The article from the African Journal of Thoracic and Critical Care Medicine provides updated guidelines on endoscopic lung volume reduction (ELVR) for treating advanced emphysema, a severe form of chronic obstructive pulmonary disease (COPD), which is prevalent in South Africa and other low- and mid...dle-income countries. The guidelines focus on identifying suitable patients based on specific criteria, such as age, lung function, and the presence of hyperinflation, while ruling out contraindications like pulmonary hypertension and recent smoking.
ELVR aims to reduce lung volume in the most damaged areas, improving breathing mechanics and quality of life. Various devices, including endobronchial valves, intrabronchial valves, and coils, are reviewed with evidence from clinical trials supporting their use. The guidelines emphasize careful patient selection and recommend only performing ELVR in specialized centers due to its high cost and risk of complications, such as pneumothorax.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions... (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a...sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Men are underrepresented in HIV testing services throughout sub-Saharan Africa. HIV testing is critical to achieve the UNAIDS 95-95-95 goals, as it is the first entry point to HIV care. In Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiag...nosed. Improved HIV testing among men is key to reaching UNAIDS goals, and to curbing HIV epidemics in the region.
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This third regional report discusses gaps and challenges in reducing the harmful use of alcohol and how countries can reverse current trends in a cost-effective and expedited way.
L’enquête a été réalisée dans la Commune de Dori, chef-lieu de la province du Seno dans la Région du Sahel. Suite à la crise sécuritaire qui prévaut au Burkina Faso depuis 2016, la commune de Dori a enregistré 66 7981 personnes déplacées à la date du 30 Avril 2022. Ce chiffre est le p...lus élevé dans la province du Séno. Les déplacées ont été contraints d’abandonner leurs moyens d’existence, font face à la précarité, bénéficient de l’assistance gouvernementale, des acteurs humanitaires et des populations hôtes.
Il s’agit d’une SMART Rapide. Les secteurs/villages ont été sélectionnés par le logiciel ENA en utilisant la probabilité proportionnelle à la taille. Quant aux ménages, ils ont été sélectionnés selon un processus de segmentation et d’échantillonnage aléatoire simple ou systématique.
Les données ont été collectées du 13 au 15 Juin 2022 par 5 équipes composées d’un chef et d’un mesureur chacune. Les équipes ont été supervisées durant toute la collecte. Les paramètres collectés étaient l’âge, le sexe, le poids, la taille, le périmètre brachial et la présence des œdèmes. Trois grappes ont été inaccessibles due aux problèmes sécuritaires et les trois grappes de réserves prévues à cet effet ont été utilisées.
Au total 25 grappes, 245 ménages, et 246 enfants ont été enquêtés. Les résultats montrent une prévalence de la malnutrition aiguë globale de 19,8 % (IC 95 % ; 14,7 - 26,1) selon le rapport poids/taille) et 5,3 % (IC 95 % : 3,0 - 9,1) selon le périmètre brachial. La malnutrition aiguë globale combinée est de 22,4 % (IC 95 % : 17,3 - 28,5).
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WHO-AIMS REPORT ON MENTAL HEALTH SYSTEM IN NEPAL
A report of the assessment of the mental health system in Nepal using the World Health Organization - Assessment Instrument for
Mental Health Systems (WHO-AIMS).
Kathmandu, Nepal
Rev. Panam Salud Publica. 2017;41:e153. doi: 10.26633/RPSP.2017.153
Worldwide, over 6 million people are infected with Trypanosoma cruzi, the pathogen that causes Chagas disease (CD). In the Americas, CD creates the greatest burden in disability-adjusted life years of any parasitic infection. In Co...lombia, 437 000 people are infected with T. cruzi, of whom 131 000 suffer from cardiomyopathy. Colombia’s annual costs for treating patients with advanced CD reach US$ 175 016 000. Although timely etiological treatment can significantly delay or prevent development of cardiomyopathy—and costs just US$ 30 per patient—fewer than 1% of people with CD in Colombia and elsewhere receive it.
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Nature, biodiversity and health: an overview of interconnections
Urbanization, land use, global trade and industrialization have led to profound and negative impacts on nature, biodiversity and ecosystems across the world. The ongoing depletion of natural resources not only affects environmental c...onditions but also has an enormous impact on the well-being and security of societies.
This report provides an overview of the impacts of the natural environment on human health. It presents the ways nature and ecosystems can support and protect health and well-being, and describes how nature degradation and loss of biodiversity can threaten human health. It is targeted at readers who do not have extensive experience with the links between nature and health.
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accessed July 2020
“Charity is at the heart of the Church, it is the reason for its action, the soul of its mission.” (Pope Francis)
The Impacts of Climate Change on Human Health
in the United States: A Scientific Assessment
Climate change is a significant threat to the health of the American people. This scientific assessment examines how climate change is already affecting human health and the changes that may occur in the fu...ture.
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Climate change triggers mounting food insecurity, poverty and displacement in Africa
The Lancet Regional Health - Americas 2024;37: 100881
Published Online 13 September 2024 https://doi.org/10.1016/j.lana.2024. 100881
UN-Water Global Analysis and Assessment of Sanitation and Drinking-water (GLAAS)