PLOS Medicine | www.plosmedicine.org
January 2013 | Volume 10 | Issue 1 | e1001371
For the primary health worker in a low/middle-income country (LMIC) setting, delivering quality primary care is challenging. This is often complicated by clinical guidance that is out of date, inconsistent and informed by evidence from high-income countries that ignores LMIC resource constraints and... burden of disease. The Knowledge Translation Unit (KTU) of the University of Cape Town Lung Institute has developed, implemented and evaluated a health systems intervention in South Africa, and localised it to Botswana, Nigeria, Ethiopia and Brazil, that simplifies and standardises the care delivered by primary health workers while strengthening the system in which they work. At the core of this intervention, called Practical Approach to Care Kit (PACK), is a clinical decision support tool, the PACK guide. This paper describes the development of the guide over an 18-year period and explains the design features that have addressed what the patient, the clinician and the health system need from clinical guidance, and have made it, in the words of a South African primary care nurse, ‘A tool for every day for every patient’. It describes the lessons learnt during the development process that the KTU now applies to further development, maintenance and in-country localisation of the guide: develop clinical decision support in context first, involve local stakeholders in all stages, leverage others’ evidence databases to remain up to date and ensure content development, updating and localisation articulate with implementation.
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Asthma is the most common non-communicable disease in children and remains one of the most common throughout the life course. The great majority of the burden of this disease is seen in low-income and middle-income countries (LMICs), which have disproportionately high asthma-related mortality relati...ve to asthma prevalence. This is particularly true for many countries in sub-Saharan Africa. Although inhaled asthma treatments (particularly those containing inhaled corticosteroids) markedly reduce asthma morbidity and mortality, a substantial proportion of the children, adolescents, and adults with asthma in LMICs do not get to benefit from these, due to poor availability and affordability. In this review, we consider the reality faced by clinicians managing asthma in the primary and secondary care in sub-Saharan Africa and suggest how we might go about making diagnosis and treatment decisions in a range of resource-constrained scenarios. We also provide recommendations for research and policy, to help bridge the gap between current practice in sub-Saharan Africa and Global Initiative for Asthma (GINA) recommended diagnostic processes and treatment for children, adolescents, and adults with asthma.
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Choko AT et al. Journal of the International AIDS Society 2017, 20:21610 http://www.jiasociety.org/index.php/jias/article/view/21610 | http://dx.doi.org/10.7448/IAS.20.1.21610
The role of environmental contamination in transmission of COVID-19 virus is currently not clear. This protocol has been designed to determine (viable) virus presence and persistence on fomites in various locations where a patient infected with COVID-19 is currently receiving care or being isolated,... and to understand how this may relate to COVID-19 transmission events in these settings. It is therefore important that it is done as part of a comprehensive outbreak investigation and that information obtained by environmental studies is combined with the results of epidemiological, laboratory and sequence data from COVID-19 patient investigations.
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HTC COUNTRY REPORT | LESOTHO
Technical brief by the H4+ (UNAIDS, UNFPA, UNICEF, UN Women, WHO and the World Bank)
Capacity Project Gender Research Brief | In Lesotho, as in many other countries, the HIV and AIDS care burden falls on the shoulders of women and girls in unpaid, invisible household and community work. This gender inequity in HRH needs to be addressed to ensure fair and sustainable responses to the... need for home and community-based HIV/AIDS care and support. The Capacity Project addressed these issues through a study of men as providers of HIV/AIDS care and support.
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The document "Global Report on Diabetes" by the World Health Organization (WHO) provides an in-depth analysis of diabetes as a global health challenge. It covers the rising prevalence of the disease, the associated risk factors, and the increasing burden on healthcare systems, particularly in low- a...nd middle-income countries. The report discusses strategies for preventing Type 2 diabetes, managing diabetes effectively, and reducing complications through integrated healthcare approaches. It emphasizes the need for global action, national policies, and collaboration across sectors to address diabetes and improve health outcomes worldwide.
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16-17 November 2017,
Hotel Djeugua, Yaoundé, Cameroon
Meeting Report December 2017
2015-16 Demographic and Health Survey and Malaria Indicator Survey