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3
En el año 2020 se registró una muerte materna cada hora en América Latina y el Caribe (ALC). Ese mismo año, la tendencia de la razón de mortalidad materna (RMM) en la Región de las Américas retrocedió de manera alarmante e inaudita a los niv
...
eles de hace veinte años. Estas cifras no solo implican un empeoramiento en los resultados, sino una profundización de las desigualdades, lo que representa miles de tragedias individuales e inaceptables que en la mayoría de los casos serían evitables. La muerte materna es el resultado de un proceso multifactorial donde interactúan elementos estructurales como el sistema económico, las condiciones ambientales y la cultura. Además, intervienen otros factores relativos a la desigualdad social, como el racismo, la pobreza, la desigualdad de género y la falta de acceso al sistema educativo
more
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 questio
...
nnaire responses were compared to post hoc consensus 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
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
WHO has updated the mpox Case reporting form (CRF) and data collection tool, mainly by reducing the number of variables. A detailed list of changes is presented in the file. The content of the Case investigation form (CIF) has not been changed.
De acuerdo con la Convención sobre los Derechos del Niño, todos los lactantes y niños tienen derecho a una buena nutrición.
La reducción de la mortalidad en menores de cinco años en la Región de las Américas es fundamental para disminuir las grandes brechas entre países, áreas y grupos humanos, y lograr la equidad en el acceso a estrategias disponibles para la prev
...
ención y el tratamiento de las enfermedades, así como la promoción del crecimiento y el desarrollo saludable de la niñez. El Objetivo de Desarrollo del Milenio número 4 está relacionado con reducir la mortalidad en menores de cinco años en dos terceras partes entre 1990 y 2015.
more
Demographic and epidemiological transitions are changing the age structure of the population and the most common diseases. Non-communicable respiratory diseases are an increasing problem at both ends of the age range in low-income and middle-income countries. In children, who represent
...
a large proportion of the total population, the increasing problem of asthma is a strain on health services. Improved survival of the older population is increasing the proportion of morbidity and mortality attributable to chronic lung diseases. Health services in low-resource countries are poorly adapted to treating chronic diseases. Designed to respond episodically to acute disease, almost all historical investment has focused on infectious diseases. Crucial to the successful management of chronic diseases is an infrastructure designed to support pro-active management, providing not only an accurate diagnosis, but also a secure supply of cost effective drugs at an affordable price. The absence of such an infrastructure in many countries and the market failure that makes drugs generally more expensive in low-resource regions means that many people with chronic non-communicable lung diseases are not given effective treatment. This has damaging economic consequences. The common causes of poor lung health in lowincome countries are not the same as those in richer countries, and there is a need to study why they are so common and how best to manage them.
more
This status report shows how far we have come—and how much further we must go—if we hope to meet the global commitments to end AIDS in children. It offers a snapshot of global progress and permits an early assessment of the impact of the Global
...
Alliance’s work.
more
Read about our flagship publication, The Global Asthma Report 2022, a 102-page cutting edge State-of-the-Art report, with contributions from 97 experts from, 31 countries.
The theme for this year is "Asthma Education Empowers", and emphasizes the
...
need to empower people with asthma with the appropriate education to manage their disease, and to recognize when to seek medical help.
more
Globally, it is estimated that 1 billion people suffer from acute and chronic respiratory conditions, making them major causes of illness and death. Although there is a relative lack of data and evidence on lung diseases beyond tuberculosis (TB) in
...
Sub-Saharan Africa (SSA), their estimated regional burden is large and growing. In addition, there is a poorly understood relationship between infections, such as TB, and non-infectious causes of lung health problems. The problem in lung diseases in SSA is exacerbated by many factors, including under-prioritisation, under-treatment and weak preventative measures.
more
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.
more
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatme
...
nt should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
The pharmacological management of asthma has changed considerably in recent decades, as it has come to be understood that it is a complex, heterogeneous disease with different phenotypes and endotypes. It is now clear that the goal of asthma treatme
...
