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.
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In September, 2018, the first international Medicine Quality and Public Health Conference was held at Oxford University, UK, to discuss opportunities and solutions to ensure that all people have access to affordable and quality-assured medical products. Delegates developed the short Oxford Statement..., calling for investment, policy change, and action to eliminate substandard and falsified medical products. The statement was born out of discussion between governments, national and international agencies, non-governmental organisations, professional associations, and academic institutions who together examined the latest evidence on the epidemiology and public health implications of substandard and falsified medical products.
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23 February 2021
This document describes the medical devices required for the clinical management of COVID-19, selected and prioritized according to the latest available evidence and interim guidelines. This includes: oxygen therapy, pulse oximeters, patient monitors, thermometers, infusion and suc...tion pumps, X-ray, ultrasound and CT scanners as well as personal protective equipment. In order to facilitate access to quality assured priority medical devices, the document also includes technical and performance characteristics, related standards, accessories and consumables. It is intended for policy-makers and planning officers in Ministries of Health, procurement and regulatory agencies, intergovernmental and international agencies as well as the medical device industry.
This document is an update to the List of priority medical devices for COVID-19 case management and Technical specifications for invasive and non-invasive ventilators for COVID-19.
This document complements the Technical specifications of personal protective equipment for COVID-19.
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The UCL–Lancet Commission on Migration and Health steps into this political debate to provide evidence for cooperation and action on what is one of the most pressing issues of the 21st century. The Commission’s foundation is that migration and health are inextricably linked—and key to sustaina...ble development. It provides a framework of migration as a dynamic process, providing evidence of the multiple factors that could be beneficial or detrimental to individuals and systems along the migration journey—at origin, transit, destination, and return. It documents the devastating impacts of forced migration, especially on girls and women, but also the overall benefits to the health of individuals and populations that migration generates. It lays out a research agenda to better ensure the health of migrants. Using the lens of health the Commission shows that migration policies can be both ethical and feasible—calling for governments, international agencies, and professionals to promote health in global mobility.
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The UK government hosted the Global Vaccine Summit on June 4, 2020 under the patronage of the Rt. Hon. Boris Johnson, Prime Minister of the United Kingdom of Great Britain and Northern Ireland. The meeting was held by videoconference in light of the ongoing COVID-19 pandemic. 2. The Summit brought... together more than 300 people, including 42 Heads of State and Government. 62 countries were represented, notably 14 Gavi implementing countries, all of the G7 nations and 19 governments of the G20. Eminent participants also included H.E. Antonio Guterres, Secretary-General of the United Nations; H.E. Moussa Faki Mahamat, Chairperson of the African Union Commission; H.E. Dr Tedros Adhanom Ghebreyesus, WHO Director-General; H.E. Henrietta Fore, UNICEF Executive Director; Bill Gates, Co-Chair of the Bill & Melinda Gates Foundation; Ministers from implementing and donor countries; CEOs of vaccine manufacturing companies and private sector partners; leaders of UN and other international agencies; senior civil society representatives; and Gavi champions. A full list of the participants can be found in Annex.
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Countries are making progress toward the global goal of 95% of people living with HIV knowing their status by 2025. However, considerable gaps remain in achieving these goals globally. Men in high HIV burden settings and men from key populations in all settings are consistently less likely to know t...heir HIV status than women. Globally, 78% of men ages 15 years and older who are living with HIV are aware of their HIV status, compared with 86% of women with HIV of these ages.
Offering HIV testing services, including HIV self-testing, at formal and informal workplaces has emerged as an effective, acceptable and feasible approach for reaching men. A 2018 World Health Organization (WHO) and International Labour Organization (ILO) policy brief provides key guiding principles for HIVST implementation at workplaces. Building on the 2018 policy brief, this brief captures early experience with HIVST implementation at workplaces and discusses emerging approaches of sustainable financing that can be adapted for HIV self-testing at workplaces.
