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1.
Int J Tuberc Lung Dis ; 27(9): 658-667, 2023 09 01.
Artículo en Inglés | MEDLINE | ID: mdl-37608484

RESUMEN

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 clinical assessment; Standard 2, In individuals (>6 years) with a clinical assessment supportive of a diagnosis of asthma, a hand-held spirometry measurement should be used to confirm variable expiratory airflow limitation by demonstrating an acute response to a bronchodilator; Standard 3, Pre- and post-bronchodilator spirometry should be performed in individuals (>6 years) to support diagnosis before treatment is commenced if there is diagnostic uncertainty; Standard 4, Individuals with an acute exacerbation of asthma and clinical signs of hypoxaemia or increased work of breathing should be given supplementary oxygen to maintain saturation at 94-98%; Standard 5, Inhaled short-acting beta-2 agonists (SABAs) should be used as an emergency reliever in individuals with asthma via an appropriate spacer device for metered-dose inhalers; Standard 6, Short-course oral corticosteroids should be administered in appropriate doses to individuals having moderate to severe acute asthma exacerbations (minimum 3-5 days); Standard 7, Individuals having a severe asthma exacerbation should receive emergency care, including oxygen therapy, systemic corticosteroids, inhaled bronchodilators (e.g., salbutamol with or without ipratropium bromide) and a single dose of intravenous magnesium sulphate should be considered; Standard 8, All individuals with asthma should receive education about asthma and a personalised action plan; Standard 9, Inhaled medications (excluding dry-powder devices) should be administered via an appropriate spacer device in both adults and children. Children aged 0-3 years will require the spacer to be coupled to a face mask; Standard 10, Children aged <5 years with asthma should receive a SABA as-needed at step 1 and an inhaled corticosteroid (ICS) to cover periods of wheezing due to respiratory viral infections, and SABA as-needed and daily ICS from step 2 upwards; Standard 11, Children aged 6-11 years with asthma should receive an ICS taken whenever an inhaled SABA is used; Standard 12, All adolescents aged 12-18 years and adults with asthma should receive a combination inhaler (ICS and rapid onset of action long-acting beta-agonist [LABA] such as budesonide-formoterol), where available, to be used either as-needed (for mild asthma) or as both maintenance and reliever therapy, for moderate to severe asthma; Standard 13, Inhaled SABA alone for the management of patients aged >12 years is not recommended as it is associated with increased risk of morbidity and mortality. It should only be used where there is no access to ICS.The following standards (14-18) are for settings where there is no access to inhaled medicines. Standard 14, Patients without access to corticosteroids should be provided with a single short course of emergency oral prednisolone; Standard 15, Oral SABA for symptomatic relief should be used only if no inhaled SABA is available. Adjust to the individual's lowest beneficial dose to minimise adverse effects; Standard 16, Oral leukotriene receptor antagonists (LTRA) can be used as a preventive medication and is preferable to the use of long-term oral systemic corticosteroids; Standard 17, In exceptional circumstances, when there is a high risk of mortality from exacerbations, low-dose oral prednisolone daily or on alternate days may be considered on a case-by-case basis; Standard 18. Oral theophylline should be restricted for use in situations where it is the only bronchodilator treatment option available.CONCLUSION: These first consensus-based clinical standards for asthma management in LMICs are intended to help clinicians provide the most effective care for people in resource-limited settings.


Asunto(s)
Asma , Países en Desarrollo , Adolescente , Adulto , Niño , Humanos , Broncodilatadores/uso terapéutico , Asma/diagnóstico , Asma/tratamiento farmacológico , Albuterol , Prednisolona
2.
Pulmonology ; 28(5): 376-395, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35568650

