Malaria remains a significant public health concern in the SADC region, accounting for 20% of childhood deaths, as well as prompting numerous outpatient visits and hospitalisations. Around three-quarters of the population, including 35 million children under the age of five and 8.5 million pregnant ...women, are at risk. Transmission patterns vary from high and stable in the north to malaria-free in the south, with low, unstable and seasonal zones in between. Although interventions such as indoor residual spraying (IRS), insecticide-treated nets (ITNs/LLINs), intermittent preventive treatment in pregnancy (IPTp), rapid diagnostic tests (RDTs), and artemisinin-based combination therapies (ACTs) have reduced the malaria burden, challenges persist in terms of funding, human resources, surveillance, and cross-border coordination. Achieving malaria elimination in the SADC region requires harmonised regional standards, strengthened surveillance, and improved access to quality treatment and policy prioritisation.
Accessed on 27/08/2025.
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Infectious Diseases of Poverty (2022) 11:111; With some 134,073,166 people living in endemic communities at risk of infection, Nigeria is the most endemic country in Africa and requires preventive chemotherapy (PC) for a total of 26.3 million persons. The National Schistosomiasis Elimination Program...me (NSCHEP), with the support of international partners, has been implementing PC in Nigeria since 2009 and most recently will need to revise its current strategy (Additional file 1). For example, the new World Health Organization (WHO) guideline has six key recommendations that will dramatically change the implementation of schistosomiasis elimination in endemic countries [3]. However, its impact and programmatic implications will vary from country to country, hence the need for a country-specific analysis. This article discusses these recommendations with specific reference to the challenges and opportunities in Nigeria. We summarise the key pointers in Additional file 1: Box 1 against the six recommendations of the WHO 2022 guideline.
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This Mpox SPRP Global Monitoring & Evaluation (M&E) Framework, also referred to as the Framework, aims to monitor and report on global progress towards these objectives, including information about country-level response efforts and WHO support to Member States. Regular collection and analysis of da...ta on these objectives, alongside the ongoing tracking of the epidemiological situation, are key to informing decision-making, operational adjustments, as well as ensuring transparency and accountability for achieving the goal to stop the Mpox outbreak. This document suggests reporting indicators for monitoring of the global response to the Mpox PHEIC as articulated in the Mpox SPRP and Operational Planning Guidelines for countries.
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Kenya has great potential for enhancing education for individuals with intellectual disabilities. The fact that it has recognized the need to care for learners with special needs is commendable. In comparison to many African countries, Kenya and Nigeria are ahead in developing programs for special e...ducation in institutions of higher learning, and in starting schools and units for special education. However, a legal mandate is still required as it would seal many loopholes that currently exist. Without it, the assessment of individual with intellectual disabilities cannot be administered correctly and professionally. In this article, the authors present a coherent account on various aspects related to learners with intellectual disabilities in Kenya. No doubt, the issues and challenges identified call for attention by not only the government of Kenya but also those interested in improving the status of learners with intellectual disabilities.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence...-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden...ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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The new WHO Guidelines on Sanitation and Health summarize the evidence on the effectiveness of a range of sanitation interventions and provide a comprehensive framework for health-protecting sanitation, covering policy and governance measures, implementation of sanitation technologies, systems and b...ehavioural interventions, risk-based management, and monitoring approaches. Critically, the guidelines articulate the role of the health sector in maximizing the health impact of sanitation interventions.
The guidelines also identify gaps in the evidence-base to guide future research efforts to improve the effectiveness of sanitation interventions.
(French, Spanish, Russian, Arabic in production)
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Antimicrobial resistance (AMR) is a multifaceted, international public health problem, which poses a direct threat to the safety of the population of South Africa. A national response is required to complement the development of a global plan, as articulated in the WHO’s draft resolution EB134/37 ...“Combating antimicrobial resistance including antibiotic resistance”, adopted by theWorld Health Assembly in May 2014. The overuse of antimicrobials is driving resistance. A return to appropriate, targeted antimicrobial use in humans, animals and the environment is critical if we are to conserve the antimicrobial armamentarium. Various interventions have been put in place to address antimicrobial resistance in South Africa. However, these are insufficient to effectively tackle the threat faced by the country. The strengths of the current system are outweighed by its weaknesses.
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The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa.
The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment
and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts.
The recommendations in these guidelines are:
1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5%
(conditional recommendation: moderate-quality evidence).
2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence).
3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence).
4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence).
Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities.
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E-learning Resources for Global Health Researchers : Many organizations offer no- and low-cost e-learning resources to those working in the field of global health research. Resources include training courses, MOOCs and course materials (presentations, videos, reading lists, visual aids, articles), ...resource centers and resource networks.
Accessed 6 March 2019.
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Chagas disease (American trypanosomiasis) is endemic in 21 countries of the Americas, where control is largely focused on elimination of the domestic insect vectors (Triatominae) coupled with measures to extend and improve the screening of blood donors in order to avoid tranfusional transmission. Th...rough national programmes and multinational initiatives coordinated by WHO-PAHO, much has been accomplished in these domains in terms of reducing transmission. Attention now turns to consolidating the successes in interrupting transmission, and improved treatment for those already infected and those who may become affected in the future. This article, based on technical discussions at the "Epidemiological and Sociological Determinants of Chagas Disease, Basic Information to Establish a Surveillance and Control Policy " meeting in Rio de Janeiro, is designed to open the debate on appropriate strategies for continuation of the successful initiatives against Chagas disease.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung function testing in this group of patients and the wi...de variety of conditions that can phenotypically present with asthma-like symptoms.
