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.
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Antibiotics and other antimicrobial agents are invaluable life savers, particularly in resource-limited countries where infectious diseases are abundant. Both uncomplicated and severe infections are potentially curable as long as the aetiological agents are susceptible to the ...antimicrobial drugs. The rapid rate with which antimicrobial agents are becoming ineffective due to resistance acquired as a result of unchecked overuse and misuse threatens to undo the benefit of controlling infections. The evidence for resistant microorganisms, many times to more than a single antimicrobial agent, has been observed globally. In Tanzania, there is evidence in the form of few scattered studies conducted in different parts of the country in a multitude of settings including health care facilities, the community, domesticated animals and wild animals
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Practical guide intended for physicians, pharmacists, nurses and medical auxiliaries. This guide is not a dictionary of pharmacological agents. It is a practical manual intended for health professionals, physicians, pharmacists, nurses and health auxiliaries invoved in curative care and drug managem...ent. We have tried to provide simple, practical solutions to the questions and problems faced by field medical staff, using the accumulated field experience of Médecins Sans Frontières, the recommendations of reference organizations such as the World Health Organization (WHO) and specialized documentation in each field. Also available in French, Spanish and Arabic
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Germany’s overall response to COVID-19 has been evaluated as reasoned and sound. Nonetheless, it has exposed weaknesses and blindspots in the German healthcare system regarding the inclusion of migrant groups. For instance, marginalised groups such as labour migrants and asylum-seekers are not con...sidered for tailored measures in the government’s response to COVID-19. On the other hand, certain efforts to include migrant groups, such as the provision of information in numerous languages, are unprecedented in the German context. They may point to increasing accommodation for diversity.
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This Situation Update describes events occurring in Bilin Township, Thaton District during the period between July and October 2017, including healthcare, education, development projects and drug issues.
While many of the countries hit by the COVID-19 in the first few months of the year are now beginning to relax lockdown measures as infection and death rates fall, in the regions most affected by HIV, TB and malaria, such as Africa, South Asia and Latin America, the pandemic continues to accelerate.... In lower resource settings, lockdowns are less effective and hard to sustain, and clinical care facilities are extremely limited. In such environments, the response to COVID-19 must focus on containing the pandemic’s spread as far as possible through testing, contact tracing and isolation, protecting the health workforce through training and the provision of personal protective equipment (PPE) and minimizing the knock-on impact on other diseases through shoring up fragile health systems, and adapting existing disease programs.
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This manual details a collaboratively developed intervention to detect and refer Buruli ulcer, Hydrocele, Leprosy
and Lymphedema cases through the use of integrated approaches at community levels. This intervention has
been developed as part of the consortium in partnership with the Nigerian Feder...al Ministry
of Health, and Ogun and Kaduna State Ministries of Health. This manual is designed to assist community and
primary level health workers to identify, refer, diagnose and treat people affected by Buruli ulcer, Hydrocele,
Leprosy and Lymphedema, within the existing patient care pathway
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Several challenges face asthma management in Egypt, including the high percentage of uncontrolled patients, inadequate compliance, and overuse of short-acting beta-agonists (SABAs) leading to increased asthma-related morbidity and mortality. In this regard, the recent Global Initiative for Asthma (G...INA) recommendations included inhaled corticosteroids containing therapy for mild asthma. Local healthcare systems and healthcare professionals (HCPs) often experience practical challenges when implementing global guidelines.
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On 19 August 2016, the former UN Secretary-General announced a new approach to cholera in Haiti, consisting of two tracks. Track 1 focuses on reducing cholera transmission, improving access to care, and addressing water, sanitation, and health system issues. Track 2 aims to provide material assistan...ce to those most affected by cholera. The Secretary-General urged Member States to show solidarity with Haiti by increasing contributions. The UN General Assembly, in resolution 71/161, recognized the UN's moral responsibility to cholera victims and called for support to eliminate cholera and address its victims' suffering. The Secretary-General was requested to provide an update on the progress of this approach.
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This topic last updated: Apr 28, 2020.
The content on the UpToDate website is not intended nor recommended as a substitute for medical advice, diagnosis, or treatment. Always seek the advice of your own physician or other qualified health care professional regarding any medical questions or conditi...ons.
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Myth: It’s better to ‘tough it out’ without taking asthma medication. The lungs do not get stronger or become better able to deal with asthma if a person tries to work through an attack without medication. In fact, the lung inflammation that goes along with an attack (see what is asthma) ...can cause permanent damage to the lungs. Always use medication according to the Asthma Action Plan. If you have questions, talk with your health care provider.
