In den letzten Jahren hat die öffentliche Debatte über Kinderschutzfragen zu entscheidenden Veränderungen - sowohl in der Öffentlichkeit wie in der Fachdebatte in Deutschland - geführt. Anfang 2012 trat ein neues Bundeskinderschutzgesetz in Kraft; der Aufarbeitungsprozess nach dem Missbrauchssk...andal, der Deutschland ab Anfang 2010 in einer breiteren öffentlichen Diskussion erschüttert hat, hat mit dem Abschluss der Arbeit der Unabhängigen Beauftragten zur Aufarbeitung des sexüllen Kindesmissbrauchs, der ehemaligen Bundesfamilienministerin Frau Dr. Christine Bergmann, und mit dem Abschlussbericht des Runden Tisches Ende 2011 eine Bestandsaufnahme abgeschlossen und eine Agenda für die weitere Arbeit der Umsetzung aufgestellt. Zu diesen zahlreichen zu bearbeitenden Punkten gehören auch ein hilfreicherer Umgang mit Betroffenen im Gesundheitswesen, eine bessere Diagnostik und Abklärung in Kinderschutzfällen, auch auf der medizinischen Seite. Verzögerungen bei der Implementation von Hilfe, Unterstützungsmaßnahmen und Therapien werden beklagt und Lotsenfunktionen in Bezug auf gesetzliche Ansprüche wie z.B. im Rahmen des Opferentschädigungsrechts werden vorgeschlagen.
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Wie reagieren Kinder und Jugendliche auf ein traumatisches Ereignis. Reagieren Kinder auf unterschiedliche Formen traumatischer Ereignisse wie Unfall, Vergewaltigung, Gewalt in der Familie jeweils anders. Wie kann ich als Familienmitglied helfen? Wie kann ich als Lehrer, Erzieher, Freund helfen? Wel...che Behandlungsmöglichkeiten gibt es? Wie erfolgreich sind diese Behandlungen? Der Ratgeber gibt hilfreiche Antworten auf diese und weitere Fragen.
Der Ratgeber liefert verständliche Informationen zum Störungsbild der Posttraumatischen Belastungsstörung in Kindheit und Jugend sowie zu dessen Behandlung. Ausführlich werden mögliche Beschwerden und Störungen der Betroffenen im zeitlichen Verlauf nach einem traumatischen Ereignis beschrieben. Detailliert wird dargestellt, wie Eltern, Erzieher oder Lehrer einen von einer Traumatisierung betroffenen jungen Menschen im alltäglichen Leben aber auch bei Diagnostik und Behandlung begleiten können. Der Ratgeber zeigt zudem auf, welche Verhaltensweisen unterstützend sind und welche die Erkrankung eher aufrechthalten können.
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It summarizes guidance on how to manage – and when to refer – children and adolescents presenting with common complaints and conditions. It includes information to enable primary health care providers to coordinate the continued care of children and adolescents with long-term conditions and dise...ases managed by specialists. Preventive and promotive measures from the newborn period to adolescence include advice on the timing and content of well-child visits, the promotion of early childhood development and health messages for adolescents.
This Pocket Book aims to improve the diagnosis and management of common conditions in children and adolescents that can be managed at the outpatient level. It helps to improve the use of laboratory and other diagnostic measures and the rational use of essential drugs and equipment.
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Heart failure (HF) is a global public health concern with disproportionate socioeconomic, morbidity and mortality burden on low- and middle-income countries (LMICs). This review summarises contemporary data on the demographic and clinical characteristics, aetiologies, treatment, economic burden and ...outcomes of HF in LMICs. Patients with HF in LMICs are younger than those from high-income countries (HICs) and present at advanced stages of the disease. Hypertension, ischaemic heart disease (IHD), cardiomyopathy (CMO), and rheumatic heart disease (RHD) are the leading causes of HF in LMICs. The contribution of infectious diseases to HF remains prominent in many LMICs. Most health facilities in LMICs lack adequate diagnostic tools for HF, and the use of evidence-based medical and device therapies is suboptimal. Further, HF in LMICs is associated with prolonged hospital stay and high in-hospital and one-year mortality. Finally, HF has profound economic impact on individual patients who, mostly, have no health insurance, and on societies where patients are young, comprising those who have the greatest potential to contribute to economic productivity.
