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2
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 treatment 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
Guide to revision of national pandemic influenza preparedness plans - Lessons learned from the 2009 A(H1N1) pandemic
Brown C., Ciotti M., Hegermann-Lindencrone M., et al
European Centre for Disease Prevention and Control (ECDC), WHO Regional Office for Europe
(2017)
C_WHO
The document “Guide to revision of national pandemic influenza preparedness plans – Lessons learned from the 2009 A(H1N1) pandemic” provides guidance for countries on how to improve and update their national pandemic preparedness plans. It is based on lessons learned from the 2009 influenza pa
...
ndemic and aims to help governments strengthen their readiness for future pandemics. The report outlines key components of effective pandemic planning, including risk assessment, coordination between sectors, communication strategies, healthcare system preparedness, vaccination and antiviral strategies, and business continuity planning. It also emphasizes the importance of international cooperation and flexible planning that can adapt to different pandemic scenarios. Overall, the guide serves as a framework to support countries in developing stronger, more coordinated responses to future influenza pandemics.
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 Asthma Control Questionnaire (ACQ)1 was developed and validated to measure the primary clinical goal of asthma management as identified by international guidelines. They indicate that to achieve good control, treatment should minimise day and night time symptoms, activity limitation, airway narr
...
owing and rescue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity. The importance of including all aspects of control in the assessment of individual patients was emphasised by a recent factor analysis which showed that clinical asthma is composed of distinct components which are not closely correlated with each other.6 However, in some studies it may not be possible to collect airway calibre or short-acting β2-agonists data. Previous analysis of non-clinical trial data suggested that when ACQ scores are analysed as group data, the heterogeneity of the way in which individual patients present with inadequate control is lost in the estimation of the mean and the need to measure each individual component of asthma control may become unnecessary. In this analysis, ACQ data from a clinical trial was used to evaluate the measurement properties (reliability, responsiveness, validity and interpretability), of three shortened versions of the ACQ. In addition, we have examined whether the precision and accuracy of estimating the effect of the intervention on asthma control was maintained when the two questions concerning airway calibre and short-acting β2-agonists use were omitted from the trial analysis.
more
Time has seen management for Cystic Fibrosis (CF) advance drastically, most recently in the development of the disease-modifying triple combination therapy ivacaftor/tezacaftor/elexacaftor. There is currently limited evidence regarding both the global epidemiology of CF and access to this transforma
...
tive therapy - and therefore where needs are not being met. Therefore, this study aims to define gaps in access to CF treatment. The results show that a significant CF patient burden exists in countries where disease-modifying drugs are unavailable, and final figures are likely underestimates. This analysis shows the potential to improve rates of diagnosis and treatment for CF, so a higher percentage of patients receive the most effective triple combination treatment.
more
The text explains the concept of disaster preparedness and outlines how societies can better prepare for and respond to emergencies. It describes key components such as risk assessment, planning, resource management, warning systems, and training, emphasizing that effective preparedness requires coo
...
rdination between institutions, communities, and individuals. The text also highlights the importance of early warning systems, showing that not only technical accuracy but also clear communication and community response are crucial. Overall, it argues that disaster preparedness is an ongoing process that combines planning, capacity building, and practical measures to reduce risks and improve emergency response.
more
This document by Medicines for Malaria Venture (MMV) highlights the significant burden of malaria on children worldwide, emphasizing the need for effective prevention, diagnosis, and treatment strategies. It reviews current challenges and progress in combating pediatric malaria, advocating for conti
...
nued research and investment to reduce malaria-related morbidity and mortality in children, especially in high-burden regions.
more
Este manual ofrece directrices prácticas para el manejo adecuado de las pruebas de diagnóstico rápido (PDR) de la malaria, destinadas al personal que trabaja en almacenes centrales, regionales y periféricos del sistema de salud. Su propósito principal es garantizar la integridad y eficacia de e
...
stas pruebas desde su recepción hasta su uso final.
Se destacan aspectos clave como la correcta recepción e inspección visual de los envíos, la verificación de daños, caducidad y componentes faltantes. Se proporcionan recomendaciones detalladas para el almacenamiento, incluyendo el control riguroso de la temperatura (idealmente entre 2 °C y 30 °C), la ventilación de los espacios, y el apilamiento seguro de las cajas.
Además, el manual aborda la gestión de inventarios con el uso de tarjetas de control, la rotación de productos bajo el principio “primero en caducar, primero en salir” (PEPS), y la realización de inventarios físicos regulares. También se detallan las buenas prácticas para el transporte por tierra, aire y agua, subrayando la importancia de proteger las pruebas del calor y de planificar bien los envíos.
Por último, se abordan medidas para la correcta gestión de residuos generados por las PDR, diferenciando entre desechos peligrosos (como lancetas, dispositivos usados y guantes contaminados) y desechos generales. Se incluyen recomendaciones para su separación, almacenamiento temporal y eliminación segura, adaptadas a contextos con recursos limitados.