The primary audiences for this policy brief are ministries of health and labour, national HIV programmes, employers’ organizations, workers’ organizations (labour unions), enterprises, implementing partners, including civil society organizations, and health insurance agencies.
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Multiple pandemics, numerous outbreaks, thousands of lives lost and billions of dollars of national income wiped out—all since the turn of this century, in barely 17 years—and yet the world’s investments in pandemic preparedness and response remain woefully inadequate. We know by now that the ...world will see another pandemic in the not-too-distant future; that random mutations occur often enough in microbes that help them survive and adapt; that new pathogens will inevitably find a way to break through our defenses; and that there is the increased potential for intentional or accidental release of a synthesized agent. Every expert commentary and every analysis in recent years tells us that the costs of inaction are immense. And yet, as
the havoc caused by the last outbreak turns into a fading memory, we become complacent and relegate the case for investing in preparedness on a back burner, only to bring it to the forefront when the next outbreak occurs. The result is that the world remains scarily vulnerable.
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This new Policy aims at ensuring that evidence-based, highimpact nutrition interventions are developed and implemented at scale. The Policy will be implemented in line with the overarching National Development Strategy, which considers nutrition as one of the priority area under the social developme...nt thematic area.
The Policy is aligned with the Scaling Up Nutrition movement, global declarations and commitments, which Malawi is signatory such as the Sustainable Development Goals and the World Health Assembly targets. The Government of Malawi is indebted to all the people and institutions that were involved in reviewing the Policy. Special appreciation goes to the World Bank, Canadian International Development Agency, United States Agency for International Development – through the Food and Nutrition Technical Assistance III Project, and the United Nations organisations for their financial and technical support.
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The SAMHSA-HRSA Center for Integrated Health Solutions (CIHS) promotes the development of integrated primary and behavioral health services to better address the needs of individuals with mental health and substance use conditions, whether seen in specialty behavioral health or primary care provider... settings. CIHS is funded jointly by the Substance Abuse and Mental Health Services Administration(SAMHSA) and the Health Resources and Services Administration (HRSA), and run by the National Council for Behavioral Health.
Despite the high prevalence of mental health and substance use problems, too many Americans go without treatment — in part because their disorders go undiagnosed. Regular screenings in primary care and other healthcare settings enables earlier identification of mental health and substance use disorders, which translates into earlier care. Screenings should be provided to people of all ages, even the young and the elderly
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User Guide.
This Laboratory Assessment Tool (LAT) is specifically designed to assess capacities of existing laboratories which have implemented or aim to implement SARS-CoV-2 testing. It addresses both core capacities of a laboratory and specificities related to SARS-CoV-2 testing. It is a focused... and shorter version from the existing complete laboratory assessment tool that can be found at https://www.who.int/ihr/publications/laboratory_tool/en/
The target audience is any stakeholder performing laboratory assessments such as national health authorities, multilateral agencies, Non-Governmental Organizations (NGOs) and laboratory managers. Assessors can use the tool, and customized if needed, to meet local requirements or assessment context. This tool is an Excel file, which enables automatic calculations of module indicators.
https://www.who.int/publications/i/item/laboratory-assessment-tool-for-laboratories-implementing-covid-19-virus-testing
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The document provides educational messages and practical guidance to prevent and manage diarrhoea, particularly in children. It emphasizes hygiene practices like proper handwashing, using latrines, and safe food handling. It also highlights the importance of breastfeeding, balanced nutrition, immuni...zation, and the use of Oral Rehydration Solutions (ORS) and zinc for treating dehydration caused by diarrhoea. Developed alongside Save the Children programs in the Democratic Republic of the Congo, the material integrates health education into schools and communities, encouraging children to act as agents of change in promoting hygiene and health practices.
