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 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.
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Policy Brief.
WHO recommends that pregnant women receive testing for HIV, syphilis and hepatitis B (HBSAg) at least once during pregnancy, preferably in the first trimester.
Dual HIV/syphilis rapid diagnostic tests (RDTs) can be used as the first test for pregnant women as part of antenatal care (...ANC).
These simple tests can be used at the point-of-care and are cost-saving compared to standard testing in ANC. They enable more women to be diagnosed with HIV and syphilis so that they can access treatment and prevent transmission to their children.
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ASLM in collaboration with the Africa Centres for Disease Control and Prevention, and in partnership with the Clinton Health Access Initiative, Amref and Last Mile Health present the Quality Assurance Framework for SARS-CoV-2 Antigen Rapid Testing f...or Diagnosis of COVID-19. This framework aims to provide general technical guidance to African Union Members States on the rollout, establishment, implementation, monitoring, and evaluation of SARS-CoV-2 Ag RDT interventions so as to effectively and efficiently detect, control and minimise errors in the performance of COVID-19 laboratory testing processes. It describes the core components for quality assurance, resources mobilisation and advocacy for scale up, monitoring, evaluation, learning and accountability for SARS-CoV-2 implementation.
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Diabetes mellitus, also called diabetes, is a chronic metabolic condition in which the hormone insulin is not produced by the
pancreas in sufficient quantities or is not utilized effectively by the body to control blood glucose levels. As a result,... blood
glucose levels are abnormally high (hyperglycaemia). Chronic uncontrolled hyperglycemia leads to long-term target organ damage, such as: retinopathy, nephropathy and neuropathy (microvascular complications); stroke, coronary heart disease
and peripheral arterial disease (macrovascular complications).
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The new WHO Guidelines on Sanitation and Health summarize the evidence on the effectiveness of a range of sanitation interventions and provide a comprehensive framework for health-protecting sanitation, covering policy and governance measures, implementation of sanitation technologies, systems and b...ehavioural interventions, risk-based management, and monitoring approaches. Critically, the guidelines articulate the role of the health sector in maximizing the health impact of sanitation interventions.
The guidelines also identify gaps in the evidence-base to guide future research efforts to improve the effectiveness of sanitation interventions.
(French, Spanish, Russian, Arabic in production)
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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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Cervical cancer, along with maternal deaths, has been identified as a national priority in
South Africa as well as other Sub-Saharan African countries. Cervical cancer is the
second most common cancer among women in South Africa, after breast cancer. Due
...">to limited access to prevention, early diagnosis and treatment, cervical cancer is often
fatal.
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This Case Study explores flood forecasting systems from the perspective of its position within the flood warning process. A method for classifying the different approaches taken in flood forecasting is introduced before the elements of a present-day flood forecasting system are discussed in detail. ...Finally, the state of the art in developing flood forecasting systems is addressed including how to deal with specific challenges posed.
The target group of this case study are decision makers in disaster risk management and/or water management. The case study should help to understand some hydrologic basics of the flood forecast and assist in the administration and implementation of an appropriate flood warning system in a specific environment, to find the best solution for a region.
Best solutions depend mainly on quality and availability of data, the areas and/or points of interest, catchment properties, cross border catchments, and financial capabilities with special consideration of flood forecast.
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The current guidelines on Integrated Management of Acute Malnutrition (IMAM), addresses the issue of improved management of severe acute malnutrition (SAM), particularly in children under 5 years of age. In the absence of standard protocols, mortality in children admitted ...ighlight medbox">to hospital with SAM can range between 20 -30% with the highest levels of 50-60% among those with oedematous malnutrition. With modern treatment regimens and improved access to treatment, case-fatality rates can be reduced to less than 5%. These provincial guidelines on IMAM in KZN, includes inpatient care protocols on the management of SAM, and outpatient and community outreach components to manage moderate acute malnutrition (MAM) and prevent deterioration to SAM.
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Climate change is one of the biggest crises of our time. Climate threats range from higher temperatures, heavy rainfalls and floods, erratic precipitation, droughts, desertification, and land degradation. This has negative implications on the quality and quantity of natural resources, such as land a...nd water, agricultural productivity, rural livelihood options, food prices, and nutrition security, particularly when there is a lack of adaptation capacities and preparedness measures (Pacillo, 2024). Farmers are at the forefront of the climate crisis where their livelihoods are being jeopardized, and they are faced with many challenges to secure water, energy, and agriculture inputs, and maintain agriculture productivity. This heightens the risk of competition over natural resources and aggravates grievances and structural inequalities related to land rights and ownership as well as land access, management, and governance. In Africa, land-related issues are among the triggers of many violent disputes (Medina et al, 2024). For instance, communal violence in Nigeria and Sudan is tied to competition over scarce fertile land and poor resource governance (Bruce and Bourdeaux, 2013).
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This report is from the National study on living conditions among people
with disabilities carried out in Nepal in 2014-2015. The study was carried
out as a household survey with two-stage stratified sampling, including a screening/listing procedure using the Washington Group on Disability
Statis...tics 6 questions, one Household questionnaire administered to
households with (Case HHs) and without disabled members (Control
HHs), one Individual Case questionnaire administered to individuals who were found to qualify as being disabled in the screening (Case
individuals), and an Individual Control questionnaire administered to
matched non-disabled individuals in the Control HHs (Control individuals). The study covers a range of indicators on level of living, such as socioeconomic indicators, economic activity, income, ownership and infrastructure, health (including reproductive health), access to health information, access to services, education, access to information, social participation, and exposure to discrimination and abuse (see all
questionnaires in Appendix).
