asthma is a chronic inflammatory and a heterogeneous condition of respiratory system whose pathogenesis is linked with variable structural changes. The clinical manifestation of asthma includes attacks of breathlessness, cough, chest tightness and wheezing. Provision of basic equipment and test for ...asthma diagnosis and access to essential medicines by asthmatic patients reduces morbidity and mortality rates. Significant progress has been made in the diagnosis and management of asthma in other countries but not in the health care delivery system in Zimbabwe. Therefore, the aim of this study was to develop algorithm for asthma diagnosis and management for Zimbabwe.
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Demographic and epidemiological transitions are changing the age structure of the population and the most common diseases. Non-communicable respiratory diseases are an increasing problem at both ends of the age range in low-income and middle-income countries. In children, who represent a large propo...rtion of the total population, the increasing problem of asthma is a strain on health services. Improved survival of the older population is increasing the proportion of morbidity and mortality attributable to chronic lung diseases. Health services in low-resource countries are poorly adapted to treating chronic diseases. Designed to respond episodically to acute disease, almost all historical investment has focused on infectious diseases. Crucial to the successful management of chronic diseases is an infrastructure designed to support pro-active management, providing not only an accurate diagnosis, but also a secure supply of cost effective drugs at an affordable price. The absence of such an infrastructure in many countries and the market failure that makes drugs generally more expensive in low-resource regions means that many people with chronic non-communicable lung diseases are not given effective treatment. This has damaging economic consequences. The common causes of poor lung health in lowincome countries are not the same as those in richer countries, and there is a need to study why they are so common and how best to manage them.
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Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se...verely affect their everyday lives. Children die from asthma, especially in low and middle-income countries (LMICs). In many countries, asthma prevalence is rising. Access to effective care and changing environments are hugely variable and may explain the higher morbidity in inner-city children, in LMICs, and in deprived populations in high-income countries. Despite the disease being eminently controllable, morbidity and mortality persist.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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L’un des principaux défis auxquels fait face le secteur de la santé au Togo est la mise à la disposition des décideurs, des partenaires et du public des données fiables, pertinentes et à temps opportun. Le présent annuaire des statistiques sanitaires a pour objectif, de contribuer à releve...r ce défi, en fournissant des informations de qualité sur le niveau de réalisation des plans d’action et des prestations de santé afin d’apprécier le niveau de performances de la mise en oeuvre des interventions à l’échelle du pays.
Cette publication retrace, sous forme de tableaux et de graphiques, les activités du département de la santé au Togo en 2016. Il s’agit : (i) des ressources en santé, (ii) de l’utilisation des services, (iii) des principales causes de morbidité et de mortalité, (iv) de la situation des maladies prioritaires et (v) des activités préventives et promotionnelles.
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Le présent document expose des recommandations exhaustives de l’OMS sur les soins prénatals systématiques à l’intention des femmes enceintes et des adolescentes. Le but de ces recommandations est de compléter les directives de l’OMS existantes sur la prise en charge des complications spé...cifiques associées à la grossesse. Elles sont destinées à refléter et à répondre à la nature complexe des problèmes entourant la pratique et la délivrance des soins prénatals et à donner la priorité à la santé et au bien-être de la personne – et pas seulement à la prévention de la mortalité et de la morbidité – selon une démarche visant le respect des droits de l’homme.
