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Buthelezi TE, Venkatakrishna SSB, Lucas S, Workman L, Dheda K, Nicol MP, Zar HJ, Andronikou S. A comparison of chest radiographic findings in human immunodeficiency virus-positive and -negative children with pulmonary tuberculosis. Clin Radiol 2024; 79:e317-e324. [PMID: 38065775 DOI: 10.1016/j.crad.2023.10.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 10/18/2023] [Accepted: 10/26/2023] [Indexed: 01/02/2024]
Abstract
AIM To compare chest radiography (CXR) findings in human immunodeficiency virus (HIV)-positive and HIV-negative children who had microbiologically confirmed pulmonary tuberculosis (PTB). MATERIALS AND METHODS Retrospective analysis of CXRs from children with known HIV status and microbiologically confirmed PTB (culture or GeneXpert Xpert MTB/RIF positive), who were hospitalised or seen at a primary healthcare centre over a 5-year period. Radiological findings were compared according to HIV and nutritional status. RESULTS CXRs of 130 children were analysed from 35 (27%) HIV- positive and 95 (73%) HIV-negative children with confirmed PTB, median age 45.7 months (interquartile range [IQR] 18-81.3 months). CXR changes consistent with PTB were reported in 21/35 (60%) of HIV-positive and 59/95 (62%) of HIV-negative patients, (p=0.81). Normal CXR was identified in 3/35 (8.6%) of HIV-positive and 5/95 (5.3%) of HIV-negative patients (p=0.81). Airway compression was present in 3/35 (8.6%) of HIV-positive and 7/95 (7.4%) of HIV-negative patients (p>0.99). Overall, lymphadenopathy was identified in 42/130 (32.3%) of patients, 11/35 (31.4 %) were HIV-positive compared with 31/95 (32.6%) HIV-negative patients. Airspace consolidation was present in 60% of both HIV-positive (21/35) and HIV-negative patients (57/95). Pleural effusion was present in 2/35 (5.7 %) of HIV-negative and 9/95 (9.5 %) of HIV-negative patients. There were no statistically significant radiological differences by HIV group. CONCLUSION There were no significant differences in the CXR findings between the HIV-positive and HIV-negative children with confirmed PTB.
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Affiliation(s)
- T E Buthelezi
- Department of Diagnostic Radiology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, South Africa
| | - S S B Venkatakrishna
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - S Lucas
- Department of Diagnostic Radiology, Chris Hani Baragwanath Academic Hospital, University of Witwatersrand, South Africa
| | - L Workman
- Department of Paediatrics & Child Health, Red Cross Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - K Dheda
- Lung Infection and Immunity Unit, Division of Pulmonology and University of Cape Town Lung Institute, Department of Medicine, University of Cape Town, South Africa
| | - M P Nicol
- Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Australia; Division of Medical Microbiology, University of Cape Town and National Health Laboratory Services, South Africa
| | - H J Zar
- Department of Paediatrics & Child Health, Red Cross Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - S Andronikou
- Department of Radiology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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2
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Donald KA, Hendrikse CJ, Roos A, Wedderburn CJ, Subramoney S, Ringshaw JE, Bradford L, Hoffman N, Burd T, Narr KL, Woods RP, Zar HJ, Joshi SH, Stein DJ. Prenatal alcohol exposure and white matter microstructural changes across the first 6-7 years of life: A longitudinal diffusion tensor imaging study of a South African birth cohort. Neuroimage Clin 2024; 41:103572. [PMID: 38309186 PMCID: PMC10847766 DOI: 10.1016/j.nicl.2024.103572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/05/2024]
Abstract
Prenatal alcohol exposure (PAE) can affect brain development in early life, but few studies have investigated the effects of PAE on trajectories of white matter tract maturation in young children. Here we used diffusion weighted imaging (DWI) repeated over three time points, to measure the effects of PAE on patterns of white matter microstructural development during the pre-school years. Participants were drawn from the Drakenstein Child Health Study (DCHS), an ongoing birth cohort study conducted in a peri-urban community in the Western Cape, South Africa. A total of 342 scans acquired from 237 children as neonates (N = 82 scans: 30 PAE; 52 controls) and at ages 2-3 (N = 121 scans: 27 PAE; 94 controls) and 6-7 years (N = 139 scans: 45 PAE; 94 controls) were included. Maternal alcohol use during pregnancy and other antenatal covariates were collected from 28 to 32 weeks' gestation. Linear mixed effects models with restricted maxium likelihood to accommodate missing data were implemented to investigate the effects of PAE on fractional anisotropy (FA) and mean diffusivity (MD) in specific white matter tracts over time, while adjusting for child sex and maternal education. We found significant PAE-by-time effects on trajectories of FA development in the left superior cerebellar peduncle (SCP-L: p = 0.001; survived FDR correction) and right superior longitudinal fasciculus (SLF-R: p = 0.046), suggesting altered white matter development among children with PAE. Compared with controls, children with PAE demonstrated a more rapid change in FA in these tracts from the neonatal period to 2-3 years of age, followed by a more tapered trajectory for the period from 2-3 to 6-7 years of age, with these trajectories differing from unexposed control children. Given their supporting roles in various aspects of neurocognitive functioning (i.e., motor regulation, learning, memory, language), altered patterns of maturation in the SCP and SLF may contribute to a spectrum of physical, social, emotional, and cognitive difficulties often experienced by children with PAE. This study highlights the value of repeated early imaging in longitudinal studies of PAE, and focus for early childhood as a critical window of potential susceptibility as well as an opportunity for early intervention.
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Affiliation(s)
- K A Donald
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa.
| | - C J Hendrikse
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - A Roos
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
| | - C J Wedderburn
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - S Subramoney
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - J E Ringshaw
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - L Bradford
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - N Hoffman
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - T Burd
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - K L Narr
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States
| | - R P Woods
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, United States; The Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States; David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - S H Joshi
- Ahmanson-Lovelace Brain Mapping Center, Department of Neurology, University of California Los Angeles, Los Angeles, CA, United States; Department of Bioengineering, University of California Los Angeles, Los Angeles, CA, United States
| | - D J Stein
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa; Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Risk and Resilience in Mental Disorders, University of Cape Town, Cape Town, South Africa
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3
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Chaya S, Vanker A, Brittain K, MacGinty R, Jacobs C, Hantos Z, Zar HJ, Gray DM. The impact of antenatal and postnatal indoor air pollution or tobacco smoke exposure on lung function at 3 years in an African birth cohort. Respirology 2023; 28:1154-1165. [PMID: 37587874 PMCID: PMC10947154 DOI: 10.1111/resp.14576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 08/02/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND OBJECTIVE Indoor air pollution (IAP) and tobacco smoke exposure (ETS) are global health concerns contributing to the burden of childhood respiratory disease. Studies assessing the effects of IAP and ETS in preschool children are limited. We assessed the impact of antenatal and postnatal IAP and ETS exposure on lung function in a South African birth cohort, the Drakenstein Child Health Study. METHODS Antenatally enrolled mother-child pairs were followed from birth. Lung function measurements (oscillometry, multiple breath washout and tidal breathing) were performed at 6 weeks and 3 years. Quantitative antenatal and postnatal IAP (particulate matter [PM10 ], volatile organic compounds [VOC]) and ETS exposures were measured. Linear regression models explored the effects of antenatal and postnatal exposures on lung function at 3 years. RESULTS Five hundred eighty-four children had successful lung function testing, mean (SD) age of 37.3 (0.7) months. Exposure to antenatal PM10 was associated with a decreased lung clearance index (p < 0.01) and postnatally an increase in the difference between resistance at end expiration (ReE) and inspiration (p = 0.05) and decrease in tidal volume (p = 0.06). Exposure to antenatal VOC was associated with an increase in functional residual capacity (p = 0.04) and a decrease in time of expiration over total breath time (tE /tTOT ) (p = 0.03) and postnatally an increase in respiratory rate (p = 0.05). High ETS exposure postnatally was associated with an increase in ReE (p = 0.03). CONCLUSION Antenatal and postnatal IAP and ETS exposures were associated with impairment in lung function at 3 years. Strengthened efforts to reduce IAP and ETS exposure are needed.
