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1
The goal of asthma treatment is to obtain clinical control and reduce future risks to the patient. To reach this goal in children with asthma, ongoing monitoring is essential. While all components of asthma, such as symptoms, lung function, bronchial hyperresponsiveness and inflammation, may exist i
...
n various combinations in different individuals, to date there is limited evidence on how to integrate these for optimal monitoring of children with asthma. The aims of this ERS Task Force were to describe the current practise and give an overview of the best available evidence on how to monitor children with asthma.
22 clinical and research experts reviewed the literature. A modified Delphi method and four Task Force meetings were used to reach a consensus.
This statement summarises the literature on monitoring children with asthma. Available tools for monitoring children with asthma, such as clinical tools, lung function, bronchial responsiveness and inflammatory markers, are described as are the ways in which they may be used in children with asthma. Management-related issues, comorbidities and environmental factors are summarised.
Despite considerable interest in monitoring asthma in children, for many aspects of monitoring asthma in children there is a substantial lack of evidence.
more
Antimicrobial resistance (AMR) has emerged as a leading cause of death in the African region, surpassing fatalities from malaria, HIV, and TB. In response to this critical threat, the region has adopted the AMR Global Action Plan and the African Union Framework for Antimicrobial Resistance Control 2
...
020 – 2025, which is tailored to meet the specific needs of African nations through a coordinated approach. While most countries in the region have developed and prioritized National Action Plans (NAPs) to tackle AMR, the overall response remains inadequate given the magnitude of the threat, which endangers human, animal, environmental, aquatic, and plant health.
Africa bears a significant burden of infectious diseases, accounting for approximately 95% of malaria deaths, 70% of people living with HIV, and 25% of TB deaths globally. In 2019, AMR was linked to approximately 55,000 deaths from HIV, 30,000 from malaria, and 255,000 overall. Major drivers of AMR in the region include the overuse and misuse of antimicrobials in human and food systems, migration, suboptimal vaccination rates, and environmental contamination from hospital and pharmaceutical effluents. Additionally, there is a lack of access to quality-assured antimicrobials and diagnostics, compounded by inadequate knowledge about AMR. Unlike high-income countries, where indiscriminate antimicrobial use is the primary factor driving AMR, African countries face additional challenges, including a lack of access to clean and safe water, poor Water, Sanitation, and Hygiene (WASH) programs, inadequate infection prevention measures, and suboptimal vaccinations for preventable diseases. One in three hospitals in the region lacks clean, safe running water, and one in eight people defecate openly due to inadequate sanitation. Investments in WASH, infection prevention, and biosecurity could save approximately 700,000 lives annually.
Addressing AMR in Africa requires a comprehensive, multi-sectoral approach involving the entire society. Sustainable access to antimicrobials, including antibiotics, vaccines, and therapeutics, is crucial, as lack of access leads to more morbidity and mortality than AMR itself. Support for the region should focus on preventing infections, strengthening health and food systems, developing human resources, ensuring sustainable access to diagnostics and therapeutics, and investing in laboratory infrastructure to support surveillance and data generation.
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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi
...
ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati
...
ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma
...
symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
more
Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women
...
and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
more
Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt
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h raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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The active participation and engagement of health and care workers (HCWs) in health emergency preparedness, readiness and response is crucial to support risk communication, community engagement and infodemic management (RCCE-IM) interventions during emergencies. HCWs hold unique position
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s in society – repeatedly being identified among the main influencers of people’s behaviours: they are one of the most trusted sources of health information and advice in communities and role models for the acceptance and uptake of protective measures during health emergencies. On the frontline, HCWs have valuable insights and knowledge that can be harnessed to support health emergencies across the entire emergency cycle. Between October and December 2023, the WHO Regional Office for Europe interviewed key informants on strategies and experiences to meaningfully engage HCWs during emergencies
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The Department of Nutrition, HIV and AIDS (DNHA) in Ministry of Health and Population is grateful to all stakeholders who contributed to the development of the Nutrition Education Communication Strategy II. The DNHA acknowledges the financial and technical support from the World Bank and USAID throu
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gh the Nutrition, HIV and AIDS project and Food and Nutrition Technical Assistance Project (FANTA III)/FHI 360, respectively. The participation of several partners including Irish Aid, the European Union (EU), Gesellschaft für Internationale Zusammenarbeit (GIZ), United Nations Children’s Fund (UNICEF), World Food Programme (WFP), World Health Organisation (WHO), Food and Agriculture Organisation (FAO), Civil Society Organisation Nutrition Alliance (CSONA), Concern Worldwide and the Clinton Health Access Initiative(CHAI).
