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1
Non-communicable diseases (NCDs) are the second common cause of death in sub-Saharan Africa (SSA) accounting for about 35% of all deaths, after a composite of communicable, maternal, neonatal, and nutritional diseases. Despite prior perception of low NCDs mortality rates, current evidence suggests t
...
hat SSA is now at the dawn of the epidemiological transition with contemporary double burden of disease from NCDs and communicable diseases. In SSA, cardiovascular diseases (CVDs) are the most frequent causes of NCDs deaths, responsible for approximately 13% of all deaths and 37% of all NCDs deaths. Although ischemic heart disease (IHD) has been identified as the leading cause of CVDs mortality in SSA followed by stroke and hypertensive heart disease from statistical models, real field data suggest IHD rates are still relatively low. The neglected endemic CVDs of SSA such as endomyocardial fibrosis and rheumatic heart disease as well as congenital heart diseases remain unconquered. While the underlying aetiology of heart failure among adults in high-income countries (HIC) is IHD, in SSA the leading causes are hypertensive heart disease, cardiomyopathy, rheumatic heart disease, and congenital heart diseases. Of concern is the tendency of CVDs to occur at younger ages in SSA populations, approximately two decades earlier compared to HIC. Obstacles hampering primary and secondary prevention of CVDs in SSA include insufficient health care systems and infrastructure, scarcity of cardiac professionals, skewed budget allocation and disproportionate prioritization away from NCDs, high cost of cardiac treatments and interventions coupled with rarity of health insurance systems. This review gives an overview of the descriptive epidemiology of CVDs in SSA, while contrasting with the HIC and highlighting impediments to their management and making recommendations.
more
Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a
...
t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
more
Prediabetes Risk Test
adapted from Bang et al., Ann Intern Med (2009)
American Diabetes Association in collaboration with the Centers for Disease Control and Prevention (CDC)
(2024)
CC2
The "Prediabetes Risk Test" is a tool designed to help individuals assess their risk for prediabetes and type 2 diabetes. The test uses a point-based system with questions about age, gender, family history of diabetes, history of high blood pressure, physical activity level, and weight category. Bas
...
ed on the total score, individuals with a score of 5 or higher are at an increased risk of prediabetes, meaning their blood sugar levels may be elevated but not yet high enough to be classified as type 2 diabetes. The test encourages individuals with a high score to consult a doctor for further testing and suggests lifestyle changes as a preventive measure. Special risk considerations are provided for certain ethnic groups, such as African American, Hispanic/Latino, American Indian, Alaska Native, Asian American, and Pacific Islander populations.
more
Effectiveness of a diabetes program based on digital health on capacity building and quality of care in type 2 diabetes: a pragmatic quasi-experimental study
Moreas Morelli, D.; Rubinstein, F.; Santero, M.; et al.
BMC Health Services Research, part of Springer Nature
(2023)
CC2
Health systems in Latin America face many challenges in controlling the increasing burden of diabetes. Digital health interventions are a promise for the provision of care, especially in developing countries where mobile technology has a high penetration. This study evaluated the effectiveness of th
...
e implementation of a Diabetes Program (DP) that included digital health interventions to improve the quality of care of persons with type 2 Diabetes (T2DM) in a vulnerable population attending the public primary care network.
more
The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir
...
ometry, and insufficient knowledge among healthcare workers. The review also highlights the stigma associated with asthma and the absence of relevant diagnostic guidelines. Solutions proposed include community education, development and adherence to diagnostic guidelines, and strengthening healthcare systems. The study aims to inform policymakers and healthcare providers to improve asthma diagnosis and care for children in these regions.
more
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
...
sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
more
Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma
...
symptoms, with marked variations in prevalence and in prevalence trends between countries and regions of the world. The Global Burden of Disease Study estimated that asthma caused the loss of 21.6 million healthy years of life (disability-adjusted life years) and 461 069 deaths in 2019. Approximately 90% of the asthma burden of disease is borne by people living low and middle income countries (LMICs). Some countries report very high (up to 90%) rates of uncontrolled asthma. While the prevalence of asthma is highest in countries with a high Socio-Demographic Index (SDI), death rates from asthma are highest in countries with low and lower middle incomes.
more
BMC Infectious Diseases volume 23, Article number: 342 (2023).