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Affiliation(s)
- S. Chaya
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - A. Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - K. Brittain
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - R. MacGinty
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - C. Jacobs
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - Z. Hantos
- Department of Anaesthesiology and Intensive TherapySemmelweis UniversityBudapestHungary
| | - H. J. Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
| | - D. M. Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and SA‐MRC Unit on Child and Adolescent HealthUniversity of Cape TownCape TownSouth Africa
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Rylance S, Bateman ED, Boulet L, Cohen M, El Sony A, Halpin DMG, Khoo EM, Marks GB, Masekela R, Mikkelsen B, Mortimer KJ, Chakaya Muhwa J, Nunes da Cunha I, Šajnić A, Salvi S, Slama S, Winders T, Yorgancioglu A, Zar HJ. Key messages and partnerships to raise awareness and improve outcomes for people with asthma and COPD in low- and middle-income countries. Int J Tuberc Lung Dis 2022; 26:1106-1108. [PMID: 36447314 DOI: 10.5588/ijtld.22.0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Affiliation(s)
- S Rylance
- Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | - E D Bateman
- Global Initiative for Asthma (GINA), Fontana, WI, USA, University of Cape Town Lung Institute, Cape Town, South Africa
| | - L Boulet
- Global Initiative for Asthma (GINA), Fontana, WI, USA, Laval University, Quebec City, QC, Canada
| | - M Cohen
- Forum of International Respiratory Societies, Lausanne, Switzerland, Asociacion Latinoamericana de Torax, Montevideo, Uruguay, Hospital Centro Medico, Guatemala City, Guatemala
| | - A El Sony
- International Union Against Tuberculosis and Lung Disease, Paris, France, Epidemiological Laboratory (Epi-Lab) for Public Health, Research and Development, Khartoum, Sudan
| | - D M G Halpin
- Global Initiative for Obstructive Lung Disease (GOLD), Fontana, WI, USA, University of Exeter Medical School, Exeter, UK
| | - E M Khoo
- International Primary Care Respiratory Group (IPCRG), Edinburgh, UK, Department of Primary Care Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - G B Marks
- International Union Against Tuberculosis and Lung Disease, Paris, France, University of New South Wales, Sydney, NSW, Australia
| | - R Masekela
- International Union Against Tuberculosis and Lung Disease, Paris, France, Global Asthma Network (GAN), Auckland, New Zealand, Pan African Thoracic Society, Congella, South Africa, Department of Paediatrics and Child Health, University of KwaZulu Natal, Durban, South Africa
| | - B Mikkelsen
- Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | - K J Mortimer
- Global Initiative for Asthma (GINA), Fontana, WI, USA, International Union Against Tuberculosis and Lung Disease, Paris, France, Global Initiative for Obstructive Lung Disease (GOLD), Fontana, WI, USA, Global Asthma Network (GAN), Auckland, New Zealand, Aintree University Hospital, Liverpool, UK
| | - J Chakaya Muhwa
- International Union Against Tuberculosis and Lung Disease, Paris, France, Kenyatta University, Nairobi, Kenya
| | | | - A Šajnić
- International Coalition of Respiratory Nurses, University Hospital Centre Zagreb, Croatia
| | - S Salvi
- Global Initiative for Obstructive Lung Disease (GOLD), Fontana, WI, USA, Pulmocare Research and Education Foundation, Pune, India
| | - S Slama
- Noncommunicable Diseases Department, World Health Organization, Geneva, Switzerland
| | - T Winders
- Global Allergy and Airways Patient Platform, Vienna, Austria
| | - A Yorgancioglu
- Global Initiative for Asthma (GINA), Fontana, WI, USA, Celal Bayar University, Manisa, Turkey
| | - H J Zar
- Forum of International Respiratory Societies, Lausanne, Switzerland, Pan African Thoracic Society, Congella, South Africa, SA Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
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5
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Bethlehem RAI, Seidlitz J, White SR, Vogel JW, Anderson KM, Adamson C, Adler S, Alexopoulos GS, Anagnostou E, Areces-Gonzalez A, Astle DE, Auyeung B, Ayub M, Bae J, Ball G, Baron-Cohen S, Beare R, Bedford SA, Benegal V, Beyer F, Blangero J, Blesa Cábez M, Boardman JP, Borzage M, Bosch-Bayard JF, Bourke N, Calhoun VD, Chakravarty MM, Chen C, Chertavian C, Chetelat G, Chong YS, Cole JH, Corvin A, Costantino M, Courchesne E, Crivello F, Cropley VL, Crosbie J, Crossley N, Delarue M, Delorme R, Desrivieres S, Devenyi GA, Di Biase MA, Dolan R, Donald KA, Donohoe G, Dunlop K, Edwards AD, Elison JT, Ellis CT, Elman JA, Eyler L, Fair DA, Feczko E, Fletcher PC, Fonagy P, Franz CE, Galan-Garcia L, Gholipour A, Giedd J, Gilmore JH, Glahn DC, Goodyer IM, Grant PE, Groenewold NA, Gunning FM, Gur RE, Gur RC, Hammill CF, Hansson O, Hedden T, Heinz A, Henson RN, Heuer K, Hoare J, Holla B, Holmes AJ, Holt R, Huang H, Im K, Ipser J, Jack CR, Jackowski AP, Jia T, Johnson KA, Jones PB, Jones DT, Kahn RS, Karlsson H, Karlsson L, Kawashima R, Kelley EA, Kern S, Kim KW, Kitzbichler MG, Kremen WS, Lalonde F, Landeau B, Lee S, Lerch J, Lewis JD, Li J, Liao W, Liston C, Lombardo MV, Lv J, Lynch C, Mallard TT, Marcelis M, Markello RD, Mathias SR, Mazoyer B, McGuire P, Meaney MJ, Mechelli A, Medic N, Misic B, Morgan SE, Mothersill D, Nigg J, Ong MQW, Ortinau C, Ossenkoppele R, Ouyang M, Palaniyappan L, Paly L, Pan PM, Pantelis C, Park MM, Paus T, Pausova Z, Paz-Linares D, Pichet Binette A, Pierce K, Qian X, Qiu J, Qiu A, Raznahan A, Rittman T, Rodrigue A, Rollins CK, Romero-Garcia R, Ronan L, Rosenberg MD, Rowitch DH, Salum GA, Satterthwaite TD, Schaare HL, Schachar RJ, Schultz AP, Schumann G, Schöll M, Sharp D, Shinohara RT, Skoog I, Smyser CD, Sperling RA, Stein DJ, Stolicyn A, Suckling J, Sullivan G, Taki Y, Thyreau B, Toro R, Traut N, Tsvetanov KA, Turk-Browne NB, Tuulari JJ, Tzourio C, Vachon-Presseau É, Valdes-Sosa MJ, Valdes-Sosa PA, Valk SL, van Amelsvoort T, Vandekar SN, Vasung L, Victoria LW, Villeneuve S, Villringer A, Vértes PE, Wagstyl K, Wang YS, Warfield SK, Warrier V, Westman E, Westwater ML, Whalley HC, Witte AV, Yang N, Yeo B, Yun H, Zalesky A, Zar HJ, Zettergren A, Zhou JH, Ziauddeen H, Zugman A, Zuo XN, Bullmore ET, Alexander-Bloch AF. Brain charts for the human lifespan. Nature 2022; 604:525-533. [PMID: 35388223 PMCID: PMC9021021 DOI: 10.1038/s41586-022-04554-y] [Citation(s) in RCA: 372] [Impact Index Per Article: 186.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/16/2022] [Indexed: 02/02/2023]
Abstract
Over the past few decades, neuroimaging has become a ubiquitous tool in basic research and clinical studies of the human brain. However, no reference standards currently exist to quantify individual differences in neuroimaging metrics over time, in contrast to growth charts for anthropometric traits such as height and weight1. Here we assemble an interactive open resource to benchmark brain morphology derived from any current or future sample of MRI data ( http://www.brainchart.io/ ). With the goal of basing these reference charts on the largest and most inclusive dataset available, acknowledging limitations due to known biases of MRI studies relative to the diversity of the global population, we aggregated 123,984 MRI scans, across more than 100 primary studies, from 101,457 human participants between 115 days post-conception to 100 years of age. MRI metrics were quantified by centile scores, relative to non-linear trajectories2 of brain structural changes, and rates of change, over the lifespan. Brain charts identified previously unreported neurodevelopmental milestones3, showed high stability of individuals across longitudinal assessments, and demonstrated robustness to technical and methodological differences between primary studies. Centile scores showed increased heritability compared with non-centiled MRI phenotypes, and provided a standardized measure of atypical brain structure that revealed patterns of neuroanatomical variation across neurological and psychiatric disorders. In summary, brain charts are an essential step towards robust quantification of individual variation benchmarked to normative trajectories in multiple, commonly used neuroimaging phenotypes.
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Affiliation(s)
- R A I Bethlehem
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK.
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK.
| | - J Seidlitz
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA.
