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Africa is witnessing an epidemic of cardiovascular disease (CVD), with staggering morbidity and mortality. The spectrum of CVD includes hypertension, rheumatic heart disease, cardiomyopathy, atherosclerotic disease, congenital heart disease and tuberculous pericarditis. Opportunities exist to alter
...
the trajectory of CVD epidemiology but require committed policy makers, functional health systems and an engaged citizenry.
more
The pharmacological treatment of heart failure has evolved over the last three decades since the demonstration of the effect of angiotensinconverting enzyme inhibitors on major cardiovascular events in patients with heart failure with reduced ejection fraction. Composite analysis of heart failure wi
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th reduced ejection fraction trials and the recent identification of newer drug treatments show early benefits on the major cardiovascular outcomes, ushering in a change of the treatment strategy; from a ‘sequential’ initiation of the treatments to a ‘simultaneous’ initiation to harness the early benefits. The adoption and implementation of these changes at the bedside have been dismal in many healthcare settings. Papua New Guinea, like many other lower-to-middle-income countries, is facing many barriers that impact on the care of heart failure patients. It needs to adopt and implement these changes to provide evidence-based treatment for its people with heart failure with reduced ejection fraction.
more
In this quality improvement study, data from the Creditor Reporting System were used to estimate flows of total DAAH and per-adolescent DAAH and to assess its distribution by donors, regions, and countries and the leading causes of burden of disease (ie,
disability-adjusted life-years) in 132 devel
...
oping countries between January 1, 2003, and December 31, 2015. Through use of a key word search and various funding allocation methods, 2 sets of estimates were produced: adolescent-targeted DAAH that included disbursements to projects with a primary adolescent health target and adolescent-inclusive DAAH that included disbursements to
projects with either a primary or partial adolescent health target, as well as projects that could benefit adolescent health but did not include age-related key words.
more
About reesource gaps for low and middle income countries
The Global Burden of Disease Study (GBD) began 30 years ago with the goal of providing timely, valid and relevant assessments of critical health outcomes. Over this period, the GBD has become progressively more granular. The latest iteration provides assessments of thousands of outcomes for diseases
...
, injuries and risk factors in more than 200 countries and territories and at the subnational level in more than 20 countries. The GBD is now produced by an active collaboration of over 8,000 scientists and analysts from more than 150 countries. With each GBD iteration, the data, data processing and methods used for data synthesis have evolved, with the goal of enhancing transparency and comparability of measurements and communicating various sources of uncertainty. The GBD has many limitations, but it remains a dynamic, iterative and rigorous attempt to provide meaningful health measurement to a wide range of stakeholders.
more
Prompted by the 20th anniversary of the 1993 World
Development Report, a Lancet Commission revisited the
case for investment in health and developed a new
investment frame work to achieve dramatic health gains by 2035. Our report has four key messages, each accompanied by opportunities for action
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by national governments of low-income and middle-income countries and by the international community.
more
The epidemiology of adult-onset type 1 diabetes (T1D) incidence is not well-characterized due to the historic focus on T1D as a childhood-onset disease.
Type 2 diabetes mellitus (T2DM) is a chronic condition characterized by insulin resistance and an inability to properly regulate blood sugar levels. The two most important risk factors for T2DM are a family history of diabetes and obesity, though age, race, diet, and exercise level also impact risk.
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Common symptoms include frequent urination, nerve damage, and dark skin patches. Treatment involves lifestyle changes like diet and exercise as well as medications like metformin, which improves insulin sensitivity and decreases glucose production in the liver. Patients are counseled on managing diabetes-related risks and provided support through organizations and groups.
more
Coronary heart disease (CHD) is the single most common cause of death globally. However, with falling CHD mortality rates, an increasingnumber of people live with CHD and may need support to manage their symptoms and improve prognosis. Cardiac rehabilitation is acomplex multifaceted intervention whi
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ch aims to improve the health outcomes of people with CHD. Cardiac rehabilitation consists of threecore modalities: education, exercise training and psychological support. This is an update of a Cochrane systematic review previouslypublished in 2011, which aims to investigate the specific impact of the educational component of cardiac rehabilitation.
