This article was published on December 10, 2020, and updated on December 16, 2020, at NEJM.org. DOI: 10.1056/NEJMoa2034577
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ...optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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This document provides information for WHO Member States, particularly low-income and middle-income countries, to strengthen preparedness and response plans with regard to the social and mental health consequences of biological and chemical attacks.
Just about everyone has experienced the joy that a healthy newborn child brings to parents, families and communities. But the arrival of a newborn who is small or sick often results in immediate worry and sadness. When the infant is at high risk of death or disability, these concerns can be a tremen...dous additional burden.
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Available in Russian
A detailed overview is provided of the implementation of alcohol policies described in the 10 action areas of the European Action Plan to Reduce the Harmful Use of Alcohol 2012–2020 (EAPA), including the current status of implementation of the five action areas of the WHO-led... SAFER initiative:
Strengthen restrictions on alcohol availability;
Advance and enforce drink–driving countermeasures;
Facilitate access to screening, brief interventions and treatment;
Enforce bans or comprehensive restrictions on alcohol advertising, sponsorship and promotion; and
Raise prices on alcohol through excise taxes and pricing policies.
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As the world population is growing and health care resources are in high demand the pressure on medical services is becoming higher. Developing countries are already at a crisis point in health care provision, and time demands a new approach in structuring medical resources. Primary care is t...he vital pillar for fundamental health care at community level and has been deemed as a cost-effective modality. In the West the primary care physician manages chronic medical conditions in communities and therefore reduces unnecessary hospital admissions. In the West, the primary care system is extremely well organised. Low-income countries must improve teaching, training and funding in primary care. In this article the urgent need for primary care is discussed in developing countries, and ways to minimise costs and improve clinical outcomes at community level.
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Every year, an estimated 15 million babies are born preterm – before 37 weeks of pregnancy. That is more than 1 in 10 live births. Approximately 1 million children die each year worldwide due to complications from their early birth. Those that survive often face a lifetime of ill-health including ...disability, learning difficulties, and visual and hearing problems.
Half of the babies born at or below 32 weeks (2 months early) die in low-income settings, due to a lack of feasible, cost-effective care, such as warmth, breastfeeding support, and basic care for infections and breathing difficulties. In high-income countries, almost all these babies survive.
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This guideline provides global, evidence-informed recommendations on daily iron supplementation in infants and children, as a public-health intervention for the prevention of anaemia and iron deficiency. It includes recommendations for iron supplementation in countries where malaria is prevalent.
ecancer has just published a comprehensive set of guidelines for paediatric cancer surgery, applicable to low and high resource settings across the world. You can read the guidelines online
The guidelines have been developed by the International Society of Paediatric Surgical Oncology (IPSO) with... authors from both High Income Countries and Lower and Middle Income Countries, and have been further validated by experts in the respective fields with the aim of providing evidence-based information for surgeons who care for children with cancer.
These guidelines include information on the care and treatment of children with malignancies, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumours (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life.
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Las Infecciones Asociadas a la Atención en Salud (IAAS) son reconocidas en la
actualidad como un problema de salud pública y existen lineamientos guber-
namentales en la mayoría de los países para constituir sistemas de vigilancia y
Programas de Prevención y Control de Infecciones para con...tener este fenóme-
no a nivel hospitalario.
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Bonchial asthma is the most common chronic respiratory disease in the world. In Kenya, it has been estimated that about 7.5% of the Kenyan population, nearly 4 million people, are currently living with asthma. Many cases tend to be underdiagnosed and undertreated which leads to high levels of morbid...ity and avoidable deaths. The consequences of poorly controlled asthma, including physical, mental, social, and economic impacts, are magnified in the poor on account of poor access to asthma services and sub-optimal quality of those services. With these guidelines, Kenya's Ministry of Health aims to work towards embedding asthma care in Universal Health Care (UHC) to ensure that quality asthma services are available in primary care settings with
referral networks strengthened for those who may require secondary and tertiary care. These national asthma guidelines will also ensure that treatment for asthma is standardized in both the public and the non-state health care sector.
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Le cadre conceptuel scientifique pour la neutralité de la dégradation des terres (LDN) fournit une base scientifique pour comprendre, mettre en œuvre et surveiller la LDN. Il a été conçu pour créer un pont entre la vision et la mise en œuvre pratique de la NCD, en définissant la NCD en term...es opérationnels. Le cadre conceptuel est un produit de l'interface science-politique de la CCD.
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The standards define 10 key competencies for health and care workers to support self-care in their clinical practice as well as the specific, measurable behaviours that demonstrate those competencies, focusing on people-centredness; decision-making; effective communication; collaboration; evidence-i...nformed practice, and personal conduct.
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This publication seeks to describe the best treatments and practices based on the scientific evidence available at the time of writing as evaluated by the authors and may change as a result of new research. Readers need to apply this knowledge to patients in accordance with the guidelines and laws o...f their country of practice. Some medications may not be available in some countries and readers should consult the specific drug information since not all the unwanted effects of medications are mentioned.
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National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.
Division of Tuberculosis Elimination.