Asthma is the most common chronic condition in children worldwide. It affects daytime activities, sleep and school attendance and causes anxiety to parents, families and other carers. The quality of asthma diagnosis and management globally still needs substantial improvement. From infancy to the tee...nage years, there are age-specific challenges, including both underdiagnosis and overdiagnosis with stigma-related barriers to treatment in some cultures and in adolescents. The Paediatric Asthma Project Plan has been initiated to strengthen diagnosis and management of asthma. This encompasses a vision for the next 10–15 years, building on the knowledge and experience from previous educational projects. It will take into account the educational needs of patients, carers and healthcare professionals as well as the accessibility and affordability of medication, particularly in low and middle-income countries where the prevalence of asthma is rising more rapidly. This overview presents a first step for those involved in the diagnosis and management of childhood asthma to strengthen care for children globally.
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Background
Noncommunicable diseases are major contributors to morbidity and mortality worldwide. Modifying the risk factors for these conditions, such as physical inactivity, is thus essential. Addressing the context or circumstances in which physical activity occurs may promote physical activity a...t a population level. We assessed the effects of infrastructure, policy or regulatory interventions for increasing physical activity.
Methods
We searched PubMed, Embase and clinicaltrials.gov to identify randomised controlled trials (RCTs), controlled before-after (CBAs) studies, and interrupted time series (ITS) studies assessing population-level infrastructure or policy and regulatory interventions to increase physical activity. We were interested in the effects of these interventions on physical activity, body weight and related measures, blood pressure, and CVD and type 2 diabetes morbidity and mortality, and on other secondary outcomes. Screening and data extraction was done in duplicate, with risk of bias was using an adapted Cochrane risk of bias tool. Due to high levels of heterogeneity, we synthesised the evidence based on effect direction.
Results
We included 33 studies, mostly conducted in high-income countries. Of these, 13 assessed infrastructure changes to green or other spaces to promote physical activity and 18 infrastructure changes to promote active transport. The effects of identified interventions on physical activity, body weight and blood pressure varied across studies (very low certainty evidence); thus, we remain very uncertain about the effects of these interventions. Two studies assessed the effects of policy and regulatory interventions; one provided free access to physical activity facilities and showed that it may have beneficial effects on physical activity (low certainty evidence). The other provided free bus travel for youth, with intervention effects varying across studies (very low certainty evidence).
Conclusions
Evidence from 33 studies assessing infrastructure, policy and regulatory interventions for increasing physical activity showed varying results. The certainty of the evidence was mostly very low, due to study designs included and inconsistent findings between studies. Despite this drawback, the evidence indicates that providing access to physical activity facilities may be beneficial; however this finding is based on only one study. Implementation of these interventions requires full consideration of contextual factors, especially in low resource settings.
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The increasing prevalence of childhood asthma in the developed world is a cause for concern. A so-called Western lifestyle has been the factor most commonly cited to explain this worrying increase in asthma prevalence. Early studies in a limited number of African countries showed a very low rural pr...evalence of childhood asthma, especially where children lived according to a traditional lifestyle. These same studies showed that asthma was not uncommon in urbanized African children. There has been an
increasing tendency over the past 20 years for those in rural communities to move to the large urban centers. This article analyses the urban-rural differences and factors that influence the development of asthma in susceptible children.
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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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Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r...egion in terms of geography, climate, wealth, and ethnicity including 20 different countries with 639 million inhabitants, where 40 million are estimated to have asthma. A common feature of LA countries is the high level of social inequalities3 (Figure 1). In LA, asthma prevalence in both children and adults is highly variable and, where high, is among the highest worldwide, particularly in coastal tropical cities.
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Chronic obstructive pulmonary disease (COPD) represents an increasing burden throughout the world. COPD-related mortality is probably underestimated because of the difficulties associated with identifying the precise cause of death. Respiratory failure is considered the major cause of death in advan...ced COPD. Comorbidities such as cardiovascular disease and lung cancer are also major causes and, in mild-to-moderate COPD, are the leading causes of mortality.
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Asthma:
• is one of the most common respiratory complaints in the world today.
• affects one in ten children (10%) and one in twenty adults (5%)
• can occur for the first time at any age, even in adulthood.
•usually begins before the age of five years. A few children affected will ...outgrow” it during their teenage years but it usually persists if contracted in adulthood.
• tends to run in families as do related allergic conditions like hay fever and eczema.
• cannot as yet be cured but if kept under control, those affected will be able to live normal lives enjoying full involvement in sport and all other activities.
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Chronic respiratory diseases (CRDs) are among the leading causes of death worldwide, with asthma rated the most common chronic disease affecting children (1). Globally, about 300 million people have asthma, and current trends suggest that an additional 100 million people may be living with asthma by... 2025.
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Beyond territorial asylum: Making protection work in a bordered world
As a global community of +750 representatives of the world’s civil society, the C20 official Engagement Group of the G20 is submitting a list of policy priorities for the upcoming G20 Finance Ministers & Central Bank Governors meeting on July 18th and the G20 Extraordinary Sherpa Meeting on July 2...4th. The proposed recommendations take into account complimentary policy areas at the intersection of health and finance policymaking; including funding gaps, systemic, fiscal and financial priorities to put global finances at the service of global health.
