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Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update
Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al.
African Journal of Thoracic and Critical Care Medicine
(2021)
CC
sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care
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and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support optimal care. The South African Thoracic Society (SATS) first published a guideline for the management of chronic persistent asthma in 1992, which has subsequently been revised several times.
The main aim of the present document was to revise and update SATS’ statement on the suggested management of chronic asthma, based on the need to promote optimal care and control of asthma, together with the incorporation of new concepts and drug developments. This revised document reinforces optimal care and incorporates the following primary objectives to achieve the recent advances in asthma care:
• continued emphasis on the use of inhaled corticosteroids (ICS) as the foundation of asthma treatment
• to reduce the reliance on short-acting beta-2 agonist (SABA) monotherapy for asthma symptoms
• to incorporate the evidence and strategy for the use of the combination of an ICS and formoterol for acute symptom relief (instead of a SABA)
• to incorporate the evidence and strategy for the use of as-needed ICS-long-acting beta agonists (LABA) for patients with infrequent symptoms or ‘mild’ asthma
• to incorporate the evidence and strategy for the use of a long-acting muscarinic antagonist (LAMA) in combination with ICS-LABA; and
• to incorporate the evidence and strategy for the use of and management with a biologic therapy in severe asthma.
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Mpox, previously known as monkeypox, is a viral illness caused by the monkeypox virus (MPXV).1
It causes a painful rash, enlarged lymph nodes, fever, headache, muscle ache, back pain and low energy or feeling sick. In most cases, the
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symptoms of mpox go away within a few weeks with supportive care. In some people, the illness can be severe
or lead to complications and even death.
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Communicable Diseases: Part 4 Other Diseases of Public Health Importance and Surveillance.
HEAT, UNICEF, Open University, AMREF
Ministry of Health, Federal Democratic Republic of Ethiopia
(2015)
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Blended Learning Modulef or the Health Extension Programme
In this study session, you will learn about the general features of faeco-oraldiseases: the main types commonly found in Ethiopia, their general symptomsand signs, how to treat mild cases
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and when to refer patients with severeconditions for specialised treatment, or laboratory tests to confirm thediagnosis. You will also learn about the importance of giving effective healtheducation to your community on ways to prevent and control faeco-oraldiseases.
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The document provides a detailed overview of cholera, including its clinical features, diagnosis, treatment, and prevention. It explains the causes of cholera, its symptoms such as severe diarrhea
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and dehydration, and the importance of rehydration therapy (oral or intravenous) to reduce mortality. The document also emphasizes public health measures, including access to clean water, proper sanitation, and vaccination, as essential strategies to control and prevent cholera outbreaks. It serves as a comprehensive resource for healthcare professionals managing cholera cases and outbreaks.
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The checklist is aligned with, and builds upon, existing COVID-19-related WHO guidelines and is structured around protective measures related to: 1) hand hygiene
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and respiratory etiquette; 2) physical distancing; 3) use of masks in schools; 4) environmental cleaning and ventilation; and 5) respecting procedures for isolation of all people with symptoms. The checklist is designed to support policy-makers, staff and officials from the education and health sectors, local authorities, school principals/leaders and administrators, teachers’ unions, community leaders, school staff, teachers, parents and caregivers.
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Case definitions, clinical classification, and disease phases Dengue, Chikungunya, and Zika
recommended
A person who lives in or has traveled in the previous 14 days to areas with dengue transmission, and presents with acute fever that has typically lasted 2 to 7 days, and two or more of the following
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clinical manifestations: nausea or vomiting, exanthema, headache or retro-orbital pain, myalgia or arthralgia, petechiae or positive tourniquet test (+), leukopenia, with or without any warning sign or sign of severity. A suspected case is also considered to be any child who resides in or has traveled in the previous 14 days to an area with dengue transmission that presents acute febrile symptoms, usually for 2 to 7 days, without an apparent focus.
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Cardiovascular disease is a major cause of disability and premature death throughout the world, and contributes substantially to the escalating costs of health care. The underlying pathology is athe
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rosclerosis, which develops over many years and is usually advanced by the time symptoms occur, generally in middle age. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. Modification of risk factors has been shown to reduce mortality and morbidity in people with diagnosed or undiagnosed cardiovascular disease.
This publication provides guidance on reducing disability and premature deaths from coronary heart disease, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established cardiovascular disease are at very high risk of recurrent events and are not the subject of these guidelines. They have been addressed in previous WHO guidelines.
