MMWR. Recommendations and Reports:
December 16, 2005 / 54(RR15);49-55
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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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.
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he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m...ethodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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Eine Studie des Deutschen Instituts für Wirtschaftsforschung e. V. (DIW Berlin) kommt zu dem Schluss, dass Geflüchtete in der Corona-Pandemie stark psychisch belastet sind und sich sehr einsam fühlen. Als Ursachen hierfür werden unter anderem fehlende soziale Teilhabe aufgrund von Sprachbarriere...n, fehlende Erwerbstätigkeit und geringe Haushaltseinkommen genannt.
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Background: Understanding the natural course of child and adolescent posttraumatic stress disorder (PTSD) has significant implications for the identification of, and intervention for, at-risk youth. We used a meta-analytic approach to examine longitudinal changes in youth PTSD prevalence and symptom...s over the first 12 months posttrauma.
Journal of Child Psychology and Psychiatry57:8 (2016), pp 884–898
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TRAUMA & GEWALT 5. Jahrgang Heft 3/2011
Research
Emerging Infectious Diseases Vol. 12, No. 5, May 2006
Aerosol pollutants are known to raise the risk of development of non-communicable respiratory diseases (NCRDs) such as asthma, chronic bronchitis, chronic obstructive pulmonary disease, and allergic rhinitis. Sub-Saharan Africa’s rapid pace of urbanization, economic expansion, and population growt...h raise concerns of increasing incidence of NCRDs. This research characterizes the state of research on pollution and NCRDs in the 46 countries of Sub-Saharan Africa (SSA). This research systematically reviewed the literature on studies of asthma; chronic bronchitis; allergic rhinitis; and air pollutants such as particulate matter, ozone, NOx, and sulfuric oxide.
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J Acquir Immune Defic Syndr Volume 78, Supplement 1, August 15, 2018
The prevalence, availability, and use of antimalarial medicines (AMLs) were studied in six Cambodian provinces along the Thai-Cambodian border. The study was divided into two parts: the first looked at the quality of AMLs available in Pursat, Pailin, Battambang, Bantey Meanchey, Oddar Meanchey, and ...Preah Vihear and the second obtained information about the availability and use of AMLs.
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Dieses Fachdossier stellt mehrere Facetten des Themas Kinderschutz vor: Was bedeutet es, Kinder vor Gewalt und Vernachlässigung zu schützen?
Welche Gefahren gibt es, wie kann man ihnen begegnen? Und wie kann Kinderschutz wirksam und nachhaltig umgesetzt werden? Wissenschaftler
und Wissenschaftle...rinnen, Fachleute und Projektpartnerinnen und -partner stellen unterschiedliche Aspekte des Themas in Deutschland und anderen
Ländern vor.
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Die WHO hat mit Hilfe der Delphi-Methode eine klinische Falldefinition für das Post-COVID-19-Syndrom entwickelt, die 12 Domänen umfasst und in allen Bereichen verwendet werden kann. Diese erste Version wurde von Patienten, Forschern und anderen Personen aus allen WHO-Regionen entwickelt, wobei dav...on ausgegangen wird, dass sich die Definition ändern kann, wenn sich neue Erkenntnisse ergeben und sich unser Verständnis der Folgen von COVID-19 weiterentwickelt.
Die Post-COVID-19-Erkrankung tritt bei Personen mit einer wahrscheinlichen oder bestätigten SARS-CoV-2-Infektion in der Anamnese auf, in der Regel drei Monate nach dem Auftreten von COVID-19 mit Symptomen, die mindestens zwei Monate anhalten und nicht durch eine andere Diagnose erklärt werden können. Zu den häufigen Symptomen gehören Müdigkeit, Kurzatmigkeit, kognitive Störungen, aber auch andere Symptome, die sich im Allgemeinen auf das tägliche Leben auswirken. Die Symptome können nach der anfänglichen Genesung von einer akuten COVID-19-Episode neu auftreten oder nach der ersten Erkrankung fortbestehen. Die Symptome können auch schwanken oder im Laufe der Zeit wieder auftreten.
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DHS Further Analysis Reports No. 111
This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delive...ry, and timely postnatal care (PNC).
This study uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12 regions. We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use. We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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This study is a theory-driven analysis of the socio-demographic determinants of maternal care seeking in Kenya. Specifically, it examines predisposing, enabling, and need factors potentially associated with use of antenatal care (ANC), health facility delivery, and timely postnatal care (PNC).This s...tudy uses data from the 2014 Kenya Demographic and Health Survey (KDHS) conducted among women age 15-49 with a live birth in the five years preceding the survey. It includes data from all 47 counties of Kenya, grouped contiguously into 12regions.We apply Andersen’s Behavioral Model of Health Services Use to examine socio-demographic predictors of health service use.We estimate logistic regression models for adequate use of ANC (defined as attending at least four ANC visits, starting in the first three months of pregnancy), delivery in a health facility, and PNC within 48 hours of delivery.
