Abstract
INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwide. Studies have shown that asthma symptoms can be controlled by the daily use of inhaled corticosteroids (ICS). The management of asthma varies in different settings.METHODS: Asthma management in 13 sub-Saharan African countries was compared to the 2018 Global Initiative for Asthma (GINA) guidelines and the 20th WHO model list of essential medicines (2019). A table with predefined criteria extracted from the international guidelines was used to analyse the content and compare the different treatment guidelines using an Excel spreadsheet.RESULTS: There are variations in the way asthma is diagnosed and treated in different countries. Countries with older treatment guidelines do not have a stepwise approach to assessing severity as stipulated by GINA. Of the 13 countries, only 46% have inhaled ICS at the primary level, 38% have ICS at the secondary level and 16% do not specify.CONCLUSION: The management of asthma varies widely between different countries in sub-Saharan Africa. The noticed variations in approach to care can be explored as an opportunity to harness resources to produce similar and updated guidelines, resulting in uniformity of care across different countries.
Highlights
Mental health disorders such as high levels of anxiety, isolation, depression and suicide ideation reported among young people living with Human Immunodeficiency-Virus (HIV) (10–24 years;young people living with HIV (YPLHIV)) contribute significantly to poor medication adherence and retention in care
There is a dearth of psychosocial support interventions to improve adherence and retention in antiretroviral treatment (ART) amongst adolescents and young adults living with HIV
Future research and programming should seek to address psychosocial support interventions or approaches designed to address the needs of YPLHIV
Summary
Mental health disorders such as high levels of anxiety, isolation, depression and suicide ideation reported among young people living with HIV (10–24 years;YPLHIV) contribute significantly to poor medication adherence and retention in care. While most of the individual, social and health systems barriers associated with ART adherence and retention in care affecting the general population apply to YPLWH, the latter face greater risks of mental and behavioural health problems, which constitute additional barriers [7, 11, 12]. Psychological risk factors such as anxiety and depressive disorders result from the chronicity of HIV infection, being orphaned, changes of guardianship, and the nature of parental and other adult support [11, 13, 14]
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