calories) should be in balance with energy expenditure. To avoid unhealthy weight gain, total fat should not exceed 30% of total energy intake (1, 2, 3). Intake of saturated fats should be less than 10% of total energy intake, and intake of trans-fats less than 1% of total energy intake, with a shift in fat consumption away from saturated fats and trans-fats to unsaturated fats (3), and towards the goal of eliminating industrially-produced trans-fats (4, 5, 6).
- Limiting intake of free sugars to less than 10% of total energy intake (2, 7) is part of a healthy diet. A further reduction to less than 5% of total energy intake is suggested for additional health benefits (7).
- Keeping salt intake to less than 5 g per day (equivalent to sodium intake of less than 2 g per day) helps to prevent hypertension, and reduces the risk of heart disease and stroke in the adult population (8).
- WHO Member States have agreed to reduce the global population’s intake of salt by 30% by 2025; they have also agreed to halt the rise in diabetes and obesity in adults and adolescents as well as in childhood overweight by 2025 (9, 10).
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Le document fournit des messages éducatifs et des conseils pratiques pour prévenir et gérer la diarrhée, en particulier chez les enfants. Il met l'accent sur les pratiques d'hygiène telles que le lavage des mains adéquat, l'utilisation de latrines et la manipulation sûre des aliments. Il soul...igne également l'importance de l'allaitement maternel, d'une alimentation équilibrée, de la vaccination et de l'utilisation de solutions de réhydratation orale (SRO) et de zinc pour traiter la déshydratation causée par la diarrhée. Développé en collaboration avec les programmes de Save the Children en République démocratique du Congo, le matériel intègre l'éducation à la santé dans les écoles et les communautés, en encourageant les enfants à agir comme agents de changement pour promouvoir les pratiques d'hygiène et de santé.
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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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Как детям живется после страшных переживаний и как можно им помочь. Собрание картин, составленное Сузаннэ Штайн (Susanne Stein) для разговоров с родителями детей, пережив...ших страшные события
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Як живеться дітям після пережитого надзвичайно великого страху і що їм може допомогти. Брошура Сюзанне Штайн (Susanne Stein) для розмов з батьками дітей, які пережили над...вичайно великий страх
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Little is known about asthma control in the rising number of African children who suffer from this condition. The Achieving Control of Asthma in Children in Africa (ACACIA) study is an observational study collecting evidence about paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Afr...ica, Uganda and Zimbabwe. The primary objectives are: (1) to identify 3000 children aged between 12 years and 14 years with asthma symptoms; and (2) to assess their asthma control, current treatment, knowledge of and attitudes to asthma and barriers to achieving good control. Secondary objective is to develop interventions addressing identified barriers to good symptom control.
Each centre will undertake screening to identify 500 school children with asthma symptoms using questions from the Global Asthma Network’s questionnaire. Children identified to have asthma symptoms will fill in a digital survey, including: Asthma Control Test, questions on medication usage and adherence, medical care, the Brief-Illness Perception questionnaire and environmental factors. Exhaled nitric oxide testing and prebronchodilator and postbronchodilator spirometry will be performed. A subgroup of children will participate in focus group discussions. Results will be analysed using descriptive statistics and comparative analysis. Informed by these results, we will assess the feasibility of potential interventions, including the adaption of a UK-based theatre performance about asthma attitudes and digital solutions to improve asthma management.
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The document provides educational messages and practical guidance to prevent and manage diarrhoea, particularly in children. It emphasizes hygiene practices like proper handwashing, using latrines, and safe food handling. It also highlights the importance of breastfeeding, balanced nutrition, immuni...zation, and the use of Oral Rehydration Solutions (ORS) and zinc for treating dehydration caused by diarrhoea. Developed alongside Save the Children programs in the Democratic Republic of the Congo, the material integrates health education into schools and communities, encouraging children to act as agents of change in promoting hygiene and health practices.