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Este manual está dirigido al personal de salud que trabaja en establecimientos periféricos y que utiliza pruebas de diagnóstico rápido (PDR) para la malaria. Proporciona instrucciones prácticas para garantizar el buen funcionamiento de estas pruebas en condiciones muchas veces difíciles, espec
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ialmente en zonas remotas y de clima cálido.
Se explican procedimientos clave para la recepción de las pruebas (verificación de daños, caducidad, condiciones de transporte), el almacenamiento (selección del lugar más fresco, control de temperatura, ventilación, uso de métodos sencillos como depósitos en el suelo o contenedores que enfrían por evaporación) y el transporte seguro, ya sea por tierra o agua, con especial atención a evitar la exposición al calor.
Además, el manual incluye pautas para la gestión de inventarios, la rotación de existencias (usando primero las pruebas con vencimiento más próximo), y el registro del uso para evitar desperdicios y asegurar la disponibilidad continua.
Finalmente, se aborda la gestión de desechos peligrosos y generales generados por el uso de las pruebas, promoviendo su separación adecuada, almacenamiento seguro y eliminación apropiada (como fosas protegidas o incineración controlada), con el fin de proteger al personal y a la comunidad.
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El propósito de esta guía es brindar orientaciones clínicas actualizadas en TB/VIH con énfasis en aspectos de diagnóstico, incluidas nuevas técnicas, así como de tratamiento vigente, sin perder de vista un enfoque de salud pública. Al recopilar y consolidar en una sola guía las últimas rec
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omendaciones de la Organización Mundial de la Salud en el tema, se busca elaborar un documento de referencia y consulta frecuente, que unifique y estandarice el manejo de la coinfección TB/VIH de manera integral en establecimientos de salud con base en el principio de “dos enfermedades, un solo paciente”. También busca sustentar la actualización de normas y guías nacionales sobre la coinfeccion y complementar el trabajo coordinado que debe existir entre los programas de prevencion y control de TB y VIH a todo nivel en el marco las doce actividades de colaboración TB/VIH recomendadas internacionalmente.
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The Strategic Malaria Communication Guide for Central America is intended to facilitate the shift from malaria control to elimination by strengthening communication and advocacy initiatives throughout the region. Based on interviews and a review of literature, the guide offers National Malaria Progr
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ammes (NMPs) recommendations on messaging, target audiences, communication channels and advocacy strategies. The guide's primary goals are to raise awareness of malaria elimination, encourage long-term commitment from decision-makers and mobilise sustainable resources. The guide outlines two strategic objectives: (1) creating a shared understanding of the long-term requirements for malaria elimination, including funding, surveillance and multi-sectoral engagement, and (2) expanding support among public, private and cross-sectoral stakeholders. With malaria cases having already reduced by 88% since 2000, the guide emphasises the importance of maintaining focus and investment in order to fully eliminate the disease and prevent its re-establishment in Central America.
Accessed on 10/06/2025.
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Social and Behaviour Change Communication (SBCC) is essential for the effective control, prevention and elimination of malaria. The 2018–2030 Strategic Framework for Malaria SBCC guides countries and partners in strengthening capacities, refining strategies and sharing best practices, all of which
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are aligned with the WHO Global Technical Strategy for Malaria. Despite progress, malaria continues to threaten billions of people, and success hinges on access to interventions and behavioural change. This framework emphasises advocacy, technical guidance and tools to ensure that SBCC is prioritised and resourced as an essential element in the global fight against malaria.
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The document provides practical guidelines for conducting a national disaster risk assessment, developed by the United Nations Office for Disaster Risk Reduction. It emphasizes the importance of understanding disaster risk as a foundation for effective disaster risk management and sustainable develo
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pment. The guidelines outline a structured process that includes preparing and scoping the assessment, conducting risk analysis, and using the results to inform policy and decision-making. They promote a comprehensive, multi-hazard approach that considers vulnerabilities, exposure, and capacities, while encouraging collaboration among governments, experts, and stakeholders. Overall, the document aims to help countries build stronger systems for assessing and managing risks, thereby enhancing resilience and reducing the impacts of disasters.
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Where there is no dentist.
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دليل عملي موجه للقابلات والأطباء المدربين في مجال التوليد والعاملين بالرعاية الصحية الذين يتعاملون مع حالات الطوارئ التوليدية
Le présent document expose des recommandations exhaustives de l’OMS sur les soins prénatals systématiques à l’intention des femmes enceintes et des adolescentes. Le but de ces recommandations est de compléter les directives de l’OMS existantes sur la prise en charge des complications spé
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cifiques associées à la grossesse. Elles sont destinées à refléter et à répondre à la nature complexe des problèmes entourant la pratique et la délivrance des soins prénatals et à donner la priorité à la santé et au bien-être de la personne – et pas seulement à la prévention de la mortalité et de la morbidité – selon une démarche visant le respect des droits de l’homme.
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