nt should be to achieve and maintain control of the disease, as well as to minimize the risks (of exacerbations, disease instability, accelerated loss of lung function, and adverse treatment effects). That requires an approach that is personalized in terms of the pharmacological treatment, patient education, written action plan, training in correct inhaler use, and review of the inhaler technique at each office visit. A panel of 22 pulmonologists was invited to perform a critical review of recent evidence of pharmacological treatment of asthma and to prepare this set of recommendations, a treatment guide tailored to use in Brazil. The topics or questions related to the most significant changes in concepts, and consequently in the management of asthma in clinical practice, were chosen by a panel of experts. To formulate these recommendations, we asked each expert to perform a critical review of a topic or to respond to a question, on the basis of evidence in the literature. In a second phase, three experts discussed and structured all texts submitted by the others. That was followed by a third phase, in which all of the experts reviewed and discussed each recommendation. These recommendations, which are intended for physicians involved in the treatment of asthma, apply to asthma patients of all ages.
more
The 2023 meeting of the WHO Clinical Consortium on Healthy Ageing (CCHA) was the group’s ninth gathering and took place in Geneva 5–7 December 2023. The meeting was structured around seven panels, with a series of technical presentations, plenar
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y discussions and group work, and a final session outlining the work programme for 2024.
more
The European Respiratory Society (ERS)/American Thoracic Society (ATS) Task Force on severe asthma includes an updated definition of severe asthma, a discussion of severe asthma phenotypes in relation to genetics, natural history, pathobiology and p
...
hysiology, as well as sections on evaluation and treatment of severe asthma where specific recommendations for practice are made. See the unabridged online version of the document for detailed discussion of the definition of severe asthma, phenotypes and recommendations for practice.
more
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 taskf
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orce was set up by the European Respiratory Society to systematically review the literature on the diagnostic accuracy of tests used to diagnose asthma in adult patients and provide recommendations for clinical practice.
more
People play an essential role in managing their own sexual and reproductive health and rights (SRHR) and as caregivers. This publication looks at self-care interventions for SRHR from a global perspective and also what is specifically happening in s
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ix countries: Burkina Faso, Ethiopia, India, Kenya, Nigeria and Uganda.
more
With Asthma Day coming up, Edrine Osteen Mukalazi sat down with Dr. Rebecca Nantanda to discuss "Closing the gap on #Asthma care for children on the Health Pot show."
Leave on a comment and let us know whether this video has been educational for
...
you.
...........................................................................................................................................................
✽ Our guest Rebecca Nantanda ✽
⊳ Dr. Rebecca Nantanda is a member of the Institute Technical Board (ITB) of Makerere University Lung Institute.
⊳ She has been involved in research on respiratory diseases in children for the past 12 years with specific focus on pneumonia and asthma.
⊳ She has a number of publications in peer-reviewed journals and has made several presentations at International and Local Scientific conferences on the above subjects.
⊳ She is currently involved in research, clinical care and pre-service and in-service training of health care professionals.
⊳ Her qualifications contain MBChB (MUST), M.Med Paediatrics and Child Health (MUK), PhD, Postdoctoral Research Fellow, Sida- Makerere Research Program.
more
Health Statistics in the Western Pacific Region 2023: Monitoring health for the SDGs is the third biennial report providing an overview of the progress of the World Health Organization (WHO) Western Pacific Region towards the health-related Sustainable Development Goal (SDG) targets. Thi
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s edition also serves as a baseline assessment for the implementation of the global WHO Fourteenth General Programme of Work 2025–2028 (GPW14) within the Western Pacific Region and the for the Regional Vision “Weaving Health for Families, Communities, and Societies of the Western Pacific Region: Working Together to Improve Health, Well-Being and Save Lives”.
more
On August 13, 2024, the Africa CDC declared the mpox outbreak a Public Health Emergency of Continental Security (PHECS). The following day, the WHO declared it a Public Health Emergency of Internati
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onal Concern (PHEIC). A coordinated, continent-wide response is essential, co-led by the African Union (AU) through the Africa CDC and the World Health Organization (WHO), in close collaboration with global partners working under a unified plan, budget, and monitoring framework.
more