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.
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This report summarizes the latest scientific knowledge on the links between exposure to air pollution and adverse health effects in children. It is intended to inform and motivate individual and collective action by health care professionals to prevent damage to children’s health from exposure to ...air pollution. Air pollution is a major environmental health threat. Exposure to fine particles in both the ambient environment and in the household causes about seven million premature deaths each year. Ambient air pollution (AAP) alone imposes enormous costs on the global economy, amounting to more than US$ 5 trillion in total welfare losses in 2013.
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The Guidance Notes seek to help operationalize, simplify and standardize the collection and reporting of data through the application of common language and methods. They provide information on the key issues to take into account in the collection of health data and the types of data that should be ...collated, and potential stakeholders to engage with. They adapt and complement the UNDRR/UNISDR Technical guidance for monitoring and reporting on progress in achieving the global targets of the Sendai Framework for Disaster Risk Reduction, which has a multisectoral target audience.
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Prevention, early identification, assessment and intervention in low- and middle-income countries | A Review | CHILD AND ADOLESCENT HEALTH AND DEVELOPMENT
Over the last decade, there have been numerous disasters and major emergencies that have profoundly impacted the lives of millions of people worldwide. To support these crises, national and international emergency medical teams (EMTs) are often deployed to assist disaster affected populations. EMTs ...are teams of healthcare professionals composed most frequently of doctors, nurses, psychologists and others to provide direct clinical care to people affected by disasters and conflicts and to support local health systems. In agreement with the World Health Organization’s (WHO) Global Health Emergency Health Workforce programme, any health professional coming from another country to practice health care in a disaster setting must be part of a team that is qualified, trained, equipped, resourced, and meets minimum acceptable standards to practice.
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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.
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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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This document updates the earlier version published in April 2020. In recent weeks, information on the potential use of chloroquine or hydroxychloroquine for the treatment of people with COVID-19 has been disseminated in academic journals and public media. Although there are now ongoing clinical tri...als testing the efficacy and safety of several medicines for COVID-19, as of the date of this document, there is a lack of quality evidence to demonstrate chloroquine and/or hydroxychloroquine are effective in the treatment of COVID-19. Evidence is recently emerging via small studies with sub-optimal methodologies that are conflicting.
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The objective of this book is to provide health workers with easily accessible information on important aspects of the medicines commonly used at primary care level in Zimbabwe. Medicines are a crucial part of the management of most of our patients, yet many medicines are potentially dangerous if no...t used correctly (by either prescriber or patient). It is important to have up-to-date information not only on the indications for, and the dose of a particular medicine, but also the contra-indications and reasons for special care, possible side effects and interactions with other medicine or medicines. The patient must also have information on how to use the preparation, what side effects may occur, and when to return for help.
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SARS-CoV-2 infections among children and adolescents cause less severe illness and fewer deaths compared to adults. While a less severe course of infection is a positive outcome, there are concerns that mild symptoms may have led to less testing, resulting in fewer identified cases of COVID-19 in ch...ildren. If children with mild or no symptoms transmit the disease, they may act as drivers of transmission within their communities. Understanding symptoms, infectivity and patterns of SARS-CoV-2 transmission in children and adolescents is essential for developing, adapting and improving control measures for COVID-19 across all ages. This is a summary of the current knowledge around SARS-CoV-2 infection acquisition and transmission and COVID-19 disease symptoms in children and adolescents. It aims to inform decisions, based on local contexts, on how to best keep schools, kindergarten and day-care facilities open and what advice to apply to intergenerational mixing.
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La publicación consiste en un instrumento de gestión, que permite unificar los criterios de manejo clínico operacional en la lucha contra la tuberculosis y contribuye a que esta enfermedad deja de ser un problema de salud pública en nuestro país.
In 2014, GHS/NACP, with support from UNICEF and other partners, conducted a situation analysis on paediatric HIV care and treatment in Ghana. The purpose of this analysis was to identify the gaps within the current delivery of paediatric HIV care and support system and develop a road map for effecti...ve implementation of Early Infant Diagnosis (EID) and to increase paediatric antiretroviral therapy (ART) coverage. The analysis identified gaps such as lack of task shifting on ART services, low paediatric ART coverage, and poor linkage of ART, EID, and PMTCT services with other RCH - immunization and nutrition services.
In view of the findings of the analysis, it was recommended that an Acceleration Plan for Paediatric HIV Services be developed to address the barriers and bottlenecks identified during the assessment. At the current pace of paediatric HIV Services, it can be extrapolated that paediatric ART coverage will increase from 26% to only about 40% by 2020; Ghana will, therefore, fall short of the global target of 90-90-90 (UNAIDS concept).