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On 14 August 2024, the Director-General of the World Health Organization determined that the upsurge of mpox in a growing number of countries in Africa constitutes a new public health emergency of international concern (PHEIC) under the International Health Regulations (IHR) (2005)
The WHO Global tuberculosis report 2024 provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
Malawi is a landlocked country with a surface area of 118,484 km2. Administratively, the country is divided into three regions, namely the Northern, Central and Southern regions. The country has 28 districts, which are further divided into traditional authorities (TA) ruled by chiefs. The TAs are su
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b-divided into villages, which form the smallest administrative units. The Village Development Committees (VDCs) under the TAs are responsible for development activities. Politically, each district is divided into constituencies that are represented by Members of Parliament (MPs) in the National Assembly for purposes of legislations. Constituencies are further divided into wards which are represented by a ward councillor at district assembly.
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interim guidance, 25 November 2024
Updated 10 August 2020
This document presents an essential medicines list (EML) to manage patients in intensive care units (ICUs) with suspected or confirmed COVID-19 diagnosis, which includes active ingredients with dosage form and concentration, and are preferably in the WHO Model Lists of Essent
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ial Medicines 2019; based on clinical presentations and symptoms identified and prioritized in World Health Organization (WHO) and Surviving Sepsis Campaign (SSC) guidelines and the evidence presented in these guidelines.
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The Privacy, Confidentiality and Security Assessment Tool - User Manual
UNAIDS (Joint United Nations Programme on HIVAIDS); PEPFAR
UNAIDS (Joint United Nations Programme on HIVAIDS); PEPFAR
(2019)
C2
UNAIDS / 2019 Guidance
First Global Patient Safety Challenge Clean Care is Safer Care
The WHO Guidelines on Hand Hygiene in Health Care provide health-care workers (HCWs), hospital administrators and health authorities with a thorough review of evidence on hand hygiene in health care and specific recommendations to impro
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ve practices and reduce transmission of pathogenic microorganisms to patients and HCWs. The present Guidelines are intended to be implemented in any situation in which health care is delivered either to a patient or to a specific group in a population. Therefore, this concept applies to all settings where health care is permanently or occasionally performed, such as home care by birth attendants.
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La recherche des contacts – associée à un dépistage rigoureux, à l’isolement et à la prise en charge des cas – est une stratégie clé pour interrompre les chaînes de transmission du SRAS-CoV-2 et réduire la mortalité associée à la COVID-19.
La fourniture de sang et de produits sanguins sûrs et efficaces pour la transfusion ou la fabrication d’autres produits sanguins fait intervenir un certain nombre de processus, allant de la sélection des donneurs de sang et de la collecte, au traitement et au dépistage des dons de sang ainsi qu
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’à l’analyse des échantillons des malades, à la délivrance de sang compatible et à son administration au patient. Il existe un risque d’erreur à chaque étape de la « chaîne de transfusion », et une défaillance à une quelconque de ces étapes peut avoir des conséquences graves pour les receveurs du sang ou des produits sanguins. Si la transfusion sanguine peut sauver des vies, elle comporte aussi des risques, en particulier la transmission des infections par le sang.
Le dépistage des infections transmissibles par transfusion (ITT) en vue d’exclure les dons de sang présentant un risque de transmettre une infection du donneur aux receveurs est une étape critique du processus visant à garantir au mieux la sécurité des transfusions. Un dépistage efficace des agents transmissibles par le sang les plus courants et les plus dangereux peut réduire le risque de transmission à des niveaux très faibles. more
Le dépistage des infections transmissibles par transfusion (ITT) en vue d’exclure les dons de sang présentant un risque de transmettre une infection du donneur aux receveurs est une étape critique du processus visant à garantir au mieux la sécurité des transfusions. Un dépistage efficace des agents transmissibles par le sang les plus courants et les plus dangereux peut réduire le risque de transmission à des niveaux très faibles. more