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA.
| | - S R White
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
| | - J W Vogel
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Informatics & Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, USA
| | - K M Anderson
- Department of Psychology, Yale University, New Haven, CT, USA
| | - C Adamson
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - S Adler
- UCL Great Ormond Street Institute for Child Health, London, UK
| | - G S Alexopoulos
- Weill Cornell Institute of Geriatric Psychiatry, Department of Psychiatry, Weill Cornell Medicine, New York, USA
| | - E Anagnostou
- Department of Pediatrics University of Toronto, Toronto, Canada
- Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada
| | - A Areces-Gonzalez
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
- University of Pinar del Río "Hermanos Saiz Montes de Oca", Pinar del Río, Cuba
| | - D E Astle
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - B Auyeung
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychology, School of Philosophy, Psychology and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - M Ayub
- Queen's University, Department of Psychiatry, Centre for Neuroscience Studies, Kingston, Ontario, Canada
- University College London, Mental Health Neuroscience Research Department, Division of Psychiatry, London, UK
| | - J Bae
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - G Ball
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia
| | - S Baron-Cohen
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridge Lifetime Asperger Syndrome Service (CLASS), Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - R Beare
- Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
- Department of Medicine, Monash University, Melbourne, Victoria, Australia
| | - S A Bedford
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - V Benegal
- Centre for Addiction Medicine, National Institute of Mental Health and Neurosciences (NIMHANS), Bengaluru, India
| | - F Beyer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - J Blangero
- Department of Human Genetics, South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley, Edinburg, TX, USA
| | - M Blesa Cábez
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - J P Boardman
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - M Borzage
- Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J F Bosch-Bayard
- McGill Centre for Integrative Neuroscience, Ludmer Centre for Neuroinformatics and Mental Health, Montreal Neurological Institute, Montreal, Quebec, Canada
- McGill University, Montreal, Quebec, Canada
| | - N Bourke
- Department of Brain Sciences, Imperial College London, London, UK
- Care Research and Technology Centre, Dementia Research Institute, London, UK
| | - V D Calhoun
- Tri-institutional Center for Translational Research in Neuroimaging and Data Science (TReNDS), Georgia State University, Georgia Institute of Technology, and Emory University, Atlanta, GA, USA
| | - M M Chakravarty
- McGill University, Montreal, Quebec, Canada
- Computational Brain Anatomy (CoBrA) Laboratory, Cerebral Imaging Centre, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - C Chen
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - C Chertavian
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - G Chetelat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Y S Chong
- Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research, Singapore, Singapore
- Department of Obstetrics and Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J H Cole
- Centre for Medical Image Computing (CMIC), University College London, London, UK
- Dementia Research Centre (DRC), University College London, London, UK
| | - A Corvin
- Department of Psychiatry, Trinity College, Dublin, Ireland
| | - M Costantino
- Cerebral Imaging Centre, Douglas Mental Health University Institute, Verdun, Quebec, Canada
- Undergraduate program in Neuroscience, McGill University, Montreal, Quebec, Canada
| | - E Courchesne
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
- Autism Center of Excellence, University of California, San Diego, San Diego, CA, USA
| | - F Crivello
- Institute of Neurodegenerative Disorders, CNRS UMR5293, CEA, University of Bordeaux, Bordeaux, France
| | - V L Cropley
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
| | - J Crosbie
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - N Crossley
- Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Instituto Milenio Intelligent Healthcare Engineering, Santiago, Chile
| | - M Delarue
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - R Delorme
- Child and Adolescent Psychiatry Department, Robert Debré University Hospital, AP-HP, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - S Desrivieres
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - G A Devenyi
- Cerebral Imaging Centre, McGill Department of Psychiatry, Douglas Mental Health University Institute, Montreal, QC, Canada
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - M A Di Biase
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - R Dolan
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, University College London, London, UK
- Wellcome Centre for Human Neuroimaging, London, UK
| | - K A Donald
- Division of Developmental Paediatrics, Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - G Donohoe
- Center for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - K Dunlop
- Weil Family Brain and Mind Research Institute, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - A D Edwards
- Centre for the Developing Brain, King's College London, London, UK
- Evelina London Children's Hospital, London, UK
- MRC Centre for Neurodevelopmental Disorders, London, UK
| | - J T Elison
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - C T Ellis
- Department of Psychology, Yale University, New Haven, CT, USA
- Haskins Laboratories, New Haven, CT, USA
| | - J A Elman
- Department of Psychiatry, Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - L Eyler
- Desert-Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, Los Angeles, CA, USA
| | - D A Fair
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - E Feczko
- Institute of Child Development, Department of Pediatrics, Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis, MN, USA
| | - P C Fletcher
- Department of Psychiatry, University of Cambridge, and Wellcome Trust MRC Institute of Metabolic Science, Cambridge Biomedical Campus, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - P Fonagy
- Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Anna Freud National Centre for Children and Families, London, UK
| | - C E Franz
- Department of Psychiatry, Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | | | - A Gholipour
- Computational Radiology Laboratory, Boston Children's Hospital, Boston, MA, USA
| | - J Giedd
- Department of Child and Adolescent Psychiatry, University of California, San Diego, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - J H Gilmore
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - D C Glahn
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - I M Goodyer
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - P E Grant
- Division of Newborn Medicine and Neuroradiology, Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - N A Groenewold
- Neuroscience Institute, University of Cape Town, Cape Town, South Africa
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - F M Gunning
- Weill Cornell Institute of Geriatric Psychiatry, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - R E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - R C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
| | - C F Hammill
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Mouse Imaging Centre, Toronto, Ontario, Canada
| | - O Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Memory Clinic, Skåne University Hospital, Malmö, Sweden
| | - T Hedden
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - A Heinz
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Berlin, Germany
| | - R N Henson
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - K Heuer
- Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Université de Paris, Paris, France
| | - J Hoare
- Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - B Holla
- Department of Integrative Medicine, NIMHANS, Bengaluru, India
- Accelerator Program for Discovery in Brain disorders using Stem cells (ADBS), Department of Psychiatry, NIMHANS, Bengaluru, India
| | - A J Holmes
- Departments of Psychology and Psychiatry, Yale University, New Haven, CT, USA
| | - R Holt
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - H Huang
- Radiology Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- The Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K Im
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
- Division of Newborn Medicine and Neuroradiology, Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - J Ipser
- Department of Psychiatry and Mental Health, Clinical Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - C R Jack
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - A P Jackowski
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- National Institute of Developmental Psychiatry, Beijing, China
| | - T Jia
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and BrainInspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
- Centre for Population Neuroscience and Precision Medicine (PONS), Institute of Psychiatry, Psychology and Neuroscience, SGDP Centre, King's College London, London, UK
| | - K A Johnson
- Harvard Medical School, Boston, MA, USA
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
| | - P B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - D T Jones
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - R S Kahn
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - H Karlsson
- Department of Clinical Medicine, Department of Psychiatry and Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - L Karlsson
- Department of Clinical Medicine, Department of Psychiatry and Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, Turku University Hospital and University of Turku, Turku, Finland
| | - R Kawashima
- Institute of Development, Aging and Cancer, Tohoku University, Seiryocho, Aobaku, Sendai, Japan
| | - E A Kelley
- Queen's University, Departments of Psychology and Psychiatry, Centre for Neuroscience Studies, Kingston, Ontario, Canada
| | - S Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - K W Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul, South Korea
| | - M G Kitzbichler
- Brain Mapping Unit, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - W S Kremen
- Department of Psychiatry, Center for Behavior Genetics of Aging, University of California, San Diego, La Jolla, CA, USA
| | - F Lalonde
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - B Landeau
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - S Lee
- Department of Brain & Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, South Korea
| | - J Lerch
- Mouse Imaging Centre, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
- Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neuroscience, University of Oxford, Oxford, UK
| | - J D Lewis
- Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - J Li
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - W Liao
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
| | - C Liston
- Department of Psychiatry and Brain and Mind Research Institute, Weill Cornell Medicine, New York, NY, USA
| | - M V Lombardo
- Autism Research Centre, Department of Psychiatry, University of Cambridge, Cambridge, UK
- Laboratory for Autism and Neurodevelopmental Disorders, Center for Neuroscience and Cognitive Systems @UniTn, Istituto Italiano di Tecnologia, Rovereto, Italy
| | - J Lv