RESUMEN

OBJECTIVE: To analyse the GARD perspective on the health effects of outdoor air pollution, and to synthesise the Portuguese epidemiological contribution to knowledge on its respiratory impact. RESULTS: Ambient air pollution has deleterious respiratory effects which are more apparent in larger, densely populated and industrialised countries, such as Canada, Iran, Brazil and Portugal, but it also affects people living in low-level exposure areas. While low- and middle-income countries (LMICs), are particularly affected, evidence based on epidemiological studies from LMICs is both limited and heterogeneous. While nationally, Portugal has a relatively low level of air pollution, many major cities face with substantial air pollution problems. Time series and cross-sectional epidemiological studies have suggested increased respiratory hospital admissions, and increased risk of respiratory diseases in people who live in urban areas and are exposed to even a relatively low level of air pollution. CONCLUSIONS: Adverse respiratory effects due to air pollution, even at low levels, have been confirmed by epidemiological studies. However, evidence from LMICs is heterogeneous and relatively limited. Furthermore, longitudinal cohort studies designed to study and quantify the link between exposure to air pollutants and respiratory diseases are needed. Worldwide, an integrated approach must involve multi-level stakeholders including governments (in Portugal, the Portuguese Ministry of Health, which hosts GARD-Portugal), academia, health professionals, scientific societies, patient associations and the community at large. Such an approach not only will garner a robust commitment, establish strong advocacy and clear objectives, and raise greater awareness, it will also support a strategy with adequate measures to be implemented to achieve better air quality and reduce the burden of chronic respiratory diseases (CRDs).


Asunto(s)
Contaminación del Aire , Trastornos Respiratorios , Contaminación del Aire/efectos adversos , Contaminación del Aire/análisis , Angola , Brasil , Estudios Transversales , Humanos , Irán , Estudios Longitudinales , Mozambique , Portugal/epidemiología , Trastornos Respiratorios/epidemiología , Trastornos Respiratorios/etiología
3.
Med J Malaysia ; 75(5): 543-547, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-32918424

RESUMEN

INTRODUCTION: This study aimed to evaluate knowledge, attitudes, practice associated with Human Papillomavirus (HPV) Vaccine for Young Children among lecturers and health staffs of Shahid Beheshti University of Medical Sciences (SBMU). METHOD: This was a cross-sectional study with 220 adults from five different specialties, randomly selected. Data was collected using 45-item questionnaire on knowledge (12- item), attitude (18-item) and practice (15-item) (KAP) about HPV. The demographic questionnaire included information on age, gender, level of education, occupation, and marital status. Content validity was calculated by content validity ratio (CVR) and content validity index (CVI). Reliability was evaluated using test-retest and by Cronbach's Alpha coefficient, internal consistency was calculated values >0.81 which considered as satisfactory. RESULTS: The mean age of the studied population was 37.70± 8.07 (23-67) years. Of the 220 participants, 80 (36.4%) were males and 140 (63.6%) were females. In evaluating KAP in the men and women, the mean and standard deviation of knowledge were estimated at good level and one-way ANOVA analysis showed significant differences between women and men (p=0.019). There was no significant difference in men and women related to attitude (p=0.92) and practice (p=0.38). CONCLUSION: The KAP about HPV among participants was significantly higher at good levels compared to average levels. Women's knowledge was significantly higher than men. Attitude and practice could have been higher because there was consensus to the usage of vaccine among the specialists to prevent HPV.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Vacunas contra Papillomavirus , Adulto , Anciano , Estudios Transversales , Femenino , Política de Salud , Humanos , Irán , Masculino , Persona de Mediana Edad , Encuestas y Cuestionarios , Adulto Joven
4.
Int J Tuberc Lung Dis ; 21(3): 351-356, 2017 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-28225348

RESUMEN

SETTING: Smoking is reported to be associated with tuberculosis (TB), but its effect on sputum smear conversion remains a matter for discussion. OBJECTIVE: To assess the effects of smoking and smoking cessation on treatment outcomes in patients newly diagnosed with TB in Iran. DESIGN: Newly diagnosed smear-positive TB patients were included in the study. All smokers participated in a smoking cessation programme. Sputum smear status was evaluated at the end of month 2, 5 and 6 of treatment, and smoking status was evaluated at the end of month 2. Differences in smear conversion rates were compared between the three groups, i.e., non-smokers, smokers and quitters. RESULTS: A total of 183 smokers and 151 non-smokers were included. When smoking cessation was assessed after 2 months, 42.6% (78/183) of the smokers were found to have quit. The cure rate at the end of 6 months, precisely compatible with the conversion rate, was significantly higher among non-smokers (P = 0.004) and quitters at 2 months (P = 0.049) than among persisting smokers (83.4%, 80.8% and 67.6%, respectively). CONCLUSION: Cure rates in patients newly diagnosed with pulmonary TB were higher in non-smokers and quitters at 2 months than in smokers. Smoking cessation advice should be included in TB control programmes.


