The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit...h DM have a worse prognosis than those without DM. Diabetes can cause myocardial ischemia via micro- and macrovasculopathy and can directly exert deleterious effects on the myocardium. Hyperglycemia, hyperinsulinemia, and insulin resistance can cause alterations in vascular homeostasis. Then, reduced nitric oxide and increased reactive oxygen species levels favor inflammation leading to atherothrombotic progression and myocardial dysfunction. The classification, diagnosis, and treatment of HF for a patient with and without DM remain the same. Until now, drugs targeting neurohumoral and metabolic pathways improved mortality and morbidity in HF with reduced ejection fraction (HFrEF). Therefore, all HFrEF patients should receive guideline-directed medical therapy. By contrast, drugs modulating neurohumoral activity did not improve survival in HF with preserved ejection fraction (HFpEF) patients. Trials investigating whether sodium-glucose cotransporter-2 inhibitors are effective in HFpEF are on-going. This review will summarize the epidemiology, pathophysiology, and treatment of HF in diabetes.
more
Asthma is one of the most common chronic respiratory conditions in the world and is increasing in prevalence, particularly in Africa and other low-income countries. The disproportionately high numbers of premature deaths and severe or uncontrolled cases in many African countries are indicative of th...eir inability to cope with a costly disease like asthma. Progress has, however, been made in understanding the complex and heterogeneous nature of the disease. The objective of this study will be to summarise the epidemiological literature on the nature of asthma in African countries.
more
Asthma is one of the most common chronic respiratory conditions in the world and is increasing in prevalence, particularly in Africa and other low-income countries. The disproportionately high numbers of premature deaths and severe or uncontrolled cases in many African countries are indicative of th...eir inability to cope with a costly disease like asthma. Progress has, however, been made in understanding the complex and heterogeneous nature of the disease. The objective of this study will be to summarise the epidemiological literature on the nature of asthma in African countries.
more
Asbestos, the most frequent cause of occupational cancer, continues to be consumed ona massive scale, with millions of people exposed on a daily basis. This review explains why we havefailed in curtailing the silent epidemic of asbestos-related disease and why the numbers of asbestosvictims are like...ly to remain high. Emerging and developed countries have to be reminded that asbestosexposure has yet to become a problem of the past. The worldwide spread of asbestos, followed by thesurge of asbestos-related cancers, resembles the lung cancer epidemic caused by smoking andstimulated by manufacturers.
more
The document outlines the 2019 update to the South African guideline for managing chronic obstructive pulmonary disease (COPD). It emphasizes the importance of early diagnosis, prevention through smoking cessation, use of bronchodilators as primary pharmacotherapy, and a comprehensive approach to pa...tient care including pulmonary rehabilitation and the management of comorbidities. The guideline also covers recommendations for handling acute exacerbations, surgical interventions, and long-term treatment options.
more
4th Edition 2018
National Malaria Elimination & Aedes Transmitted Disease Control Program
Disease Control Unit Directorate General of Health Services
Asthma is the most common chronic disease in children, imposing a consistent burden on health system. In recent years, prevalence of asthma symptoms became globally increased in children and adolescents, particularly in Low-Middle Income Countries (LMICs). Host (genetics, atopy) and environmental fa...ctors (microbial exposure, exposure to passive smoking and air pollution), seemed to contribute to this trend. The increased prevalence observed in metropolitan areas with respect to rural ones and, overall, in industrialized countries, highlighted the role of air pollution in asthma inception. Asthma accounts for 1.1% of the overall global estimate of “Disability-adjusted life years” (DALYs)/100,000 for all causes. Mortality in children is low and it decreased across Europe over recent years. Children from LMICs particularly suffer a disproportionately higher burden in terms of morbidity and mortality. Global asthma-related costs are high and are usually are classified into direct, indirect and intangible costs. Direct costs account for 50–80% of the total costs. Asthma is one of the main causes of hospitalization which are particularly common in children aged < 5 years with a prevalence that has been increased during the last two decades, mostly in LMICs. Indirect costs are usually higher than in older patients, including both school and work-related losses. Intangible costs are unquantifiable, since they are related to impairment of quality of life, limitation of physical activities and study performance. The implementation of strategies aimed at early detect asthma thus providing access to the proper treatment has been shown to effectively reduce the burden of the disease.
more
BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed.
OBJE...CTIVES. To quantify the burden of asthma in the South African (SA) population and identify the risk factors associated with disease severity in the local context.
METHODS. The SA 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 epidemiology task group reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system.
