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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This study compared clinical and autopsy findings for three asbestos-related diseases (asbestosis, mesothelioma and lung cancer) in former asbestos mineworkers, and explored factors that influenced agreement between clinical and autopsy findings using data from two compensation systems. In South Afr...ica, statutory compensation for occupational lung diseases in mineworkers makes provisions for autopsy examinations of the cardio-respiratory organs at the National Institute for Occupational Health (NIOH) in Johannesburg. In addition, the Johannesburg-based Asbestos Relief Trust and Kgalagadi Relief Trust (the “Trusts”) compensate individuals with defined asbestos-related diseases who worked in or lived near qualifying asbestos mining or processing operations. The Trusts also compensate dependents of deceased qualifying mineworkers and therefore encourage statutory autopsies for the detection of previously undiagnosed asbestos-related disease or disease that may have progressed to higher compensation grades.
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poo...rly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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The document is an instructional guide in english on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prepara...tion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in arabic on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, preparat...ion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in Burmese on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prepara...tion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in Portuguese on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prep...aration of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in somali on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, preparat...ion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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The document is an instructional guide in Spanish on how to use a metered-dose inhaler (MDI) with a spacer. It provides detailed, step-by-step instructions for using the device effectively to manage respiratory conditions like asthma. The guide emphasizes the importance of correct technique, prepara...tion of the inhaler, and proper administration to maximize the medication's effectiveness. It also highlights essential points for cleaning the spacer and mentions contacting a healthcare professional for additional assistance or guidance.
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In the Region of the Americas, as of 24 February 2023 (16:00 EST), there are a total of 58,578 confirmed cases of mpox (Table 1, Figure 2) were reported from 31 countries and territories, including 76 deaths in: United States of America (34), Brazil (15), Peru (15), Mexico (4), Chile (2), Ecuador (3...), Argentina (2), and Cuba (1), reported from 31 (Table 1, Annex 1, Figure 3). In the last 4 weeks (28 January – 24 February 2023), 607 additional mpox cases were reported from 16 countries and territories, including 9 deaths in Ecuador (1) and United States (8). Eight countries in the Region account for 97% of confirmed cases: United States of America, Brazil, Colombia, Mexico, Peru, Canada, Chile, and Argentina – listed by total number of cases in decrease order (Figure 4). The number of new weekly reported cases in EW 7 compared to EW 6 of 2023 (% variation) decreased by 55%.
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In Latin America and the Caribbean (LAC), one maternal death was registered every hour in 2020. That same year, the trend in the maternal mortality ratio (MMR) for the Region of the Americas regressed alarmingly and unprecedentedly to the levels seen two decades ago. In addition to indicating a wors...ening of health outcomes, these figures also signal a deepening of inequalities, representing thousands of individual, unacceptable tragedies that in most cases could have been preventable. Maternal death is the result of a multifactorial process in which structural elements such as the economic system, environmental conditions, and culture interact. Other factors related to social inequality are also present, such as racism, poverty, gender inequality, and lack of access to the education system. The current situation calls for urgent mobilization of the health systems of LAC countries in order to strengthen efforts to combat maternal mortality, especially in countries that are still far from achieving the SHAA2030 regional target. For this reason, a preventive, health-promoting, life-course-based approach is needed, with models of care centered on women, families, and the community Scientific evidence shows that health systems with a solid foundation in primary health care (PHC) achieve better outcomes, greater equity, and reduced health expenditures. To address this, PAHO proposes a strategy, aimed primarily at women who are in the most vulnerable situation, who are the ones who represent the greatest burden of maternal mortality, to accelerate the reduction of maternal mortality in the Region of the Americas, based on the expansion and strengthening of PHC.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa...l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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The Asthma Control Questionnaire (ACQ) was developed to measure the primary goals of asthma management as identified by international guidelines. All guidelines indicate that to achieve good control, treatment should minimise day- and night-time symptoms, activity limitation, airway narrowing and re...scue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity. Three independent studies have provided evidence that the ACQ is valid for measuring asthma control and has strong measurement properties for use both in clinical practice and research. In addition, the smallest change in score that can be considered clinically important has been determined.
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Globally, it is estimated that 1 billion people suffer from acute and chronic respiratory conditions, making them major causes of illness and death. Although there is a relative lack of data and evidence on lung diseases beyond tuberculosis (TB) in Sub-Saharan Africa (SSA), their estimated regional ...burden is large and growing. In addition, there is a poorly understood relationship between infections, such as TB, and non-infectious causes of lung health problems. The problem in lung diseases in SSA is exacerbated by many factors, including under-prioritisation, under-treatment and weak preventative measures.