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
- School of Biomedical Engineering and Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
| | - C Lynch
- Weil Family Brain and Mind Research Institute, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - T T Mallard
- Department of Psychology, University of Texas, Austin, TX, USA
| | - M Marcelis
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, EURON, Maastricht University Medical Centre, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - R D Markello
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - S R Mathias
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - B Mazoyer
- Institute of Neurodegenerative Disorders, CNRS UMR5293, CEA, University of Bordeaux, Bordeaux, France
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - P McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M J Meaney
- Ludmer Centre for Neuroinformatics and Mental Health, Douglas Mental Health University Institute, Montreal, Quebec, Canada
- Singapore Institute for Clinical Sciences, Singapore, Singapore
| | - A Mechelli
- Bordeaux University Hospital, Bordeaux, France
| | - N Medic
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - B Misic
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - S E Morgan
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Department of Computer Science and Technology, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - D Mothersill
- Department of Psychology, School of Business, National College of Ireland, Dublin, Ireland
- School of Psychology and Center for Neuroimaging and Cognitive Genomics, National University of Ireland Galway, Galway, Ireland
- Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - J Nigg
- Department of Psychiatry, School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - M Q W Ong
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - C Ortinau
- Department of Pediatrics, Washington University in St Louis, St Louis, MO, USA
| | - R Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Lund University, Clinical Memory Research Unit, Lund, Sweden
| | - M Ouyang
- Radiology Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - L Palaniyappan
- Robarts Research Institute and The Brain and Mind Institute, University of Western Ontario, London, Ontario, Canada
| | - L Paly
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders", Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - P M Pan
- Department of Psychiatry, Federal University of Sao Poalo (UNIFESP), Sao Poalo, Brazil
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Sao Poalo, Brazil
| | - C Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, Carlton South, Victoria, Australia
- Melbourne School of Engineering, The University of Melbourne, Parkville, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - M M Park
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - T Paus
- Department of Psychiatry, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Quebec, Canada
- Departments of Psychiatry and Psychology, University of Toronto, Toronto, Ontario, Canada
| | - Z Pausova
- The Hospital for Sick Children, Toronto, Ontario, Canada
- Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
| | - D Paz-Linares
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for NeuroInformation, University of Electronic Science and Technology of China, Chengdu, China
- Cuban Neuroscience Center, Havana, Cuba
| | - A Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - K Pierce
- Department of Neuroscience, University of California, San Diego, San Diego, CA, USA
| | - X Qian
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J Qiu
- School of Psychology, Southwest University, Chongqing, China
| | - A Qiu
- Department of Biomedical Engineering, The N.1 Institute for Health, National University of Singapore, Singapore, Singapore
| | - A Raznahan
- Section on Developmental Neurogenomics, Human Genetics Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - T Rittman
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - A Rodrigue
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - C K Rollins
- Department of Neurology, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Boston Children's Hospital, Boston, MA, USA
| | - R Romero-Garcia
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Instituto de Biomedicina de Sevilla (IBiS) HUVR/CSIC/Universidad de Sevilla, Dpto. de Fisiología Médica y Biofísica, Seville, Spain
| | - L Ronan
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - M D Rosenberg
- Department of Psychology and Neuroscience Institute, University of Chicago, Chicago, IL, USA
| | - D H Rowitch
- Department of Paediatrics and Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, UK
| | - G A Salum
- Department of Psychiatry, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital de Clinicas de Porto Alegre, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry (INPD), São Paulo, Brazil
| | - T D Satterthwaite
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Lifespan Informatics & Neuroimaging Center, University of Pennsylvania, Philadelphia, PA, USA
| | - H L Schaare
- Otto Hahn Group Cognitive Neurogenetics, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Institute of Neuroscience and Medicine (INM-7: Brain and Behaviour), Research Centre Juelich, Juelich, Germany
| | - R J Schachar
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | - A P Schultz
- Harvard Medical School, Boston, MA, USA
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA
| | - G Schumann
- Centre for Population Neuroscience and Stratified Medicine (PONS), Institute for Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
- PONS-Centre, Charite Mental Health, Dept of Psychiatry and Psychotherapy, Charite Campus Mitte, Berlin, Germany
| | - M Schöll
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, University of Gothenburg, Gothenburg, Sweden
- Dementia Research Centre, Queen's Square Institute of Neurology, University College London, London, UK
| | - D Sharp
- Department of Brain Sciences, Imperial College London, London, UK
- Care Research and Technology Centre, UK Dementia Research Institute, London, UK
| | - R T Shinohara
- Penn Statistics in Imaging and Visualization Center, Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Center for Biomedical Image Computing and Analytics, Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - I Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - C D Smyser
- Departments of Neurology, Pediatrics, and Radiology, Washington University School of Medicine, St Louis, MO, USA
| | - R A Sperling
- Harvard Medical School, Boston, MA, USA
- Harvard Aging Brain Study, Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, MA, USA
| | - D J Stein
- SA MRC Unit on Risk and Resilience in Mental Disorders, Dept of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - A Stolicyn
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - G Sullivan
- MRC Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Y Taki
- Institute of Development, Aging and Cancer, Tohoku University, Seiryocho, Aobaku, Sendai, Japan
| | - B Thyreau
- Institute of Development, Aging and Cancer, Tohoku University, Seiryocho, Aobaku, Sendai, Japan
| | - R Toro
- Université de Paris, Paris, France
- Department of Neuroscience, Institut Pasteur, Paris, France
| | - N Traut
- Department of Neuroscience, Institut Pasteur, Paris, France
- Center for Research and Interdisciplinarity (CRI), Université Paris Descartes, Paris, France
| | - K A Tsvetanov
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
- Department of Psychology, University of Cambridge, Cambridge, UK
| | - N B Turk-Browne
- Department of Psychology, Yale University, New Haven, CT, USA
- Wu Tsai Institute, Yale University, New Haven, CT, USA
| | - J J Tuulari
- Department of Clinical Medicine, Department of Psychiatry and Turku Brain and Mind Center, FinnBrain Birth Cohort Study, University of Turku and Turku University Hospital, Turku, Finland
- Department of Clinical Medicine, University of Turku, Turku, Finland
- Turku Collegium for Science, Medicine and Technology, University of Turku, Turku, Finland
| | - C Tzourio
- Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, Bordeaux, France
| | - É Vachon-Presseau
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Quebec, Canada
| | | | - P A Valdes-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China
- Alan Edwards Centre for Research on Pain (AECRP), McGill University, Montreal, Quebec, Canada
| | - S L Valk
- Institute for Neuroscience and Medicine 7, Forschungszentrum Jülich, Jülich, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - T van Amelsvoort
- Department of Psychiatry and Neurosychology, Maastricht University, Maastricht, The Netherlands
| | - S N Vandekar
- Department of Biostatistics, Vanderbilt University, Nashville, TN, USA
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Vasung
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | - L W Victoria
- Weill Cornell Institute of Geriatric Psychiatry, Department of Psychiatry, Weill Cornell Medicine, New York, NY, USA
| | - S Villeneuve
- McConnell Brain Imaging Centre, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - A Villringer
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
| | - P E Vértes
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- The Alan Turing Institute, London, UK
| | - K Wagstyl
- Wellcome Centre for Human Neuroimaging, London, UK
| | - Y S Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- National Basic Science Data Center, Beijing, China
- Research Center for Lifespan Development of Brain and Mind, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - S K Warfield
- Computational Radiology Laboratory, Boston Children's Hospital, Boston, MA, USA
| | - V Warrier
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - E Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - M L Westwater
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - H C Whalley
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - A V Witte
- Department of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
- Clinic for Cognitive Neurology, University of Leipzig Medical Center, Leipzig, Germany
- Faculty of Medicine, CRC 1052 'Obesity Mechanisms', University of Leipzig, Leipzig, Germany
| | - N Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- National Basic Science Data Center, Beijing, China
- Research Center for Lifespan Development of Brain and Mind, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - B Yeo
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- Centre for Sleep and Cognition and Centre for Translational MR Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore, Singapore
- Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore, Singapore
| | - H Yun
- Division of Newborn Medicine and Neuroradiology, Fetal Neonatal Neuroimaging and Developmental Science Center, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - A Zalesky
- Melbourne Neuropsychiatry Centre, University of Melbourne, Melbourne, Victoria, Australia
- Department of Biomedical Engineering, University of Melbourne, Melbourne, Victoria, Australia
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, SA-MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - A Zettergren
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Gothenburg, Sweden
| | - J H Zhou
- Center for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Electrical and Computer Engineering, National University of Singapore, Singapore, Singapore
- Center for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - H Ziauddeen
- Department of Psychiatry, University of Cambridge, Cambridge, UK
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Wellcome Trust-MRC Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - A Zugman
