Long Acting Muscarinic Antagonists (LAMA) such as tiotropium and glycopyrronium are used in the management of COPD1. They have been shown to improve lung function, quality of life and exercise tolerance. They have also been associated with reduced COPD-related exacerbations, associated hospitalisati...ons and duration of hospital stay. Both the South African Thoracic Society (SATS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD), guidelines recommend the use of long acting anticholinergic drugs (or long acting beta agonists) in moderate to very severe disease as defined by lung function (FEV1). The most up to date guideline, utilizing the GRADE methodology (European Respiratory Society guidelines of 2017), confirms their superiority over long acting β agonists (LABA) as monotherapy for COPD in that LAMA's have demonstrated greater efficacy in terms of exacerbation reduction, with similar safety profile.2 These recommnedations are supported by published peer-reviewed
evidence including individual papers and Cochrane reviews.
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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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Voices from Leaders in the Field
Towards Malaria Elimination
The goal of this contingency plan for El Nino related epidemics is to contribute to the reduction in mortality and morbidity associated with El Nino epidemic threats by ensuring that appropriate systems to support health emergency preparedness, timely response and post disaster recovery and mitigati...on are in place at the national, district, health facility and community levels in Rwanda.
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This handbook aims to help labour inspectors deal with the issue of HIV/AIDS.
It establishes the links between the key principles and core responsibilities of labour inspectorates and the management of HIV/ AIDS at the workplace.
It includes training activities and practical tools to help inspecto...rs integrate HIV/AIDS in their work.
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This strategy takes into account the policies formulated by sectors with cross-cutting interests in school meals, such as education, health, social protection and agriculture.The strategy further complements the provisions of the National School Health Policy and the asso...ciated National School Health Guidelines (2009) into a school meals framework with six strategic objectives. Above all, the strategy encourages inter-ministerial coordination, multi-sectoral planning, stable funding and monitoring and evaluation for home-grown school meals to all children in Kenya.
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As a result of Russia’s invasion of Ukraine, the people of Ukraine, especially the most vulnerable, are paying an enormous price. Lives and livelihoods are being lost, with more than ten million people forced from their homes— and their country—in search of safety. The war has unleashed catast...rophic damage to the country’s economy and threatens lasting increases in poverty and societal upheaval. The scale of the war and the devastation it has caused have jeopardized Ukraine’s hard-fought development gains, through destruction of production and property, disruption of trade, diminished investment due to amplified uncertainty, and erosion of human capita
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In support of the African decade of disabled persons | 1st January 199 - 31st of December 2009