Several forms of therapy can prevent coronary, cerebral and peripheral vascular events. Decisions about whether to initiate specific preventive action, and with what degree of intensity, should be guided by estimation of the risk of any such vascular event. The risk prediction charts that accompany these guidelinesb allow treatment to be targeted accord-
ing to simple predictions of absolute cardiovascular risk.
Recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies. The guidelines provide a framework for the development of national guidance on prevention of cardiovascular disease that takes into account the particular political, economic, social and medical circumstances.
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WHO guidelines for clinical management of arboviral diseases: dengue, chikungunya, Zika and yellow fever
recommended
The new WHO guidelines provide clinical management recommendations for four of the most widespread arboviruses affecting humans: dengue, chikungunya, Zika, and yellow fever.
An integrated approach is vital, as these four diseases often present wi
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th similar symptoms, especially in the early stages of infection, and multiple arboviruses may circulate simultaneously in certain regions. This makes clinical differentiation challenging, particularly where diagnostic testing is not readily available.
This guideline is available in online format on the MAGICapp platform
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The ICOPE guidance for person-centred assessment and pathways in primary care (ICOPE Handbook) helps community health and care workers put the recommendations outlined in the ICOPE Guidelines into p
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ractice. The Handbook assists with setting person-centred goals, screening for loss in a range of domains of intrinsic capacity and assessing health and social care needs to develop a personalised care plan. The care plan may include multiple interventions to manage declines in intrinsic capacity, provide social care and support, support self-management and support caregivers. The domains of intrinsic capacity include cognitive decline, limited mobility, malnutrition, visual impairment, hearing loss and depressive symptoms.
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Accessed 21 July 2021:The Caregiver Booklet is designed to help patients,family members, and community caregivers in the home-based care of serious long term illness. Home care is best for many people with long term illnesses,including those w
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ho are close to the end of life. All patients being cared for at home should be first assessed and treated by a health worker, who will help caregivers provide high quality home care and ensure that medicines are taken correctly.
This booklet explains how to:
1. Deal with specific symptoms.
2. Provide care for terminal and bedridden patients at home.
3. Decide when to seek help from a health facility.
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Best Practice for the Care of Patients with Tuberculosis: a Guide for Low-Income Countries
recommended
G. Williams, E. Alarcón, S. Jittimanee et al.
The International Union Against Tuberculosis and Lung Disease
(2017)
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2nd edition.
The practical aspects of TB patient care from the onset of symptoms to the completion of treatment are covered in this guide
Injury to the skin and underlying tissues from acute exposure to
a large external dose of radiation is referred to as cutaneous
radiation injury (CRI). Acute radiation syndrome (ARS) 1 will
usually be accompani
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ed by some skin damage; however, CRI
can occur without symptoms of ARS. This is especially true with
acute exposures to beta radiation or low-energy x-rays, because
beta radiation and low-energy x-rays are less penetrating and less
likely to damage internal organs than gamma radiation is. CRI can
occur with radiation doses as low as 2 Gray (Gy) or 200 rads 2 and
the severity of CRI symptoms will increase with increasing doses.
Most cases of CRI have occurred when people inadvertently came
in contact with unsecured radiation sources from food irradiators,
radiotherapy equipment, or well depth gauges. In addition, cases of
CRI have occurred in people who were overexposed to x-radiation
from fluoroscopy units.
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16 Dec. 2020
This document provides guidance to Ministries of Health (MOHs), laboratory personnel and implementing partners in African Union Member States on the application of rapid antigen tests to COVID-19 testing. The guidance serves as referen
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ce for policymakers, laboratory leads, implementing partners, and experts on use case scenarios and associated testing algorithms for COVID-19 antigen tests. It recommends the use of antigen tests to increase access to testing and enable timely results for persons with or without symptoms in specific settings. The document will be reviewed and updated as more evidence becomes available regarding the use of rapid antigen tests for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from global studies and evaluation efforts.
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Antimicrobial resistance is one of the most important threats to the health worldwide. Antimicrobial resistance or drug resistance is the reduction of the pharmaceutical effects of a drug against a disease or reduction of its effectiveness in improving the clinical
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signs of a disease. Antimicrobial resistance occurs naturally but misuse of antibiotics in human and animals significantly accelerates the process of developing antimicrobial resistance. In fact, antimicrobial resistance refers to the resistance of a microorganism to one or more antimicrobial drugs which had been previously sensitive to these drugs. Antimicrobial resistance can occur in a wide variety of pathogens including bacteria, parasites, viruses, fungi, and cancer cells and may threaten the life of every person, in every age, and in every country
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The strategy recommends that AU Member States should enhance, where feasible, existing COVID-19 surveillance to include:
Community-based surveillance to detect symptomatic cases early for treatment and to avert viral transmission;
Sentin
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el surveillance in high-risk populations to detect and track both presymptomatic and asymptomatic cases; and
Wastewater surveillance to monitor early environmental signs of virus transmission and identify communities where targeted interventions can be implemented to decrease transmission.