- National Institute of Developmental Psychiatry for Children and Adolescents (INPD), Sao Poalo, Brazil
- National Institute of Mental Health (NIMH), National Institutes of Health (NIH), Bethesda, MD, USA
- Department of Psychiatry, Escola Paulista de Medicina, São Paulo, Brazil
| | - X N Zuo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Developmental Population Neuroscience Research Center, IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
- National Basic Science Data Center, Beijing, China
- Research Center for Lifespan Development of Brain and Mind, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Key Laboratory of Brain and Education, School of Education Science, Nanning Normal University, Nanning, China
| | - E T Bullmore
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - A F Alexander-Bloch
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
- Department of Child and Adolescent Psychiatry and Behavioral Science, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Lifespan Brain Institute, The Children's Hospital of Philadelphia and Penn Medicine, Philadelphia, PA, USA
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Dheda K, Charalambous S, Karat AS, von Delft A, Lalloo UG, van Zyl Smit R, Perumal R, Allwood BW, Esmail A, Wong ML, Duse AG, Richards G, Feldman C, Mer M, Nyamande K, Lalla U, Koegelenberg CFN, Venter F, Dawood H, Adams S, Ntusi NAB, van der Westhuizen HM, Moosa MYS, Martinson NA, Moultrie H, Nel J, Hausler H, Preiser W, Lasersohn L, Zar HJ, Churchyard GJ. A position statement and practical guide to the use of particulate filtering facepiece respirators (N95, FFP2, or equivalent) for South African health workers exposed to respiratory pathogens including Mycobacterium tuberculosis and SARS-CoV-2. Afr J Thorac Crit Care Med 2021; 27:10.7196/AJTCCM.2021.v27i4.173. [PMID: 34734176 PMCID: PMC8545268 DOI: 10.7196/ajtccm.2021.v27i4.173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2021] [Indexed: 12/21/2022] Open
Abstract
SUMMARY Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is transmitted mainly by aerosol in particles <10 µm that can remain suspended for hours before being inhaled. Because particulate filtering facepiece respirators ('respirators'; e.g. N95 masks) are more effective than surgical masks against bio-aerosols, many international organisations now recommend that health workers (HWs) wear a respirator when caring for individuals who may have COVID-19. In South Africa (SA), however, surgical masks are still recommended for the routine care of individuals with possible or confirmed COVID-19, with respirators reserved for so-called aerosol-generating procedures. In contrast, SA guidelines do recommend respirators for routine care of individuals with possible or confirmed tuberculosis (TB), which is also transmitted via aerosol. In health facilities in SA, distinguishing between TB and COVID-19 is challenging without examination and investigation, both of which may expose HWs to potentially infectious individuals. Symptom-based triage has limited utility in defining risk. Indeed, significant proportions of individuals with COVID-19 and/or pulmonary TB may not have symptoms and/or test negative. The prevalence of undiagnosed respiratory disease is therefore likely significant in many general clinical areas (e.g. waiting areas). Moreover, a proportion of HWs are HIV-positive and are at increased risk of severe COVID-19 and death. RECOMMENDATIONS Sustained improvements in infection prevention and control (IPC) require reorganisation of systems to prioritise HW and patient safety. While this will take time, it is unacceptable to leave HWs exposed until such changes are made. We propose that the SA health system adopts a target of 'zero harm', aiming to eliminate transmission of respiratory pathogens to all individuals in every healthcare setting. Accordingly, we recommend: the use of respirators by all staff (clinical and non-clinical) during activities that involve contact or sharing air in indoor spaces with individuals who: (i) have not yet been clinically evaluated; or (ii) are thought or known to have TB and/or COVID-19 or other potentially harmful respiratory infections;the use of respirators that meet national and international manufacturing standards;evaluation of all respirators, at the least, by qualitative fit testing; andthe use of respirators as part of a 'package of care' in line with international IPC recommendations. We recognise that this will be challenging, not least due to global and national shortages of personal protective equipment (PPE). SA national policy around respiratory protective equipment enables a robust framework for manufacture and quality control and has been supported by local manufacturers and the Department of Trade, Industry and Competition. Respirator manufacturers should explore adaptations to improve comfort and reduce barriers to communication. Structural changes are needed urgently to improve the safety of health facilities: persistent advocacy and research around potential systems change remain essential.
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Affiliation(s)
- K Dheda
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute and South African MRC/UCT Centre for
the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa
- Faculty of Infectious and Tropical Diseases, Department of Immunology and Infection, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - S Charalambous
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - A S Karat
- TB Centre, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - A von Delft
- School of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa
- TB Proof, South Africa
| | - U G Lalloo
- Gateway Private Hospital Medical Centre, Umhlanga Ridge, South Africa
- Durban International Clinical Research Site, Durban, South Africa
| | - R van Zyl Smit
- Division of Pulmonology and Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - R Perumal
- Centre for Lung Infection and Immunity, Division of Pulmonology, Department of Medicine and UCT Lung Institute and South African MRC/UCT Centre for
the Study of Antimicrobial Resistance, University of Cape Town, Cape Town, South Africa
| | - B W Allwood
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - A Esmail
- Clinical Trials Unit, University of Cape Town Lung Institute, South Africa
| | - M L Wong
- Division of Pulmonology, Department of Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - A G Duse
- Clinical Microbiology & Infectious Diseases, School of Pathology of the NHLS & University of the Witwatersrand, Johannesburg, South Africa
| | - G Richards
- Department of Critical Care, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - C Feldman
- Department of Internal Medicine, School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - M Mer
- Department of Medicine, Divisions of Pulmonology and Critical Care, Charlotte Maxeke Johannesburg Academic Hospital and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - K Nyamande
- Department of Pulmonology, Nelson R Mandela School of Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - U Lalla
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - C F N Koegelenberg
- Division of Pulmonology, Department of Medicine, Stellenbosch University and Tygerberg Hospital, Cape Town, South Africa
| | - F Venter
- Ezintsha, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - H Dawood
- Greys Hospital, Pietermaritzburg, South Africa
| | - S Adams
- Division of Occupational Medicine, School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - N A B Ntusi
- Division of Cardiology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - H-M van der Westhuizen
- TB Proof, South Africa
- Nuffield Department of Primary Care Health Sciences, University of Oxford, United Kingdom
| | - M-Y S Moosa
- Department of Infectious Diseases, Division of Internal Medicine, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
- Southern African HIV Clinicians Society
| | - N A Martinson
- Perinatal HIV Research Unit (PHRU), University of the Witwatersrand, Johannesburg, South Africa
- Johns Hopkins University Center for TB Research, Baltimore, MD, USA
| | - H Moultrie
- National Institute for Communicable Diseases, Division of the National Health Laboratory Service, Johannesburg, South Africa
- Clinical Microbiology & Infectious Diseases, School of Pathology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - J Nel
- Division of Infectious Diseases, Department of Medicine, University of the Witwatersrand, Johannesburg, South Africa
| | - H Hausler
- TB HIV Care, Cape Town, South Africa
| | - W Preiser
- Division of Medical Virology, Faculty of Medicine and Health Sciences, Stellenbosch University and National Health Laboratory Service Tygerberg, Cape Town,
South Africa
| | - L Lasersohn
- South African Society of Anaesthesiologists
- Department of Anaesthesia, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Division of Critical Care, Chris Hani Baragwanath Hospital and University of the Witwatersrand, Johannesburg, South Africa
| | - H J Zar
- Department of Paediatrics & Child Health, Red Cross Children’s Hospital and SAMRC Unit on Child and Adolescent Health, University of Cape Town, South Africa
| | - G J Churchyard
- The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Medicine, Vanderbilt University, Nashville, Tennessee, USA
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7
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Goldblatt D, Johnson M, Falup-Pecurariu O, Ivaskeviciene I, Spoulou V, Tamm E, Wagner M, Zar HJ, Bleotu L, Ivaskevicius R, Papadatou I, Jõgi P, Lischka J, Franckling-Smith Z, Isarova D, Grandjean L, Zavadska D. Cross-sectional prevalence of SARS-CoV-2 antibodies in healthcare workers in paediatric facilities in eight countries. J Hosp Infect 2021; 110:60-66. [PMID: 33422589 PMCID: PMC7836791 DOI: 10.1016/j.jhin.2020.12.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/24/2020] [Accepted: 12/26/2020] [Indexed: 12/11/2022]
Abstract
Background Healthcare workers (HCWs) have been disproportionately affected by coronavirus disease 2019 (COVID-19), which may be driven, in part, by nosocomial exposure. If HCW exposure is predominantly nosocomial, HCWs in paediatric facilities, where few patients are admitted with COVID-19, may lack antibodies to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and be at increased risk during the current resurgence. Aim To compare the seroprevalence of SARS-CoV-2 amongst HCWs in paediatric facilities in seven European countries and South Africa (N=8). Methods All categories of paediatric HCWs were invited to participate in the study, irrespective of previous symptoms. A single blood sample was taken and data about previous symptoms were documented. Serum was shipped to a central laboratory in London where SARS-CoV-2 immunoglobulin G was measured. Findings In total, 4114 HCWs were recruited between 1st May and mid-July 2020. The range of seroprevalence was 0–16.93%. The highest seroprevalence was found in London (16.93%), followed by Cape Town, South Africa (10.36%). There were no positive HCWs in the Austrian, Estonian and Latvian cohorts; 2/300 [0.66%, 95% confidence interval (CI) 0.18–2.4] HCWs tested positive in Lithuania; 1/124 (0.81%, 95% CI 0.14–4.3) HCWs tested positive in Romania; and 1/76 (1.3%, 95% CI 0.23–7.0) HCWs tested positive in Greece. Conclusion Overall seroprevalence amongst paediatric HCWs is similar to their national populations and linked to the national COVID-19 burden. Staff working in paediatric facilities in low-burden countries have very low seroprevalence rates and thus are likely to be susceptible to COVID-19. Their susceptibility to infection may affect their ability to provide care in the face of increasing cases of COVID-19, and this highlights the need for appropriate preventative strategies in paediatric healthcare settings.
