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Toolboxes
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2
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 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
Open Forum Infect Dis . 2022 Apr 5;9(5):ofac148.doi: 10.1093/ofid/ofac148. eCollection 2022 May. Dolutegravir HIV drug resistance (HIVDR) data from Africa remain sparse. We reviewed HIVDR results of Malawians on dolutegravir-based antiretroviral therapy (November 2020– September 2021). Of 6462 eli
...
gible clients, 33 samples were submitted to South Africa, 27 were sequenced successfully, and 8 (30%) had dolutegravir HIVDR. Malawi urgently requires adequate HIVDR testing capacity.
more
Since February 24th, 2022, the beginning of Russia’s aggression against Ukraine, more than 80,000 women were expected to give birth. Therefore, understanding the impact of war on the perinatal health of women is an important requisite
...
to improve perinatal care. This narrative synthesis has two main purposes: on one hand, it aims to summarize the current evidence available based on perinatal health outcomes and care among perinatal women; on the other, it attempts to identify the gaps still present in research in relation to perinatal care.
more
An estimated 1.3 billion people globally experience significant disability. This figure has grown over the last decade and will continue to rise due to demographic and epidemiological changes. In 20
...
22, the World Health Organization launched the Global report on health equity for persons with disabilities. This report demonstrated that many persons with disabilities are still being left behind. Experiencing persistent health inequities, persons with disabilities die earlier, they have poorer health and functioning, and they are more affected by health emergencies than the general population. These differences are largely associated with unjust factors both inside and beyond the health sector and are avoidable. The Global Report called upon Member States to take actions to make health sector more inclusive for persons with disabilities through the primary health care approach. This will be essential for countries to make health coverage truly universal and to progress towards other health-related targets in the sustainable development goals.
more
Based on an increasing body of evidence pointing at the positive impact that social assistance has had in Malawi, the region and beyond, government is encouraged to continue investing in and supporting the expansion and comprehensiveness of social p
...
rotection programmes in both rural and urban areas, ensuring they effectively target and adequately address needs and vulnerabilities across the lifecycle, in line with the Malawi National Social Support Programme (MNSSP II) and Vision 2063. In addition, Government and Development Partners are encouraged to further the integration between social protection, the humanitarian and the disaster risk management sectors in response to shocks and stresses, through the roll out of a fully shock-sensitive social protection system.
more
In 2008 the Ministry of Health and Social Services (MOHSS) commissioned a national health and social service system review which found that although some progress has been made in primary health care, provision of health services did not go beyond the health facilities, irrespective of the fast dist
...
ances between the Health facilities and community. The review then recommended that health services should be extended in a structured manner to communities through the establishment of paid health workers.
more
Each year WHO and UNICEF jointly review reports submitted by Member States regarding national immunization coverage, finalized survey reports as well as data from the published and grey literature. Based on these data, with due consideration to pote
...
ntial biases and the views of local experts, WHO and UNICEF attempt to distinguish between situations where the available empirical data accurately reflect immunization system performance and those where the data
are likely to be compromised and present a misleading view of immunization coverage while jointly estimating the most likely coverage levels for each country.
more
It is against this background that the Ministry of Health and Sanitation with its partners have
taken the lead to develop Essential Health Services Package (EHSP). The MOHS believes that the
development of EHSP; defining the services that should
...
be available at each level of care
(community to tertiary level), for each age cohort, and across each public health functions, not
only allows for more effective and equitable health service delivery, but also for the
establishment of a functional referral system and allocation of appropriate investments for high
impact interventions. The package is expected to set precedence in defining ‘essential’ set of
services for the population in Sierra Leone, structurally promoting integration of health services,
and providing succinct guidance to partners and stakeholders on the country priorities.
more
Mpox, previously known as monkeypox, is a viral illness caused by the monkeypox virus (MPXV).1
It causes a painful rash, enlarged lymph nodes, fever, headache, muscle ache, back pain and low energy or feeling sick. In most cases, the symptoms of mpox go away within a few weeks with supportive care
...
. In some people, the illness can be severe
or lead to complications and even death.
more
This paper presents a bibliometric analysis of the literature on private health aid and official health assistance between 2000 and 2022. It provides an overview of the sites and themes in the literature pertaining to development assistance in healt
...
h, and collates the significant policy recommendations presented therein. Several crucial findings emerge from the bibliometric analysis: 44.2 percent of the 489 papers/articles assessed focused on lower-middle-income countries, while 37.7 percent focused on low-income countries. However, authors affiliated with institutes and organisations from lower-middle- and low-income countries contributed merely 15.5 percent and 11.8 percent, respectively, of the papers assessed. Most (72.7 percent) were written by authors from highmiddle-
and high-income countries. Additionally, despite non-governmental
organisations, philanthropies, and private businesses constituting about 20 percent of development assistance donors, a mere 4 percent of all papers focused on these entities.
more
The objectives of this guideline are the same as those of the 2011 edition, namely to provide evidence-based normative guidance on interventions to improve adolescent morbidity and mortality by redu
...