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Le suicide est évitable. Pourtant, toutes les 40 secondes, une personne se suicide quelque part dans le monde et bien plus tentent de mettre fin à leurs jours. Aucune région ni aucune tranche d’âge n’est épargnée. Il touche toutefois particulièrement les jeunes de 15 à 29 ans, chez qui i...l constitue la deuxième cause de mortalité à l’échelle mondiale
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Les maladies infectieuses sont en constante mutation. De nouvelles maladies apparaissent, d’autres qui sont bien connues se propagent ou refont surface, et quelques rares fois, une maladie est éradiquée. Les maladies infectieuses telles que le VIH, la tuberculose et le choléra sont des causes c...onsidérables de morbidité et de mortalité dans plusieurs régions du monde. Le personnel de la santé joue un rôle primordial, en ce qui concerne la protection de leurs clients contre les maladies infectieuses et leurs traitements en cas d’infection. Dans le cadre de leur travail, le personnel de santé accomplisse des tâches cliniques ou autres activités susceptibles de les exposer ainsi que leurs clients aux microorganismes – orga- nismes potentiellement infectieux. Bon nombre de ces clients sont malades et, par conséquent, sont plus vulnérables aux infections ou peuvent avoir des infec-tions susceptibles d’être transmises à d’autres personnes. Par chance, l’ensemble du personnel travaillant dans les services de santé est en mesure d’exécuter des procédés simples visant à minimiser le risque – vis-à-vis d’eux-mêmes et de leurs clients – et réduire la propagation des infections. Ces pratiques peuvent être intégrées à moindre frais dans les habitudes quotidiennes au sein des établissements de santé du monde entier. Ce guide de référence est spécialement conçu pour l’emploi à tous les niveaux du système sanitaire, depuis les plus grands hôpitaux jusqu’aux plus petits dispensaires ou centres de santé, dans des établissements où les ressources sont rares.Ce guide, publié pour la première fois en 1999, a été mis à jour. Bien que la plu-part des pratiques restent inchangées, il a fait l’objet de quelques modifications significatives – par exemple, concernant les recommandations liées au lavage des mains et aux précautions standard. Toutefois, ce guide continue de présenter des recommandations pratiques en matière de procédés simples et relativement peu coûteux pouvant être exécutés partout, à l’aide des matériels de base et des équi-pements de niveau technologique moyen.
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Par ailleurs l’existence d’éléments épidémiologiques en faveur d’une sous-estimation du nombre réel de cas de COVID-19 et de l’existence d’une transmission communautaire soutenue dans une zone géographique pour lesquels les deux critères ci-dessus ne sont pas observés pourra être ...prise en compte dans la décision de l’inclure dans la liste des zones d’exposition à risque (par exemple : un taux de mortalité parmi les cas confirmés beaucoup plus élevé qu’attendu ; la détection de cas exportés depuis cette zone dans plusieurs pays ; une proportion importante des cas confirmés sans historique de voyage/séjour dans une zone d’exposition à risque ni contact identifié avec un cas confirmé de COVID-19).
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Le Burkina Faso traverse des flambées épidémiques complexes sans précédent de la poliomyélite et du virus Corona qui affectent gravement le pays.
Avec de multiples maladies endémiques et d'autres flambées signalées telles que la rougeole, la méningite, le virus Corona, découvert pour l...a première fois en Chine début décembre 2019, a gravement affecté la population du Burkina Faso et son système de santé. Comme c'est le cas pour plusieurs pays Il s'agit de la première histoire de l'épidémie de corona virus dans le Pays, et qui est l'un des pays à avoir enregistré de nombreux cas avec un taux de mortalité élevé. La particularité est le mélange de crise humanitaire et la pandémie COVID-19 marqué par une transmission interhumaine active et étendue dans différentes régions du pays.
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Les Centres africains de contrôle et de prévention des maladies (Africa CDC) ont pris connaissance des communiqués de presse concernant les résultats préliminaires d'un vaste essai clinique randomisé mené au Royaume-Uni, qui incluait la dexaméthasone, un corticostéroïde, parmi les médicam...ents utilisés pour le traitement des patients atteints de COVID-19. Les chercheurs ont rapporté que l'administration de dexaméthasone par voie orale ou injectable a permis de réduire d'environ un tiers la mortalité chez les patients COVID-19i qui nécessitaient une ventilation mécanique et d'environ un cinquième chez les patients nécessitant de l'oxygène. Depuis la publication de ces rapports médiatiques, les autorités sanitaires du Royaume-Uni et d'Afrique du Sud ont adopté la dexaméthasone pour le traitement des patients atteints de formes graves de COVID-19
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Dans le plan stratégique de lutte contre le paludisme 2011-2015 révisé en 2013,
le Burkina Faso a retenu les axes stratégiques suivants: la prise en charge des
cas de paludisme, le traitement préventif intermittent du paludisme chez les
femmes enceintes et les enfants, la chimio prévention ...du paludisme saisonnier
(CPS), la lutte contre les vecteurs, la gestion de l’approvisionnement des
produits de lutte contre le paludisme, la communication, le suivi-évaluationrecherche et la gestion du programme.
