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The World Health Organization (WHO) fact sheet on ambient (outdoor) air quality and health highlights the significant health risks posed by outdoor air pollution. It reports that in 2019, ambient air pollution was responsible for approximately 4.2 million premature deaths globally, primarily due to
...
exposure to fine particulate matter (PM2.5), which leads to cardiovascular and respiratory diseases, as well as cancers. The fact sheet emphasizes that 99% of the global population lived in areas exceeding WHO air quality guidelines in 2019, with low- and middle-income countries bearing the highest burden. To mitigate these health impacts, WHO advocates for policies and investments that promote cleaner transportation, energy-efficient housing, improved waste management, and access to clean household energy.
more
The World Health Organization (WHO) fact sheet on ambient (outdoor) air quality and health highlights the significant health risks posed by outdoor air pollution. It reports that in 2019, ambient air pollution was responsible for approximately 4.2 million premature deaths globally, primarily due to
...
exposure to fine particulate matter (PM2.5), which leads to cardiovascular and respiratory diseases, as well as cancers. The fact sheet emphasizes that 99% of the global population lived in areas exceeding WHO air quality guidelines in 2019, with low- and middle-income countries bearing the highest burden. To mitigate these health impacts, WHO advocates for policies and investments that promote cleaner transportation, energy-efficient housing, improved waste management, and access to clean household energy.
more
The World Health Organization (WHO) fact sheet on ambient (outdoor) air quality and health highlights the significant health risks posed by outdoor air pollution. It reports that in 2019, ambient air pollution was responsible for approximately 4.2 million premature deaths globally, primarily due to
...
exposure to fine particulate matter (PM2.5), which leads to cardiovascular and respiratory diseases, as well as cancers. The fact sheet emphasizes that 99% of the global population lived in areas exceeding WHO air quality guidelines in 2019, with low- and middle-income countries bearing the highest burden. To mitigate these health impacts, WHO advocates for policies and investments that promote cleaner transportation, energy-efficient housing, improved waste management, and access to clean household energy.
more
The World Health Organization (WHO) fact sheet on ambient (outdoor) air quality and health highlights the significant health risks posed by outdoor air pollution. It reports that in 2019, ambient air pollution was responsible for approximately 4.2 million premature deaths globally, primarily due to
...
exposure to fine particulate matter (PM2.5), which leads to cardiovascular and respiratory diseases, as well as cancers. The fact sheet emphasizes that 99% of the global population lived in areas exceeding WHO air quality guidelines in 2019, with low- and middle-income countries bearing the highest burden. To mitigate these health impacts, WHO advocates for policies and investments that promote cleaner transportation, energy-efficient housing, improved waste management, and access to clean household energy.
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The World Health Organization (WHO) fact sheet on ambient (outdoor) air quality and health highlights the significant health risks posed by outdoor air pollution. It reports that in 2019, ambient air pollution was responsible for approximately 4.2 million premature deaths globally, primarily due to
...
exposure to fine particulate matter (PM2.5), which leads to cardiovascular and respiratory diseases, as well as cancers. The fact sheet emphasizes that 99% of the global population lived in areas exceeding WHO air quality guidelines in 2019, with low- and middle-income countries bearing the highest burden. To mitigate these health impacts, WHO advocates for policies and investments that promote cleaner transportation, energy-efficient housing, improved waste management, and access to clean household energy.
more
The World Health Organization (WHO) fact sheet on ambient (outdoor) air quality and health highlights the significant health risks posed by outdoor air pollution. It reports that in 2019, ambient air pollution was responsible for approximately 4.2 million premature deaths globally, primarily due to
...
exposure to fine particulate matter (PM2.5), which leads to cardiovascular and respiratory diseases, as well as cancers. The fact sheet emphasizes that 99% of the global population lived in areas exceeding WHO air quality guidelines in 2019, with low- and middle-income countries bearing the highest burden. To mitigate these health impacts, WHO advocates for policies and investments that promote cleaner transportation, energy-efficient housing, improved waste management, and access to clean household energy.
