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This review examines high-quality research evidence that synthesises the efects of extreme heat on human health in tropical
Africa. Web of Science (WoS) was used to identify research articles on the efects extreme heat, humidity, Wet-bulb Globe
Temperature (WBGT), apparent temperature, wind, Heat
...
Index, Humidex, Universal Thermal Climate Index (UTCI), heatwave, high temperature and hot climate on human health, human comfort, heat stress, heat rashes, and heat-related morbidity
and mortality
more
Non-Communicable Diseases (NCDs), including mental disorders, currently pose one of the biggest threats to health and development globally, particularly in low and middle income countries2. It is predicted that unless proven interventions are rapidly implemented in countries, in the short to medium
...
term, health care costs will increase exponentially and severe negative consequences will ensue not only to individuals and families but to whole societies and economies. NCDs are already a major burden in South Africa, but without added rigorous and timely action the health and development consequences may well become catastrophic. Immediate and additional, high quality, evidence based and focussed interventions are needed to promote health, prevent disease and provide more effective and equitable care and treatment for people living with NCDs at all levels of the health system. The problem is further compounded by the rising global prevalence of multi-morbidity (defined as the coexistence of two or more chronic diseases in one individual).
more
The coronavirus disease (COVID-19) pandemic exacerbated pre-existing inequalities in the treatment and care of noncommunicable diseases (NCDs). This report examines the effect of the COVID-19 pandemic on access to NCD medicines, and the policies and strategies implemented by countries and health sys
...
tems to anticipate and mitigate stresses across NCD medicine supply chains. The full range of upstream and downstream impacts are investigated, including: manufacturing; procurement, importation and last mile delivery; patient-level effects through affordability and availability; and the effects on NCD medicine availability by category of disease. The report culminates in recommended actions and interventions for key stakeholders in the NCD pharmaceutical supply chain, including governments, regulatory authorities, manufacturers and the private sector; as well as directions for future research for improving access and supply chain access resilience.
more
A 20-year follow-up study on chronic respiratory effects of exposure to cotton dust
Wang, X-R.; Zhang, H-X.; Sun, B-X.; et al.
European Respiratory Journal, part of the European Respiratory Society (ERS)
(2005)
CC2
The article "A 20-year follow-up study on chronic respiratory effects of exposure to cotton dust" evaluates the long-term impact of cotton dust exposure on respiratory health. It followed a cohort of Chinese cotton and silk workers from 1981 to 2001, comparing lung function and symptoms. Results sho
...
wed that cotton workers experienced greater declines in lung function and persistent respiratory symptoms compared to silk workers. The study found that exposure to airborne endotoxins in cotton dust was strongly linked to chronic respiratory impairment. It highlighted that stopping exposure helped improve lung function, particularly in non-smoking men, while smokers continued to show negative effects.
more
The article "Asthma in South African adolescents: a time trend and risk factor analysis over two decades" investigates the prevalence and risk factors for asthma in Cape Town adolescents from 2002 to 2017. The study finds that while the overall prevalence of asthma remained similar, the severity of
...
the condition increased significantly. Risk factors for asthma and severe cases include smoking, pet exposure, outdoor pollution, and living in informal housing. Despite these trends, underdiagnosis remains a concern, as only one-third of adolescents with current or severe asthma had been formally diagnosed. The article emphasizes the need for better public health strategies to address environmental exposures and improve asthma diagnosis and treatment.
more
Providing quality, stigma-free services is essential to equitable health care for all and achieving global HIV goals and broader Sustainable Development Goals related to health. Every person has the right to the highest attainable standard of physical and mental health. Countries have a legal obliga
...
tion to develop and implement legislation and policies that guarantee universal access to quality health services and address the root causes of health disparities, including poverty, stigma and discrimination.