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Each year, ≈795 000 individuals in the United States experience a stroke, of which 87% (690 000) are ischemic and 185 000 are recurrent.1 Approximately 240 000 individuals experience a transient ischemic attack (TIA) each year.2 The risk of recurrent stroke or TIA is high but can be mitiga...ted with appropriate secondary stroke prevention. In fact, cohort studies have shown a reduction in recurrent stroke and TIA rates in recent years as secondary stroke prevention strategies have improved.3,4 A meta-analysis of randomized controlled trials (RCTs) of secondary stroke prevention therapies published from 1960 to 2009 showed a reduction in annual stroke recurrence from 8.7% in the 1960s to 5.0% in the 2000s, with the reduction driven largely by improved blood pressure (BP) control and use of antiplatelet therapy.5 The changes may have been influenced by changes in diagnostic criteria and differing sensitivities of diagnostic tests over the years.
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Myocardial infarctions are generally clinically classified into ST elevation MI (STEMI) and non-ST elevation MI (NSTEMI), based on changes in ECG. When blood flow to a part of the heart stops or the heart is injured and fails to receive enough oxygen required for its adequate functioning the conditi...on is termed as STEMI or the ‘heart-attack’ in laymen language. Patients with elevated cardiac troponin levels but negative CK-MB who were formerly diagnosed with unstable angina or minor myocardial injury are now reclassified as non-ST-segment elevation Myocardial Infarction (non-STEMI) even in the absence of diagnostic changes.
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The Pandemic Influenza Preparedness (PIP) Framework is a World Health Assembly resolution adopted unanimously by all Member States in 2011. It brings together Member States, industry, other stakeholders and WHO to implement a global approach to pandemic influenza preparedness and response. The Frame...work includes a benefit-sharing mechanism called the Partnership Contribution (PC). The PC is collected as an annual cash contribution from influenza vaccine, diagnostic, and pharmaceutical manufacturers that use the WHO Global Influenza Surveillance and Response System (GISRS). Funds are allocated for: (a) pandemic preparedness capacity building; (b) response activities during the time of an influenza pandemic; and (c) PIP Secretariat for the management and implementation of the Framework.
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To assess the quality of Indian clinical practice guidelines (CPG)s for the management of cardiovascular conditions, MEDLINE, Embase, Google Scholar and websites of relevant medical associations and government organisations were searched, from inception until August 2020, to identify Indian CPGs for... the management of cardiovascular disease (CVD) conditions, produced in or between 2010 and 2019. Excluded were CPGs that were not specific to India, focused on alternative systems of medicine, of non-CVD conditions (even if they included a component of CVD), and those related to the electronic devices, cardiac biomarkers, or diagnostic procedures. Quality of the each included CPG was assessed using the AGREE II tool by four reviewers in duplicate, independently. Each AGREE II domain score and overall quality score was considered low (≤40%), moderate (40.1%-59.9%), and high (≥60%). Of the 23 CPGs included, six (26%) were reported to be adapted from other CPGs. Fourteen (61%) CPGs were produced by medical associations, six (26%) by individual authors and three (13%) by government agencies. Based on the AGREE II overall quality score, two (9%) CPGs were of high quality, four (17%) and seventeen (74%) CPGs were of moderate and low quality, respectively. Except for scope and purpose, and clarity of presentation all other domains were rated low. The quality of most Indian CPGs for managing CVD conditions assessed using the AGREE II tool was moderate-to-low. Combined efforts from different stakeholders are needed to develop, disseminate and implement high-quality CPGs while identifying and addressing barriers to their uptake to optimize patient care and improve outcomes.
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Africa CDC Institute of Pathogen Genomics (IPG) was launched in November 2019 and operates under the Division of Laboratory Systems and Networks.
IPG coordinate the implementation of molecular diagnostics, pathogen genomics and bioinformatics in National Public Health Institutions (NPHIs) and/or Re...fe-
-rence Laboratories (NRLs) across Africa.
Africa CDC and APHF are coordinating a continental initiative to maximize the benefits of molecular approaches and pathogen genomics for more effective
outbreak preparedness, prevention, response, and for the control and elimination of endemic diseases in Africa. One of Africa CDC’s flagship initiative is the Africa
Pathogen Genomics Initiative (Africa PGI), a partnership that aims to strengthen laboratory systems and enhance genomic surveillance by equipping the continent’s
public health institutions with the tools, training, and data infrastructure.
About the Project
In 2023, 166 outbreaks and public health events were reported in Africa. This calls for a resilient laboratory systems for timely detection and reporting of current and future outbreaks. This project aims to scale up molecular diagnostic and genomic sequencing-based detection and characterization of outbreaks.
Africa CDC is working with Member States to develop guidance, diagnostic algorithm, training and capacity building to enable outbreak detection, and reporting to inform public health response.
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The "Cystic Fibrosis Fact Sheet" by the National Heart, Lung, and Blood Institute provides an overview of cystic fibrosis (CF), a chronic and often fatal genetic disorder affecting the respiratory and digestive systems. The document outlines the causes, genetic inheritance patterns, and symptoms of ...CF, which include thick mucus buildup, respiratory issues, and digestive problems. It also discusses diagnostic methods, such as the sweat test and genetic testing, and highlights current treatment approaches focused on symptom management, including chest therapy, medications, and potential gene therapy. The fact sheet emphasizes patient and family education to improve quality of life and support coping strategies.
