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Ablo Prudence Wachinou, Serge Ade, Gildas Agodokpessi, Berenice Awanou, Dissou Affolabi, Wilfried Bekou, Marius Esse, Gabriel Ade, Severin Anagonou, Anthony D. Harries,1Programme National contre la Tuberculose (PNT), Cotonou, Bénin
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Background Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income ... (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 risk 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
Over 90% of the morbidity and mortality related to chronic obstructive pulmonary disease (COPD) and asthma occurs in low-income and middle-income <... (LMICs) due to well documented factors including decreased access to screening, trained health professionals, and therapies for disease management. Inhaler therapy (eg, aerosolised medications by inhalation, nebulisation, or propellant) is the mainstay of treatment for COPD and asthma. Adherence to maintenance medications for COPD and asthma results in improved lung function and quality of life, as well as decreased hospitalisation and mortality. WHO have included short-acting beta-agonists, long-acting muscarinic antagonists, and inhaled corticosteroids on the essential medications list, with a target goal of achieving 80% availability of these medications in public and private facilities. However, despite these efforts, accessibility, and affordability of medications for COPD and asthma remains scarce. more
Q6: What is the added advantage of doing neuroimaging in people with convulsive epilepsy in non-specialist settings in low and middle income countries... more
Accessed: 02.05.2020 The COVID-19 Hygiene Hub is a free service to help actors in low- and middle-income countries rapidly share, design, and ad... more
The incidence of circulatory disorders is increasing worldwide, affecting both low- and middle-income countries and some high-... countries. There is evidence of rising incidence and prevalence rates, even among younger individuals, along with an increasing prevalence of risk factors such as high blood pressure, diabetes, and obesity. These indicators suggest that current approaches are not effective in managing and reducing the burden of conditions affecting circulatory health. more
Non- Communicable Diseases (NCDs) over the years have not been given much attention in Ghana and in most Low and Middle- Income Countries (LMICs). ... more
Prevention, early identification, assessment and intervention in low- and middle-income countries | A Review | CHILD AND ADOLESCENT HEALTH AND DEVE... more
The 2020 Report analyzes global health spending for 190 countries from 2000 to 2018 and provides insights as to the health spending trajectory from the MDG era to the SDG era prior to the crisis of 2020. The report shows that global spending on heal... more
The availability of controlled medicines is crucial for patients requiring palliative care, pain relief and symptom management. Many individuals worldwide, especially in low- and middle-income ..., continue to experience limited access to these essential medicines. Enhancing access to controlled medicines is paramount in promoting universal health coverage. This report offers a detailed situational analysis of policies and programmes aimed at improving access to affordable, high-quality controlled medicines for pain management in the WHO South-East Asia Region. The report identifies the existing barriers, challenges and possible solutions to facilitate access to such medicines across all Member States. more
A new formulation of a drug to prevent excessive bleeding following childbirth could save thousands of women’s lives in low- and lower-middle-income cou..., according to a study led by the World Health Organization (WHO) in collaboration with MSD for Mothers and Ferring Pharmaceuticals. Currently WHO recommends oxytocin as the first-choice drug for preventing excessive bleeding after childbirth. Oxytocin, however, must be stored and transported at 2–8 degrees Celsius, which is hard to do, in many countries, depriving many women of access to this lifesaving drug. When they can obtain it, the drug may be less effective because of heat exposure. more
The aim of the WHO QualityRights tool kit is to support countries in assessing and improving the quality and human rights of their mental health and social care facilities. The tool kit is based on an extensive international review by people with ... more
The global burden of disease due to mental disorders continues to rise, especially in low- and middle-income countries (LMIC). In addition to causi... more
Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The pri... more
Q5: What is the added advantage of doing an electroencephalography (EEG) in people with convulsive epilepsy in non- specialist settings in low and middle income ...? more
ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online The guidelines have been developed by the International ... more
Hypertension is the leading preventable risk factor for cardiovascular diseases and disability globally. In low- and middle-income countries hypert... more
Chronic Obstructive Pulmonary Disease (COPD) is now one of the top three causes of death worldwide and 90% of these deaths occur in low- and middle-income ... (LMICs). More than 3 million people died of COPD in 2012 accounting for 6% of all deaths globally. COPD represents an important public health challenge that is both preventable and treatable. COPD is a major cause of chronic morbidity and mortality throughout the world; many people suffer from this disease for years and die prematurely from it or its complications. Globally, the COPD burden is projected to increase incoming decades because of continued exposure to COPD risk factors and aging of thepopulation. more
Every year, around 830 000 children die from unintentional or "accidental" injuries. The vast majority of these injuries occur in low-income and middle-in... countries. However, dozens of prevention strategies and programmes exist. If they were integrated into other child survival programmes and implemented on a larger scale, many of these deaths and much of the injury-related disability could be prevented.
The report documents the magnitude, risks and prevention measures for child injuries globally –particularly for drowning, burns, road traffic injuries, falls and poisoning.
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Inequality of access to palliative care and symptom relief is one of the greatest disparities in global health care (1). Currently, there is avoidable suffering on a massive scale due to lack of access to palliative care and symptom relief in low- a... more
Child marriage is defined as a formal or informal union before the age of 18. The practice affects mostly girls. While child marriage is especially prevalent in low and lower-middle income ..., it is also observed in other countries. It endangers the life trajectories of girls in multiple ways. Child brides are at greater risk of experiencing a range of poor health outcomes, having children at younger ages when they are not yet ready to do so, dropping out of school, earning less over their lifetimes and living in poverty compared to their peers who marry at later ages. Child brides may also be more likely to experience intimate partner violence, have restricted physical mobility, and limited decision making ability. M more