more
Asthma is the most common chronic respiratory disease among school-going adolescents worldwide. However, the burden of severe asthma is highest in Sub-Saharan Africa. This study aimed to explore teachers’ perceptions of asthma care across six African countries. We conducted focus group discussions
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(FGDs) using a semi-structured interview guide. Interviews were audio-recorded, transcribed verbatim and analysed thematically. FGDs were conducted in Kumasi(Ghana), Blantyre (Malawi), Lagos (Nigeria), Durban (South Africa), Kampala (Uganda), and Harare (Zimbabwe) between 01 November 2020 and 30 June 2021. We identified two key themes related to asthma care; barriers to asthma care and suggestions to improve the care of adolescents with asthma. Barriers reported by teachers included a lack of knowledge and skills among themselves, adolescents, and caregivers. In addition, some traditional beliefs of teachers on asthma exacerbated challenges with asthma care in schools. Regarding suggestions, most teachers identified a need for all-inclusive asthma training programmes for teachers, adolescents and caregivers, focusing on acute episodes and mitigating triggers. Utilising teachers with personal experiences with asthma to advocate and support these initiatives was suggested. Further suggestions included the need for annual screening to enable early identification of adolescents with asthma and clarify restrictions on teachers administering asthma medications. Teachers across African schools identify multiple barriers to asthma care. Structured school education programs and annual asthma screening are key to addressing some barriers to care.
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The article "An Official ATS Workshop Report: Issues in Screening for Asthma in Children" summarizes discussions from a workshop organized by the American Thoracic Society (ATS) on the challenges of asthma screening in children. The report reviews the effectiveness of population-based asthma screeni
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ng programs, highlights the limitations of current methods, and discusses case detection as an alternative. It assesses asthma's impact as a public health issue, explores the feasibility of screening tests, and examines the economic and practical challenges. The workshop concludes that broad population-based screening may not be justified without better evidence and targeted efforts to improve follow-up care and treatment access.
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This study identifies barriers and provides recommendations to improve asthma care in children across sub-Saharan Africa, where qualitative data is lacking despite high rates.
Background
Asthma education, a key component of long-term asthma management, is challenging in resource-limited settings with shortages of clinical staff. Task-shifting educational roles to lay (non-clinical) staff is a potential solution. We conducted a randomised controlled trial of an enhanced a
...
sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study
García-Marcos, L.; Chiang, C. Y.; Asher, I.; et al.
The Lancet Global Health Volume 11, Issue 2e218-e228February 2023
(2023)
CC2
Asthma is one of the most common non-communicable diseases globally. This study aimed to assess asthma medicine use, management plan availability, and disease control in childhood, adolescence, and adulthood across different country settings.
Although asthma is very common, affecting 5–10% of the population, the diagnosis of asthma in adults remains a challenge in the real world, which results in both over- and under-diagnosis. A taskforce was set up by the European Respiratory Society to systematically review the literature on the dia
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gnostic accuracy of tests used to diagnose asthma in adult patients and provide recommendations for clinical practice.
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BMJ Open Quality 2017;6:e000145. doi:10.1136/
bmjoq-2017-000145Although there are many evidence-based practices that reduce the risk of maternal and neonatal mortality around the time of birth, there remains a gap between what is known and the care received. This knowdo gap is a source of preventab
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le maternal and perinatal deaths and is the focus of improvement efforts in many countries. Following an increase in perinatal and maternal deaths, Gobabis District Hospital initiated a quality improvement (QI) initiative to increase adherence to these WHO Safe Childbirth Checklist (SCC)-targeted essential birth practices.
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In this ISNTD Connect and GSA collaborative webinar scientists discuss schistosomiasis control, elimination and innovation in the Philippines.
The presentation titled "Malaria Capacity Building Initiative" outlines efforts led by the WHO and partner organizations to strengthen the skills and systems needed to fight malaria globally. It highlights the need for a coordinated, long-term strategy to build human resource capacity in malaria-end
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emic countries—especially among national malaria control programs, frontline health workers, NGOs, and WHO staff. The document reviews past and current training activities, such as workshops on case management, entomology, vector control, epidemiology, and planning. It emphasizes the development of standardized training materials and competency frameworks, the role of national and regional training centers, and the use of blended learning methods (e.g., e-learning and in-person sessions). The goal is not just to deliver training, but to build sustainable capacity through partnerships, continuous improvement, quality assurance, and integration into health systems. It also calls for better coordination, tracking of trained personnel, and engagement of ministries of finance to ensure long-term support.
more
Malaria Journal (2024) 23:255. Seasonal malaria chemoprevention (SMC) is a World Health Organization-recommended intervention for the prevention of malaria among children at high risk in areas with seasonal transmission. During the coronavirus disease 2019 (COVID-19) pandemic, SMC drug distribution
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was rapidly adapted to reduce contact and mitigate the risk of transmission between communities and community distributors, with caregivers administering doses.
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