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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.
more
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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This report explores the extent to which evidence, policy, normative guidance and commitments on HIV and gender-based violence, and their interlinkages, is being translated into action on the ground in fragile settings. These issues are explored through the lens of training of peace support operatio
...
ns deploying African troops across Africa and beyond.
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Where there is no doctor Chapter 3
Humanitarian Accountability Report
James Darcy, Jessica Alexander, Maria Kiani et al.
Humanitarian Accountability Partnership (HAP)
(2013)
The report offers an overview of the progress the humanitarian sector has made and the obstacles it has faced over the past 10 years. Accountability is no longer just a fashionable term, there is now a shared understanding of what it takes to be accountable. From changes at policy level, to concrete
...
actions taken in the field, this report documents this sector-wide shift. It also shows that being accountable to the people we aim to serve is not just the right thing to do, it is also the best way to ensure programmes are relevant, effective, efficient and sustainable
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http://dx.doi.org/10.4172/2329-9088.1000136
Trop Med Surg 2013, 1:136
Series on Disability-Inclusive Development. This publication introduces the key concepts for disability-inclusive development and highlights practical examples by CBM, to contribute to the dialogue on disability-inclusive development
Recommandations pour une Approche de Santé publique.
Juin 2013.
UNICEF Strategic Plan 2018-2021. Draft Theory of Change Paper
La quatrième édition des Lignes directrices de l'OMS pour la qualité de l'eau potable s'appuie sur plus de 50 ans d'orientations sur la qualité de l'eau potable qui font autorité en matière de mesures de santé publique lorsqu’il s’agit de mettre en place des réglementations et des normes
...
nationales pour garantir la sécurité de l'eau.
Ces lignes directrices s’adressent principalement aux responsables de la réglementation dans le domaine de l’eau et de la santé, aux décideurs et à leurs conseillers, et ont pour objectif d’aider lors de la mise au point de normes nationales. Elles sont aussi utilisées, ainsi que les documents associés, par comme source d’informations sur la qualité et l’hygiène de l’eau et sur les stratégies de gestion efficaces. more
Ces lignes directrices s’adressent principalement aux responsables de la réglementation dans le domaine de l’eau et de la santé, aux décideurs et à leurs conseillers, et ont pour objectif d’aider lors de la mise au point de normes nationales. Elles sont aussi utilisées, ainsi que les documents associés, par comme source d’informations sur la qualité et l’hygiène de l’eau et sur les stratégies de gestion efficaces. more
La promotion de la santé et la prévention des maladies nécessitent une action multisectorielle qui renforce les environnements favorables à la santé et oriente les comportements. Au niveau des cantons et des communes, de nombreuses politiques, telles
la protection de la jeunesse, la promotion
...
de la santé à l’école, la promotion de la santé et de la sécurité au travail, l’action sociale, le soutien au logement, la promotion de l’intégration, l’aménagement du territoire, la gestion de la mobilité ou la protection
de l’environnement sont des leviers très efficaces pour améliorer l’état de santé de la population.
L’argumentaire «Promouvoir la santé et prévenir les maladies» a pour objectif d’expliquer les enjeux et
d’inciter les personnes actives dans ces divers domaines à intégrer la promotion de la santé dans leurs activités et projets. Cela exige de leur mettre à disposition des informations actuelles et facilement compréhensibles
more
Prevention Gap Report
UNAIDS; AIDSinfo
(2016)
C2
Joint United Nations Programme on HIV/AIDS
Children, HIV and AIDS - Avert
Avert
(2017)
C2
