Low-and middle-income countries (LMICs) bear a disproportionately high burden of the global morbidity and mortality caused by chronic respiratory diseases (CRDs) including asthma, chronic obstructive pulmonary disease, bronchiectasis and post-tuberculous lung disease. CRDs are strongly associated with poverty, infectious diseases, and other non-communicable diseases, and contribute to complex multi-morbidity, with significant consequences for the lives and livelihoods of those affected.The relevance of CRDs to health and socioeconomic wellbeing is expected to increase over time, as life expectancies rise and the competing risks of early childhood mortality and infectious diseases plateau. As such, the World Health Organization has identified the prevention and control of CRDs as an urgent development issue and essential to the achievement of the Sustainable Development Goals.In this review we focus on CRDs in low-and middle-income settings (LMICs). We discuss the early life origins of CRDs, challenges in prevention, diagnosis and management in LMICs, and pathways to solutions to achieve true Universal Health Coverage.

for the African Forum for Research and Education in Health (AFREhealth) COVID-19 Research Collaboration on Children and Adolescents IMPORTANCE Little is known about COVID-19 outcomes among children and adolescents in sub-Saharan Africa, where preexisting comorbidities are prevalent. OBJECTIVE To assess the clinical outcomes and factors associated with outcomes among children and adolescents hospitalized with COVID-19 in 6 countries in sub-Saharan Africa. DESIGN, SETTING, AND PARTICIPANTS This cohort study was a retrospective record review of data from 25 hospitals in the

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We reviewed the current literature on the burden of asthma in South Africa (SA) in the context of other low-and middle-income countries and on rural and urban differences in prevalence and severity of asthma. Methods The SA Childhood Asthma Working Group (SACAWG) convened in January 2017 with six task groups, each headed by a leader (Appendix A), constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The task groups reviewed the available scientific literature on the burden of asthma from high-quality datasets and any local data on asthma prevalence and severity in This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Spirometry forms an important component in the diagnosis and management of pulmonary diseases in children. In the paediatric setting, there are different challenges in terms of performance and interpretation of good quality and reliable tests. An awareness of the physiological and developmental aspects that exist in children is necessary to improve the quality and reliability of spirometry. We reviewed the recommendations on the technical aspects of performing spirometry in children, from the available guidelines and clinical trials. The focus was on the indications, methods and the interpretation of lung function tests in children <12 years of age. Reliable lung function testing can be performed in children, but an awareness of the limitations, the use of incentives and a dedicated lung function technologist are necessary.

Spirometry is an important tool in the surveillance, epidemiology, diagnosis, and management of respiratory disease, yet its accessibility is currently limited in Africa where the burden of respiratory diseases is amongst the highest globally. The reasons for limited access to spirometry in Africa include poor access to training and skilled technicians, limited availability of equipment, consumables, and technical support, and lack of human and financial resources. The Pan African Thoracic Society, working together with regional African thoracic societies and key research initiatives in Africa, have made progress in training and education, but a lot of work is still needed to meet the challenges faced. Accurately defining these challenges of access to high quality spirometry, development of local, standardised, and context-specific training and quality assurance tools; development of appropriate reference standards and innovative approaches to addressing the challenges of access to equipment, consumables and technical support are needed. Training and research collaborations that include regional thoracic societies, health system leaders, the Pan African Thoracic Society and international role players in the field are key to maximising available intellectual and financial resources. Hence ensuring that access to high quality spirometry measures that are used effectively in tackling the burden of respiratory disease in Africa.

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