Directives nationales de prise en charge du paludisme 6
L’objectif des présentes directives est de standardiser les protocoles de prise en
charge du paludisme dans le but de contribuer à la réduction de la morbidité et
de la mortalité liées à cette maladie. Ces directives traitent spécifiquement de la
définition de cas, de la classification des formes cliniques, des modalités de prise
en charge des cas, des modalités de la prévention du paludisme pendant la
grossesse et chez le nourrisson, et enfin du suivi-évaluation des activités de
prise en charge du paludisme.
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Le document, intitulé « Progrès dans la prévention et le contrôle des maladies non transmissibles », rend compte des efforts mondiaux pour réduire l’impact des MNT (maladies non transmissibles), telles que les maladies cardiaques, le cancer, le diabète et les maladies respiratoires chroniq...ues, conformément aux engagements pris lors de réunions de haut niveau des Nations Unies. Il souligne les progrès insuffisants pour atteindre l’objectif de développement durable 3.4, qui vise à réduire d’un tiers la mortalité prématurée liée aux MNT d'ici 2030. Les principaux défis incluent le manque de financement, la mise en œuvre limitée d’interventions efficaces et des obstacles politiques et économiques, en particulier dans les pays à faible revenu. Le rapport appelle à renforcer la coopération internationale, à réformer les politiques et à adopter des approches innovantes pour atteindre les objectifs mondiaux en matière de santé.
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Despite progress in improving antiretroviral therapy (ART) for people with HIV in Malawi, the burden of HIV infections and HIV treatment outcomes among key populations is suboptimal. Client-centered differentiated service delivery approaches may facilitate addressing HIV prevention and treatment nee...ds of key populations in Malawi.
Methods
De-identified program data routinely collected as part of the LINKAGES project–Malawi were assembled from October 2017 to September 2019. HIV case finding was compared across different testing modalities for each population. Poisson regression was used to estimate the association between testing modalities and ART initiation.
Results
Of the 18 397 people included in analyses, 10 627 (58%) were female sex workers (FSWs), 2219 (12%) were men who have sex with men (MSM), and 4970 (27%) were clients of FSWs. HIV case finding varied by modality and population, with index testing and enhanced peer outreach demonstrating high yield despite reaching relatively few individuals. FSWs who tested positive through risk network referral testing were more likely to initiate ART within 30 days compared with those who tested positive through clinic-based testing (adjusted risk ratio [aRR], 1.50; 95% CI, 1.23–1.82). For MSM, index testing (aRR, 1.45; 95% CI, 1.06–2.00) and testing through a drop-in center (aRR, 1.82; 95% CI, 1.19–2.78) were associated with 30-day ART initiation.
Conclusions
These data suggest that differentiated HIV testing and outreach approaches tailored to the needs of different key populations may facilitate improved ART initiation in Malawi. Achieving 0 new infections by 2030 suggests the need to adapt treatment strategies given individual and structural barriers to treatment for key populations with HIV in high-prevalence settings.
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The document titled "Prevención y control del cólera" (Cholera Prevention and Control) provides essential guidance on preventing and managing cholera, a disease characterized by severe watery diarrhea and vomiting. Without prompt treatment, cholera can lead to death due to dehydration within hours.... The disease is primarily transmitted through the ingestion of food or water contaminated with the feces of an infected person.