Asunto(s)
Antituberculosos/administración & dosificación , Cese del Hábito de Fumar , Fumar/epidemiología , Tuberculosis Pulmonar/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Irán , Masculino , Persona de Mediana Edad , Esputo/microbiología , Factores de Tiempo , Resultado del Tratamiento , Tuberculosis Pulmonar/diagnóstico
5.
Int J Tuberc Lung Dis ; 20(5): 679-84, 2016 May.
Artículo en Inglés | MEDLINE | ID: mdl-27084824

RESUMEN

BACKGROUND: The association between pulmonary tuberculosis (PTB) and tobacco smoke has been verified by most studies on the subject; figures from different countries for the prevalence of smoking among PTB patients vary. OBJECTIVE: To assess the prevalence of and factors associated with smoking among TB patients in Iran. DESIGN: In this cross-sectional study, subjects were included on a first-come, first-served basis from among newly diagnosed PTB patients using a multistage cluster sampling method during 2012-2014. Data were collected during face-to-face interviews and a questionnaire was used to gather information on smoking habits. RESULTS: Of 1127 newly diagnosed PTB patients included in the study (mean age 50.0 ± 19.8 years), 228 (20.2%) were daily smokers, 20 (1.8%) were occasional smokers and 93 (8.9%) had quit before diagnosis. Simultaneous drug use (P < 0.001, OR 75.21), increasing age (P = 0.001), being single (P < 0.001, OR 16.95), being an Iranian national (P < 0.001, OR 6.26) and living in a rural area (P < 0.001, OR 5.85) were found to be independent risk factors for smoking in study patients. CONCLUSION: The prevalence of smoking among PTB patients in Iran is relatively high. It is therefore necessary to include smoking cessation interventions in the National TB Programme.


Asunto(s)
Fumar/epidemiología , Tuberculosis Pulmonar/epidemiología , Adulto , Anciano , Distribución de Chi-Cuadrado , Estudios Transversales , Femenino , Hábitos , Conductas Relacionadas con la Salud , Conocimientos, Actitudes y Práctica en Salud , Encuestas Epidemiológicas , Humanos , Entrevistas como Asunto , Irán/epidemiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Prevalencia , Factores de Riesgo , Fumar/efectos adversos , Fumar/psicología , Factores de Tiempo , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/psicología
6.
Int J Tuberc Lung Dis ; 18(3): 352-6, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24670575

RESUMEN

SETTING: National Referral Centre for Tuberculosis (TB), Tehran, Iran. OBJECTIVE: To determine the impact of chronic renal failure (CRF) on TB treatment outcomes. DESIGN: A retrospective study was conducted among adult TB patients with CRF and age- and sex-matched TB controls without CRF treated at the National Research Institute of Tuberculosis and Lung Disease from 2004 to 2011. Multivariate analysis was performed to determine the impact of CRF on drug-induced hepatitis (DIH), treatment failure and all-cause mortality. RESULTS: A total of 55 TB cases with CRF and 165 TB cases without CRF were included in the study. Baseline demographic and clinical characteristics were similar, except that TB cases with CRF were more likely to be of Iranian nationality (94.5% vs. 83%, P = 0.04). During anti-tuberculosis treatment, 40 (18.2%) patients developed DIH, none failed treatment and 15 (6.8%) died. Patients with CRF were more likely to develop DIH (27.3% vs. 15.2%, P = 0.04) and to die during treatment (16.4% vs. 3.6%, P = 0.001). CRF remained significantly associated with all-cause mortality (HR 4.87, 95%CI 1.73-13.65) in multivariate analysis, whereas the relationship with DIH was not. CONCLUSION: TB patients with CRF are at increased risk of death. More intensive monitoring of patients with CRF should be considered by the National TB Programme.


Asunto(s)
Antituberculosos/uso terapéutico , Insuficiencia Renal Crónica/complicaciones , Tuberculosis/tratamiento farmacológico , Anciano , Antituberculosos/efectos adversos , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Distribución de Chi-Cuadrado , Femenino , Humanos , Irán , Estimación de Kaplan-Meier , Modelos Logísticos , Masculino , Persona de Mediana Edad , Análisis Multivariante , Oportunidad Relativa , Modelos de Riesgos Proporcionales , Insuficiencia Renal Crónica/diagnóstico , Insuficiencia Renal Crónica/mortalidad , Estudios Retrospectivos , Medición de Riesgo , Factores de Riesgo , Factores de Tiempo , Resultado del Tratamiento , Tuberculosis/complicaciones , Tuberculosis/diagnóstico , Tuberculosis/mortalidad
7.
East Mediterr Health J ; 19(4): 369-72, 2013 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-23882963