Tuberculosis (TB) is among the leading causes of death globally. The disease has a huge burden in Namibia, with a case notification rate of at least 442 per 100,000. To date, Namibia is among the countries with the highest global TB bur
...
den, despite all efforts to reduce it. This study aimed to determine the factors associated with the unsuccessful treatment outcomes of the Directly Observed Therapy Short course (DOTS) programme in the Kunene and Oshana regions.
more
Reprod Health 19, 143 (2022). https://doi.org/10.1186/s12978-022-01452-4.
Delivery of quality reproductive health services has been documented to depend on the availability of healthcare workers who are adequately supported with appropriate training. However, unmet training needs among healthcare
...
workers in reproductive, maternal, and newborn health (RMNH) in low-income countries remain disproportionately high. This study investigated the effectiveness of training with onsite clinical mentorship towards self-reported performance in RMNH among healthcare workers in Mwanza Region, Tanzania.
more
Parasites Vectors 14, 50 (2021). https://doi.org/10.1186/s13071-020-04555-8
Programme Nationale de Lutte contre le Paludisme - Plan Stratégique National 2023-2027 - République de Guinée
Minsitère de la Santé et de l’hygiène Publique
Direction nationale de l’épidemiologie et de la lutte contre la maladie
(2023)
C2
Le Plan Stratégique National de Lutte contre le Paludisme 2023–2027 de la Guinée vise à réduire de 80 % l’incidence et la mortalité liées au paludisme d’ici 2027, en s’appuyant sur les leçons des années précédentes. Il prévoit des actions renforcées de prévention (moustiquaire
...
s, lutte antivectorielle, chimio-prévention saisonnière, prévention chez les femmes enceintes et les enfants), une amélioration de la prise en charge des cas à tous les niveaux (public, privé, communautaire), ainsi qu’un renforcement de la gestion, des ressources, de la gouvernance, de la communication et de l’évaluation. L’objectif final est de guider le pays vers la pré-élimination du paludisme, en assurant l’accès universel à des soins de qualité et en mobilisant tous les acteurs nationaux et internationaux.
more
Plan Stratégique National de Lutte contre le Paludisme au Sénégal 2021–2025
Programme National de Lutte contre le Paludisme (PNLP), Sénégal
Ministère de la Santé et de l’Action Sociale, République du Sénégal
(2020)
C2
Le Plan Stratégique National de Lutte contre le Paludisme au Sénégal 2021–2025 a pour objectif de réduire l’incidence et la mortalité liées au paludisme d’au moins 75 % par rapport à 2019 et d’interrompre la transmission locale dans au moins 80 % des districts éligibles. Il repos
...
e sur une approche multisectorielle combinant prévention (moustiquaires, pulvérisation, chimioprévention), diagnostic, traitement, surveillance, gestion des stocks et communication pour le changement de comportement. Le plan vise aussi à renforcer la gouvernance, l’équité, la recherche et la mobilisation des ressources, en s’appuyant sur les partenariats locaux, privés et internationaux pour atteindre l’objectif d’un Sénégal sans paludisme à l’horizon 2030.
more
Stratégie intégrée de Communication pour la Lutte contre le Paludisme au Sénégal
Programme National de Lutte contre le Paludisme (PNLP), Sénégal
Ministère de la Santé et de l’Action Sociale, République du Sénégal
(2016)
C2
La Stratégie intégrée de communication pour la lutte contre le paludisme au Sénégal (2016) vise à renforcer la prévention et la prise en charge du paludisme par des actions de communication efficaces. Elle combine plaidoyer, mobilisation sociale et communication pour le changement de comporte
...
ment afin d’augmenter l’utilisation des moustiquaires imprégnées, le recours au traitement précoce, la chimio-prévention saisonnière et l’aspersion intradomiciliaire. Le document définit les objectifs, les messages clés, les cibles, les canaux de communication (comme la radio, la télévision, les activités communautaires) et les mécanismes de suivi-évaluation. L’accent est mis sur la coordination nationale et locale pour harmoniser les actions, renforcer l’adhésion des communautés et garantir un impact durable sur la santé publique au Sénégal.
more
Bhana A et al. Journal of the International AIDS Society 2021, 24(S2):e25713
Manuel de la sage-femme, de l’inf rmière et du médecin
Desinfection Solaire de L'eau
Regula Meierhofer, Martin Wegelin, Xiomara del Rosario Torres, et al.
EAWAG, SANDEC, SODIS Solar Water Disinfection
(2005)
Pour le personnel de santé et les travailleurs de la nutrition dans les situations d’urgence