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High levels of storage iron may increase malaria susceptibility. This risk has not been investigated in semi-immune adolescents. We investigated whether baseline iron status of nonpregnant adolescent girls living in a high malaria transmission area in Burkina Faso affected malaria risk during the fo...llowing rainy season. For this prospective study, we analysed data from an interim safety survey, conducted six months into a randomised iron supplementation trial. We used logistic regression to model the risk of P. falciparum infection prevalence by microscopy, the pre-specified interim safety outcome, in relation to iron status, nutritional indicators and menarche assessed at recruitment.
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Dieser 40-seitige Ratgeber richtet sich an geflüchtete und neuzugewanderte Männer und möchte helfen, die Orientierung in Deutschland bei Fragen zum Thema Gewalt zu erleichtern. Er möchte über die Schutz- und Unterstützungsmöglichkeiten informieren, sowie über Möglichkeiten, gewalttätiges V...erhalten bei sich selbst oder anderen zu erkennen und zu verringern. Die Themen des Ratgebers sind:
Formen zwischenmenschlicher Gewalt und Folgen für Betroffene
Der Einfluss von Werten und Normen auf Gewalthandeln
Wandel in der Einstellung zu Gewalt
Rechtliche Grundlagen und Gesetze in Deutschland
Psychologische Ursachen für gewaltsames Verhalten
Wege aus der Gewalt
Der Ratgeber wurde im Rahmen des bundesweiten Projekts „MiMi-Gewaltprävention mit Migrantinnen für Migrantinnen” entwickelt.
Er steht in 15 Sprachen zum Download zur Verfügung.
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Die aktuelle weltpolitische Lage führt dazu, dass immer mehr potentiell traumatisierte Kinder der Unterstützung von Fachleuten – auch in der psychologischen Grundversorgung - bedürfen. Traumata können bei Kindern aber auch durch Hospitalisationen und damit verbundene medizinische Eingriffe, Un...fälle o.ä. ausgeloest werden, wie im Folgenden beschrieben wird.
Die Diagnose von Traumafolgestörungen bei Kindern ist durch die Tatsache erschwert, dass sie eine Reihe unspezifischer und altersabhängiger Symptome zeigen, die auch bei anderen Störungen auftreten, was unter Umständen zu Fehldiagnosen (ADHS) führen kann.
Aus diesem Grund hat die vorliegende Arbeit zum Ziel, Fachpersonen eine Zusammenstellung grundlegender Informationen zur Entstehung und Diagnostik von Traumafolgestörungen sowie einen Überblick über gängige Diagnoseinstrumente zur Verfügung zu stellen.
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Das „Abkommen über die Rechtsstellung der Flüchtlinge“- wie der eigentliche Titel der Genfer Flüchtlingskonvention (GFK) lautet – wurde am 28. Juli 1951 verabschiedet. Bis heute ist die GFK das wichtigste internationale Dokument für den Flüchtlingsschutz. Die Genfer Flüchtlingskonvention... war zunächst darauf beschränkt, hauptsächlich europäische Flüchtlinge direkt nach dem Zweiten Weltkrieg zu schützen. Um den geänderten Bedingungen von Flüchtlingen weltweit gerecht zu werden, wurde der Wirkungsbereich der Konvention mit dem Protokoll von 1967 sowohl zeitlich als auch geografisch erweitert. Insgesamt 147 Staaten sind bisher der Genfer Flüchtlingskonvention und/oder dem Protokoll von 1967 beigetreten.
Für Versionen in anderen Sprachen (z.B. Russisch, Spanisch, Englisch, Französisch und Chinesisch) gehe zu http://www.unhcr.org/cgi-bin/texis/vtx/home.
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Heart failure with a reduced ejection fraction (HFrEF) is a condition frequently encountered by healthcare professionals and, in order to achieve the best outcomes for patients, needs to be managed optimally. This guideline document is based on the European Society of Cardiology Guidelines for the t...reatment of acute and chronic heart failure published in 2016, and summarises what is considered the best current management of patients with the condition. It provides information on the definition, diagnosis and epidemiology of HFrEF in the African context. The best evidence-based treatments for HFrEF are discussed, including established therapies (beta-blockers, ACE-i/ARBs, mineralocorticoid receptor antagonists (MRAs), diuretics) that form the cornerstone of heart failure management as well as therapies that have only recently entered clinical use (angiotensin receptor-neprilysin inhibitor (ARNI), sodium/glucose cotransporter-2 (SGLT2) inhibitors). Guidance is offered in terms of more invasive therapies (revascularisation, implantable cardioverter defibrillators (ICDs) and cardiac resynchronisation therapy (CRT) by implantation of a biventricular pacemaker with (CRT-D) or without (CRT-P) an ICD, left ventricular assist device (LVAD) use and heart transplantation) in order to ensure efficient use of these expensive treatment modalities in a resourcelimited environment. Furthermore, additional therapies (digoxin, hydralazine and nitrates, ivabradine, iron supplementation) are discussed and advice is provided on general preventive strategies (vaccinations). Sections to discuss conditions that are particularly prevalent in sub-Saharan Africa (HIV-associated cardiomyopathy (CMO), peripartum CMO, rheumatic heart disease, atrial fibrillation) have been added to further improve clinical care for these commonly encountered disease processes.
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