RESUMEN

While airways reactivity is among the characteristics of asthma, it is not considered a sufficient condition diagnostically and the methacholine challenge is a non-specific diagnostic aid in cases of chronic cough and reactive airways disease. The aim of this cross-sectional study was to determine the metacholine response positivity and diagnosis of asthma in patients with chronic cough presenting to a hospital in Tehran during 2007 and 2008. Of 101 patients with chronic cough (with no history of sinusitis, recent pulmonary infection, bronchitis, gasteroesophageal reflux or underlying pulmonary conditions), 51.5% showed reactive airways disease to the methacholine test, 40.6% were unreactive and 7.9% were indeterminate. A positive methacholine challenge test was positively correlated with new wheezing. Although the methacholine challenge test is not a primary test for evaluating chronic cough, if no other reason for chronic cough is found, it may be a guiding test for asthma.


Asunto(s)
Asma/epidemiología , Hiperreactividad Bronquial/epidemiología , Tos/epidemiología , Adolescente , Adulto , Anciano , Asma/diagnóstico , Hiperreactividad Bronquial/diagnóstico , Hiperreactividad Bronquial/metabolismo , Pruebas de Provocación Bronquial , Enfermedad Crónica , Tos/metabolismo , Estudios Transversales , Femenino , Humanos , Irán/epidemiología , Masculino , Cloruro de Metacolina/metabolismo , Persona de Mediana Edad , Pruebas de Función Respiratoria , Ruidos Respiratorios , Adulto Joven
8.
(East. Mediterr. health j).
en Inglés | WHO IRIS | ID: who-118397

RESUMEN

While airways reactivity is among the characteristics of asthma, is not considered a sufficient condition diagnostically and the methacholine challenge is a non-specific diagnostic aid in cases of chronic cough and reactive airways disease. The aim of this cross-sectional study was to determine the metacholine response positivity and diagnosis of asthma in patients with chronic cough presenting to a hospital in Tehran during 2007 and 2008. Of 101 patients with chronic cough [with no history of sinusitis, recent pulmonary infection, bronchitis, gasteroesophageal reflux or underlying pulmonary conditions], 51.5% showed reactive airways disease to the methacholine test, 40.6% were unreactive and 7.9% were indeterminate. A positive methacholine challenge test was positively correlated with new wheezing. Although the methacholine challenge test is not a primary test for evaluating chronic cough, if no other reason for chronic cough is found, it may be a guiding test for asthma


Asunto(s)
Tos , Enfermedad Crónica , Estudios Transversales , Asma , Ruidos Respiratorios , Cloruro de Metacolina
9.
East Mediterr Health J ; 18(8): 803-10, 2012 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-23057368

RESUMEN

This cross-sectional survey aimed to provide an overview of tobacco control strategies in the countries of the Eastern Mediterranean Region (EMR). A questionnaire to collate data on implementation of 6 major policies was developed based on the previously published Tobacco Control Scale and using MPOWER measures of the WHO Tobacco Free Initiative and the Tobacco Atlas. Only 3 of the 21 countries scored higher than 50 out of 100: Islamic Republic of Iran (61), Jordan (55) and Egypt (51) More than half of countries scored less than 26. Highest scores were achieved by Afghanistan in cigarette pricing, Oman in smoking bans in public places, Islamic Republic of Iran in budgeting, prohibition of advertisements and health warnings against smoking and Syrian Arab Republic, Tunisia and Kuwait in tobacco cessation programmes. The low mean total score in EMR countries (29.7) compared with European countries (47.2) highlights the need for better future planning and policy-making for tobacco control in the Region.


Asunto(s)
Política de Salud , Nicotiana , Fumar/legislación & jurisprudencia , Publicidad/legislación & jurisprudencia , Comparación Transcultural , Estudios Transversales , Promoción de la Salud/estadística & datos numéricos , Humanos , Medio Oriente , Fumar/economía , Cese del Hábito de Fumar/legislación & jurisprudencia , Prevención del Hábito de Fumar , Impuestos/legislación & jurisprudencia , Contaminación por Humo de Tabaco/legislación & jurisprudencia , Contaminación por Humo de Tabaco/prevención & control
10.
East Mediterr Health J ; 18(9): 957-61, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23057389

