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The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project

Kirenga, B.J.; Chakaya, J.; Yimer, G. et al. Journal of Allergy and Clinical Immunology: Global (2024) CC

Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. This article wants to determine the burden (prevalence, mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethio... more

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South African cardiovascular risk stratification guideline for non-cardiac surgery

Alphonsus, C.; Naidoo, N.; Motshabi, P. et al. South African Medical Journal (2021) CC

The South African (SA) guidelines for cardiac patients for non-cardiac surgery were developed to address the need for cardiac risk assessment and risk stratification for elective non-cardiac surgical patients in SA, and more broadly in Africa. The guidelines were developed by updating the Canadian ...Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Non-cardiac Surgery, with a search of literature from African countries and recent publications. The updated proposed guidelines were then evaluated in a Delphi consensus process by SA anaesthesia and vascular surgical experts. The recommendations in these guidelines are: 1. We suggest that elective non-cardiac surgical patients who are 45 years and older with either a history of coronary artery disease, congestive cardiac failure, stroke or transient ischaemic attack, or vascular surgical patients 18 years or older with peripheral vascular disease require further preoperative risk stratification as their predicted 30-day major adverse cardiac event (MACE) risk exceeds 5% (conditional recommendation: moderate-quality evidence). 2. We do not recommend routine non-invasive testing for cardiovascular risk stratification prior to elective non-cardiac surgery in adults (strong recommendation: low-to-moderate-quality evidence). 3. We recommend that elective non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease should have preoperative natriuretic peptide (NP) screening (strong recommendation: high-quality evidence). 4. We recommend daily postoperative troponin measurements for 48 - 72 hours for non-cardiac surgical patients who are 45 years and older with a history of coronary artery disease, or stroke or transient ischaemic attack, or congestive cardiac failure or vascular surgical patients 18 years or older with peripheral vascular disease, i.e. (i) a baseline risk >5% for MACE 30 days after elective surgery (if no preoperative NP screening), or (ii) an elevated B-type natriuretic peptide (BNP)/N-terminal-prohormone B-type natriuretic peptide (NT-proBNP) measurement before elective surgery (defined as BNP >99 pg/mL or a NT-proBNP >300 pg/mL) (conditional recommendation: moderate-quality evidence). Additional recommendations are given for the management of myocardial injury after non-cardiac surgery (MINS) and medications for comorbidities. more

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World Heart Federation Roadmap on Atrial Fibrillation – A 2020 Update

Freedman, B.; Hindricks, G.; Banerjee, A. Global Heart (2021) CC

The World Heart Federation (WHF) commenced a Roadmap initiative in 2015 to reduce the global burden of cardiovascular disease and resultant burgeoning of healthcare costs. Roadmaps provide a blueprint for implementation of priority solutions for the principal cardiovascular diseases leading to death... more

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Hypertension WHO

World Health Organization WHO (2024) CC

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure. Blood is carried from the heart to all parts of the body in the vessels. Each time the heart beats, it pumps blood into the vessels. Blood pressure is created by th... more

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Delivery of cardiology services in Africa during the COVID-19 pandemic: what should we expect after this pandemic?

Nganou-Gnindjio, C.N.; Temgoua, M.N.; Kuate, L.M. et al. (2021) CC

Background: COVID-19 is a global public health crisis that affects all sectors; studying the impact of this pandemic on the delivery of cardiology services in Africa is crucial as COVID-19-related cardiovascular complications may worsen the CVD burden in this already highly affected and resource-lim... more

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First WHO report details devastating impact of hypertension and ways to stop it

World Health Organization WHO (2023) C_WHO

The World Health Organization (WHO) released its first-ever report on the devastating global impact of high blood pressure, along with recommendations on the ways to win the race against this silent killer. The report shows approximately 4 out of every 5 people with hypertension are not adequately t... 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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Promoting Cardiovascular Health in the Developing World

Institute of Medicine (2010) CC

Cardiovascular disease (CVD) is often thought to be a problem of wealthy, industrialized nations. The term “cardiovascular disease” is used throughout the report to refer to cardiac disease, vascular diseases of the brain and kidney, and peripheral vascular disease. The report’s main focus is ... more

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The State and Direction of Treatment of Heart Failure with Reduced Ejection Fraction in Papua New Guinea

Kawa, L.B. Journal of Asian Pacific Society of Cardiology (2023) CC

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... more

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Diabetes and kidney disease

International Diabetes Federation (2023) CC2

Diabetes is one of the leading causes of chronic kidney disease (CKD). Up to 40% of people living with diabetes develop CKD, and the number of new cases of CKD in people with type 2 diabetes increased by 74% between 1990 and 2017. The prevalence of diabetes-related CKD varies widely between countrie... more

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Breathe easy: Learning about adolescent asthma

Ramnath, K. Media Production Archives (2022) CC

Asthma is a common breathing condition. Chances are that at least one in every fifth person will have it. People with asthma might have a cough, or wheeze and a feeling of tightness in their chests. A group of researchers from the United Kingdom teamed up with seven African countries to learn about ... more

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Загрязнение воздуха внутри жилых помещений

World Health Organization WHO (2023) C_WHO

Worldwide, around 2.3 billion people still cook using solid fuels (such as wood, crop waste, charcoal, coal and dung) and kerosene in open fires and inefficient stoves. Most of these people are poor and live in low- and middle-income countries. There is a large discrepancy in access to cleaner cooki... more

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Global Alliance against Chronic Respiratory Diseases (GARD): generel meeting report, Seol, Repblic of Korea, 1-2 June 2007

World Health Organization WHO (2007) CC2

Everyone in the world is exposed to risk factors for chronic respiratory disease (CRD). Three billion people live in urban areas and are exposed to outdoor air pollution. Two billion people are exposed to solid fuel combustion which represents one of the major risk factors worldwide. One billion peo... more

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A worldwide charter for all children with asthma

Szefler, S. J.; Fitzgerald, D. A.; Adachi, Y.; (2020) CC2

Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se... more

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Vigilância global, prevenção e controlo das doenças respiratórias crónicas: uma abordagem integradora

Bousquet, J.; Khaltaev, N. (2007) C_WHO

Chronic respiratory diseases, such as asthma and chronic obstructive pulmonary disease, kill more than four million people every year and affect hundreds of millions more. These diseases erode the health and well-being of the patients and have a negative impact on families and societies. Women ... more

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Prevention of Allergy and Allergic Asthma

World Health Organization WHO; World Allergy Organization-IAACI (WAO) (2002) CC2

The prevalance of asthma an allergy, defined as immunologically mediated hypersensitivity, is increasing. It is estimated that over 20% of the world population suffers from IgE-mediated allergic disease, such as allergic asthma, allergic rhinitis and allergic conjunctivitis, atopic eczema/atopic der... more

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Global surveillance, prevention and control of chronic respiratory diseases - a comprehensive approach

Bousquet, J.; Khaltaev, N. (2007) C_WHO

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Severe and Difficult Asthma: Diagnosis and Management—Challenges for a Low‐Resource Environment

Bush, A. Springer Link (2021) CC2

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 ... more

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Algorithm for asthma diagnosis and management at Chitungwiza Central Hospital, Zimbabwe

Ndarukwa, P.; Chimbari, M.J.; Sibanda, E.N. (2020) CC2

asthma is a chronic inflammatory and a heterogeneous condition of respiratory system whose pathogenesis is linked with variable structural changes. The clinical manifestation of asthma includes attacks of breathlessness, cough, chest tightness and wheezing. Provision of basic equipment and test for ... 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