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Cardiovascular disease (CVD) is the leading cause of global deaths, with the majority occurring in low- and middle-income countries (LMIC). The primary and secondary prevention of CVD is suboptimal throughout the world, but the evidence-practice gaps are much more pronounced in LMIC. Barriers at the... patient, health-care provider, and health system level prevent the implementation of optimal primary and secondary prevention. Identification of the particular barriers that exist in resource-constrained settings is necessary to inform effective strategies to reduce the identified evidence-practice gaps. Furthermore, targeting modifiable factors that contribute most significantly to the global burden of CVD, including tobacco use, hypertension, and secondary prevention for CVD will lead to the biggest gains in mortality reduction. We review a select number of novel, resource-efficient strategies to reduce premature mortality from CVD, including: (1) effective measures for tobacco control; (2) implementation of simplified screening and management algorithms for those with or at risk of CVD, (3) increasing the availability and affordability of simplified and cost-effective treatment regimens including combination CVD preventive drug therapy, and (4) simplified delivery of health care through task-sharing (non-physician health workers) and optimizing self-management (treatment supporters). Developing and deploying systems of care that address barriers related to the above, will lead to substantial reductions in CVD and related mortality.
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The Government of Liberia (GoL) reports three additional EVD cases linked to the Margibi County cluster, including one in Liberia’s Montserrado County; new confirmed case total reaches six
Recently extended Operation Northern Push strengthens contact tracing and EVD prevention activities ...in Sierra Leone
The Government of Guinea (GoG) and EVD response actors investigate source of infection for EVD-positive nurse in Forécariah Prefecture, the area’s first confirmed case among health care workers since March
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Malaria in children presents significant clinical challenges, with variations in presentation based on the malaria parasite involved and the child's underlying health conditions. The World Health Organization reports high incidence rates, particularly in sub-Saharan Africa, and emphasizes the import...ance of effective treatment strategies. First-line treatment often involves Artemether-Lumefantrine (ALu), while severe malaria requires careful management and the use of intravenous Quinine. Management protocols emphasize early diagnosis and the monitoring of severe complications to reduce mortality.
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Pregnancy and childbirth during adolescence profoundly affects the lives of millions of girls worldwide, and is a leading cause of maternal mortality and morbidity, and infant and child mortality. Every year, an estimated 21 million girls aged 15–19 years old in low- and middle-income countries be...come pregnant, and approximately 12 million give birth.
For many adolescent girls, the ability to control their sexual lives remains limited. Long-standing gender inequalities and discrimination, marginalization, harmful social and gender norms, and denial of rights, compounded by poverty and violence, render them vulnerable to early pregnancy, HIV and other health threats. Lack of age-appropriate sexual and reproductive health and rights (SRHR) information and services create additional barriers to care and support; as a result, adolescent girls who become pregnant are much more likely to go on to have rapid repeated births.
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Cancellation of scheduled surgery leads to operating theatre under-occupancy and is recognised as a major cause of emotional trauma to patients and their families. This study aimed to assess the incidence of elective surgery cancellation in order to make proposals for healthcare improvement.
The Knowledge Translation Unit is a group within the University of Cape Town’s Lung Institute and Department of Medicine who has worked on primary care programmes to strengthen provision of evidence-informed care in low-resources settings in South Africa, Ethiopia, Nigeria and Brazil for two decad...es. See here for more information. We are working around the clock to help health workers in these and similar settings to manage the COVID-19 pandemic. These can be accessed below. We are also working to expand these to support primary healthcare workers, patients and households. You can also access our free online training.
For purposes of assisting communities during the COVID-19 pandemic, we are making our COVID-19 and related materials freely available for others to use subject to some simple conditions.
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The document is a comprehensive practical guide for managing cholera epidemics. It includes detailed instructions on outbreak investigation, control measures, case management, and the organization of treatment facilities. It emphasizes strategies such as rehydration therapy, water sanitation, hygien...e promotion, and vaccination to prevent the spread of cholera. The guide serves as a resource for healthcare professionals, logisticians, and public health officials to respond effectively to cholera outbreaks.
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The2020 Focused Updates to the Asthma Management Guidelines: A Report from the National Asthma Education and Prevention Program Coordinating Committee Expert Panel Working Group was coordinated and supported by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Healt...h. It is designed to improve patient care and support informed decision making about asthma management in the clinical setting. This update addresses six priority topic areas as determined by the state of the science at the time of a needs assessment, and input from multiple stakeholders:
• Fractional Exhaled Nitric Oxide Testing
• Indoor Allergen Mitigation
• Intermittent Inhaled Corticosteroids
• Long-Acting Muscarinic Antagonists
• Immunotherapy in the Treatment of Allergic Asthma
• Bronchial Thermoplasty
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Infectious diseases are the leading cause of death globally, particularly among children and young adults. The spread of new pathogens and the threat of antimicrobial resistance pose particular challenges in combating these diseases. Major Infectious Diseases identifies feasible, cost-effective pack...ages of interventions and strategies across delivery platforms to prevent and treat HIV/AIDS, other sexually transmitted infections, tuberculosis, malaria, adult febrile illness, viral hepatitis, and neglected tropical diseases. The volume emphasizes the need to effectively address emerging antimicrobial resistance, strengthen health systems, and increase access to care. The attainable goals are to reduce incidence, develop innovative approaches, and optimize existing tools in resource-constrained settings.
Large File: 136 MB!!!!! Please download from the website link!
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