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poo...rly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu...s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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Lancet Glob Health 2020 Published Online October 22, 2020 https://doi.org/10.1016/S2214-109X(20)30325-9
The Zambia Malaria Campaign, implemented by Breakthrough ACTION, used culturally tailored radio adverts and a campaign song to encourage key behaviours for preventing and treating malaria. The campaign targeted high-risk groups, such as pregnant women and caregivers of children under five, and deliv...ered messages in multiple local languages, including English, Siswati and Tonga. The audio content encouraged the consistent use of insecticide-treated nets (ITNs), seeking timely care for fevers, and preventing malaria during pregnancy. Through addressing common myths and promoting positive social norms in an engaging way, the campaign aimed to increase community knowledge and encourage long-lasting behavioural change in malaria-endemic regions of Zambia.
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Pregnant travelers face numerous risks, notably increased susceptibility to or severity of multiple infections, including malaria. Because pregnant women residing in areas non-endemic for malaria are unlikely to have protective immunity, travel to endemic areas poses risk of severe illness and pregn...ancy complications, such as low birthweight and fetal loss. If travel to malaria-endemic areas cannot be avoided, preventive measures are critical. However, malaria chemoprophylaxis in pregnancy can be challenging, since commonly used regimens have varying levels of safety data and national guidelines differ. Furthermore, although chloroquine and mefloquine have wide acceptance for use in pregnancy, regional malaria resistance and non-pregnancy contraindications limit their use. Mosquito repellents, including N,N-diethyl-m-toluamide (DEET) and permethrin treatment of clothing, are considered safe in pregnancy and important to prevent malaria as well as other arthropod-borne infections such as Zika virus infection. Pregnant travelers at risk for malaria exposure should be advised to seek medical attention immediately if any symptoms of illness, particularly fever, develop.
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Every two minutes, a child under the age of 5 dies from malaria. Under-five children accounted for 67 per cent of all malaria deaths worldwide in 2018. Most of them occurred in sub-Saharan Africa where an estimated 24 million children were infected with its deadliest form. In addition to being the t...hird-deadliest infectious disease for children, malaria infection and the costs of treatment traps families in a cycle of illness, suffering and poverty.This year’s World Malaria Day is marred by the emergence of the COVID-19 outbreak, which further threatens people’s lives and well-being. Public health officials are taking precautionary and often aggressive measures to limit transmission of this virus, including reductions in social movement, physical distancing, hand-washing and recommending the use of personal protection equipment in high-risk settings. However, while focusing on combating this disease, the world cannot afford to ignore other diseases, such as malaria.
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The document focuses on educating children and communities about diarrhoea prevention and management through creative and interactive approaches. It highlights the importance of hygiene practices, oral rehydration solutions (ORS), zinc supplements, and proper nutrition to combat diarrhoea. Developed... with the support of Save the Children, the material is designed for use in schools, homes, and community groups, encouraging children to act as messengers of health education to promote lifelong healthy habits.
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Asthma is one of the neglected diseases in Africa with a high prevalence. Allergic fungal diseases have been reported to complicate asthma progression and treatment outcomes. However, data about fungal asthma and its associated complications are limited in Africa. We aimed to estimate the burden of ...fungal asthma among adults and children in Africa using a systematic review.
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Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia...ry education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa...l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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The article "Asthma treatment in children: A guide to screening for and management of hypothalamic-pituitary-adrenal axis suppression" discusses the risks associated with the use of corticosteroids in pediatric asthma treatment. It highlights that prolonged corticosteroid use can suppress the hypoth...alamic-pituitary-adrenal (HPA) axis, potentially leading to adrenal insufficiency, especially during stress. The article reviews diagnostic and screening approaches, recommending specific tests and management strategies based on current evidence. It emphasizes the need for monitoring children on corticosteroids to mitigate the risk of serious complications and suggests modifications in treatment to prevent HPA axis suppression.
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