Research globally has shown that metered dose inhaler (MDI) technique is poor,
with patient education and regular demonstration critical in maintaining correct use of
inhalers. Patient information containing pictorial aids improves understanding of medicine
usage; however, manufacturer leaflets i...llustrating MDI use may not be easily understood by
low-literacy asthma patients.
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The article presents findings from the BREATHE study, which assessed the distribution of COPD-related symptoms in the Middle East and North Africa (MENA) region. The study involved a large cross-sectional survey in 11 countries, collecting data on respiratory symptoms, smoking habits, and potential ...COPD prevalence in adults aged 40 and older. Results showed that 14.3% of the surveyed population reported symptoms consistent with COPD, with variations across countries. Women reported symptoms more frequently than men, though diagnosed COPD was more common in men. The study highlighted smoking, including waterpipe use, as significant risk factors and called attention to underdiagnosed COPD in the region, emphasizing the need for increased awareness and better diagnostic practices.
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We aimed to estimate the incidence, mortality, disability-adjusted life years (DALYs) for chronic obstructive pulmonary disease (COPD) in 204 countries and territories. We examined the variations in these trends by country, gender, age group, and sociodemographic index (SDI).
Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt...h raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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Asthma is the commonest chronic respiratory tract disease in children. In low-income countries, challenges exist in asthma diagnosis. In surveys done in children, the prevalence of ‘asthma’ defined by symptoms is high compared to ‘doctor diagnosed asthma’. The questions answered by this revi...ew are What challenges have been experienced in the diagnosis of asthma in children? What solutions will address these challenges?
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Cardiovascular diseases, principally ischemic heart disease (IHD), are the most important cause of death and disability in the majority of low- and lower-middle-income countries (LLMICs). In these countries, IHD mortality rates are significantly greater in individuals of a low socioeconomic status (...SES).
Three important focus areas for decreasing IHD mortality among those of low SES in LLMICs are (1) acute coronary care; (2) cardiac rehabilitation and secondary prevention; and (3) primary prevention. Greater mortality in low SES patients with acute coronary syndrome is due to lack of awareness of symptoms in patients and primary care physicians, delay in reaching healthcare facilities, non-availability of thrombolysis and coronary revascularization, and the non-affordability of expensive medicines (statins, dual anti-platelets, renin-angiotensin system blockers). Facilities for rapid diagnosis and accessible and affordable long-term care at secondary and tertiary care hospitals for IHD care are needed. A strong focus on the social determinants of health (low education, poverty, working and living conditions), greater healthcare financing, and efficient primary care is required. The quality of primary prevention needs to be improved with initiatives to eliminate tobacco and trans-fats and to reduce the consumption of alcohol, refined carbohydrates, and salt along with the promotion of healthy foods and physical activity. Efficient primary care with a focus on management of blood pressure, lipids and diabetes is needed. Task sharing with community health workers, electronic decision support systems, and use of fixed-dose combinations of blood pressure-lowering drugs and statins can substantially reduce risk factors and potentially lead to large reductions in IHD. Finally, training of physicians, nurses, and health workers in IHD prevention should be strengthened.
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Disease epidemiology has a deeper relationship with the dynamic nature of culture. Health behaviors in general are largely shaped by the cultural norms and customs in a society. A mere identification of a behavior could be only a layer on the outer sphere of a particular disease epidemiology and the... interventional efforts to counteract such behaviors through for example public health measures could be futile and volatile, unless the deeper cultural factors are addressed.
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The2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group was coordinated and supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Healt...h. It is designed to improve patient care and support informed decision making about asthma management in the clinical setting. This update addresses six priority topic areas as determined by the state of the science at the time of a needs assessment, and input from multiple stakeholders:
• Fractional Exhaled Nitric Oxide Testing
• Indoor Allergen Mitigation
• Intermittent Inhaled Corticosteroids
• Long-Acting Muscarinic Antagonists
• Immunotherapy in the Treatment of Allergic Asthma
• Bronchial Thermoplasty
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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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The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on evaluation and tr...eatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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Silicosis is not a new disease; the impact of silica dust on respiratory function was observed by Hippocrates in 430 B.C. and in the 16th century by Agricol. In 1713, Rammazini described silicotic nodules in post-mortems of stone cutters presenting with respiratory symptoms. In the mid-late 1800s,... the introduction of mechanized tools in the mining sector rapidly increased levels of silica exposure, resulting in an increase in cases and our understanding of silicosis.