This article provides an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions.
The South African 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 asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence.
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In this paper we aim to provide information on the importance of efficiency measurement of health care facilities in developing countries. We state that efficiency measurement can be a substantial contribution to saving lives. Therefore we analyse the performance of health centres in rural Burkina F...aso making use of data which were taken from a comprehensive long-term cost information system. In the subsequent parts of this article, the study site is described and the DEA method outlined. The ensuing analysis of the data is carried out in two stages. Firstly, quantitative aspects concerning relative efficiency are presented. Secondly, the measures of performance are explained. The implications of the results are then discussed.
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Diabetes mellitus, commonly known as diabetes, is a group of metabolic disorders characterized by the presence of hyperglycaemia in the absence of treatment. The heterogeneous aetiopathology includes defects in insulin secretion, insulin action, or both. The long-term specific complications of diabe...tes include retinopathy, nephropathy, and neuropathy. People with diabetes are also at increased risk of other diseases, including cardiac, peripheral arterial and cerebrovascular disease, cataracts, erectile dysfunction, and nonalcoholic fatty liver disease. They are also at an increased risk of some infectious diseases such as tuberculosis, and are likely to experience poorer outcomes.
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The Framework serves to guide efforts to deliver safe and sustainable water, sanitation and hygiene (WASH), health care waste management and reliable electricity in all health care facilities. The ultimate aim is to provide quality care for all. The Framework reflects a global consultative process a...nd includes data and recommendations articulated in recent WHO/UNICEF global reports on WASH, waste and electricity in health care facilities. It also provides an operational roadmap for implementing the 2023 United Nations General Assembly (UNGA) resolution on WASH, waste and electricity in health care facilities. The target audiences for this Framework include health leaders and programme managers at the global and national levels; policymakers; WASH, waste and energy leaders and technical experts; development partners and finance institutions; and actors and experts on gender equality, disability and social inclusion and climate; and, more generally, civil society. The Framework addresses the WASH, waste and electricity elements of the WHO comprehensive approach to build safe, climate-resilient and environmentally sustainable health care facilities.
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The new five-year agenda of WHO in Africa, The Africa Health Transformation Programme, 2015–2020: a vision for universal health coverage, is the strategic framework that will guide WHO’s contribution to the emerging sustainable development platform in Africa. It articulates a vision for health a...nd development that aims to address the unacceptable inequalities and inequities that have kept our region lagging far behind others in terms of health indices and enjoyment of the highest attainable standard of life.
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Today there are Community-based Rehabilitation (CBR) programmes in a large number of countries. In many countries, the CBR approach is a part of the national rehabilitation services. However, there is a lack of reliable data about persons with disabilities who benefit from CBR and the kind of benefi...ts they receive. This article reviews the disability data collection systems and presents some case studies to understand the influence of operational factors on data collection in the CBR programmes. The review shows that most CBR programmes use a variable number of broad functional categories to collect information about persons with disabilities, combined occasionally with more specific diagnostic categories. This categorisation is influenced by local contexts and operational factors, including the limitations of human and material resources available for its implementation, making it difficult to have comparable CBR data. Therefore, any strategies to strengthen the data collection in CBR programmes must take these operational factors into account.
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his revision to the Disaster Management Team’s (DMT) multi-sector response plan for COVID-19 is meant to align the multi-sector plan with the Department of Health’s COVID-19 Emergency Response Plan issued on 24 April 2020. Additionally, at the time of this version, the Department of Education an...d Department for Community Development and Religion have also issued their own national COVID-19 response and recovery plans.
The Government’s plan maintains a health sector focus and plans for a ‘worst case’ scenario, articulating the process of progressing into containment and subsequently mitigation of community transmission and on to recovery. It presents an opportunity to improve the core capacities of the whole of government, to see where both health and non-health sectors fit in and respond in the immediate and medium terms, and to adapt to the ‘new normal’ that this coronavirus has inevitably presented
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The notion of dignity can simply be defined as the inherent and inalienable worth of all human beings irrespective of social status such as race, gender, physical or mental state1. Dignity is deeply embedded in international human rights instruments.
In fact the very first article of the Universal ...Declaration of Human Rights states that “All human beings are born free and equal in dignity and rights”2, 3. Protection and respect of human rights are the necessary prerequisites to ensure that people are not stripped of their dignity.
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Chronic obstructive pulmonary disease (COPD) is a complex disease that requires differential diagnosis and proper classification to identify appropriate therapy. Nonpharmacologic therapy and preventative measures should be utilized to prevent worsening of disease, symptoms, and complications. The Gl...obal Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines classify a patient’s COPD and provide recommendations for first-line treatment. The 2021 update included information regarding the use of e-cigarettes as nicotine replacement, triple therapy, and how the SARS-CoV-2 virus impacted patients with COPD. This article will focus on the diagnosis, classification, and treatment of COPD, as well as recently updated information regarding the use of e-cigarettes and the impact of COVID-19.
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