The article "A 20-year follow-up study on chronic respiratory effects of exposure to cotton dust" evaluates the long-term impact of cotton dust exposure on respiratory health. It followed a cohort of Chinese cotton and silk workers from 1981 to 2001, comparing lung function and symptoms. Results sho...wed that cotton workers experienced greater declines in lung function and persistent respiratory symptoms compared to silk workers. The study found that exposure to airborne endotoxins in cotton dust was strongly linked to chronic respiratory impairment. It highlighted that stopping exposure helped improve lung function, particularly in non-smoking men, while smokers continued to show negative effects.
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The article "Under- and over-diagnosis of COPD: a global perspective" reviews the worldwide variation in the prevalence of chronic obstructive pulmonary disease (COPD) and issues related to its misdiagnosis. It highlights that COPD is under-diagnosed due to factors such as limited access to spiromet...ry and variable diagnostic criteria, especially in low- and middle-income countries. Conversely, over-diagnosis often results from reliance on non-standard criteria or inadequate spirometry use. The article discusses key risk factors, including age, gender, exposure to pollutants, and comorbidities, and emphasizes the need for standardized diagnostic practices to better address and manage COPD globally.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ with severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensu...s diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m...ethodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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About one fourth of the world’s population is estimated to have been infected with the tuberculosis (TB) bacilli, and about 5–10% of those infected develop TB disease in their lifetime. The risk for TB disease after infection depends on several factors, the most important being the person’s im...munological status. TB preventive treatment (TPT) given to people at highest risk of progressing from TB infection to disease remains a critical element to achieve the global targets of the End TB Strategy, as reiterated by the second UN High Level Meeting on TB in 2023. Delivering TPT effectively and safely necessitates a programmatic approach to implement a comprehensive package of interventions along a cascade of care: identifying individuals at highest risk, screening for TB and ruling out TB disease, testing for TB infection, and choosing the preventive treatment option that is best suited to an individual, managing adverse events, supporting medication adherence and monitoring programmatic performance.
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The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and physiology, as well as sections on evaluation and tr...eatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
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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...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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Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We aimed to better understand social norms and commun...ity perceptions of preterm infants and KMC (facility-initiated and community-continued) in Malawi, a country with a high preterm birth rate, to inform a pilot social and behavior change program.
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To identify and to assess factors enhancing or hindering the delivery of breast and cervical cancer screening services in Malawi with regard to accessibility, uptake, acceptability and effectiveness.
Systematic review of published scientific evidence. A search of six bibliographic databases and gre...y literature was executed to identify relevant studies conducted in Malawi in the English language, with no time or study design restrictions. Data extraction was conducted in Excel and evidence synthesis followed a thematic analysis approach to identify and compare emerging themes.
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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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As our world changes, so too does the burden of disease. Globalisation, evolving trade and consumption patterns, and increased access to life-saving medical care are just some of the factors that have transformed the global health landscape.
This is the 42nd situation report for the multi-country outbreak of mpox, which provides an update on the epidemiological situation of mpox in Africa (including countries in the WHO African Region and some countries in the WHO Eastern Mediterranean Region), with data as of 3 November 2024.
There has been a rapid expansion of cash-based, social protection programmes in sub-Saharan Africa (SSA) in recent years as Governments increasingly realise the enormous benefits cash transfers offer (World Bank, 2018). In fact, as an investment in human capital and inclusive economic development, ...social protection is arguably one of the most efficient uses of Government resources and “one of the smartest investments that policymakers can support” (Cummins, 2021).
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UNICEF Malawi and its partners are prioritizing renewable energy solutions for children and communities across the country to access clean and affordable electricity, with a focus on hard-to-reach, rural communities unable to access the national electricity grid.
HIV testing programmes need to ensure that all clients who test for HIV are provided with correct diagnoses. The accuracy of HIV testing is critical to prevent misdiagnosis, as the consequences of giving an incorrect test result can be serious for clients, HIV testing services, HIV programmes and pu...blic health.
With the evolution of global HIV epidemiology, HIV testing approaches must also evolve to maintain accuracy and efficiency in population-level diagnosis. Reports suggest that misdiagnosis of HIV status may occur when suboptimal testing algorithms and out-of-date testing strategies are used. As a result of changing epidemiology and declining HIV positivity in testing, WHO recommends all countries use a standard three-test strategy to ensure a PPV of at least 99%, minimizing false-positive misdiagnosis. The WHO-recommended HIV testing strategy, along with quality assurance measures such as retesting to verify a positive diagnosis prior to initiation of HIV treatment, is cost-effective as it prevents misdiagnosis and unnecessary initiation of costly lifelong treatment.
This implementation guide provides practical advice on switching to a three-test strategy and instituting other measures that can help national HIV programmes deliver high-quality, accurate HIV testing services and ensure that misdiagnosis is minimized.
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Antimicrobials are medicines, including antibiotics, antivirals, antifungals, and antiparasitics, that are used to prevent and treat infections in humans, animals, and plants. Antimicrobial Resistance (AMR) arises when bacteria, viruses, fungi, and parasites no longer respond to these medicines, ren...dering them ineffective and making infections more difficult to treat. This resistance increases the risk of disease spread, severe illness, disability, and death. Although AMR is a natural phenomenon driven by genetic
changes in pathogens, it is significantly accelerated by human activities such as the misuse and overuse of antimicrobials in healthcare, agriculture, and animal husbandry.
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Caring for burns patients from the incident scene to definitive treatment can be a complex, resource-consuming process with the potential to overwhelm health system capacity.This document provides practical guidance for building capacity and capability for burns care from clinical, human resources a...nd operational perspectives. It is therefore recommended that guidance in this document be applied to any contexts in which the local health system might struggle to cope and require surge support.
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Мы предлагаем вам ознакомиться с практическим руководством Программы Организации Объединенных Наций по международному контролю над наркотиками (ЮНДКП) по планир...ованию и предоставлению услуг в области лечения наркомании и реабилитации.
Издание Лечение наркомании и реабилитация: практическое руководство по планированию и осуществлению призвано служить практическим средством для правительств, специалистов по планированию политики, лиц, предоставляющих услуги и обеспечивающих лечение. Представленный материал может быть полезен в весьма различных национальных и культурных условиях
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Pneumonia and diarrhoea account for 23% of under-five mortality and were responsible for an estimated 1.17 million deaths in children under five globally. Furthermore, pneumonia and diarrhoea were responsible for 18% of mortality in children 5–9 years of age, resulting in an estimated 86 000 preve...ntable deaths globally in 2021. Existing World Health Organization (WHO) guidance on the clinical management of pneumonia and diarrhoea has mainly focused on children less than 5 years of age.
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