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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
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sthma care intervention for children in Malawi, which included reallocation of asthma education tasks to lay-educators. In this qualitative sub-study, we explored the experiences of asthmatic children, their families and lay-educators, to assess the acceptability, facilitators and barriers, and perceived value of the task-shifting asthma education intervention.
Methods
We conducted six focus group discussions, including 15 children and 28 carers, and individual interviews with four lay-educators and a senior nurse. Translated transcripts were coded independently by three researchers and key themes identified.
Results
Prior to the intervention, participants reported challenges in asthma care including the busy and sometimes hostile clinical environment, lack of access to information and the erratic supply of medication. The education sessions were well received: participants reported greater understanding of asthma and their treatment and confidence to manage symptoms. The lay-educators appreciated pre-intervention training, written guidelines, and access to clinical support. Low education levels among carers presented challenges, requiring an open, non-critical and individualised approach.
Discussion
Asthma education can be successfully delivered by lay-educators with adequate training, supervision and support, with benefits to the patients, their families and the community. Wider implementation could help address human resource shortages and support progress towards Universal Health Coverage.
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The global prevalence, morbidity and mortality related to childhood asthma among children has increased significantly over the last 40 years. Although asthma is recognized as the most common chronic disease in children, issues of underdiagnosis and undertreatment persist. There are substantial globa
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l variations in the prevalence of asthma symptoms in children, with up to 13-fold differences between countries. The rising number of hospital admissions for asthma may reflect an increase in asthma severity, poor disease management and/or the effect of poverty. The financial burden of asthma is relatively high within developed countries (those for which data is available) spending 1 to 2% of their healthcare budget on this condition. Established in 1989, the Global Initiative for Asthma (GINA) attempts to raise awareness about the increasing prevalence of asthma, improve management and reduce the burden of asthma worldwide. Despite global efforts, GINA has not achieved its goal, even among developed nations. There are multiple barriers to reducing the global burden of asthma, including limited access to care and/or medications, and lack of prioritization as a public healthcare priority. In addition, the diversity of healthcare systems worldwide and large differences in access to care require that asthma management guidelines be tailored to local needs.
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Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the prevalence of asthma is among the highest in the world. Asthma admissions are very common in children, l
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eading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.
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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
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ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local and national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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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
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ng and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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Several challenges face asthma management in Egypt, including the high percentage of uncontrolled patients, inadequate compliance, and overuse of short-acting beta-agonists (SABAs) leading to increased asthma-related morbidity and mortality. In this regard, the recent Global Initiative for Asthma (G
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INA) recommendations included inhaled corticosteroids containing therapy for mild asthma. Local healthcare systems and healthcare professionals (HCPs) often experience practical challenges when implementing global guidelines.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life. The aim of this journal is to provide an eviden
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ce-based approach for chronic asthma management in young children and adolescents and provide guidance on the use of new asthma drugs in children.
For that, the South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which are covered in another CME article in this edition of SAMJ.
The final conclusions are that it is important to ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical. Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved, medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
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Impact of COVID-19 on Pediatric Asthma: Practice Adjustments and Disease Burden
Papadopoulos, N.G.; Custovic, A.; Deschildre, A. et al.
The Journal of Allergy and Clinical Immunology: In Practice
(2020)
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Coronavirus disease 2019 has a mild disease course in children and adolescents. Chronic respiratory conditions, including asthma, have been suggested as risk factors; however, asthma in children is highly variable in both triggers and severity.
During the pandemic, pediatric asthma services limite
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d consultations and established virtual clinics. However, respondents perceived their patients’ asthma control to be retained or even improved, while treatment adherence was considered increased. Children with asthma were not disproportionately affected by coronavirus disease 2019.