RESUMEN

Patterns of drug resistance in recurrent cases of tuberculosis may be different than in those without a history of treatment. In this retrospective study, the drug resistance pattern and outcome of treatment with DOTS category I (CAT I) regimen was compared in 63 recurrent cases and 872 new cases of pulmonary tuberculosis from April 2003 to January 2008 at the National Research Institute of Tuberculosis and Lung Disease in Tehran, Islamic Republic of Iran. Resistance to isoniazid and ethambutol was significantly more common in recurrent cases, but there were no differences in rates of resistance to rifampin, pyrazinamide, streptomycin or the rate of multi-drug resistant strains. Resistance to streptomycin was the most common. No significant differences in treatment outcome and deaths were found between the 2 groups. Due to the low frequency of multi-drug resistance in the recurrent cases, a CAT I regimen may be suitable for empirical therapy before drug sensitivity results become available.


Asunto(s)
Antituberculosos/uso terapéutico , Tuberculosis Resistente a Múltiples Medicamentos/epidemiología , Tuberculosis Pulmonar/epidemiología , Adulto , Anciano , Femenino , Conductas Relacionadas con la Salud , Humanos , Masculino , Persona de Mediana Edad , Recurrencia , Estudios Retrospectivos , Factores Socioeconómicos , Tuberculosis Resistente a Múltiples Medicamentos/tratamiento farmacológico , Tuberculosis Pulmonar/tratamiento farmacológico
11.
Int Arch Allergy Immunol ; 158(4): 418-22, 2012.
Artículo en Inglés | MEDLINE | ID: mdl-22487848

RESUMEN

IL-2-inducible T-cell kinase (ITK) deficiency is a rare inherited immunodeficiency disease characterized by homozygous mutations in the ITK gene and the inability to control Epstein-Barr virus (EBV) infection leading to EBV-associated lymphoproliferative disorders of B cell origin. Many aspects of its clinical presentation and immunologic phenotype are still unclear to clinicians. We report on a 14-year-old female patient with complaints of an 8-month history of cough and fever. Imaging studies revealed diffuse pulmonary nodules and mediastinal lymphadenopathy. Transbronchial lung biopsy showed nonmalignant polyclonal B cell proliferation. High titers of EBV DNA were detected by PCR analysis in bronchoalveolar lavage fluid, bone marrow, and blood. Genomic analysis revealed a homozygous single base pair deletion in exon 5 of the ITK gene (c.468delT) in this patient. Treatment with rituximab (anti-CD20 mab) resulted in complete clinical remission with resolution of pulmonary lesions and a negative EBV titer in serum. All patients with EBV-associated lymphoproliferative disorders should be analyzed for mutations in ITK.


Asunto(s)
Infecciones por Virus de Epstein-Barr/enzimología , Neumonía Viral/enzimología , Proteínas Tirosina Quinasas/genética , Adolescente , Anticuerpos Monoclonales de Origen Murino/uso terapéutico , Linfocitos B/efectos de los fármacos , Linfocitos B/patología , Linfocitos B/virología , Líquido del Lavado Bronquioalveolar/virología , Tos/diagnóstico , Tos/tratamiento farmacológico , Tos/enzimología , Tos/patología , Tos/virología , ADN Viral/análisis , Infecciones por Virus de Epstein-Barr/tratamiento farmacológico , Infecciones por Virus de Epstein-Barr/patología , Femenino , Fiebre/diagnóstico , Fiebre/tratamiento farmacológico , Fiebre/enzimología , Fiebre/patología , Fiebre/virología , Humanos , Factores Inmunológicos/uso terapéutico , Pulmón/diagnóstico por imagen , Pulmón/efectos de los fármacos , Pulmón/enzimología , Pulmón/patología , Pulmón/virología , Activación de Linfocitos/efectos de los fármacos , Activación de Linfocitos/genética , Trastornos Linfoproliferativos/diagnóstico por imagen , Trastornos Linfoproliferativos/tratamiento farmacológico , Trastornos Linfoproliferativos/enzimología , Trastornos Linfoproliferativos/patología , Trastornos Linfoproliferativos/virología , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/patología , Mutación Puntual , Rituximab , Tomografía Computarizada por Rayos X
12.
Int J Tuberc Lung Dis ; 16(2): 268-72, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22236931

