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 ris...k 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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Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r...eport was published in 2014, and updated in 2015, reflecting an evolving understanding of heterogeneous airways disease, a broader evidence base, increasing interest in targeted treatment, and evidence about effective implementation approaches. During development of the report, the clinical utility of recommendations and strategies for their practical implementation were considered in parallel with the scientific evidence.
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Several challenges face asthma management in Egypt, including the high percentage of uncontrolled patients, inadequate compliance, and overuse of short-acting beta-agonists (SABAs) leading to increased asthma-related morbidity and mortality. In this regard, the recent Global Initiative for Asthma (G...INA) recommendations included inhaled corticosteroids containing therapy for mild asthma. Local healthcare systems and healthcare professionals (HCPs) often experience practical challenges when implementing global guidelines.
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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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The HIV/AIDS Sustainability Index Dashboard is a tool completed every two years by President’s Emergency Plan for AIDS Relief (PEPFAR) teams, host government and partner stakeholders to sharpen the understanding of each country’s sustainability landscape and to assist PEPFAR and other donors in ...making informed HIV/AIDS investment decisions. Based on responses to more than 100 questions, the SID assesses the current state of sustainability of national HIV/AIDS responses across 17 critical elements. Scores for these elements are displayed on a color-coded dashboard, together with contextual charts and information. As the SID is completed over time,
it will allow stakeholders to track progress and gaps across these key components of financial and programmatic sustainability.
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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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This brief highlights the urgency of addressing gender inequalities across the Rio Conventions, provides examples of where progress has been made, and identifies clear entry points for addressing gender equality considerations across the Conventions. It makes recommendations for actions to accelerat...e the synergistic implementation of the gender provisions and action plans of the Conventions.
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TOWARDS 30 YEARS OF THE BEIJING DECLARATION AND PLATFORM FOR ACTION: UNITE TO END VIOLENCE AGAINST WOMEN
Concept Note
An Infographic Guide to Technology-facilitated Gender-based Violence (TFGBV) offers a visually engaging toolkit designed to raise awareness and deepen understanding of the pervasive and harmful impact of TFGBV on women and girls in all their diversity.
Los días 2, 3 y 4 de diciembre del 2008, se realizó la reunión subregional “Alimentación y Nutrición del Niño Pequeño”, en la ciudad de Lima-Perú. El propósito general de la reunión fue analizar la interrelación entre la salud, la nutrición y el desarrollo infantil, dentro del marco... de la “Estrategia Global para la Alimentación y Nutrición del Infante y Niño Pequeño” (OMS/UNICEF).
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Informe Conjunto de Organizaciones de Defensa del Derecho a la Salud al Comité de Derechos Económicos y Sociales de las Naciones Unidas, con motivo del Examen del 3er Informe Periódico del Estado Venezolano en el Período de Sesión 55° del Pacto Internacional de Derechos Económicos, Sociales y... Culturales
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Thousands of HIV-positive Venezuelans have been forced to leave the country, after facing discrimination and zero treatment options, according to UNAIDS.
Patients once received free ARV treatment under Venezuela’s National AIDS Program. In 2017, the country essentially ran out of ARVs—about 9 p...eople a day died from HIV-related illnesses that year.
“Today, HIV patients in Venezuela have three options: go untreated, buy the medication abroad or on the black market for large sums, or leave the country,” writes Gabriela Mesones Rojo.
The exodus of untreated Venezuelans could shift the course of the epidemic throughout the region.
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El ámbito de aplicación incluye a todos los trabajadores involucrados en trabajos de asistencia sanitaria (comprendidos los desarrollados en aislamiento, traslados, labores de limpieza, eliminación de residuos,etc.), así como los de transportes aéreo,marítimo y ferrocarril de ...larga distancia o internacional, los colectivos de rescate (bomberos, salvamento marítimo, policía, guardia civil, etc.), atención al público, hostelería, sector servicios, etc. Dado que el contacto con el virus puede afectar a entornos sanitarios y no sanitarios, corresponde a las empresas evaluar el riesgo de exposición y seguir las recomendaciones que sobre el particular emita el servicio de prevención,siguiendo las pautas y recomendaciones formuladas por las autoridades sanitarias.
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International Journal of Special Education. Vol.29 (3) 2014, 69-81
Educating students with disabilities in an inclusive general education setting has been shown to increase academic achievement, increase peer acceptance, increase self esteem, create a richer friendship network, and have positive li...fetime benefits (higher salaried jobs, independent living). In addition, inclusion can have benefits for students without disabilities. The West African nation of Senegal has pledged to increase inclusive education for students with disabilities by 2015. Issues that affect inclusive education for all in Senegal are access to schooling, community and societal perceptions of individuals with disabilities, poverty, and teacher training and pedagogy. To increase inclusive education for all in Senegal the country must increase access to schooling through physical accessibility and decentralization, create community awareness campaigns that increase knowledge of disabilities, and develop teacher training that fosters a student-centered pedagogy.
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Ten Principles of Catholic Social Teaching
accessed July 2020