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The webpage provides detailed information about asbestosis, a lung disease caused by inhaling asbestos fibers. It outlines various asbestos-related diseases, including benign and malignant pleural conditions as well as lung cancer. Asbestosis is described as a diffuse fibrotic disease of lung tissue... resulting from prolonged and intense exposure to asbestos fibers, progressing slowly over time. The page covers the causes, risk factors, and pathology of the disease, highlighting different types of asbestos fibers and their effects on the lungs. It also discusses symptoms, diagnostic procedures, and potential complications, such as the increased risk of lung cancer and mesothelioma. Preventive measures and recommendations for those affected are also included.
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The article "Asthma treatment in children: A guide to screening for and management of hypothalamic-pituitary-adrenal axis suppression" discusses the risks associated with the use of corticosteroids in pediatric asthma treatment. It highlights that prolonged corticosteroid use can suppress the hypoth...alamic-pituitary-adrenal (HPA) axis, potentially leading to adrenal insufficiency, especially during stress. The article reviews diagnostic and screening approaches, recommending specific tests and management strategies based on current evidence. It emphasizes the need for monitoring children on corticosteroids to mitigate the risk of serious complications and suggests modifications in treatment to prevent HPA axis suppression.
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The article "Barriers and determinants of asthma control in children and adolescents in Africa: a systematic review" analyzes factors contributing to poor asthma control in African youth. Based on studies conducted between 2014 and 2019 in Nigeria, Uganda, and South Africa, the review identifies key... challenges such as limited access to asthma diagnosis, inadequate use of inhaled corticosteroids, and environmental and socio-economic factors. It finds that urban living, older age, and concurrent allergic conditions significantly affect asthma management. The study emphasizes the need for improved diagnostic tools, better access to treatment, and tailored public health interventions to enhance asthma outcomes in African children.
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The article presents findings from the BREATHE study, which assessed the distribution of COPD-related symptoms in the Middle East and North Africa (MENA) region. The study involved a large cross-sectional survey in 11 countries, collecting data on respiratory symptoms, smoking habits, and potential ...COPD prevalence in adults aged 40 and older. Results showed that 14.3% of the surveyed population reported symptoms consistent with COPD, with variations across countries. Women reported symptoms more frequently than men, though diagnosed COPD was more common in men. The study highlighted smoking, including waterpipe use, as significant risk factors and called attention to underdiagnosed COPD in the region, emphasizing the need for increased awareness and better diagnostic practices.
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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 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.
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The article analyzes the prevalence and risk factors of chronic respiratory diseases, focusing on sub-Saharan Africa. It highlights that environmental exposures, such as biomass fuel usage and air pollution, significantly contribute to respiratory health issues in the region. The research underlines... the limited healthcare infrastructure, insufficient diagnostic tools, and the need for comprehensive data collection to better understand the burden of respiratory diseases. The authors advocate for targeted public health interventions, improved access to healthcare, and policies aimed at reducing exposure to risk factors to mitigate the prevalence of respiratory conditions.
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The document titled "Early Warning Signs of COPD" from the American Lung Association outlines what COPD is, its risk factors, and the importance of recognizing early symptoms such as persistent cough, breathlessness, and frequent chest infections. It emphasizes the need for early consultation with a... healthcare provider and diagnostic testing like spirometry to confirm COPD. Early diagnosis and treatment can help slow disease progression and improve quality of life.
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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 relati...ve 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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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...gnostic accuracy of tests used to diagnose asthma in adult patients and provide recommendations for clinical practice.
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Cystic fibrosis (CF) was earlier thought to be a disease prevalent in the West among Caucasians. However, quite a number of recent studies have uncovered CF cases outside of this region, and reported hundreds of unique and novel variant forms of CFTR. Here, we discuss the evidence of CF in parts of... the world earlier considered to be rare; Africa, and Asia. This review also highlighted the CFTR mutation variations and new mutations discovered in these regions. This discovery implies that the CF data from these regions were earlier underestimated. The inadequate awareness of the disease in these regions might have contributed towards the poor diagnostic facilities, under-diagnosis or/and under-reporting, and the lack of CF associated health policies. Overall, these regions have a high rate of infant, childhood and early adulthood mortality due to CF. Therefore, there is a need for a thorough investigation of CF prevalence and to identify unique and novel variant mutations within these regions in order to formulate intervention plans, create awareness, develop mutation specific screening kits and therapies to keep CF mortality at bay.
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