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Compared to the previous five-year assessment period 2011–2015, the current five-year period 2015–2019 has seen a continued increase in carbon dioxide (CO2 ) emissions and an accelerated increase in the atmospheric concentration of major greenhouse gases (GHGs), with growth rates nearly 20% high...er. The increase in the oceanic CO2 concentration has increased the ocean’s acidity.
The five-year period 2015–20191 is likely to be the warmest of any equivalent period on record globally, with a 1.1 °C global temperature increase since the pre-industrial period and a 0.2 °C increase compared to the previous five-year period.
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The report offers an overview of the progress the humanitarian sector has made and the obstacles it has faced over the past 10 years. Accountability is no longer just a fashionable term, there is now a shared understanding of what it takes to be accountable. From changes at policy level, to concrete... actions taken in the field, this report documents this sector-wide shift. It also shows that being accountable to the people we aim to serve is not just the right thing to do, it is also the best way to ensure programmes are relevant, effective, efficient and sustainable
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En este documento se ofrece, en un formato de fácil consulta, el panorama general de las cuestiones relativas a la salud y los derechos sexuales y reproductivos que pueden afectar a los derechos humanos, la salud y el bienestar de los adolescentes (de edades comprendidas entre los 10 y los 19 años...) y las directrices pertinentes de la Organización Mundial de la Salud (OMS) para abordar dichas cuestiones. Este documento permite acceder al amplio conjunto de directrices de la OMS al respecto y constituye un útil recurso para la labor de promoción, formulación de políticas, investigación y diseño de programas y proyectos. Tiene por finalidad apoyar la aplicación de la Estrategia Mundial para la Salud de la Mujer, el Niño y el Adolescente 2016-2030 (1) y está armonizado con las medidas mundiales aceleradas en favor de la salud de los adolescentes (AA HA!) de la OMS y el marco operativo de la OMS sobre salud sexual y su relación con la salud reproductiva (2, 3).
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STUDY REPORT | This study of the impact of the Nepal earthquake of 25 April, 2015, aims to understand the impact factors leading to the exclusion of older people and persons with disabilities from humanitarian action, barriers to their inclusion, and the extent to which their skills and knowledge we...re utilised to promote inclusive humanitarian action and, using this understanding, to formulate a set of recommendations for promoting inclusion. These recommendations will be used to sensitise the broader humanitarian community to the need for inclusive disaster risk management practices in future emergency responses which pay attention to factors such as gender, age, disability and ethnicity, and build upon the capacities of older people and persons with disabilities.
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This Guidance Document provides practical assistance to Country Offices scaling up programmes to manage SAM in young children. It outlines a step-by-step process through which countries can analyse their current situation, identify barriers and bottlenecks through the MoRES approach, and plan action... to scale-up treatment. In particular it addresses the challenge of supporting governments to accelerate and sustain scale-up, build national capacities and source reliable and sustained supplies and financing for managing SAM. This document also provides complementary background information, references to international technical recommendations, resources and tools.
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Disinfection of drinking-water supplies has been one of the most significant public health advancements of the last century with respect to reducing waterborne disease.
Although chlorine has been used as the disinfectant of choice for public drinking-water supplies for the past century, a numbe...r of emerging or alternative compounds are used or are being considered for the disinfection of drinking-water.
This series reviews the state of the knowledge on the application, efficacy and toxicity of bromine, iodine and silver as drinking-water disinfectants.
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The report provides the much-needed evidence to design interventions for children in Kenya and as such we urge partners to use this report as a document for planning for children.
This report is from the National study on living conditions among people
with disabilities carried out in Nepal in 2014-2015. The study was carried
out as a household survey with two-stage stratified sampling, including a screening/listing procedure using the Washington Group on Disability
Statis...tics 6 questions, one Household questionnaire administered to
households with (Case HHs) and without disabled members (Control
HHs), one Individual Case questionnaire administered to individuals who were found to qualify as being disabled in the screening (Case
individuals), and an Individual Control questionnaire administered to
matched non-disabled individuals in the Control HHs (Control individuals). The study covers a range of indicators on level of living, such as socioeconomic indicators, economic activity, income, ownership and infrastructure, health (including reproductive health), access to health information, access to services, education, access to information, social participation, and exposure to discrimination and abuse (see all
questionnaires in Appendix).
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