Bronchial asthma is the most frequent chronic respiratory disease in both adults and children. The prevalence and burden of asthma vary considerabl...y between different regions of the world. Information on asthma in Africa is fragmentary and relatively old.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of... the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relative to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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Health care-associated infection (HCAI) places a serious disease burden and has a significant economic impact on patients and health-care systems throughout the world. Yet good hand hygiene, the ...simple task of cleaning hands at the right times and in the right way, can save lives. World Health Organization (WHO) has developed evidence-based WHO Guidelines on Hand Hygiene in Health Care to support health-care facilities to improve hand hygiene and thus reduce HCAI.
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Urogenital schistosomiasis is a common neglected tropical disease in many rural communities in African countries, with patches of infection in the Eastern Mediterranean Region. Globally, an estimate...d 239 million people are currently infected, with burden estimated at more than 3.5 million disability-adjusted life years (DALYs). In many endemic areas, severely infected individuals may suffer fibrosis of the bladder, kidney damage, bladder cancer, and death if untreated. This, however, depends on several factors such as host-parasite genetics, degree and length of exposure, intensity of infection, host immune response to the parasites, and coinfections with other tropical diseases such as malaria and HIV-1.
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ince the introduction of multidrug therapy (MDT), there has been significant progress in reducing the prevalence of leprosy and the occurrence of n...ew cases. Global strategies have evolved with progress in reducing the disease burden. Encouraged by the decrease in the number of cases on treatment, the World Health Assembly passed a resolution calling on Member States to accelerate efforts towards global elimination of leprosy as a public health problem by 2000.
Most countries reached the milestone by 2010. The global strategies for 2006–2015 focused on sustaining high-quality leprosy services and early diagnosis. Reduction in the disease burden was measured in terms of grade-2 disability (G2D) or visible deformities in new cases. Since 2016, the strategies have included reduction of stigmatization of people with leprosy.
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Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is pr...edicted that unless proven interventions are rapidly implemented in countries, in the short to medium term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
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The article examines the epidemiology of chronic obstructive pulmonary disease (COPD) in the Middle East, North Africa, and Turkey. It provides an overview ...">of COPD prevalence, associated risk factors, and challenges in diagnosis and treatment across these regions. The study highlights smoking and environmental exposures, such as dust and pollution, as significant contributors to COPD. It also points out the gaps in awareness, healthcare infrastructure, and the availability of diagnostic tools, which hinder effective management of the disease. The authors emphasize the need for comprehensive public health strategies, education, and improved access to healthcare to address the COPD burden in these areas.
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Buruli ulcer is a disease of skin and soft tissue with the potential to leave sufferers scarred and disabled. It is caused by an environmental pathogen, Mycobacterium
ulcerans, that produces a des...tructive toxin. The exact mode of transmission is unclear. The main burden of disease falls on children living in sub-Saharan Africa, but healthy people of all ages, races, and socioeconomic classes are susceptible.
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Diets are changing everywhere, and the burden of disease associated with unhealthy diets is a worldwide concern. Measurement and monitoring ...lass="attribute-to-highlight medbox">of diets across countries and population groups is critical. However, there are no harmonized metrics for tracking how the healthfulness of diets around the world is evolving.
This report assesses the validity, usefulness and fitness for purpose of existing healthy diet metrics as global and national monitoring indicators, presents a comparative assessment of selected healthy diet metrics and discusses priorities and opportunities to improve diet monitoring. This report is an important first step of the Healthy Diets Monitoring Initiative to respond to the need for developing healthy diets metrics for assessing and monitoring diets at national and global level.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention ...e-to-highlight medbox">of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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The article outlines the prioritized research agenda for the prevention and control of chronic respiratory diseases (CRDs) as part of the World Hea...lth Organization's (WHO) action plan on noncommunicable diseases (NCDs) from 2008 to 2013. It highlights the significant global impact of CRDs, including asthma, chronic obstructive pulmonary disease (COPD), and other related conditions, particularly in low- and middle-income countries (LMICs). The document stresses the need for effective prevention strategies and better surveillance, as well as enhanced healthcare infrastructure and resources in LMICs. It calls for research into CRD risk factors, effective interventions, and integrated care approaches that align with broader NCD prevention programs. The article emphasizes the importance of public health initiatives and cross-sector collaborations to reduce the disease burden and improve patient outcomes.
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Cryptococcal disease is one of the most common opportunistic infections among people living with advanced HIV disease and is a major contributor to... severe illness, morbidity, and mortality, particularly in sub-Saharan Africa.
These guidelines update the recommendations that were first released in 2018 on diagnosing, preventing, and managing cryptococcal disease. In response to important new evidence that became available in 2021, these new guidelines strongly recommend a single high dose of liposomal amphotericin B as part of the preferred induction regimen for the treatment of cryptococcal meningitis in people living with HIV. This simplified regimen - a single high dose of liposomal amphotericin B paired with other standard medicines (flucytosine and fluconazole) - is as effective as the previous WHO standard of care, with the benefits of lower toxicity and fewer monitoring demands.
The objective of these guidelines is to provide updated, evidence-informed recommendations for treating adults, adolescents and children living with HIV who have cryptococcal disease. These guidelines are aimed at HIV programme managers, policymakers, national treatment advisory boards, implementing partners and health-care professionals providing care for people living with HIV in resource-limited settings with a high burden of cryptococcal disease.
