Accessed on 20.10.2020
L͛analyse des tendances récentes montre que le Burkina Faso a enregistré une réduction significative de la mortalité infanto-juvénile. Même si aucune des cibles des OMD 4 et 5 n͛a été atteinte par le pays, le taux de mortalité infanto-juvénile est passé de 129
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pour mille naissances vivantes en 2010 à 82 pour mille naissances
vivantes en 2015, soit une baisse de 7.3% par an. Ceci est en grande partie dû aux progrès enregistrés en matière de lutte contre la mortalité au bénéfice de la tranche juvénile (de 1 à 4 ans). Cependant, comme près de la moitié des enfants âgés de moins de cinq ans continuent de mourir au cours de leur première
année de vie, il reste beaucoup à faire pour l͛atteinte de la vision globale d͛élimination de la mortalité infanto-juvénile évitable et de réduction de la mortalité des mères comme partie prenante des Objectifs de Développement Durable (ODD).
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Der Nationale Pandemieplan besteht aus zwei Teilen. Teil I beschreibt Strukturen und Massnahmen, Teil II stellt die wissenschaftlichen Grundlagen für die Inflünzapandemieplanung und -bewältigung dar. Der vorliegende Teil I wurde von der Arbeitsgruppe Infektionsschutz der Arbeitsgemeinschaft der O
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bersten Landesgesundheitsbehörden unter Mitwirkung des Bundesministeriums für Gesundheit, des Robert Koch- Instituts, des Paul-Ehrlich-Instituts und der Bundeszentrale für gesundheitliche Aufklärung erstellt. Er beschreibt die Strukturen auf Bundesund Länderebene, erörtert Massnahmen und gibt Empfehlungen zur Vorbereitung auf eine Inflünzapandemie sowie für die Pandemiebewältigung auf unterschiedlichen Planungs- und Handlungsebenen. Damit dient er als Grundlage für die Pandemieplanung im medizinischen und nichtmedizinischen Bereich und in der öffentlichen Verwaltung.
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The document discusses physical inactivity as a major risk factor for non-communicable diseases (NCDs), which contribute to two-thirds of global deaths, primarily in low- and middle-income countries. It emphasizes the global prevalence of physical inactivity and its health risks, such as increased m
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ortality and chronic diseases. The text advocates for simple, sustainable interventions to promote physical activity, such as public initiatives like car-free days, to prevent and manage NCDs. It highlights the importance of exercise in improving physical and mental health and calls for collaborative, comprehensive approaches to increase activity levels.
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The Noncommunicable Diseases Country Profiles 2018 by the World Health Organization (WHO) provides an in-depth look at the burden of noncommunicable diseases (NCDs) such as cardiovascular diseases, cancer, chronic respiratory diseases, and diabetes across WHO Member States. It includes data on NCD m
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ortality, risk factors like tobacco use, unhealthy diets, physical inactivity, and excessive alcohol consumption, as well as country-specific responses and health system capacities to manage and prevent NCDs.
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The GOLD website is dedicated to providing comprehensive information on Chronic Obstructive Pulmonary Disease (COPD). It offers resources and guidelines for healthcare professionals and public health authorities to improve the diagnosis, management, and prevention of COPD worldwide. The site include
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s the latest reports, strategies, and updates on COPD research, emphasizing evidence-based practices for better patient outcomes. GOLD also provides educational materials, workshops, and support for implementing COPD care programs, aiming to raise global awareness and promote effective treatments for COPD.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
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ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequent in children. A task force supported by the European Respiratory Society has developed these evidence
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-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Although asthma is very common, affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world, which results in both over- and under-diagnosis. A taskforce was set up by the European Respiratory Society to systematically review the literature on the dia
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gnostic accuracy of tests used to diagnose asthma in adult patients and provide recommendations for clinical practice.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung function testing in this group of patients and the wi
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de variety of conditions that can phenotypically present with asthma-like symptoms.
This article provides an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions.
The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence.