To protect against cholera and other diarrheal diseases, the document emphasizes the importance of drinking safe water, such as bottled water with intact seals, boiled water, or water treated with chlorine products. Frequent handwashing with safe water and soap is recommended, and in the absence of soap, hands can be cleaned using ash or sand followed by rinsing with safe water. Proper sanitation practices, such as using latrines or burying feces and avoiding defecation near water sources, are crucial. The document also highlights safe food practices, including thoroughly cooking food (especially seafood), consuming it while hot, keeping it covered, and peeling fruits and vegetables. Ensuring the safe cleaning of kitchens and areas where the family bathes or washes clothes is also advised.
In case of diarrheal illness, the document stresses the immediate use of oral rehydration solution (ORS) to prevent dehydration and the importance of seeking medical attention as quickly as possible. Patients should continue ORS intake both at home and during transit to a health facility. These preventative measures and prompt treatment strategies are vital for reducing cholera transmission and mortality.
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The 2018 NDHS is a national sample survey that provides up-to-date information on demographic and health indicators. The sample was selected using a stratified, two-stage cluster design, with enumeration areas (EAs) as the sampling units for the first stage. The second stage was a complete listing o...f households carried out in each of the 1,400 selected EAs. The target groups were women age 15-49 and men age 15-59
in randomly selected households across Nigeria. A representative sample of approximately 42,000 households was selected for the survey. One-third of the households (14,000) were selected for malaria, anaemia, and genotype testing of children age 6-59 months. Also, in the subsample of households selected
for the men’s survey, one eligible woman in each household was randomly selected for additional questions regarding domestic violence. Specifically, information was collected on fertility levels, marriage, fertility preferences, awareness and use of family planning methods, child feeding practices, nutritional status of women and children, adult and childhood mortality, awareness and attitudes regarding
HIV/AIDS, and female genital mutilation. The survey also assessed the nutritional status (according to weight and height measurements) of women and children in these households. In addition to presenting national estimates, the report provides estimates of key indicators for both rural and urban areas, the country’s six geopolitical zones and 36 states, and the Federal Capital Territory (FCT).
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This review focusses on the interactions between the etiologic agent of Chagas disease, Trypanosoma cruzi, and its triatomine vector. The flagellate mainly colonizes the intestinal tract of the insect. The effect of triatomines on trypanosomes is indicated by susceptibility and refractoriness phenom...ena that vary according to the combination of the strains. Other effects are apparent in the different regions of the gut. In the stomach, the majority of ingested blood trypomastigotes are killed while the remaining transform to round stages. In the small intestine, these develop into epimastigotes, the main replicative stage. In the rectum, the population density is the highest and is where the infectious stage develops, the metacyclic trypomastigote. In all regions of the gut, starvation and feeding of the triatomine affect T. cruzi. In the small intestine and rectum, starvation reduces the population density and more spheromastigotes develop. In the rectum, feeding after short-term starvation induces metacyclogenesis and after long-term starvation the development of specific cells, containing several nuclei, kinetoplasts and flagella. When considering the effects of T. cruzi on triatomines, the flagellate seems to be of low pathogenicity. However, during stressful periods, which are normal in natural populations, effects occur often on the behaviour, eg, in readiness to approach the host, the period of time before defecation, dispersal and aggregation. In nymphs, the duration of the different instars and the mortality rates increase, but this seems to be induced by repeated infections or blood quality by the feeding on infected hosts. Starvation resistance is often reduced by infection. Longevity and reproduction of adults is reduced, but only after infection with some strains of T. cruzi. Only components of the surface coat of blood trypomastigotes induce an immune reaction. However, this seems to act against gut bacteria and favours the development of T. cruzi.
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The Democratic Republic of Timor-Leste has the highest TB incidence rate in the South East Asian Region - 498 per 100,000, which is the seventh highest in the world. In Timor-Leste TB is the eighth most common cause of death.