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Affiliation(s)
- D Goldblatt
- Great Ormond Street Institute of Child Health, University College London, London, UK; Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK.
| | - M Johnson
- Great Ormond Street Institute of Child Health, University College London, London, UK
| | - O Falup-Pecurariu
- Children's Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - I Ivaskeviciene
- Paediatric Centre, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - V Spoulou
- 'Agia Sophia' Children's Hospital of Athens, Athens, Greece
| | - E Tamm
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - M Wagner
- Division of Neonatology, Paediatric Intensive Care and Neuropaediatrics, Department of Paediatrics, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - L Bleotu
- Children's Clinic Hospital, Faculty of Medicine, Transilvania University, Brasov, Romania
| | - R Ivaskevicius
- Paediatric Centre, Institute of Clinical Medicine, Vilnius University, Vilnius, Lithuania
| | - I Papadatou
- Immunobiology and Vaccinology Research Laboratory, National and Kapodistrian University of Athens, Athens, Greece
| | - P Jõgi
- Children's Clinic of Tartu University Hospital, Tartu, Estonia
| | - J Lischka
- Clinical Division of Paediatric Pulmonology, Allergology and Endocrinology, Department of Paediatrics and Adolescent Medicine, Comprehensive Centre for Paediatrics, Medical University of Vienna, Vienna, Austria
| | - Z Franckling-Smith
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, and SA-MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - D Isarova
- Children's Clinical University Hospital, Riga, Latvia
| | - L Grandjean
- Great Ormond Street Institute of Child Health, University College London, London, UK; Great Ormond Street Children's Hospital NHS Foundation Trust, London, UK
| | - D Zavadska
- Children's Clinical University Hospital, Riga, Latvia
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8
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Zar HJ, Moore DP, Andronikou S, Argent AC, Avenant T, Cohen C, Green RJ, Itzikowitz G, Jeena P, Masekela R, Nicol MP, Pillay A, Reubenson G, Madhi SA. Diagnosis and management of community-acquired pneumonia in children: South African Thoracic Society guidelines. Afr J Thorac Crit Care Med 2020; 26:10.7196/AJTCCM.2020.v26i3.104. [PMID: 34471872 PMCID: PMC7433705 DOI: 10.7196/ajtccm.2020.v26i3.104] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Pneumonia remains a major cause of morbidity and mortality amongst South African children. More comprehensive immunisation regimens, strengthening of HIV programmes, improvement in socioeconomic conditions and new preventive strategies have impacted on the epidemiology of pneumonia. Furthermore, sensitive diagnostic tests and better sampling methods in young children improve aetiological diagnosis. OBJECTIVES To produce revised guidelines for pneumonia in South African children under 5 years of age. METHODS The Paediatric Assembly of the South African Thoracic Society and the National Institute for Communicable Diseases established seven expert subgroups to revise existing South African guidelines focusing on: (i) epidemiology; (ii) aetiology; (iii) diagnosis; (iv) antibiotic management and supportive therapy; (v) management in intensive care; (vi) prevention; and (vii) considerations in HIV-infected or HIVexposed, uninfected (HEU) children. Each subgroup reviewed the published evidence in their area; in the absence of evidence, expert opinion was accepted. Evidence was graded using the British Thoracic Society (BTS) grading system. Sections were synthesized into an overall guideline which underwent peer review and revision. RECOMMENDATIONS Recommendations include a diagnostic approach, investigations, management and preventive strategies. Specific recommendations for HIV infected and HEU children are provided. VALIDATION The guideline is based on available published evidence supplemented by the consensus opinion of SA paediatric experts. Recommendations are consistent with those in published international guidelines.
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Affiliation(s)
- H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
- South African Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, South Africa
| | - D P Moore
- Department of Paediatrics and Child Health, Chris Hani Baragwanath Academic Hospital, and Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - S Andronikou
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
- Department of Pediatric Radiology, Perelman School of Medicine, University of Philadephia, USA
| | - A C Argent
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - T Avenant
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - C Cohen
- Centre for Respiratory Diseases and Meningitis, National Institute for Communicable Diseases, Johannesburg, South Africa
| | - R J Green
- Department of Paediatrics and Child Health, Faculty of Health Sciences, University of Pretoria, South Africa
| | - G Itzikowitz
- Department of Paediatrics and Child Health, Red Cross War Memorial Children’s Hospital and Faculty of Health Sciences, University of Cape Town, South Africa
| | - P Jeena
- Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - R Masekela
- Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - M P Nicol
- Division of Medical Microbiology, Department of Pathology, Faculty of Health Sciences, University of Cape Town, South Africa; and Division of Infection and Immunity, School of Biomedical Sciences, University of Western Australia, Perth, Australia
| | - A Pillay
- Department of Paediatrics and Child Health, Nelson R Mandela School of Medicine, School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - G Reubenson
- Department of Paediatrics and Child Health, Rahima Moosa Mother and Child Hospital, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - S A Madhi
- South African Medical Research Council Vaccine and Infectious Diseases Analytics Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Science and Technology/National Research Foundation: South African Research Chair in Vaccine Preventable Diseases, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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9
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Chakaya J, Binegdie A, Irungu A, Pearson B, Gray D, Zar HJ, Schewitz I, Kagima J, Mortimer K, Ozoh OB, Masekela R, Gordon SB, Worodria W, Aluoch J. COVID-19 in Africa: preparing for the storm. Int J Tuberc Lung Dis 2020; 24:744-746. [PMID: 32718414 DOI: 10.5588/ijtld.20.0281] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- J Chakaya
- Department of Medicine, Dermatology, Psychiatry and Therapeutics, Kenyatta University, Nairobi, Kenya, Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - A Binegdie
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - A Irungu
- Gertrude's Children's Hospital, Nairobi, Kenya
| | | | - D Gray
- Division of Paediatric Pulmonology, Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa
| | - H J Zar
- Department of Paediatrics & Child Health and SA Medical Research Council Unit on Child & Adolescent Health, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - I Schewitz
- Department of Cardiothoracic Surgery, University of Pretoria, Pretoria, South Africa
| | - J Kagima
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Department of Internal Medicine, Kenyatta National Hospital, Nairobi, Kenya
| | - K Mortimer
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| | - O B Ozoh
- Department of Medicine, College of Medicine, University of Lagos, Lagos, Nigeria
| | - R Masekela
- Department of Paediatrics and Child Health, Nelson R Mandela School of Clinical Medicine, College of Health Sciences, University of KwaZulu Natal, Durban, South Africa
| | - S B Gordon
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Malawi-Liverpool Wellcome Trust Clinical Research Programme, Queen Elizabeth Central Hospital, College of Medicine, Blantyre, Malawi
| | - W Worodria
- Infectious Diseases Research Collaboration, Mulago Hospital, Makerere University, Kampala, Uganda
| | - J Aluoch
- The Nairobi Hospital, Nairobi, Kenya, ,
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10