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This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management for asthma and suggests an appropriate strategy for implementing supported self-management.
Asthma is the most common chronic illness of childhood. The prevalence is rising and the mortality and morbidity from asthma are unacceptably high in South Africa. This article emphasizes the importance to make a correct diagnosis based, most importantly, on the clinical history and supported by inv
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estigations. Further, the appropriate drug and device must be chosen to achieve good asthma control. It explains that patients must be followed up regularly and their asthma control must be assessed so that the treatment can then be adjusted according to the level of control. Additionally, Asthma education and adherence are important components of management of the condition.
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Asthma prevalence is increasing worldwide and surveys indicate that the majority of patients in developed and developing countries do not receive optimal care and are therefore not well controlled. The aim of these guidelines is to promote a better standard of treatment based on advances in the unde
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rstanding of the pathophysiology and pharmacotherapy of asthma and to encourage uniformity in the management of asthma.
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The increasing prevalence of childhood asthma in the developed world is a cause for concern. A so-called Western lifestyle has been the factor most commonly cited to explain this worrying increase in asthma prevalence. Early studies in a limited number of African countries showed a very low rural pr
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evalence of childhood asthma, especially where children lived according to a traditional lifestyle. These same studies showed that asthma was not uncommon in urbanized African children. There has been an
increasing tendency over the past 20 years for those in rural communities to move to the large urban centers. This article analyses the urban-rural differences and factors that influence the development of asthma in susceptible children.
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This guideline covers diagnosing, monitoring and managing asthma in adults, young people and children. It aims to improve the accuracy of diagnosis, help people to control their asthma and reduce the risk of asthma attacks. It does not cover managing severe asthma or acute asthma attacks. It emphasi
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zes the importance to include advice in the personalised
action plan on minimising indoor air pollution and reducing exposure to outdoor air pollution.
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Since there is no single objective diagnostic test for asthma this study suggests an approach of collecting and assembling pieces of clinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demonstration of symptom and airway variability and/or br
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onchodilator responsiveness over time, to support a clinical diagnosis.
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Men are underrepresented in HIV testing services throughout sub-Saharan Africa. HIV testing is critical to achieve the UNAIDS 95-95-95 goals, as it is the first entry point to HIV care. In Malawi, an estimated 14% of HIV positive men are undiagnosed, while only 6% of HIV positive women remain undiag
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nosed. Improved HIV testing among men is key to reaching UNAIDS goals, and to curbing HIV epidemics in the region.
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The webpage from the Institute for Health Metrics and Evaluation (IHME) discusses the global impact of diet on health, highlighting poor dietary habits as a major contributor to deaths worldwide, primarily through cardiovascular diseases. It emphasizes the health risks of high sodium intake and insu
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fficient consumption of fruits, vegetables, and whole grains while advocating for dietary improvements to reduce disease burden and improve overall health.
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Asthma is a common breathing condition. Chances are that at least one in every fifth person will have it. People with asthma might have a cough, or wheeze and a feeling of tightness in their chests. A group of researchers from the United Kingdom teamed up with seven African countries to learn about
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the challenges that children living with asthma in Africa face. One part of their research focuses on air pollution specifically. This research indicates ways to deal with asthma triggers and help more people understand asthma and enjoy a normal active life.
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Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee
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nage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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Coronavirus disease 2019 has a mild disease course in children and adolescents. Chronic respiratory conditions, including asthma, have been suggested as risk factors; however, asthma in children is highly variable in both triggers and severity.
During the pandemic, pediatric asthma services limite
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d consultations and established virtual clinics. However, respondents perceived their patients’ asthma control to be retained or even improved, while treatment adherence was considered increased. Children with asthma were not disproportionately affected by coronavirus disease 2019.
Trigger avoidance and treatment adherence can rapidly improve asthma control in children, even under lockdown pressure. Children/adolescents with asthma do not appear to need additional prophylactic measures from coronavirus disease 2019 when asthma is well-treated. This article analyses the effect of COVID-19 on Asthma in children, providing information for management guidelines.
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