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A major objective of this open access book is to summarize the current status of Buruli Ulcer (BU) research for the first time. It will identify gaps in our knowledge, stimulate research and support... control of the disease by providing insight into approaches for surveillance, diagnosis, and treatment of Buruli Ulcer. Book chapters will cover the history, epidemiology diagnosis, treatment and disease burden of BU and provide insight into the microbiology, genomics, transmission and virulence of Mycobacterium ulcerans. ; Supports further investigation by summarizing state of the art in the field of Buruli ulcer research Enriches understanding of epidemiology of Buruli ulcer in different geographic regions Reviews exhaustively the characteristics of Mycobacterium ulcerans disease
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Myanmar is one of the world’s 22 high tuberculosis (TB) burden countries, and supporting TB control in Myanmar is a global priority. This report reflects the findings, discussions, conclusions and... recommendations of the fourth international review mission of the Myanmar National TB Programme (NTP), which brought together international and national partners to review progress in TB control and to offer guidance on future TB control directions and efforts.
A high-quality national disease prevalence survey completed in 2010 demonstrated a TB disease burden two to three times higher than anticipated on the basis of previous surveys. In 2011 about 200 000 adults and children will have developed TB, including 20 000 HIV infected and 9000 suffering from MDR-TB, both of which will require additional care and costly treatment. TB remains among the top killers of adults, and more women die of TB than from maternal causes.
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Noncommunicable diseases (NCDs) are responsible for 81% of all deaths in the region of the Americas, of... which 34% befall prematurely in people between 30- 69 years old. The burden of theses diseases and their common risk factors jeopardize the health systems to provide adequate management, as well as to implement customized policies and interventions. The PAHO/WHO STEPwise approach to NCD risk factor surveillance (STEPS) is a simple, sequential, standardized method for collecting, analyzing, and disseminating data on key NCD risk factors in countries in adults from 18 to 69 years old. This survey covers key modifiable risk factors: tobacco use, alcohol use, physical inactivity, and unhealthy diet, as well as key biological risk factors: overweight and obesity, raised blood pressure, raised blood glucose, and abnormal blood lipids. STEPS is a household survey that gathers information on the risk factors through a face-to-face interview (step 1), simple physical measurements (step 2), and collection of urine and blood samples for biochemical analysis (step 3). Every step has a core set of questions, measurements, and expanded sets depending on the countries' needs and interests. It also has optional modules. Implementing STEPS allows the comparability of data within and between countries due to its standardized data collection. It also helps health services plan public health priorities and monitors and evaluates population-wide interventions. It is designed to help countries build and strengthen their capacity to conduct surveillance. STEPS captures 11 of the 25 indicators outlined in the NCD Global Monitoring Framework relating to 7 of the nine global targets.
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Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in ...Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions (FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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Trypanosoma cruzi is the etiological agent of Chagas disease (CD), considered one of the most important parasitic infections in Latin America. Betw...een 25 and 90 million humans are at infection risk via at least one of multiple infection mechanisms. Under natural conditions, the principal transmission modes are transplacental or via one of more than 140 hematophagous triatomine bugs (Reduviidae: Triatominae). Triatomines acquire the parasite from mammal reservoirs due to their obligate blood-feeding (albeit triatomines can also feed on non-reservoir vertebrates such as birds and reptiles). The disease burden for CD in the Latin America and Caribbean region, based on disability-adjusted life-years (DALYs), is at least five times greater than that of malaria, and is approximately one-fifth that of HIV/AIDS. In recent decades, CD has extended to other continents outside natural reservoir or vector distributions due to human migration, with a minimum estimated 10 million individuals infected worldwide.
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Chronic Obstructive Pulmonary Disease (COPD) is now one of the top three causes of death worldwide and 90% ...ox">of these deaths occur in low- and middle-income countries (LMICs).
More than 3 million people died of COPD in 2012 accounting for 6% of all deaths globally. COPD represents an important public health challenge that is both preventable and treatable. COPD is a major cause of chronic morbidity and mortality throughout the world; many people suffer from this disease for years and die prematurely from it or its complications. Globally, the COPD burden is projected to increase incoming decades because of continued exposure to COPD risk factors and aging of thepopulation.
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Hypertension is the number one health related risk factor in India, with the largest contribution to burden of disease and mortality. It contribute...s to an estimated 1.6 million deaths, due to ischemic heart disease and stroke, out of a total of about 10 million deaths annually in India. Fifty seven percent of deaths related to stroke and 24% of deaths related to coronary heart disease are related to hypertension. Hypertension is one of the commonest non-communicable diseases in India, with an overall prevalence of 29.8% among the adult population, and a higher prevalence in urban areas (33.8% vs. 27.6%)
according to recent estimates.
Awareness of hypertension in India is low while appropriate treatment and control among those with hypertension is even lower: Hypertension is a chronic, persistent, largely asymptomatic disease. A majority of the patients with hypertension in India are unaware of their condition. This is because of low levels of awareness and the lack of screening for hypertension in adults-either as a systematic programme or as an opportunistic exercise during visits to healthcare providers.
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The webpage from the Institute for Health Metrics and Evaluation (IHME) features a podcast discussing chronic respiratory diseases and their global impact. It highlights the growing burden ...ss="attribute-to-highlight medbox">of diseases such as chronic obstructive pulmonary disease (COPD) and asthma worldwide. The podcast provides insights into the challenges faced in managing and preventing these diseases, emphasizing the importance of early diagnosis, public health strategies, and global data to inform healthcare policies. Experts discuss the role of environmental and lifestyle factors in disease prevalence and outline ways to mitigate these risks through improved healthcare and awareness.
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