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Bédard A, Antó JM, Fonseca JA, Arnavielhe S, Bachert C, Bedbrook A, Bindslev‐Jensen C, Bosnic‐Anticevich S, Cardona V, Cruz AA, Fokkens WJ, Garcia‐Aymerich J, Hellings PW, Ivancevich JC, Klimek L, Kuna P, Kvedariene V, Larenas‐Linnemann D, Melén E, Monti R, Mösges R, Mullol J, Papadopoulos NG, Pham‐Thi N, Samolinski B, Tomazic PV, Toppila‐Salmi S, Ventura MT, Yorgancioglu A, Bousquet J, Pfaar O, Basagaña X, Aberer W, Agache I, Akdis CA, Akdis M, Aliberti MR, Almeida R, Amat F, Angles R, Annesi‐Maesano I, Ansotegui IJ, Anto JM, Arnavielle S, Asayag E, Asarnoj A, Arshad H, Avolio F, Bacci E, Baiardini I, Barbara C, Barbagallo M, Baroni I, Barreto BA, Bateman ED, Bedolla‐Barajas M, Bewick M, Beghé B, Bel EH, Bergmann KC, Bennoor KS, Benson M, Bertorello L, Białoszewski AZ, Bieber T, Bialek S, Bjermer L, Blain H, Blasi F, Blua A, Bochenska Marciniak M, Bogus‐Buczynska I, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briedis V, Brightling CE, Brozek J, Bucca C, Buhl R, Buonaiuto R, Panaitescu C, Burguete Cabañas MT, Burte E, Bush A, Caballero‐Fonseca F, Caillaud D, Caimmi D, Calderon MA, Camargos PAM, Camuzat T, Canfora G, Canonica GW, Carlsen KH, Carreiro‐Martins P, Carriazo AM, Carr W, Cartier C, Casale T, Castellano G, Cecchi L, Cepeda AM, Chavannes NH, Chen Y, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciaravolo MM, Ciceran A, Cingi C, Ciprandi G, Carvalho Coehlo AC, Colas L, Colgan E, Coll J, Conforti D, Constantinidis J, Correia de Sousa J, Cortés‐Grimaldo RM, Corti F, Costa E, Costa‐Dominguez MC, Courbis AL, Cox L, Crescenzo M, Custovic A, Czarlewski W, Dahlen SE, D'Amato G, Dario C, da Silva J, Dauvilliers Y, Darsow U, De Blay F, De Carlo G, Dedeu T, de Fátima Emerson M, De Feo G, De Vries G, De Martino B, Motta Rubini NP, Deleanu D, Denburg JA, Devillier P, Di Capua Ercolano S, Di Carluccio N, Didier A, Dokic D, Dominguez‐Silva MG, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, El‐Gamal Y, Eklund P, Eller E, Emuzyte R, Farrell J, Farsi A, Ferreira de Mello J, Ferrero J, Fink‐Wagner A, Fiocchi A, Fontaine JF, Forti S, Fuentes‐Perez JM, Gálvez‐Romero JL, Gamkrelidze A, García‐Cobas CY, Garcia‐Cruz MH, Gemicioğlu B, Genova S, Christoff G, Gereda JE, Gerth van Wijk R, Gomez RM, Gómez‐Vera J, González Diaz S, Gotua M, Grisle I, Guidacci M, Guldemond NA, Gutter Z, Guzmán MA, Haahtela T, Hajjam J, Hernández L, Hourihane JO, Huerta‐Villalobos YR, Humbert M, Iaccarino G, Illario M, Ispayeva Z, Jares EJ, Jassem E, Johnston SL, Joos G, Jung KS, Just J, Jutel M, Kaidashev I, Kalayci O, Kalyoncu AF, Karjalainen J, Kardas P, Keil T, Keith PK, Khaitov M, Khaltaev N, Kleine‐Tebbe J, Kowalski ML, Kuitunen M, Kull I, Kupczyk M, Krzych‐Fałta E, Lacwik P, Laune D, Lauri D, Lavrut J, Le LTT, Lessa M, Levato G, Li J, Lieberman P, Lipiec A, Lipworth B, Lodrup Carlsen KC, Louis R, Lourenço O, Luna‐Pech JA, Magnan A, Mahboub B, Maier D, Mair A, Majer I, Malva J, Mandajieva E, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maspero JF, Mathieu‐Dupas E, Matta Campos JJ, Matos AL, Maurer M, Mavale‐Manuel S, Mayora O, Meco C, Medina‐Avalos MA, Melo‐Gomes E, Meltzer EO, Menditto E, Mercier J, Miculinic N, Mihaltan F, Milenkovic B, Moda G, Mogica‐Martinez MD, Mohammad Y, Momas I, Montefort S, Mora Bogado D, Morais‐Almeida M, Morato‐Castro FF, Mota‐Pinto A, Moura Santo P, Münter L, Muraro A, Murray R, Naclerio R, Nadif R, Nalin M, Napoli L, Namazova‐Baranova L, Neffen H, Niedeberger V, Nekam K, Neou A, Nieto A, Nogueira‐Silva L, Nogues M, Novellino E, Nyembue TD, O'Hehir RE, Odzhakova C, Ohta K, Okamoto Y, Okubo K, Onorato GL, Ortega Cisneros M, Ouedraogo S, Pali‐Schöll I, Palkonen S, Panzner P, Park HS, Papi A, Passalacqua G, Paulino E, Pawankar R, Pedersen S, Pépin JL, Pereira AM, Persico M, Phillips J, Picard R, Pigearias B, Pin I, Pitsios C, Plavec D, Pohl W, Popov TA, Portejoie F, Potter P, Pozzi AC, Price D, Prokopakis EP, Puy R, Pugin B, Pulido Ross RE, Przemecka M, Rabe KF, Raciborski F, Rajabian‐Soderlund R, Reitsma S, Ribeirinho I, Rimmer J, Rivero‐Yeverino D, Rizzo JA, Rizzo MC, Robalo‐Cordeiro C, Rodenas F, Rodo X, Rodriguez Gonzalez M, Rodriguez‐Mañas L, Rolland C, Rodrigues Valle S, Roman Rodriguez M, Romano A, Rodriguez‐Zagal E, Rolla G, Roller‐Wirnsberger RE, Romano M, Rosado‐Pinto J, Rosario N, Rottem M, Ryan D, Sagara H, Salimäki J, Sanchez‐Borges M, Sastre‐Dominguez J, Scadding GK, Schunemann HJ, Scichilone N, Schmid‐Grendelmeier P, Sarquis Serpa F, Shamai S, Sheikh A, Sierra M, Simons FER, Siroux V, Sisul JC, Skrindo I, Solé D, Somekh D, Sondermann M, Sooronbaev T, Sova M, Sorensen M, Sorlini M, Spranger O, Stellato C, Stelmach R, Stukas R, Sunyer J, Strozek J, Szylling A, Tebyriçá JN, Thibaudon M, To T, Todo‐Bom A, Trama U, Triggiani M, Suppli Ulrik C, Urrutia‐Pereira M, Valenta R, Valero A, Valiulis A, Valovirta E, van Eerd M, van Ganse E, van Hage M, Vandenplas O, Vezzani G, Vasankari T, Vatrella A, Verissimo MT, Viart F, Viegi G, Vicheva D, Vontetsianos T, Wagenmann M, Walker S, Wallace D, Wang DY, Waserman S, Werfel T, Westman M, Wickman M, Williams DM, Williams S, Wilson N, Wright J, Wroczynski P, Yakovliev P, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zhang L, Zhong N, Zernotti ME, Zhanat I, Zidarn M, Zuberbier T, Zubrinich C, Zurkuhlen A. Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air ® App. Allergy 2020; 75:1672-1688. [PMID: 31995656 DOI: 10.1111/all.14204] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/23/2019] [Accepted: 12/05/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently. METHODS All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated. RESULTS A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures. CONCLUSIONS VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.
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MacGinty RP, Kariuki SM, Barnett W, Wedderburn CJ, Hardy A, Hoffman N, Newton CR, Zar HJ, Donald KA, Stein DJ. Associations of antenatal maternal psychological distress with infant birth and development outcomes: Results from a South African birth cohort. Compr Psychiatry 2020; 96:152128. [PMID: 31715335 PMCID: PMC6945113 DOI: 10.1016/j.comppsych.2019.152128] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 07/30/2019] [Accepted: 09/09/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Antenatal maternal psychological distress is common in low and middle-income countries (LMIC), but there is a dearth of research on its effect on birth and developmental outcomes in these settings, particularly in Sub-Saharan Africa. This study set out to identify risk factors for antenatal maternal psychological distress and determine whether antenatal maternal psychological distress was associated with infant birth and developmental outcomes, using data from the Drakenstein Child Health Study (DCHS), a birth cohort study in South Africa. METHODS Pregnant women were enrolled in the DCHS from primary care antenatal clinics. Antenatal maternal psychological distress was measured using the Self-Reporting Questionnaire 20-item (SRQ-20). A range of psychosocial measures, including maternal childhood trauma, depression, and posttraumatic stress disorder (PTSD) were administered. Birth outcomes, including premature birth, weight-for-age z-score and head circumference-for-age z-score, were measured using revised Fenton growth charts. The Bayley III Scales of Infant and Toddler Development was administered at 6 months of age to assess infant development outcomes, including cognitive, language, and motor domains in a subset of n=231. Associations of maternal antenatal psychological distress with psychosocial measures, and with infant birth and developmental outcomes were examined using linear regression models. RESULTS 961 women were included in this analysis, with 197 (21%) reporting scores indicating the presence of psychological distress. Antenatal psychological distress was associated with maternal childhood trauma, antenatal depression, and PTSD, and inversely associated with partner support. No association was observed between antenatal maternal psychological distress and preterm birth or early developmental outcomes, but antenatal maternal psychological distress was associated with a smaller head circumference at birth (coefficient=-0.30, 95% CI: -0.49; -0.10). CONCLUSION Antenatal maternal psychological distress is common in LMIC settings and was found to be associated with key psychosocial measures during pregnancy, as well as with adverse birth outcomes, in our study population. These associations highlight the potential value of screening for antenatal maternal psychological distress as well as of developing targeted interventions.