The health sector is uniquely placed to lead in addressing inequity, assuring safe personcentred care for everyone and improving social determinants of health by overcoming taboos and discriminatory or stigmatizing behaviours associated with HIV, viral hepatitis and sexually transmitted infections (STIs). Improving health care quality and reducing stigma work together to enhance health outcomes for people living with HIV. Together, they make health care services more accessible, trustworthy and supportive. This encourages early diagnosis, consistent treatment and improved mental well-being. Thus, people living with HIV are more likely to engage with and benefit from health care services, leading to improved overall health.
more
Risk factors for asthma among schoolchildren who participated in a casecontrol study in urban Uganda
Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia
...
ry education for fathers (adjusted OR (95% CI); 2.32 (1.71–3.16)) and mothers (1.85 (1.38–2.48)); area of residence at birth, with children born in a small town or in the city having an increased asthma risk compared to schoolchildren born in rural areas (2.16 (1.60–2.92)) and (2.79 (1.79–4.35)), respectively; father’s and mother’s history of asthma; children’s own allergic conditions; atopy; and cooking on gas/electricity. In conclusion, asthma was associated with a strong rural-town-city risk gradient, higher parental socio-economic status and urbanicity. This work provides the basis for future studies to identify specific environmental/lifestyle factors responsible for increasing asthma risk among children in urban areas in LMICs.
more
Background
Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris
...
k factors for asthma in adolescents in an LMIC.
Methods
A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021.
Results
A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01.
Conclusion
Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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
This report explores the extent to which evidence, policy, normative guidance and commitments on HIV and gender-based violence, and their interlinkages, is being translated into action on the ground in fragile settings. These issues are explored through the lens of training of peace support operatio
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ns deploying African troops across Africa and beyond.
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 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
National action plans on antimicrobial resistance (AMR) often overlook the critical intersection of gender, despite evidence that exposure and susceptibility to infection, health-seeking behaviours, as well as antimicrobial prescribing and use patterns are all influenced by gender.
The 2023 meeting of the WHO Clinical Consortium on Healthy Ageing (CCHA) was the group’s ninth gathering and took place in Geneva 5–7 December 2023. The meeting was structured around seven panels, with a series of technical presentations, plenary discussions and group work, and a final session o
...
utlining the work programme for 2024.
more
Chronic respiratory diseases, such as asthma and
chronic obstructive pulmonary disease, kill more than
four million people every year and affect hundreds
of millions more. These diseases erode the health
and well-being of the patients and have a negative
impact on families and societies. Women
...
and
children are particularly vulnerable, especially those
in low and middle income countries, where they are
exposed on a daily basis to indoor air pollution from
solid fuels for cooking and heating. In high income
countries, tobacco is the most important risk factor
for chronic respiratory diseases, and in some of
these countries, tobacco use among women and
young people is still increasing.
more
Women, girls and marginalized groups who are largely dependent on natural resources for livelihoods are among the hardest hit by extreme weather patterns. These weather patterns limit their access to food, water, shelter, education and access to essential health services, including those that addres
...
s sexual and reproductive health and rights (SRHR), gender-based violence (GBV) and preventing harmful practices such as child marriage and female genital mutilation.
more
To give you a better idea of when and how psychotherapy can help you, we have written this brochure titled Paths to Psychotherapy. While it is therefore primarily intended for people who have never been treated by a psychotherapist, the brochure can also enable those who have previously had psychoth
...
erapy to find out about the range of psychotherapeutic care and assistance that is currently available. Regardless of your previous experience with psychotherapy, this brochure offers you clear information about what a mental illness is, whether scheduling an initial appointment is advisable, and the circumstances in which psychotherapeutic treatment is necessary.
more
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.
more
The guidance document provides a set of indicators for assessing the status of development, implementation and monitoring of key policy interventions for prevention and control of NCDs and injuries. It promotes city-level evidence based decision-making processes to identify gaps and take appropriate
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s actions to strengthen responses. Additionally, using the standardized indicators can facilitate cross-city learning, sharing best practices and lessons learnt in implementing various policy interventions.
more
The WHO Global tuberculosis report 2024 provides a comprehensive and up-to-date assessment of the TB epidemic, and of progress in prevention, diagnosis and treatment of the disease, at global, regional and country levels. This is done in the context of global TB commitments, strategies and targets.
Kangaroo mother care (KMC) is a critical strategy to care for preterm and low birth weight infants in resource-limited settings. Despite evidence of its effectiveness and low cost, coverage has remained low, largely due to sociocultural barriers. We aimed to better understand social norms and commun
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ity perceptions of preterm infants and KMC (facility-initiated and community-continued) in Malawi, a country with a high preterm birth rate, to inform a pilot social and behavior change program.
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