cing the chances of early pregnancy and its resulting poor health outcomes. The specific objectives of the guideline were to: 1. identify effective interventions to prevent early pregnancy by influencing factors such as early marriage, coerced sex, unsafe abortion, access to contraceptives and access to maternal health services by adolescents; and 2. provide an analytical framework for policy-makers and programme managers to use when selecting evidence-based interventions to prevent early pregnancy and negative health outcomes when they occur that are most appropriate for the needs of their countries and context. The recommendations and best practice statements described in this document aim to enable evidence-based decision-making with respect to preventing early pregnancy and poor reproductive outcomes among adolescents in low- and middle-income country contexts.
more
WHO recommends artemisinin-based combination therapies for treating uncomplicated malaria, alongside studies to monitor treatment effectiveness. Given the threat of antimalarial resistance, including partial resistance in several African countries,
...
molecular tools are vital for tracking resistance. In 2015, WHO launched the External Quality Assessment scheme for nucleic acid amplification testing to ensure reliable lab results. Coordinated by WHO and operated by the United Kingdom National External Quality Assessment Service for Parasitology, the scheme provides quality-controlled specimens and reports to help improve testing accuracy. Experts recently discussed expanding the scheme to include antimalarial resistance markers.
more
The Manual for Parasitological Surveillance in Prevention of Reintroduction or Re-establishment of Malaria in Sri Lanka (2019) provides guidelines to health professionals on how to conduct effective
...
malaria surveillance to prevent the reintroduction of the disease in Sri Lanka, which was certified malaria-free in 2016.
The manual outlines strategies for active and passive case detection, laboratory diagnosis, case investigation, foci investigation, and follow-up measures. It emphasizes targeted screening of high-risk populations, including travelers and migrant workers, and explains the importance of prompt reporting, accurate parasitological confirmation, and coordination between healthcare levels. The overall goal is to maintain Sri Lanka’s malaria-free status by ensuring early detection and rapid response to any imported or locally suspected malaria cases.
more
The annual bulletin of the Mekong Malaria Elimination (MME) programme is a yearly report that reviews ongoing efforts to combat multidrug resistance and eliminate malaria in the 6 countries of the Greater Mekong subregion (GMS): Cambodia, China (Yun
...
nan province), Lao People's Democratic Republic, Myanmar, Thailand and Viet Nam.
more
The global cholera statistics for 2024, showing an increase in both the number of people who fell sick and died from the disease.
Reported cholera cases rose by 5% and deaths by 50% in 2024 compared to 2023, with more than 6000 people dying from a
...
disease that is both preventable and treatable. While these numbers are themselves alarming, they are underestimates of the true burden of cholera.
Weekly epidemiological record WER No 36, 2025, 100, 347–364
more
WHO guideline on HIV service delivery
recommended
Updated guidance on the integration of diabetes, hypertension and mental health services, and interventions to support adherence to antiretroviral therapy. The guideline offers practical implementa
...
tion guidance for countries and key stakeholders as well as outlining key research gaps. As life expectancy for people living with HIV continues to increase, managing noncommunicable diseases, mental health, and adherence to antiretroviral therapy is essential to sustaining treatment success, quality of life, and engagement in care. A life course approach addresses these needs from childhood through older age. Service integration supports more person-centred, coordinated care across the life course.
more
Operational requirements for implementing WHO recommendations in digital systems. 2nd edition.
To ensure that countries can effectively benefit from digital health investments, “digital adaptation kits” (DAKs) are designed
...
to facilitate the accurate reflection of WHO’s clinical, public health and data use guidelines in the digital systems that countries are adopting. DAKs are operational, software-neutral, standardized documentations that distil clinical, public health and data use guidance into a format that can be transparently incorporated into digital systems.
more
Facts For Life
recommended
Handbook on pregnancy, childbirth, childhood illnesses, child development and the care of children. The handbook, Facts for Life, provides vital messages and information for mothers, fathers, other family members and caregivers and communities to us
...
e in changing behaviours and practices that can save and protect the lives of children and help them grow and develop to their full potential.
This version of Facts for Life builds on the three previous editions, which have been helping families and communities around the world since 1989. Newborn Health has been added to the Safe Motherhood chapter, giving attention to child survival from the first stage of life. A new chapter, Child Protection, has been included, focusing attention on the actions needed to ensure children grow up in protective environments.
more
The IMCI model handbook provides a detailed explanation of the IMCI case management guidelines. It is organized into seven main parts: overview of the IMCI process; assess and classify the sick child age 2 months up to 5 years; assess and classify t
...
he sick young infant age 1 week up to 2 months; identify treatment; treat the sick child or the sick young infant; communicate and counsel; and give follow-up care.
Teaching institutions are advised to adapt the handbook in two ways:
to ensure that all text, charts and illustrations are consistent with nationally-adapted IMCI clinical guidelines, and
to ensure that its content and format corresponds to the teaching approach used by the institution.
more
