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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is limited by the inability to perform objective lung fu
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nction testing in this group of patients and the wide variety of conditions that can phenotypically present with asthma-like symptoms.
This article provides an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions.
The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence.
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In 2022, Namibia had an estimated population of 2.6 million people, where 51 per cent per cent are females and 52.5 per cent of households in urban areas, with fast-growing urban informal settlements which lack access to basic services. Namibia has a young population; 42 per cent are
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children (0-17 years), 13 per cent are under-five, per cent and 19 per cent are aged 15 to 24 years. With the right investment on children and youth, this represents an opportunity for a demographic dividend.
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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 nee
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ds substantial improvement. From infancy to the teenage 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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Severe and difficult asthma in a low- and middle-income country (LMIC) can relate to lack of availability of basic medications; potentially reversible factors such as poor adherence or comorbidities such as obesity inhibiting a good response to treatment; and (rarely) true severe, therapy-resistant
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asthma. However, definitions of severity should encompass not merely doses of prescribed medication, but also underlying risk. The nature of asthmatic airway disease shows geographical variation, and LMIC asthma should not be assumed to be phenotypically the same as that in high-income countries (HICs). The first assessment step is to ensure another diagnosis is not being missed. Largely, political action is needed if children with asthma are to get access to basic medications. If a child is apparently not responding to low dose, simple medications, the next step is not to increase the dose but perform a detailed assessment of what factors (for example co-morbidities such as obesity, or social factors like poor adherence) are inhibiting a treatment response; in most cases, an underlying reason can be found. An assessment of risk of future severe asthma attacks, side-effects of medication and impaired lung development is also important. True severe, therapy-resistant asthma is rare and there are multiple underlying molecular pathologies. In HICs, steroid-resistant eosinophilia would be treated with omalizumab or mepolizumab, but the cost of these is prohibitive in LMICs, the biomarkers of successful therapy are likely only relevant to HICs. In LMICs, a raised blood eosinophil count may be due to parasites, so treating asthma based on the blood eosinophil count may not be appropriate in these settings.
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Children without access to safe water are more likely to die in infancy -- and throughout childhood -- from diseases caused by
water-borne bacteria, to which their small bodies are more vulnerable.
Chapter 21 from "Where there is no doctor"
For over a decade, Senegalese and international journalists, human rights advocates, and child protection experts have documented and denounced the ongoing exploitation, abuse and neglect of children
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living in many of Senegal’s traditional Quranic schools, or daaras. Thousands of these children, known as talibés, continue to live in conditions of extreme squalor, deprived of adequate food and medical care.
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Accessed April 2014
Vitamin A deficiency is a risk factor for blindness and for mortality from measles and diarrhoea in children aged 6–59 months. We aimed to estima
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te trends in the prevalence of vitamin A defi ciency between 1991 and 2013 and its mortality burden in low-income and middle-income countries.
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Don’t Leave Them Alone: The future of the cross-border response in north west Syria
ATAA Humanitarian Relief Association, BINAA for Development, Children Of One world, et al.
Save the Children
(2021)
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This report, written by ATAA Humanitarian Relief Association, BINAA for Development, Children Of One world, Hand in Hand for Aid and Development, H
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oran Foundation, Hurras Network, MARAM Foundation, Orange Organization, Syrian American Medical Society, Save the Children and Shafak Organization, provides insights on the humanitarian situation on the ground in north west Syria.
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Guiding Principles for Feeding Infants and Young Children During Emergencies
recommended
WHO
(2004)
These guidelines have been developed specifically to address ethical issues of conducting research in children.
Europe PMC Funders Group
Author Manuscript
Arch Dis Child. Author manuscript; available in PMC 2013 November 01.
Published in final edited form as:
Arch Dis Child. 2013 May ; 98(5): 323–327. doi:10.1136/archdischild-2012-302079.
The report provides the much-needed evidence to design interventions for children in Kenya and as such we urge partners to use this report as a document f
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or planning for children.
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Including Therapeutic Food, Dietary Vitamin and Mineral Supplementation - 2nd edition
Psychosocial Support and Social and Emotional Learning for Children and Youth in Emergency Settings
recommended
The purpose of this paper is to clarify relevant terminologies and approaches relating to psychosocial well-being and social and emotional learning (SEL) in education in crisis affected contexts, and to explore how psychosocial support (PSS) and social and emotional learning relate to one another.
Children in Kabwe are especially at risk because they are more likely to ingest lead dust when playing in the soil, their brains and bodies are still developing, and they absorb four to five times as much lead as adults. The consequences
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for children who are exposed to high levels of lead and are not treated include reading and learning barriers or disabilities; behavioral problems; impaired growth; anemia; brain, liver, kidney, nerve, and stomach damage; coma and convulsions; and death. After prolonged exposure, the effects are irreversible. Lead also increases the risk of miscarriage and can be transmitted through both the placenta and breastmilk.
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Guidelines for the Prevention and Treatment of Opportunistic Infections in Children With and Exposed to HIV
recommended
Full Guidelines