RESUMEN

BACKGROUND: Smoking cessation programmes were first introduced in Iran in 1997. To date a number of types of nicotine replacement therapy have been prescribed. OBJECTIVE: To evaluate the effectiveness of varenicline for tobacco cessation. METHODS: This was a randomised parallel clinical study conducted in 2010. Participants were smokers willing to quit who were visiting a smoking cessation clinic for the first time and were randomly divided into three groups: all three groups received brief counselling on cessation, Group 2 received nicotine patches and Group 3 was prescribed varenicline for 8 weeks. RESULTS: There were 272 participants in the study: 91 in Group 1, 92 in Group 2 and 89 in Group 3. At the end of the first month, 128 of the 272 subjects (47.1%) succeeded in quitting: 17 (18.7%) in Group 1, 60 (65.2%) in Group 2 and 51 (57.3%) in Group 3 (P = 0.000). At follow-up after 12 months, 58 subjects (21.3%) remained smoke-free, of whom 6 (6.6%) were in Group 1, 23 (25%) in Group 2 and 29 (32.6%) in Group 3 (P = 0.000). CONCLUSION: In the study, varenicline treatment was slightly more effective than but not significantly different from nicotine replacement therapy.


Asunto(s)
Benzazepinas/uso terapéutico , Quinoxalinas/uso terapéutico , Cese del Hábito de Fumar/métodos , Fumar/epidemiología , Adulto , Femenino , Estudios de Seguimiento , Humanos , Irán/epidemiología , Masculino , Agonistas Nicotínicos/uso terapéutico , Prevalencia , Estudios Retrospectivos , Fumar/efectos adversos , Resultado del Tratamiento , Vareniclina
13.
East Mediterr Health J ; 18(11): 1102-6, 2012 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-23301371

RESUMEN

The aim of this cross-sectional observational study was to address the health care situation in regard to smoking cessation efforts and expenditure, and to provide a basis for future studies and for implementing tobacco control programmes throughout the Eastern Mediterranean Region of the World Health Organization. Information collected included methods and cost of services for tobacco cessation from all 16 participating countries. In 10 countries, cessation programmes were directed by primary physicians. In 13 countries, nicotine gum and in 14 countries nicotine patches were accessible in pharmacies. Bupropion was available at pharmacies (with a written prescription) in 6 countries and varenicline in 7 countries. However, the mean cost of each service was significantly higher than the price of a pack of cigarettes. In countries with support services for tobacco cessation, directors need to provide care at the society level that is considerably less costly and widely accessible.


Asunto(s)
Gastos en Salud/estadística & datos numéricos , Atención Primaria de Salud/economía , Atención Primaria de Salud/métodos , Cese del Hábito de Fumar/economía , Cese del Hábito de Fumar/métodos , Bupropión/administración & dosificación , Bupropión/economía , Estudios Transversales , Humanos , Medio Oriente/epidemiología , Fumar/economía , Cese del Uso de Tabaco/economía , Cese del Uso de Tabaco/métodos , Dispositivos para Dejar de Fumar Tabaco/economía , Dispositivos para Dejar de Fumar Tabaco/estadística & datos numéricos
14.
(East. Mediterr. health j).
en Inglés | WHO IRIS | ID: who-118538

RESUMEN

This cross-sectional survey aimed to provide an overview of tobacco control strategies in the countries of the Eastern Mediterranean Region [EMR]. A questionnaire to collate data on implementation of 6 major policies was developed based on the previously published Tobacco Control Scale and using MPOWER measures of the WHO Tobacco Free Initiative and the Tobacco Atlas. Only 3 of the 21 countries scored higher than 50 out of 100: Islamic Republic of Iran [61], Jordan [55] and Egypt [51]. More than half of countries scored less than 26. Highest scores were achieved by Afghanistan in cigarette pricing, Oman in smoking bans in public places, Islamic Republic of Iran in budgeting, prohibition of advertisements and health warnings against smoking and Syrian Arab Republic, Tunisia and Kuwait in tobacco cessation programmes. The low mean total score in EMR countries [29.7] compared with European countries [47.2] highlights the need for better future planning and policy-making for tobacco control in the Region


Asunto(s)
Estudios Transversales , Encuestas y Cuestionarios , Fumar , Cese del Hábito de Fumar , Productos de Tabaco , Nicotiana
15.
(East. Mediterr. health j).
en Inglés | WHO IRIS | ID: who-118519