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Diabetes is one of the leading causes of death globally. India is home to the second-largest population suffering from diabetes. This underscores the need to build capacity of primary care physicians (PCPs) for better disease management. This narrative review article aims to describe the emergence o...f diabetes education and capacity-building programs for PCPs and its current situation in India. The review highlighted that major emphasis on diabetes was given only when the WHO estimated that morbidity and mortality due to diabetes would increase to 35% in India. As a result, National Diabetes Control Program was launched in 1987. Yet, very little attention was paid to diabetology in under-graduation. In the last decade, few public and private institutions have developed diabetes related capacity-building programs for PCPs independently or in collaborations. These programs include 16 fellowships, 4 diplomas, 12 certificate programs, and 6 other diabetes training programs, which have their own pros and cons. As medical science is changing rapidly, PCPs need to upgrade their skills and knowledge regularly to manage NCDs such as diabetes more effectively and efficiently. This can be possible only if scientific, evidence-based, and quality-oriented capacity-building programs are provided to the healthcare workforce.
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The article "Economic Burden of Chronic Obstructive Pulmonary Disease (COPD): A Systematic Literature Review" examines the financial impact associated with moderate-to-very severe COPD. The review analyzes studies published between 2006 and 2016 that discuss healthcare resource utilization (HRU), di...rect costs, and indirect costs related to COPD, with a focus on Europe and North America. It highlights that direct costs, including hospitalizations and medical treatments, increase with the severity of COPD and the frequency of exacerbations. Multivariate analyses identify key factors driving these costs, such as comorbidities and prior treatment history. The findings underscore the significant economic burden of COPD on healthcare systems and emphasize the need for improved management strategies to reduce costs and optimize patient care.
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The article examines the epidemiology of chronic obstructive pulmonary disease (COPD) in the Middle East, North Africa, and Turkey. It provides an overview of COPD prevalence, associated risk factors, and challenges in diagnosis and treatment across these regions. The study highlights smoking and en...vironmental exposures, such as dust and pollution, as significant contributors to COPD. It also points out the gaps in awareness, healthcare infrastructure, and the availability of diagnostic tools, which hinder effective management of the disease. The authors emphasize the need for comprehensive public health strategies, education, and improved access to healthcare to address the COPD burden in these areas.
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The global epidemic of type 2 Diabetes Mellitus (T2DM) presents significant challenges to world health both in terms of financial costs as well as morbidity. Thus, considerable research has been focussed on the prevention or delay of the onset of T2DM.
Type 2 Diabetes Mellitus (T2DM) is one of the ...most costly and burdensome of chronic diseases and is a global epidemic. Estimates by the International Diabetes Federation indicate that 387 million people have diabetes, and that this figure is expected to rise to 592 million by 2035 with an additional 175 million cases currently undiagnosed.
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Lack of information about economic burden of COPD is a major cause of lack of attention to this chronic condition from governments and policymakers.
Diabetes mellitus (DM) is one of the commonest chronic diseases worldwide. Self-Management Education (SME) is regarded as a critical element of treatment for all people with diabetes, as well as those at risk of developing the condition. While a great variety of diabetes self-management education (D...SME) interventions are available in high-income countries, limited information exists on educational programs for the prevention and management of diabetes complications in Africa. This study, therefore, aimed at synthesizing information in the literature to describe the state of the science of DSME interventions in the WHO African Region.
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Objectives Our study aimed to systematically review the literature and synthesise findings on potential associations of built environment characteristics with type 2 diabetes (T2D) in Asia.
The article "The burden of chronic obstructive pulmonary disease and its attributable risk factors in the Middle East and North Africa region, 1990–2019" provides an analysis of the prevalence, mortality, and disability-adjusted life-years (DALYs) due to COPD in the MENA region from 1990 to 2019. ...The study uses data from the Global Burden of Disease (GBD) 2019 and shows that while age-standardized death and DALY rates have decreased over 30 years, COPD remains a significant health issue, especially among older populations. The main risk factors identified are smoking, ambient particulate pollution, and occupational exposure. The research underscores the impact of socioeconomic factors and recommends targeted public health initiatives to reduce the burden.
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The article "The Rising Burden of Non-Communicable Diseases in the Americas and the Impact of Population Aging" examines how the aging population in the Americas is contributing to the growing burden of non-communicable diseases (NCDs), despite improvements in disease prevention and health care. Usi...ng data from the World Health Organization and the United Nations, the study analyzes trends in population growth, aging, and NCD-related mortality and disability rates from 2000 to 2019 across 33 countries.
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