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The Sustainable Development Goals (SDGs) aim to transform our world. They are a call to action to end poverty and inequality, protect the planet, and ensure that all people enjoy health, justice and prosperity. It is critical that no one is left behind. In 2015, all the countries in the United... Nations adopted the 2030 Agenda for Sustainable Development. It sets out 17 Goals, which include 169 targets. These wide-ranging and ambitious Goals interconnect. SDG 3 is to ensure healthy lives and promote well-being for all at all ages. It has 13 targets measured through 26 indicators. However, a person’s health and well-being are affected not only by disease and treatment, but also by social and economic factors such as housing, poverty and education. Health targets can therefore also be found across the other SDGs. This fact sheet shows how alcohol consumption undermines commitments to achieve 13 of the 17 SDGs, impacting on a range of health-related indicators, such as child health, infectious diseases and road injuries as well as much broader range of indicators related to economic and social development, environment and equality. The inclusion of a specific target on harmful use of alcohol (SDG 3.5: strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol) into the SDGs demonstrates the key role of alcohol within the global development agenda. The factsheet highlights positive examples of Member States’ experiences. It provides a short overview of the most cost-effective and feasible policy recommendations to reduce alcohol consumption and alcohol-attributable burden in the WHO European Region, in line with the European Action Plan to Reduce the Harmful Use of Alcohol. It also suggests some important resources for Member States. This factsheet was launched as part of the European Awareness Week on Alcohol Related Harm 2020.
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The paper presents interview data from Malawian government representatives, trade unionists, employers and people with disabilities from the country's largest cities Lilongwe and Blantyre. Findings relate to the gap between the discourse of employers and government officials and that of workers with... disabilities. Firstly, we find a policy-based assumption of a formalised workforce that is not representative of the predominantly informal disabled workforce. Secondly, the disruptive, intermittent and often reactive nature of non-governmental organisation (NGO) interventions can limit long-term inclusivity agendas and undermine the work of disabled activists in Malawi. Lastly, we present findings on the stigmatised nature of disability in these urban centres. We find that stigma is economic: Urban workers with disabilities are discriminated against locally by employers, landlords and banks on assumptions they will not produce or earn enough to meet productivity demands, rent or repayment costs.
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The document "Priority medical devices list for the COVID-19 response and associated technical specifications" complements this guideline.
This document provides interim guidance on the quality, performance characteristics and related standards of personal protective equipment (PPE) to be used i...n the context of COVID-19. This includes WHO Priority Medical Devices, specifically: surgical masks, non-surgical masks, gloves, googles, face shields, gowns and N95 masks. It is intended for procurement agencies, occupational health departments, infection prevention and control departments or focal points, health facility administrators, biomedical and materials engineering, PPE manufacturers and public health authorities at both national and facility levels.
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The Africa Centres for Disease Control and Prevention (Africa CDC) Biosafety and Biosecurity Initiative was launched by the Africa CDC in April 2019 with the aim of strengthening the African Union (AU) Member States’ biosafety and biosecurity systems and enabling them to comply with national and i...nternational requirements for biosafety and biosecurity including the International Health Regulations (IHR) (2005), the Biological Weapons Convention (BWC), and United Nations Security Council Resolution (UNSCR) 1540 and the multi-country Global Health Security Agenda (GHSA). The World Health Organization (WHO) Joint External Evaluation (JEE) and the Global Health Security Index report confirmed the known capacity gaps in biosafety and biosecurity among Africa Union Member (AU).
The regional consultations by Africa CDC conducted between 2019-2021 highlighted the deficiency or limited availability of standardized and regionally recognized training programs in the continent, limiting biosafety and biosecurity capacity building efforts in the region. In response, Africa CDC working with AU Member States developed a home grown, implementable and accessible professional training and certification program that is both recognized and endorsed by AU Member States. The Regional Training and Certification Program for Biosafety and Biosecurity Professionals, for African Biosafety and Biosecurity Professionals (RTCP-BBP) has four (4) areas of specialization, namely
- Selection, Installation, Maintenance and Certification of Biological Safety Cabinets
- Biorisk Management
- Design and Maintenance of Facilities Handling High Risk Pathogens (Biocontainment Engineering)
- Biological Waste management
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The World Health Organization's Regional Office for Africa webpage on diabetes provides an overview of the disease's impact in the African Region. It highlights that diabetes is a serious, chronic, and costly condition, with projections estimating cases to rise to 23.9 million by 2030. The page outl...ines risk factors such as physical inactivity, overweight and obesity, tobacco use, and diets high in unhealthy fats and calories. It also discusses the three main types of diabetes: type 1, type 2, and gestational diabetes. Recent surveys indicate that up to 15% of adults aged 25 to 64 in the region have diabetes, with many unaware of their condition. The lack of access to proper treatment and medications, especially insulin, often leads to complications like neurological, vascular, or visual disorders, heart disease, stroke, lower limb amputation, and kidney failure.
