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Effectiveness of community health worker training programmes for cardiovascular disease management in low-income and middle-income countries: a systematic review

Abdel-All, M; Putica, B.; Praveen, D. et al. BMJ Open (2017) CC

Introduction Community health workers (CHWs) are increasingly being tasked to prevent and manage cardiovascular disease (CVD) and its risk factors in underserved populations in low-income and middle-income countries (LMICs); however, little is known about the required training necessary for them to ... more

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Infrastructure, policy and regulatory interventions to increase physical activity to prevent cardiovascular diseases and diabetes: a systematic review

Durão, S.; Burns, J.; Schmidt, B. et al. BMC Public Health (2023) CC

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. more

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Advocation for Cholesterol control: A world heard federation toolkit

World Heart Federation (2022) CC

The World Heart Federation (WHF) is a leading global advocate for stronger legislation and policies regarding cardiovascular disease (CVD) and its risk factors, including raised cholesterol. The present Cholesterol Advocacy Toolkit 2022 provides WHF member organizations with information as well as p... more

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Kenya Asthma Management Guideline

Ministry of Health (2021) CC

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... more

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Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

Cooper, P. J.; Figueiredo, C. A.; Rodriguez, A.; et al. (2023) CC2

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... more

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Supported self-management for asthma

Hinnock, H. Breathe (2015) CC

This articel summarises the evidence base underpinning supported self-management for asthma. It provides clinicians with a practical approach to providing supported self-management for asthma and suggests an appropriate strategy for implementing supported self-management.

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The National Asthma Education Programme and asthma in Africa

South African Medical Journal; SAMJ (2019) CC2

The National Asthma Education Programme (NAEP) is a registered non-profit organisation whose mission is to provide asthma education to healthcare professionals, patients and the lay public. It was founded in 1994 by Dr Mike Greenblatt and Profs Dave Luyt and Robin Green. This year NAEP celebrates it... more

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A summary of the new GINA strategy: a roadmap to asthma control

Reddel, H. K.; Bateman, E. D.; Becker, A.; et al. (2015) CC2

Over the past 20 years, the Global Initiative for Asthma (GINA) has regularly published and annually updated a global strategy for asthma management and prevention that has formed the basis for many national guidelines. However, uptake of existing guidelines is poor. A major revision of the GINA r... more

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The Global Asthma Report 2022

Global Asthma Network (2022) CC2

The Global Asthma Report (GAR) 2022, prepared by the Global Asthma Network (GAN), is the fourth such report (others 2011, 2014, 2018). GAN builds upon the work of the International Study of Asthma and Allergies in Childhood (ISAAC) and The International Union Against Tuberculosis and Lung Disease (T... more

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Global Strategy for Asthma Management and Prevention (2022 update)

Global Initiative for Asthma (2022) CC2

The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge and practice at the date of publication. When assessi... more

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Global Strategy for Asthma Management and Prevention (2019 update)

Global Initiative for Asthma (2019) CC2

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Asthma morbidity in Africa: Is it time to act to achieve asthma care for all?

Thembelihle Hlophe, S.; Stolbrink, M.; Govender, K.; et al. (2023) CC2

As we approach World Asthma Day on the May 2, 2023, we reflect on the theme “ Asthma Care for All”. Prevalence of Asthma is increasing amongst children, adolescents and adults. Under-diagnosis, underutilization of inhaled corticosteroids, inaccessibility of treatment, and unaffordability of medi... more

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Asthma management in low and middle income countries: case for change

Mortimer, K.; Reddel, H. K.; Pitrez, P. M.; et al. (2022) CC2

Asthma is the most common noncommunicable disease in children, and among the most common in adults. According to the most recent estimates from the Global Asthma Network Phase I study, around one in 10 children and adults have symptoms of asthma and one in 20 school-aged children have severe asthma ... more

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2020 Brazilian Thoracic Association recommendations for the management of asthma

Menezes Pizzichini, M. M.; de Carvalho-Pinto, R. M.; Delfini Cançado, J. E.; et al. (2020) CC2

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... more

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Recomendações para o manejo da asma da Sociedade Brasileira de Pneumologia e Tisiologia – 2020

Menezes Pizzichini, M. M.; de Carvalho-Pinto, R. M.; Delfini Cançado, J. E.; et al. (2020) CC2

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The increasing burden of asthma in South African children: A call to action

Masekela, R.; Gray, C.L.; Green, R.J. et al. The South African Medical Journal (2018) CC

BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed. OBJE... more

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Task-shifting to improve asthma education for Malawian children: a qualitative analysis

Nkhalamba, L.; Rylance, S.; Muula, S. A. et al. Human Resources for Health (2021) CC

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... more

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Risk factors for asthma among schoolchildren who participated in a casecontrol study in urban Uganda

Mpairwe, H.; Namutebi, M.; Nkurunungi, G. et al. eLife (2019) CC

Data on asthma aetiology in Africa are scarce. We investigated the risk factors for asthma among schoolchildren (5–17 years) in urban Uganda. We conducted a case-control study, among 555 cases and 1115 controls. Asthma was diagnosed by study clinicians. The main risk factors for asthma were tertia... more

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Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa

Mphahlele, R.; Lesosky, M.; Masekela, R. BMJ Open Respiratory Research (2023) CC

Background Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and ris... more

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International study of asthma and allergies in childhood (ISAAC): rationale and methods

Asher, M.I.; Keil, U.; Anderson, H.R. European Respiratory Journal (1995) CC

he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m... more