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Long Acting Muscarinic Antagonists (LAMA) such as tiotropium and glycopyrronium are used in the management of COPD1. They have been shown to improve lung function, quality of life and exercise tolerance. They have also been associated with reduced COPD-related exacerbations, associated hospitalisati
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ons and duration of hospital stay. Both the South African Thoracic Society (SATS) and Global Initiative for Chronic Obstructive Lung Disease (GOLD), guidelines recommend the use of long acting anticholinergic drugs (or long acting beta agonists) in moderate to very severe disease as defined by lung function (FEV1). The most up to date guideline, utilizing the GRADE methodology (European Respiratory Society guidelines of 2017), confirms their superiority over long acting β agonists (LABA) as monotherapy for COPD in that LAMA's have demonstrated greater efficacy in terms of exacerbation reduction, with similar safety profile.2 These recommnedations are supported by published peer-reviewed
evidence including individual papers and Cochrane reviews.
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The document provides detailed clinical guidelines for the therapy of Type 1 Diabetes as developed by the German Diabetes Association (DDG). It focuses on individualized insulin therapy, structured patient training, and monitoring of blood glucose levels. The guidelines emphasize preventing complica
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tions like ketoacidosis and hypoglycemia while improving patients' quality of life through education and tailored medical care. Recommendations include the use of both basal and bolus insulin, continuous glucose monitoring, and integrating psychosocial support into treatment plans. The document serves as a comprehensive resource for healthcare professionals managing Type 1 Diabetes.
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Background: The impacts of air pollutants on health range from short-term health impairments to hospital admissions
and deaths. Climate change is leading to an increase in air pollution.
The Global Status Report on Noncommunicable Diseases (NCDs) 2014 by the World Health Organization outlines the global impact of NCDs, including cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases, which are responsible for a significant portion of global mortality, particular
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ly in low- and middle-income countries.
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Under- and over-diagnosis of COPD: a global perspective
Ho T., Cusack R.P., Chaudhary N. et al.
Breathe, part of the European Respiratory Society (ERS)
(2019)
CC2
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
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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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People with asthma should be encouraged to take part in any sport they choose. If someone with asthma is having difficulty with sport, it means their asthma may not be under control. You will need to see your doctor to review your controller treatment and the way you use your medications in oder to
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allow you to live your life to the full with no limitations on activities or sport.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid
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ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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Healthy Settings, a key component of Malawi’s Health Sector Strategic Plan (HSSP) 2011–2016, is the World Health Organization’s (WHO) holistic community-led approach to achieving health improvement by addressing social determinants of health, an approach which is central to the current WHO fra
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mework on integrated people-centred health services. Healthy Settings projects by their construct have many different components which vary from one group and community to another depending on their priorities: from housing, hospital improvements and waste management to “softer” interventions like leadership skills training and health promotion. It can be challenging to find relevant indicators to monitor and assess the impact of such a complex holistic project, this paper explores if social capital data can provide useful impact assessment indicators at the start of such a project.
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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,
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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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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
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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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interim guidance, 25 November 2024
Safe sanitation is essential for health, from preventing infections to improving and maintaining mental and social
well-being. Lack of adequate sanitation contributes to diarrhoeal diseases, parasitic infections, and undernutrition, as
well as posing significant risks and causing anxiety, especial
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ly for women and girls. Achieving universal access to safe
sanitation, which protects health, privacy, and dignity, is a global development goal and a recognized basic human right.
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Based on an increasing body of evidence pointing at the positive impact that social assistance has had in Malawi, the region and beyond, government is encouraged to continue investing in and supporting the expansion and comprehensiveness of social protection programmes in both rural and urban areas,
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ensuring they effectively target and adequately address needs and vulnerabilities across the lifecycle, in line with the Malawi National Social Support Programme (MNSSP II) and Vision 2063. In addition, Government and Development Partners are encouraged to further the integration between social protection, the humanitarian and the disaster risk management sectors in response to shocks and stresses, through the roll out of a fully shock-sensitive social protection system.
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It is estimated that around 2 billion people worldwide do not have access to essential medicines. Access to medicines in the Eastern Mediterranean Region varies among countries, depending on their income level and allocation of domestic resources to medicine and vaccine procurement. Access to safe a
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nd effective antibiotics remains a major challenge, especially for low- and middleincome countries. Barriers to access include high prices for new products, weak regulatory systems, substandard and falsified antibiotics, shortages of essential antimicrobials and inefficient procurement and supply management systems.
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Vaccines contribute to the battle against antimicrobial resistance (AMR) by preventing infections and thereby reducing antimicrobial use and the incidence of disease from resistant pathogens. By preventing infection transmission, vaccines extend population protection by also reducing the risk of inf
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ection among the unvaccinated (herd immunity). A first comprehensive study found that
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To provide a foundation for the strategic policy and programme development needed to ensure the sustainable implementation of effective interventions for reducing the global burden of PPH
A Learning Programme for Professionals
A practical handbook. This Health Cluster Guide (2nd edition, 2020) provides practical advice on how WHO, Health Cluster Coordinators and partners can work together during a humanitarian crisis to achieve the aims of reducing avoidable mortality, morbidity and disability, and restoring the delivery
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of and equitable access to preventive and curative health care.
It highlights key principles of humanitarian health action and how coordination and joint efforts among health and other sector actors can increase the effectiveness and efficiency of health interventions and promote better health outcomes. It draws on Inter-Agency Standing Committee and other expert guidance and includes lessons from field experience in acute and protracted crises.
The coordination principles and practice presented in Health Cluster Guide are equally valid for coordinators and members of health sector groups that seek to achieve effective health action in countries where the cluster approach has not been formally adopted.
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A guide for effective aid
This guide provides a comprehensive overview of essential information related to immunization, including technical information about vaccines, a review of immunization program management best practices, guidance on the delivery of immunization services, monitoring and evaluation, disease surveillanc
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e, and the role of behavior change.
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