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 aimed to determine the prevalence, severity and ris...k 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.
more
The emergency Water, Sanitation and Hygiene Promotion (WASH) gap analysis project was funded by The Humanitarian Innovation Fund (HIF), a program managed by Enhancing Learning and Research for Humanitarian Assistance (ELRHA) in partnership with the Active Learning Network for Accountability and Per...formance in Humanitarian Action (ALNAP), and is a component of a larger initiative to identify and support innovations in emergency WASH. This paper gives an explanation of the background, methodology, and findings of the program.
more
Guidelines for Prevention and Reponse
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatment should be to achieve and maintain control of the... disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
TB policies in 24 Countries
A survey of prevention, testing and treatment policies and practices
Лечение туберкулеза в 24 странах
Исследование диагностической и клинической практики
Ghana Med J. 2012 Jun;46(2 Suppl):69-78.
the Lancet : Published Online July 31, 2015 http://dx.doi.org/10.1016/S0140-6736(15)61117-5
For the estimated 20 million refugees and 25 million internally displaced people worldwide, well-planned settlements can help to maximise their protection and security, and support them to minimise the spread of disease, manage natural resources sustainably, and maintain good relations with their ho...sts until durable solutions to their displacement are achieved.
The result of extensive consultations with a wide range of specialist organisations, this book takes a holistic view of shelter for displaced populations, extending beyond refugee camps to consider support for all of the settlement and shelter options open to displaced people. It offers co-ordinators and specialists a common planning tool which links strategy, programmes, projects, and technical information for use in the field
more
Lessons from the Africa Regional Stigma Training Programme
Supporting community action on AIDS in developing countries
Брошюра состоит из двух частей. В первой приводятся практические примеры, иллюстрирующие все составляющие ухода за пациентами, во второй части представлены данны... и комментарии о последних исследованиях и разработках.
more
Practical guide for doctors, nurses,laboratory technicians, medical auxiliaries,water and sanitation specialists and logisticians.
The document is a comprehensive guide for managing cholera epidemics, providing detailed protocols for prevention, outbreak investigation, treatment, and control mea...sures. It covers essential aspects like rehydration therapy, water sanitation, hygiene promotion, and setting up treatment centers. Designed for medical and non-medical staff, it aims to support effective epidemic response and reduce cholera-related morbidity and mortality.
more
Democratic dispensation in 1994 created a political and social platform that reshaped life in South Africa. There was a surge in common belief that the inequity and wrong of Apartheid should and could be rectified. Equity of access to water and sanitation were obvious targets for improvement. In 199...4, an estimated 14–15 million South Africans were without access to an improved water supply, while close to 21 million - more than half of the population at that time - did not have access to improved sanitation facilities. These problems were most severe in poorer rural areas. The water and sanitation sector became unified by the vision of universal access for all South Africans. This case study documents the progression of the sector between 1994 and 2016, and analyzes the impact of local systems created in South Africa to respond to the water and sanitation challenge.
more
Submission by the WHO Collaborating Centre on training and policy on opioid availability and WHO collaborating Centre for community participation in palliative care and long term care To the Indian Nursing Council for consideration to be included in the Undergraduate Nursing education curriculum
Pharmaceuticals 2024, 17(6), 691; https://doi.org/10.3390/ph17060691
Working Document, September 2017