RESUMEN

Patterns of drug resistance in recurrent cases of tuberculosis may be different than in those without a history of treatment. In this retrospective study, the drug resistance pattern and outcome of treatment with DOTS category I [CAT I] regimen was compared in 63 recurrent cases and 872 new cases of pulmonary tuberculosis from April 2003 to January 2008 at the National Research Institute of Tuberculosis and Lung Disease in Tehran, Islamic Republic of Iran. Resistance to isoniazid and ethambutol was significantly more common in recurrent cases, but there were no differences in rates of resistance to rifampin, pyrazinamide, streptomycin or the rate of multi-drug resistant strains. Resistance to streptomycin was the most common. No significant differences in treatment outcome and deaths were found between the 2 groups. Due to the low frequency of multi-drug resistance in the recurrent cases, a CAT I regimen may be suitable for empirical therapy before drug sensitivity results become available


Asunto(s)
Tuberculosis Resistente a Múltiples Medicamentos , Resistencia a Medicamentos , Resultado del Tratamiento , Recurrencia , Estudios Retrospectivos , Tuberculosis Pulmonar , Isoniazida , Etambutol , Rifampin , Pirazinamida , Estreptomicina , Tuberculosis
16.
(East. Mediterr. health j).
en Inglés | WHO IRIS | ID: who-118486

RESUMEN

The aim of this cross-sectional observational study was to address the health care situation in regard to smoking cessation efforts and expenditure, and to provide a basis for future studies and for implementing tobacco control programmes throughout the Eastern Mediterranean Region of the World Health Organization. Information collected included methods and cost of services for tobacco cessation from all 16 participating countries. In 10 countries, cessation programmes were directed by primary physicians. In 13 countries, nicotine gum and in 14 countries nicotine patches were accessible in pharmacies. Bupropion was available at pharmacies [with a written prescription] in 6 countries and varenicline in 7 countries. However, the mean cost of each service was significantly higher than the price of a pack of cigarettes. In countries with support services for tobacco cessation, directors need to provide care at the society level that is considerably less costly and widely accessible


Asunto(s)
Costos y Análisis de Costo , Encuestas y Cuestionarios , Estudios Transversales , Dispositivos para Dejar de Fumar Tabaco , Cese del Hábito de Fumar
17.
(East. Mediterr. health j).
en Inglés | WHO IRIS | ID: who-118334

RESUMEN

This cross-sectional survey aimed to provide an overview of tobacco control strategies in the countries of the Eastern Mediterranean Region [EMR]. A questionnaire to collate data on implementation of 6 major policies was developed based on the previously published Tobacco Control Scale and using MPOWER measures of the WHO Tobacco Free Initiative and the Tobacco Atlas. Only 3 of the 21 countries scored higher than 50 out of 100: Islamic Republic of Iran [61], Jordan [55] and Egypt [51]. More than half of countries scored less than 26. Highest scores were achieved by Afghanistan in cigarette pricing, Oman in smoking bans in public places, Islamic Republic of Iran in budgeting, prohibition of advertisements and health warnings against smoking and Syrian Arab Republic, Tunisia and Kuwait in tobacco cessation programmes. The low mean total score in EMR countries [29.7] compared with European countries [47.2] highlights the need for better future planning and policy-making for tobacco control in the Region

20.
Eur Respir J ; 36(5): 995-1001, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20223919

RESUMEN

The 2008-2013 World Health Organization (WHO) action plan on noncommunicable diseases (NCDs) includes chronic respiratory diseases as one of its four priorities. Major chronic respiratory diseases (CRDs) include asthma and rhinitis, chronic obstructive pulmonary disease, occupational lung diseases, sleep-disordered breathing, pulmonary hypertension, bronchiectiasis and pulmonary interstitial diseases. A billion people suffer from chronic respiratory diseases, the majority being in developing countries. CRDs have major adverse effects on the life and disability of patients. Effective intervention plans can prevent and control CRDs, thus reducing morbidity and mortality. A prioritised research agenda should encapsulate all of these considerations in the frame of the global fight against NCDs. This requires both CRD-targeted interventions and transverse NCD programmes which include CRDs, with emphasis on health promotion and disease prevention.


Asunto(s)
Salud Global , Enfermedades Pulmonares/prevención & control , Enfermedades Pulmonares/terapia , Investigación/tendencias , Organización Mundial de la Salud , Enfermedad Crónica , Comorbilidad , Humanos , Enfermedades Pulmonares/epidemiología , Prevalencia
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