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Le présent document donne des lignes directrices provisoires afin de garantir l’efficacité des communications sur les risques relatives à la transmission du virus Zika et aux complications potentielles. Le lien de causalité entre l’infection à virus Zika et ces complications potentielles n...a pas encore été prouvé. Malgré ces incertitudes, des stratégies de communication efficaces devraient être mises en œuvre afin de permettre aux gens de prendre les meilleures décisions éclairées pour se protéger et protéger leurs familles et leurs communautés. Les présentes lignes directrices sont destinées à être utilisées par les responsables, le personnel et les bénévoles chargés de la communication sur les risques et la santé à l’échelle mondiale, régionale ou nationale; les professionnels de la communication; les anthropologues; les sociologues; les agents de santé; les administrateurs des hôpitaux; les responsables communautaires; les gestionnaires de programme et les décideurs politiques.
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In the year 2008, for the first time in history, more than half of the world’s population was living in urban areas. Cities have become more numerous, more populous, and denser. The complexity and density of urban environments significantly alter the viability of certain humanitarian protection st...rategies that might work well in rural, more sparsely populated areas. In addition, it has become difficult to draw the line between acute and chronic vulnerability and therefore, the identification of beneficiaries. This blur in distinction between chronic and acute vulnerability has raised a number of important questions for humanitarian organizations regarding if and how they should intervene. While many such organizations are equipped with the appropriate skills to mitigate overwhelming public health challenges is such contexts, the absence of a crisis point - such as armed conflict or natural disaster - brings the mandate of humanitarian agencies into question.
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Vector-borne diseases are responsible for 17% of the global burden of communicable diseases and more than 500 000 deaths annually. The ambitious global targets for the control of vector-borne diseases come in the context of the (re-)emergence of diseases, increasing resistances to insecticides and u...ncertainty related to the financing of global vector control efforts. The United Nations 2030 Agenda with its related Sustainable Development Goals (SDGs), the New Urban Agenda adopted at the United Nations Conference on Housing and Sustainable Urban Development (Habitat III)
in Quito in 2016 and WHO’s Global vector control response 2017–2030 (WHO, 2017a) emphasize the value of elevating multisectoral actions and strategies that extend beyond the health sector to the core of integrated vector control.
This policy brief underlines the important role housing conditions have in the transmission of vector-borne diseases and showcases interventions and policies the housing sector can contribute to effective, integrated and intersectoral vector-borne diseases management.
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With the growing prevalence of type 2 diabetes, particularly in emerging countries, its management in the context of available resources should be considered. International guidelines, while comprehensive and scientifically valid, may not be appropriate for regions such as Asia, Latin America or Afr...ica, where epidemiology, patient phenotypes, cultural conditions and socioeconomic status are different from America and Europe. Although glycaemic control and reduction of micro- and macrovascular outcomes remain essential aspects of treatment, access and cost are major limiting factors; therefore, a pragmatic approach is required in restricted-resource settings. Newer agents, such as sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in particular, are relatively expensive, with limited availability despite potentially being valuable for patients with insulin resistance and cardiovascular complications. This review makes a case for the role of more accessible second-line treatments with long-established efficacy and affordability, such as sulfonylureas, in the management of type 2 diabetes, particularly in developing or restricted-resource countries.
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