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Clinical standards for the diagnosis and management of asthma in low- and middle-income countries.

ABSTRACT:

SUBMITTER: Jayasooriya S

PROVIDER: S-EPMC10443788 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Clinical standards for the diagnosis and management of asthma in low- and middle-income countries.

Jayasooriya S S Stolbrink M M Khoo E M EM Sunte I T IT Awuru J I JI Cohen M M Lam D C DC Spanevello A A Visca D D Centis R R Migliori G B GB Ayuk A C AC Buendia J A JA Awokola B I BI Del-Rio-Navarro B E BE Muteti-Fana S S Lao-Araya M M Chiarella P P Badellino H H Somwe S W SW Anand M P MP Garcí-Corzo J R JR Bekele A A Soto-Martinez M E ME Ngahane B H M BHM Florin M M Voyi K K Tabbah K K Bakki B B Alexander A A Garba B L BL Salvador E M EM Fischer G B GB Falade A G AG ŽivkoviĆ Zorica Z Romero-Tapia S J SJ Erhabor G E GE Zar H H Gemicioglu B B Brandão H V HV Kurhasani X X El-Sharif N N Singh V V Ranasinghe J C JC Kudagammana S T ST Masjedi M R MR Velásquez J N JN Jain A A Cherrez-Ojeda I I Valdeavellano L F M LFM Gómez R M RM Mesonjesi E E Morfin-Maciel B M BM Ndikum A E AE Mukiibi G B GB Reddy B K BK Yusuf O O Taright-Mahi S S Mérida-Palacio J V JV Kabra S K SK Nkhama E E Filho N R NR Zhjegi V B VB Mortimer K K Rylance S S Masekela R R RR

The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease 20230901 9

BACKGROUND: The aim of these clinical standards is to aid the diagnosis and management of asthma in low-resource settings in low- and middle-income countries (LMICs).METHODS: A panel of 52 experts in the field of asthma in LMICs participated in a two-stage Delphi process to establish and reach a consensus on the clinical standards.RESULTS: Eighteen clinical standards were defined: Standard 1, Every individual with symptoms and signs compatible with asthma should undergo a cl ...[more]

PMID: 37608484

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Project description:IntroductionIn light of the limited impact the syndromic management approach has had on the global sexually transmitted infection (STI) epidemic, we assessed a care model comprising point-of-care (POC) STI testing, immediate treatment, and expedited partner therapy (EPT) among a cohort of young women at high HIV risk in South Africa.Methods and findingsHIV negative women presenting for STI care underwent POC testing for Chlamydia trachomatis (CT), Neisseria gonorrhoeae (NG) and Trichomonas vaginalis (TV), and swabs were sent for NG culture and susceptibility testing. Results were available within 2 hours and women with STIs were immediately treated and offered EPT packs, including medication, condoms, and information for sexual partners. An EPT questionnaire was administered after one week, and women retested for STIs after 6 and 12 weeks. 267 women, median age 23 (IQR 21-26), were recruited and 88.4% (236/267) reported genital symptoms. STI prevalence was CT 18.4% (95%CI 13.7-23.0), NG 5.2% (95%CI 2.6-7.9) and TV 3.0% (95%CI 1.0-5.0). After 12 weeks, all but one NG and two CT infections were cleared. No cephalosporin-resistant NG was detected. Of 63/267 women (23.6%) diagnosed with STIs, 98.4% (62/63) were offered and 87.1% (54/62) accepted EPT. At one week 88.9% (48/54) stated that their partner had taken the medication. No allergic reactions or social harms were reported. Of 51 women completing 6-week follow up, detection rates were lower amongst women receiving EPT (2.2%, 1/46) compared to those who did not (40.0%, 2/5), p = 0.023. During focus group discussions women supported the care model, because they received a rapid, specific diagnosis, and could facilitate their partners' treatment.ConclusionsPOC STI testing and EPT were acceptable to young South African women and their partners, and could play an important role in reducing STI reinfection rates and HIV risk. Larger studies should evaluate the feasibility and cost-effectiveness of implementing this strategy at population level.

Dataset Information

Clinical standards for the diagnosis and management of asthma in low- and middle-income countries.

Publications

Clinical standards for the diagnosis and management of asthma in low- and middle-income countries.

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