The salient observations are as follows:
In 2018, 487 (12.5%) of the... 3906 notified TB patients were tested for RR-TB and only 12 lab confirmed RR-TB patients were initiated on standard MDR-TB treatment of 20-months duration, (a 3-fold increase in RR-TB detection compared with 2017). This amounts to treatment coverage of only 17% of 72 estimated MDR/RR-TB among notified TB patients (3906) and 5% of 240 estimated incident MDR-TB patients as compared to 62% treatment coverage of 6300 incident drug sensitive TB patients estimated in TLS. The treatment success in the 2016 annual cohort of 6 MDR-TB patients has been reported at 83%. 80% of TB patients know their HIV Status with around 1% TB-HIV co-infection, 37/ 77 (48%) TB-HIV Co-infection Detected. Of the 387 PLHIV currently alive on ART, exact status on TB screening and testing is unknown. % of PLHIV newly enrolled in HIV care who received IPT is not known.
In 2018, the mortality rate for TB was 94 deaths per 100,000 people (1200 per annum) in TL with an increasing mortality trend (Figure 1), despite TB services being available for nearly two decades.
A survey of catastrophic costs due to TB (2016) highlights that 83% of TB patients are reported to be facing catastrophic costs due to the disease. This is the highest rate in the world.
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In 2015, the United Nations set important targets to reduce premature
cardiovascular disease (CVD) deaths by 33% by 2030. Africa disproportionately
bears the brunt of CVD burden and has one of the highest risks of dying
from non-communicable diseases (NCDs) worldwide. There is currently
an epide...miological transition on the continent, where NCDs is projected
to outpace communicable diseases within the current decade. Unchecked
increases in CVD risk factors have contributed to the growing burden of three
major CVDs—hypertension, cardiomyopathies, and atherosclerotic diseasesleading to devastating rates of stroke and heart failure. The highest age
standardized disability-adjusted life years (DALYs) due to hypertensive heart
disease (HHD) were recorded in Africa. The contributory causes of heart failure
are changing—whilst HHD and cardiomyopathies still dominate, ischemic
heart disease is rapidly becoming a significant contributor, whilst rheumatic
heart disease (RHD) has shown a gradual decline. In a continent where health
systems are traditionally geared toward addressing communicable diseases,
several gaps exist to adequately meet the growing demand imposed by CVDs.
Among these, high-quality research to inform interventions, underfunded
health systems with high out-of-pocket costs, limited accessibility and
affordability of essential medicines, CVD preventive services, and skill
shortages. Overall, the African continent progress toward a third reduction
in premature mortality come 2030 is lagging behind. More can be done in
the arena of effective policy implementation for risk factor reduction and
CVD prevention, increasing health financing and focusing on strengthening
primary health care services for prevention and treatment of CVDs, whilst
ensuring availability and affordability of quality medicines. Further, investing
in systematic country data collection and research outputs will improve the accuracy of the burden of disease data and inform policy adoption on
interventions. This review summarizes the current CVD burden, important
gaps in cardiovascular medicine in Africa, and further highlights priority
areas where efforts could be intensified in the next decade with potential
to improve the current rate of progress toward achieving a 33% reduction
in CVD mortality.
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Cholera is an acute gastrointestinal infection caused by the bacterium Vibrio Cholerae serogroup O1 or O139, and is often linked to unsafe drinking water, lack of proper sanitation and personal hygiene. It adversely affects mostly the poor and vulnerable populations in countries, which are already d...eprived of proper health facilities and conducive environmental conditions. The disease spreads through oro-fecal transmission by the ingestion of contaminated food or water or by person-to-person contact. It has a short incubation period of 2 hours to 5 days and the number of affected cases can rapidly increase across large regions. Cholera is a significant threat to global public health leading to an estimated 3-5 million cases per year worldwide, with an annual toll of 100,000 deaths. The disease was first reported in 1817 from the Ganges Delta of India and since then the ongoing 7th pandemic has emerged from Indonesia, reached Africa in 1970 and Somalia happens to be one of the early affected countries. Over the past few decades,
Somalia has witnessed the occurrence of repeated AWD/Cholera disease outbreaks that have caused high morbidity and mortality across the country.
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