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Standard operating procedures (SOP) for the management of tuberculosis in children
National Tuberculosis, Leprosy and Lung Disease Program (NTLD-Program), Kenya
Ministry of Health, Kenya
(2017)
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2nd edition. Children with TB comprise about 10-12% of the total TB cases diagnosed in the country. This burden is likely to be higher given the challenges in diagnosing TB in children. The symptoms of TB in children mimic those of other childhood d
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iseases. Children do not readily expectorate and they have pauci-bacillary TB hence some will be missed using bacteriological tests. The government has however introduced GeneXpert molecular testing that is more sensitive than microscopy in detecting TB. Health care workers therefore need a reference guide to obtaining sputum from children for testing. Treatment of TB in children has been reviewed and now includes Ethambutol. There are now improved paediatric friendly TB medicines for treatment of TB in children and health care workers need a reference guide to enable them accurately dispense the TB medicine to children. Malnutrition is a common predisposing factor for TB in children. On the other hand, TB predisposes children to malnutrition or worsens an existing state of malnutrition. Nutrition care and support forms an integral part of treatment for a child with TB disease.
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Cystic Fibrosis - What Is Cystic Fibrosis
National Heart, Lung, and Blood Institute (NHLBI)
U.S. Department of Health and Human Services
(2024)
CC2
The "Cystic Fibrosis Fact Sheet" by the National Heart, Lung, and Blood Institute provides an overview of cystic fibrosis (CF), a chronic and often fatal genetic disorder affecting the respiratory
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and digestive systems. The document outlines the causes, genetic inheritance patterns, and symptoms of CF, which include thick mucus buildup, respiratory issues, and digestive problems. It also discusses diagnostic methods, such as the sweat test and genetic testing, and highlights current treatment approaches focused on symptom management, including chest therapy, medications, and potential gene therapy. The fact sheet emphasizes patient and family education to improve quality of life and support coping strategies.
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This threat assessment addresses the implications of the ongoing Marburg virus disease (MVD) outbreak in
Rwanda for the European Union/European Economic Area (EU/EEA). MVD is a severe disease in humans and,
although uncommon, it has the potential
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to cause epidemics with significant case fatality. All recorded MVD
outbreaks to date have originated in Africa. MVD is not an airborne disease and is considered not to be
contagious before symptoms appear. Direct contact with the blood and other body fluids of infected people
and animals or indirect contact with contaminated surfaces and materials like clothing, bedding and medical
equipment is required for transmission. The risk of infection is minimised when proper infection prevention and
control precautions are strictly followed. There is no approved treatment or vaccine for MVD; however, several
pharmaceuticals and candidate MVD vaccines are under investigation.
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Since the release of the first volume in May 2020, the COVID-19 pandemic has continued to rage around the world. By mid-March, 2021, countries around the globe had reported over 123 million cases—a nearly five-fold increase since this report’s previous volume—
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and over 2.7 million deaths attributed to the disease. And while new case loads are currently on the rise again, the global health community has already administered almost 400 million doses of vaccines, at last offering some signs of hope and progress.
Economic impacts threaten to undo decades of recent progress in poverty reduction, child nutrition and gender equality, and exacerbate efforts to support refugees, migrants, and other vulnerable communities. National and local governments—together with international and private-sector partners—must deploy vaccines as efficiently, safely and equitably as possible while still monitoring for new outbreaks and continuing policies to protect those who do not yet have immunity.
More than ever, the world needs reliable and trustworthy data and statistics to inform these important decisions. The United Nations and all member organizations of the Committee for the Coordination of Statistical Activities (CCSA) collect and make available a wealth of information for assessing the multifaceted impacts of the pandemic. This report updates some of the global and regional trends presented in Volume I and offers a snapshot of how COVID-19 continues to affect the world today across multiple domains.
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Mpox can spread in humans through close contact, usually skin-to-skin contact, including sexual contact, with an infected person or animal, as well as with materials contaminated with the virus such as clothing, beddings and towels,
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and respiratory droplets in prolonged face to face contact. People remain infectious from the onset of symptoms until all the lesions have scabbed and healed. The virus may spread from infected animals through handling infected meat or through bites or scratches. Diagnosis is confirmed by polymerase chain reaction (PCR) testing of material from a lesion for the virus’s DNA.
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