CONCLUSIONS. Asthma in children remains a common condition, which has shown an increasing prevalence in urban and rural populations of SA. Of concern is that almost half of children in urban communities experience severe asthma symptoms, and many asthmatics lack a formal diagnosis and thus access to treatment. Exposure to tobacco smoke and living in highly polluted areas increase the severity of wheezing in young children.
more
The document presents Cameroon's National Response Plan for the 2018 cholera outbreak, covering August to October 2018. It highlights the epidemiological situation, with outbreaks reported in the North and Central regions and a total of 109 suspected cases and 9 deaths by July 2018. The plan outline...s strategies for controlling the epidemic, including epidemiological surveillance, improved access to clean water, sanitation, mass vaccination, community awareness campaigns, and hospital and community-based treatment.
The response is coordinated by the Ministry of Public Health, WHO, and various partners, focusing on early detection, rapid response, and multi-sectoral collaboration. Challenges include poor sanitation, limited healthcare infrastructure, and cross-border disease transmission risks. The plan emphasizes resource mobilization, monitoring, and evaluation to contain the outbreak and prevent future cases.
more
Given the intimate association between silicosis and tuberculosis, understanding the epidemiology of the South African gold mining industry silicosis epidemic is essential to current initiatives to control both silicosis and tuberculosis in this population, one of the most heavily affected globally.... The study’s objectives were to compare the prevalence of silicosis among working black gold miners in South Africa during 2004–2009 to that of previous studies, including autopsy series, and to analyse the influence of silicosis and/or tuberculosis on exiting employment.
more
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 en...vironmental 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.
more
Cardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. The term “cardiovascular disease” is used throughout the report to refer to cardiac disease, vascular diseases of the brain and kidney, and peripheral vascular disease. The report’s main focus is ...on the major contributors to global CVD mortality, coronary heart disease and stroke, and on the major modifiable risk factors for cardiovascular diseases. In fact, as the leading cause of death worldwide, CVD now has a major impact not only on developed nations but also on low and middle income countries, where it accounts for nearly 30 percent of all deaths. The terms “developed” and “high income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as high income economies. The terms “developing” and “low and middle income countries” are used interchangeably throughout the report to refer to countries classified by the World Bank as low, lower middle, and upper middle income economies. The increased prevalence of risk factors for CVD and related chronic diseases in developing countries, including tobacco use, unhealthy dietary changes, reduced physical activity, increasing blood lipids, and hypertension, reflects significant global changes in behavior and lifestyle. The term “chronic diseases” is used throughout the report to refer to CVD and the following related chronic diseases that share many common risk factors: diabetes, cancer, and chronic respiratory disease. These changes now threaten once-low-risk regions, a shift that is accelerated by industrialization, urbanization, and globalization. The potentially devastating effects of these trends are magnified by a deleterious economic impact on nations and households, where poverty can be both a contributing cause and a consequence of chronic diseases. The accelerating rates of unrecognized and inadequately addressed CVD and related chronic diseases in both men and women in low and middle income countries are cause for immediate action.
more
The article investigates the global burden and risk factors of chronic obstructive pulmonary disease (COPD). It emphasizes that COPD is a leading cause of morbidity and mortality worldwide, with significant health and economic impacts. The study identifies smoking as the primary risk factor, but als...o highlights other contributors such as occupational exposure, air pollution, and respiratory infections. The authors discuss variations in COPD prevalence and mortality rates across different regions, influenced by socioeconomic and environmental factors. The article calls for comprehensive public health strategies to reduce exposure to risk factors and improve early diagnosis and management to curb the global impact of COPD.
more
The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct ...definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
more
The aim of the present study was to predict which patients with severe or difficult-to-treat asthma are at highest risk for healthcare utilisation can be predicted so as to optimise clinical management. Data were derived from 2,821 adults with asthma enrolled in The Epidemiology and Natural History ...of Asthma: Outcomes and Treatment Regimens (TENOR) study. Multiple potential predictors were assessed at baseline using a systematic algorithm employing stepwise logistic regression. Outcomes were asthma-related hospitalisations or emergency department (ED) visits within 6 months following baseline.
more
Considerable energy has been expended over the last two decades in developing methods for identifying the presence of asthma among participants in population studies. The objective of this endeavour has commonly been to enable epidemiological research on risk factors for asthma, with the ultimate ai...m of preventing the disease. However, there are other reasons for measuring the prevalence of asthma in populations, including the desire to assess the burden of disease attributable to asthma, to track changes over time, and to compare the prevalence among population groups defined by geographical, demographic or social factors. Two major international collaborative studies arising from this work have made major contributions to our knowledge about asthma
more