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With sustained economic growth in many parts of the developing world, an increasing number of countries are transitioning away from the most subsidized development finance as they exceed income and other qualification requirements. Cross-country evidence suggests that Development Assistance Committe...e (DAC) donors view the crossing over of the World Bank’s International Development Association (IDA) eligibility threshold to signal that a country needs less aid, with subsequent reductions in both IDA and other donors’ concessional funding. Within the health sector, it is particularly important to understand the implications of these status changes for children under five years of age since improving early childhood health is critical to fostering health and social and economic development. Therefore, we examine the implications of the IDA transition by measuring the extent t which World Bank commitments—including both IDA and IBRD—are directed to infant and child health needs in Nigeria. Ordinary Least Squares (OLS) models were used in a difference-indifferences (DID) strategy to compare World Bank IBRD/IDA lending before and after the crossover to regions with varying initial levels of under-five and infant need.
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Tracking global malaria spending provides insight into how far the world is from reaching the malaria funding target of $6·6 billion annually by 2020. Because most countries with a high burden of malaria are low income or lower-middle income, mobilising additional government resources for malaria m...ight be challenging.
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Chagas Disease (CD) affects 6–7 million people worldwide and isrelated topoverty-promo ting conditions. Chronic asymptomatic cases are mostly invisible tohealth systems. Aiming totranslate CD discoveries into education/information practices toraise alertness and empowerment ofaffected people; and ...toperform an active search of CD cases, articulating intersectoral actions toimprove the access ofinfected people tothe local health service for the treatment of CD; our research group developed and tested under field conditions as innovative social technology: an itinerant education interdisciplinarysetting named “Chagas Express XXI”
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Soil-transmitted helminths (STH) affect 1.45 billion people worldwide, and high intensity infections are associated with anemia, undernutrition and impaired cognition, particularly among children. Mathematical models suggest it may be possible to interrupt the transmission of STH in a community by e...xpanding mass drug administration (MDA) from targeted high-risk groups (primarily school-aged children and women of child-bearing age) to all community members with high coverage. The DeWorm3 Project will test the feasibility of this approach to interrupting the transmission of STH using a series of cluster randomized trials in Benin, India and Malawi. Each study area (population 80,000) will be divided into 40 clusters and randomized to community-wide or standard-of-care targeted MDA for three years. Two years following the final round of MDA, prevalence of STH will be compared between arms and transmission interruption assessed in each cluster. The DeWorm3 trials will provide stakeholders with information regarding the potential to switch from STH control to a more ambitious and sustainable strategy.
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In 2005, the World Health Organization (WHO) recognized Chagas disease (CD; Trypanosoma cruzi infection) as a neglected tropical disease (NTD) [1] and included it into the global plan to combat NTDs [2]. The Target 3.3 of the United Nations Sustainable Development Goals (UN/SDG) aims at ending the e...pidemics of NTDs by 2030 [3]. Mother-to-child (congenital/connatal) transmission is currently the main mode of transmission of T. cruzi over blood transfusions and organ transplantations in vector-free areas within and outside Latin America (LA). Based on recent demonstrations that congenital transmission can be prevented [4–7], WHO has shifted its objective, in 2018, from control to elimination of congenital CD (cCD).
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Many countries have made significant progress in the implementation of World Health Organization recommended preventive chemotherapy strategy, to eliminate lymphatic filariasis (LF). However, pertinent challenges such as the existence of areas of residual infections in disease endemic districts pose... potential threats to the achievements made. Thus, this study was undertaken to assess the importance of these areas in implementation units (districts) where microfilaria (MF) positive individuals could not be found during the mid-term assessment after three rounds of mass drug administration.
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The project was developed by the International Federation of Medical Students’ Associations (IFMSA), in line with the Federation’s statement “a world in which students are equipped with knowledge, skills and value to take on health leadership roles locally and globally so to... shape a sustainable future”. This was supported by an ongoing and vital engagement from the World Health Organization (WHO) and their work the United Nations Alliance on Climate Change Education, Training and Public Awareness. The overall objective was to create a “all in one” type of resource to bring together climate change, health and youth advocacy.
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The marathon to eradicate polio is on its final lap: the world is more than 99% of the way to success. After millennia of living with poliovirus and suffering the paralysis it causes, today nearly all the world’s people live in polio-free countries; two of the three strains of wild poliovirus (WPV...) have been eradicated. Some 20 million people are walking who would have been paralysed had it not been for the efforts of national governments and health workers. If eradicating polio has been a marathon, the finishing line is in sight.
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The strengthened plan aims to achieve and sustain a polio-free world through a focus on implementation and accountability. Emphasis will be on cutting outbreak response times; increasing vaccine demand; transforming campaign effectiveness; working systematically through integration; increasing acce...ss in inaccessible areas; transitioning towards government ownership; and improving decision-making and accountability.
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