Trigger avoidance and treatment adherence can rapidly improve asthma control in children, even under lockdown pressure. Children/adolescents with asthma do not appear to need additional prophylactic measures from coronavirus disease 2019 when asthma is well-treated. This article analyses the effect of COVID-19 on Asthma in children, providing information for management guidelines.
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BMC Pregnancy Childbirth 2022 Apr 5;22(1):284. doi: 10.1186/s12884-022-04619-w. Adolescent reproductive health is still a challenge in Low and Middle Income Come Countries (LMICs). However, the reasons for the inability of most pregnant adolescent girls to access and utilize maternal and child heal
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th information (MCHI) are not well-documented. This is despite the policy guidelines promoting the provision of this necessary information to pregnant adolescents in order to prepare them for delivery. This provision is one of the strategies envisaged to improve their attendance of ANC visits and their maternal and child health.
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The motivations behind China’s allocation of health aid to Africa remain complex due to limited information on the details of health aid project activities. Insufficient knowledge about the purpose of China’s health aid hinders our understanding of China’s comprehensive role in supporting Afri
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ca’s healthcare system. To address this gap, our study aimed to gain better insights into China’s health aid priorities and the factors driving these priorities across Africa. To achieve this, we utilized AidData’s Chinese Official Finance Dataset and adhered to the Organisation for Economic Co-operation and Development (OECD) guidelines.
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The document titled "Checklist for Assessing Management of Severe Malaria" is part of the MalariaCare Toolkit. It provides a structured tool for supervisors conducting outreach training and supportive supervision (OTSS) visits in healthcare facilities. The checklist is designed to evaluate and guide
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the clinical management of severe malaria cases, including diagnostics, treatment planning, complication management, patient monitoring, and the administration of injectable artesunate. It also includes sections for direct observation of clinical procedures and supervisor feedback to help improve healthcare worker performance and adherence to national treatment guidelines.
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WHO has updated it recommendations for 3 key malaria prevention strategies: seasonal malaria chemoprevention (SMC), perennial malaria chemoprevention (PMC – previously known as intermittent preventive treatment in infants, or IPTi) and intermittent preventive treatment of malaria in pregnancy (IPT
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p). When given to the young children and pregnant women who are most vulnerable to malaria, preventive chemotherapy has been shown to be a safe, effective and cost-effective strategy for reducing the disease burden and saving lives.
The updated recommendations on SMC, PMC and IPTp, published today in the WHO Guidelines for malaria, will support the broader use of chemoprevention among young children at high risk of severe malaria in areas with both seasonal and year-round transmission and promote expanded access to preventive chemotherapy in pregnancy.
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The purpose of this guide is to provide updated clinical guidance on TB/HIV, with an emphasis on diagnostic aspects—including new techniques—as well as current treatment, while maintaining a public health approach. By compiling and consolidating the latest World Health Organization recommendatio
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ns on the subject into a single guide, the aim is to create a reference and consultation document that is frequently used, and that unifies and standardizes the comprehensive management of TB/HIV co-infection in healthcare facilities based on the principle of “two diseases, one patient.” It also seeks to support the updating of national standards and guidelines on co-infection and to complement the coordinated work that must exist between TB and HIV prevention and control programs at all levels, within the framework of the twelve internationally recommended TB/HIV collaborative activities.
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The "Integrated Management of Malaria Training – Health Worker’s Manual" is a practical guide developed by Uganda’s Ministry of Health to train healthcare workers at all levels in the effective diagnosis, treatment, prevention, and management of malaria. It aligns with national malaria treatme
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nt guidelines and aims to improve the quality of care and reduce malaria-related illness and death. The manual covers key topics such as clinical assessment of fever, use of rapid diagnostic tests (RDTs), case management of uncomplicated and severe malaria, malaria in pregnancy, co-infections like HIV, as well as community engagement and proper documentation. It includes structured training sessions, case studies, and job aids designed to strengthen the skills of health workers in both public and private sectors, and to ensure standardized, evidence-based malaria care across the country.
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