Ce chapitre fait partie du Rapport 2024 sur les résultats.
La République démocratique du Congo (RDC) occupe la 2ème place en termes de nombre de cas de paludisme et de décès associés dans le monde (12% des cas et 13% des décès), et représente à elle seule 54,6% des cas en Afrique centrale (OMS, Rapport Mondial sur la situation du paludisme 2022). ...La coordination des activités de changement social et comportemental entre les partenaires dans le pays reste un défi.
Une stratégie nationale solide de lutte contre le paludisme est essentielle pour coordonner et amplifier les efforts de lutte contre le paludisme dans toute la RDC. Breakthrough ACTION a joué un rôle central dans l’élaboration et la finalisation de la Stratégie nationale de SBC contre le paludisme 2024-2028, qui s’aligne sur le Plan stratégique national de lutte contre le paludisme 2024-2028. Cette mise à jour de la Stratégie nationale de lutte contre le paludisme intègre des conseils sur l’introduction du vaccin antipaludique en RDC, des informations clés issues des récentes études de recherche sur le paludisme menées par Breakthrough ACTION, ainsi que des messages de santé prioritaires actualisés destinés aux hommes, aux prestataires de services, aux femmes enceintes et aux femmes ayant des enfants de moins de cinq ans.
more
La Stratégie nationale de communication pour le paludisme 2017–2020 de la République Démocratique du Congo vise à améliorer les comportements de prévention, de détection et de traitement du paludisme à travers une communication sociale et comportementale (CSC) structurée et contextuelle. ...Élaborée par le Programme National de Lutte contre le Paludisme (PNLP), elle s’inscrit dans la vision d’un accès équitable aux messages de santé et à des services de qualité pour toute la population.
Cette stratégie met l’accent sur l’adoption de pratiques essentielles telles que l’utilisation correcte des moustiquaires imprégnées, le recours systématique au test de diagnostic rapide avant tout traitement, la prise en charge précoce des cas, en particulier chez les enfants de moins de cinq ans et les femmes enceintes, ainsi que l’adhésion complète aux traitements prescrits. Elle cible prioritairement les ménages, les femmes enceintes, les enfants, les agents de santé communautaires, les enseignants, les leaders religieux et les médias.
Pour atteindre ses objectifs, la stratégie mobilise plusieurs canaux de communication, notamment les médias de masse (radio, télévision, affichage), la communication interpersonnelle via les agents communautaires, et des campagnes de mobilisation sociale. Elle identifie également plusieurs obstacles, tels que les croyances erronées, le faible niveau d’éducation sanitaire et les disparités d’accès à l’information dans les zones rurales.
Enfin, le document propose des mécanismes de suivi et d’évaluation clairs, avec des indicateurs pour mesurer l’exposition aux messages, la compréhension, et les changements de comportement au sein des communautés. Cette stratégie vise à créer un environnement favorable à la réduction durable du fardeau du paludisme en RDC.
more
Le Plan Stratégique National de Lutte contre le Paludisme de la RDC vise à renforcer la communication pour le changement social et comportemental (CSC/CCC) dans la lutte contre le paludisme. Il a pour objectif d’améliorer les connaissances, attitudes et pratiques des populations pour encourager... l’adoption de comportements préventifs et curatifs.
Ce document propose une stratégie de communication structurée, basée sur une analyse contextuelle des comportements, croyances et obstacles sociaux. Il cible en priorité les femmes enceintes, les enfants de moins de cinq ans, les agents communautaires, les leaders religieux, les enseignants, et les médias. Les messages sont adaptés aux réalités locales et diffusés par des canaux variés : radios communautaires, théâtre, affiches, séances éducatives, et implication des leaders d'opinion.
Le plan insiste sur l’importance de la mobilisation sociale, de l’approche participative et du dialogue communautaire pour renforcer l’adhésion aux pratiques comme l’utilisation des moustiquaires imprégnées, le recours au test de diagnostic rapide, l’observance des traitements, et la fréquentation des centres de santé. Il prévoit aussi des mécanismes de suivi-évaluation et de renforcement des capacités des acteurs.
En résumé, ce document constitue un cadre opérationnel pour rendre la communication plus efficace, inclusive et durable dans la lutte contre le paludisme en RDC.
more
Asthma has a significant impact on people of all ages, particularly children. A lack of universally accepted case definition and confirmatory tests and a poor understanding of major risks interfere with a global response. We aimed to provide global estimates of asthma prevalence and cases in 2019 ac...ross four main epidemiological case definitions – current wheezing, ever wheezing, current asthma, and ever asthma. We further investigated major associated factors to determine regional and national distributions of prevalence and cases for current wheezing and ever asthma.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and national responses, facilitating analysis and compa...rison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
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 ...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.
more
Chronic obstructive pulmonary disease (COPD) is a term used to describe chronic lung diseases including emphysema and chronic bronchitis. COPD is characterized by breathlessness. Some people with COPD also experience tiredness and chronic cough with or without mucus.
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and national responses, facilitating analysis and compa...rison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and national responses, facilitating analysis and compa...rison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and national responses, facilitating analysis and compa...rison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
more
The Noncommunicable Diseases (NCD) Data Portal offers comprehensive data on NCDs such as cardiovascular diseases, cancer, diabetes, and chronic respiratory diseases. It provides country-specific information on NCD mortality rates, risk factors, and national responses, facilitating analysis and compa...rison across regions. The portal also includes resources like publications and tools to support global efforts in NCD prevention and control.
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
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