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At the end of 2023, WHO convened our first-ever annual WHO Stakeholder Review Conference for Prevention and Response to Sexual Misconduct. Aimed at joint learning and frank discussion on challenges faced in the achieving zero tolerance for all forms of sexual misconduct by aid workers, the Conferenc...e brought together Member States, Civil Society Organizations, United Nations Agencies and Programmes, academia and media joined by WHO personnel. A set of recommendations to support all agencies are documented in the Conference Report. In addition, WHO’s Director-General hosted a social engagement segment on the evening of Day 1 to further underscore the centrality of a victim and survivor-centred approach, to celebrate progress however small, and to reaffirm commitment and renew energy for the journey ahead. The Conference took place on 30 November and 1 December 2023 in Geneva, Switzerland
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The IFRC Psychosocial Centre has published a guidance note providing an overview of the psychosocial consequences of virus outbreaks, with a focus on mpox, and outlines key considerations for MHPSS programming.
The current mpox outbreaks present numerous challenges for responding National Societi...es. A key issue is addressing stigma as individuals infected, or suspected of having mpox may experience social ostracization, discrimination, and even violence. In many African communities, where cultural and social norms are vital to community health, considering the cultural and psychosocial implications of virus outbreaks is integral for effective disease management. In addition, Red Cross Red Crescent staff and volunteers may be personally exposed and working in complex environments with rumours and misinformation generating fear and anxiety. This guidance addresses the key mental health and psychosocial support implications of the ongoing mpox crisis.
Guleed Dualeh, MHPSS Advisor
This guidance note is intended for Red Cross Red Crescent National Societies and IFRC departments who may be responding to mpox in their country, or region. It includes guidance on:
Common reactions and behaviours in epidemics
Caring for staff and volunteers in health emergencies
Integration of MHPSS considerations for into health responses
Links to existing relevant materials
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Coronavirus disease 2019 has a mild disease course in children and adolescents. Chronic respiratory conditions, including asthma, have been suggested as risk factors; however, asthma in children is highly variable in both triggers and severity.
During the pandemic, pediatric asthma services limite...d consultations and established virtual clinics. However, respondents perceived their patients’ asthma control to be retained or even improved, while treatment adherence was considered increased. Children with asthma were not disproportionately affected by coronavirus disease 2019.
Trigger avoidance and treatment adherence can rapidly improve asthma control in children, even under lockdown pressure. Children/adolescents with asthma do not appear to need additional prophylactic measures from coronavirus disease 2019 when asthma is well-treated. This article analyses the effect of COVID-19 on Asthma in children, providing information for management guidelines.
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Most of the global burden of sepsis occurs in low- and middle-income countries (LMICs), but the prevalence and etiology of sepsis in LMICs are not well understood. In particular, the lack of laboratory infrastructure in many LMICs has historically precluded an assessment of the pathogens leading to ...sepsis. A recent systematic review found that data describing antimicrobial resistance were absent for 43% of countries in Africa, and only two countries have national antimicrobial resistance plans. In addition, small studies have identified indiscriminate antibiotic use both in and out of hospital settings in sub-Saharan Africa. The absence of microbiological data and lack of antibiotic stewardship complicate sepsis management and almost certainly worsens outcomes, particularly in low-resource systems. The purpose of this study was to examine the prevalence, etiology, and outcomes of sepsis among a cohort of critically ill patients in a referral hospital of Malawi, with a focus on the prevalence of culture-confirmed bacteremia and urinary tract infections.
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The United Nations Framework Convention on Climate Change (UNFCCC) established its Financial Mechanism to facilitate the provision and transfer of resources from developed to developing countries. The Global Environment Facility became the first operating entity of the Financial Mechanism after the ...Conference of the Parties (COP) to the UNFCCC, and the GEF Council agreed to a Memorandum of Understanding (MOU) in 1996. This agreement placed the GEF under the guidance of the COP, as Article 11 of the Convention states that the Financial Mechanism “shall function under the guidance of and be accountable to the Conference of the Parties, which shall decide on its policies, program priorities and eligibility criteria related to this Convention.”
The yearly COPs have provided an opportunity for Parties to update and renew their guidance to the GEF. To date, there have been 145 UNFCCC COP decisions and 526 paragraphs that offer guidance to the GEF (see Table 1). In addition, the Conferences of the Parties serving as the meeting of the Parties to the Paris Agreement (CMA) have issued 40 decisions and 115 paragraphs as guidance to the GEF (see Table 2). Key areas of Convention guidance have included: the GEF’s role as an operating entity of the Financial Mechanism, including the Paris Agreement; the GEF’s institutional and procedural reform; transparency and access to GEF funds; country engagement and empowerment; reporting on greenhouse gas (GHG) inventories; support for technology transfer; and ongoing programming in mitigation and adaptation.
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Based on an increasing body of evidence pointing at the positive impact that social assistance has had in Malawi, the region and beyond, government is encouraged to continue investing in and supporting the expansion and comprehensiveness of social protection programmes in both rural and urban areas,... ensuring they effectively target and adequately address needs and vulnerabilities across the lifecycle, in line with the Malawi National Social Support Programme (MNSSP II) and Vision 2063. In addition, Government and Development Partners are encouraged to further the integration between social protection, the humanitarian and the disaster risk management sectors in response to shocks and stresses, through the roll out of a fully shock-sensitive social protection system.
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