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This third edition of the National Gender Statistics Report provides the updated sex-disaggregated data in twelve fields: Population and Youth; Education; Health and Nutrition; Economic Activity and time use; Poverty & Social Protection; Justice & Human rights; Environment and Natural Resources; Dec...isionmaking and Public life; Infrastructure, ICT and Media; Trade and Business and Industry; Agriculture, Livestock and Forestry, and lastly the Income and Access to Finance. It should be noted that this report takes into account almost all quantitative indicators of the United Nations Minimum Set of Gender Indicators (UNMSGI) as developed by the United Nations Statistical Division (UNSD) and some of the approved quantitative SDGs gender related indicators.
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Regional Network for Equity in Health in east and southern Africa (EQUINET): Disussion Paper 110
This report compiles evidence from published, grey literature and key informants on the UNMHCP
since its introduction in Uganda’s health system, and findings were further validated during a oneda...y
national stakeholder meeting.
Three main factors motivated introduction of the UNMHCP. First, Uganda, along with other lowincome countries, was unable to implement holistically the primary healthcare (PHC) concepts as set out in the Alma Ata Declaration. Second, the macro-economic restructuring carried out in the 1990s, which was an international conditionality for low-income countries to access development financing, influenced the trend towards more stringent prioritisation of health interventions as a means of rationing and targeting use of resources. Third, the government sought to achieve equity with a service package that would be universally available for all people.
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The report offers 20 top recommendations for getting ahead of future outbreaks in Yemen and similarly complex humanitarian settings.
In 2015, Yemen was declared a Level 3 emergency by the UN, kicking into gear the highest level of humanitarian support. A massive cholera outbreak followed, leading <...span class="attribute-to-highlight medbox">to 1 million suspected cases in 2 waves from September 2016-July 2018.
“We largely know ‘what to do’ to control cholera, but context-specific practices on ‘how to do it’ in order to surmount challenges to coordination, logistics, insecurity, access and politics remain needed,” the report states.
While the response improved between the 2 waves, there were gaps. For one, Yemen’s history of cholera should have triggered a heavy focus on pre-planning for an epidemic, such as stockpiling supplies and doubling down on community-based surveillance, the report fou
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Data on the essential building blocks of mental health systems, including mental health
governance, financing, service delivery, human resources and information, are reported. For
mental health planning, it is important to know not only the level ...of resources in these six areas,
but also how those resources are being organized and utilized. Thus, data on efficiency, access,
equity, linkages with other sectors and respect for human rights are reported as well.
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Early Childhood Matters is a journal about early childhood. It looks at specific issues regarding the development of young children, in particular from a psychosocial perspective. It is published twice per year by the Bernard van Leer Foundation.
On Page 54 of this issue the ...te-to-highlight medbox">article titled: "Parenting in times of war: supporting caregivers and children in crisis" can be found. In this article: Humanitarian interventions to support and guide parents and caregivers in times of war can mitigate the negative effects of violence and chaos on children and promote their resilience and development. This article highlights recent findings from the International Rescue Committee’s parenting programmes in Syria, underscoring the importance of such programmes not only in strengthening caregiving practices but also in addressing the psychological needs of parents.
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In recent years Terre des Hommes Netherlands observed the steady rise of a new form of child sexual exploitation. One that is enabled and fuelled by rapid technological advances, increasing global connectivity, persisting poverty rates, and growing disparity in the global distribution of resources. ...Terre des Hommes Netherlands received alarming signals from collaborating project partners from the Philippines that new commercial child exploitation trades are evolving and spreading parallel to rising global Internet access rates and developments in communications technology.
Webcam child sex tourism is evidently growing, closely related to child prostitution, child trafficking and child abuse. What is not clear however, are the psychological and social consequences of this new phenomenon. To date, no research has been done on the psychosocial consequences of webcam sex for children. The aim of this research is therefore to gain more knowledge on the psychosocial consequences of webcam child sex tourism for children and to give insight into the antecedent factors that play a role.
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Coronavirus Disease-19 (COVID-19) was declared a global pandemic on 11 March 2020, and Malawi declared its first case on 2 April. As of 30 April, there were 36 confirmed positive cases of COVID-19 and 3 deaths. A State of Disaster was declared by President ...>Arthur Peter Mutharika on 20 March and a 21-day lockdown was implemented from 18 April to 9 May. The lockdown measures include: bans on public gatherings; closure of schools; and bans on international flights and cross-border passenger buses.
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his document, a first of its kind, clearly sets out the standards for rehabilitation and provides guidance on building or strengthening the capacity of EMTs in this area.The importance of early rehabilitation for functional outcomes is well documented. Rehabilitation needs can pe...rsist far beyond the departure of EMTs; therefore, close, supportive collaboration must be established with local services. Emergency response presents an opportunity to rebuild devastated health systems and build local rehabilitation capacity. This document emphasizes the importance of aligning practices to the local context and maximizing opportunities for training and mentorship. The minimum standards and recommendations described will result in faster access of patients to rehabilitation services and equipment and a better transition between EMTs and local health facilities.
Available in English, German, Arabic, Chinese
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Primary health care, as outlined in the 1978 Declaration of Alma-Ata and again 40 years later in the 2018 WHO/UNICEF document A vision for primary health care in the 21st century: towards universal health coverage and the Sustainable Development Goals, is a whole-of-government and whole-of-society a...pproach to health that combines the following three components: multisectoral policy and action; empowered people and communities; and primary care and essential public health functions as the core of integrated health services.(1) Primary health care-oriented health systems are health systems organized and operated so as to make the right to the highest attainable level of health the main goal, while maximizing equity and solidarity. They are composed of a core set of structural and functional elements that support achieving universal coverage and access to services that are acceptable to the population and that are equity enhancing. The term “primary care” refers to a key process in the health system that supports first-contact, accessible, continued, comprehensive and coordinated patient-focused care.
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