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Affiliation(s)
- R P MacGinty
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa.
| | - S M Kariuki
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK
| | - W Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa
| | - C J Wedderburn
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; Department of Clinical Research, London School of Hygiene & Tropical Medicine, London, UK
| | - A Hardy
- Statistical Consulting Service, Department of Statistical Science, University of Cape Town, South Africa
| | - N Hoffman
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa
| | - C R Newton
- KEMRI-Wellcome Trust Research Programme, Kilifi, Kenya; Department of Psychiatry, University of Oxford, UK
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa; South African Medical Research Council (SAMRC), Unit on Child & Adolescent Health, Cape Town, South Africa
| | - K A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - D J Stein
- Department of Psychiatry & Neuroscience Institute, University of Cape Town, South Africa; South African Medical Research Council (SAMRC) Unit on Risk & Resilience in Mental Disorders, South Africa
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Vanker A, Barnett W, Brittain K, Gie RP, Koen N, Myers B, Stein DJ, Zar HJ. Antenatal and early life tobacco smoke exposure in an African birth cohort study. Int J Tuberc Lung Dis 2018; 20:729-37. [PMID: 27155174 DOI: 10.5588/ijtld.15.0697] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Exposure to tobacco smoke in African infants has not been well studied, despite the high burden of childhood respiratory disease in these communities. OBJECTIVE To investigate the prevalence of antenatal and early life tobacco smoke exposure and associations with infant birth outcomes in an African birth cohort, the Drakenstein Child Health Study. METHODS Self-report questionnaires assessing maternal and household smoking were administered. Maternal and infant urine cotinine testing was conducted antenatally, at birth and at 6-10 weeks of life to measure tobacco smoke exposure. Multivariate regression models explored the associations between exposure to smoke and infant birth outcomes. RESULTS Of 789 pregnant women included, 250 (32%) were active smokers on cotinine testing. At birth and at 6-10 weeks of life, respectively 135/241 (56%) and 154/291 (53%) infants had urine cotinine levels indicating tobacco smoke exposure. Household smoking was prevalent and was associated with positive infant cotinine test results. Antenatal maternal smoking was associated with decreased infant birthweight-for-age Z-score (0.3, 95%CI 0.1-0.5). CONCLUSION Antenatal and early life tobacco smoke exposure is highly prevalent in this community, and may impact on birth outcomes and subsequent child health. Smoking cessation interventions are urgently needed to reduce tobacco smoke exposure in African communities.
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Affiliation(s)
- A Vanker
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and Medical Research Council (MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - W Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and Medical Research Council (MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - K Brittain
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and Medical Research Council (MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - R P Gie
- Department of Paediatrics and Child Health, Tygerberg Children's Hospital, Stellenbosch University, Cape Town, South Africa
| | - N Koen
- Department of Psychiatry and Mental Health and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - B Myers
- Alcohol Tobacco and Other Drug Research Unit, South African Medical Research Council and Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - D J Stein
- Department of Psychiatry and Mental Health and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, and Medical Research Council (MRC) Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
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McIlleron H, Hundt H, Smythe W, Bekker A, Winckler J, van der Laan L, Smith P, Zar HJ, Hesseling AC, Maartens G, Wiesner L, van Rie A. Bioavailability of two licensed paediatric rifampicin suspensions: implications for quality control programmes. Int J Tuberc Lung Dis 2018; 20:915-9. [PMID: 27287644 DOI: 10.5588/ijtld.15.0833] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING To assess the revised World Health Organization-recommended dose of 10-20 mg/kg rifampicin (RMP), we studied the steady state pharmacokinetics of RMP in South African children who received standard treatment for drug-susceptible tuberculosis (TB). OBJECTIVE To determine the formulation effect on the pharmacokinetics of RMP. DESIGN RMP plasma concentrations were characterised in 146 children (median age 1.4 years, range 0.2-10.2). The morning dose on the day of the pharmacokinetic evaluation was administered as one of two RMP single-drug oral suspensions. RESULTS While one formulation achieved 2 h concentrations in the range of those observed in adults (median 6.54 mg/l, interquartile range [IQR] 4.47-8.84), the other attained a median bioavailability of only 25% of this, with a median 2 h concentration of 1.59 mg/l (IQR 0.89-2.38). CONCLUSION RMP is a key drug for the treatment of TB. It is critical that the quality of RMP suspensions used to treat childhood TB is ensured.
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Affiliation(s)
- H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - H Hundt
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - W Smythe
- Division of Clinical Pharmacology, Department of Medicine, Clinical Research Centre, Health Sciences Faculty, University of Cape Town, Cape Town, South Africa
| | - A Bekker
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - J Winckler
- Department of Paediatrics and Child Health, and Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - L van der Laan
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - P Smith
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health, and Medical Research Council Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa; Red Cross War Memorial Children's Hospital, Cape Town, South Africa
| | - A C Hesseling
- Desmond Tutu TB Centre, Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - G Maartens
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - L Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - A van Rie
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA; International Health Unit, Epidemiology and Social Medicine, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
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Bousquet J, Farrell J, Crooks G, Hellings P, Bel EH, Bewick M, Chavannes NH, de Sousa JC, Cruz AA, Haahtela T, Joos G, Khaltaev N, Malva J, Muraro A, Nogues M, Palkonen S, Pedersen S, Robalo-Cordeiro C, Samolinski B, Strandberg T, Valiulis A, Yorgancioglu A, Zuberbier T, Bedbrook A, Aberer W, Adachi M, Agusti A, Akdis CA, Akdis M, Ankri J, Alonso A, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Bai C, Baiardini I, Bachert C, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Kheder AB, Bennoor KS, Benson M, Bergmann KC, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosnic-Anticevitch S, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Caimmi D, Calderon MA, Calverley PM, Camargos PAM, Canonica GW, Camuzat T, Carlsen KH, Carr W, Carriazo A, Casale T, Cepeda Sarabia AM, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, Cirule I, Cox L, Costa DJ, Custovic A, Dahl R, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, De Manuel Keenoy E, Demoly P, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fabbri LM, Fletcher M, Fiocchi A, Fink Wagner A, Fonseca J, Fokkens WJ, Forastiere F, Frith P, Gaga M, Gamkrelidze A, Garces J, Garcia-Aymerich J, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grisle I, Grouse L, Gutter Z, Guzmán MA, Heaney LG, Hellquist-Dahl B, Henderson D, Hendry A, Heinrich J, Heve D, Horak F, Hourihane JOB, Howarth P, Humbert M, Hyland ME, Illario M, Ivancevich JC, Jardim JR, Jares EJ, Jeandel C, Jenkins C, Johnston SL, Jonquet O, Julge K, Jung KS, Just J, Kaidashev I, Khaitov MR, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Klimek L, Koffi N’Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen K, Louis R, MacNee W, Magard Y, Magnan A, Mahboub B, Mair A, Majer I, Makela MJ, Manning P, Mara S, Marshall GD, Masjedi MR, Matignon P, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Menzies-Gow A, Merk H, Michel JP, Miculinic N, Mihaltan F, Milenkovic B, Mohammad GMY, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Morgan M, Mösges R, Mullol J, Nafti S, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Ninot G, Nyembue TD, O’Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Panzner P, Papadopoulos N, Papi A, Park HS, Passalacqua G, Pavord I, Pawankar R, Pengelly R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Poethig D, Pohl W, Popov TA, Portejoie F, Potter P, Postma D, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Reitamo S, Rennard S, Rodenas F, Roberts J, Roca J, Rodriguez Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rosenwasser L, Rottem M, Ryan D, Sanchez-Borges M, Scadding GK, Schunemann HJ, Serrano E, Schmid-Grendelmeier P, Schulz H, Sheikh A, Shields M, Siafakas N, Sibille Y, Similowski T, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Sunyer J, Thijs C, To T, Todo-Bom A, Triggiani M, Valenta R, Valero AL, Valia E, Valovirta E, Van Ganse E, van Hage M, Vandenplas O, Vasankari T, Vellas B, Vestbo J, Vezzani G, Vichyanond P, Viegi G, Vogelmeier C, Vontetsianos T, Wagenmann M, Wallaert B, Walker S, Wang DY, Wahn U, Wickman M, Williams DM, Williams S, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5). Clin Transl Allergy 2017; 7:5. [PMID: 28239450 PMCID: PMC5319069 DOI: 10.1186/s13601-016-0135-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 11/10/2022] Open
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Budree S, Stein DJ, Brittain K, Goddard E, Koen N, Barnett W, Myer L, Zar HJ. Maternal and infant factors had a significant impact on birthweight and longitudinal growth in a South African birth cohort. Acta Paediatr 2017; 106:1793-1801. [PMID: 28796908 PMCID: PMC5656834 DOI: 10.1111/apa.14015] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 08/07/2017] [Indexed: 01/29/2023]
Abstract
Aim This birth cohort study investigated longitudinal infant growth and associated factors in a multiethnic population living in a low‐resource district surrounding the town of Paarl in South Africa. Methods Between March 2012 and October 2014, all mothers attending their second trimester antenatal visit at Paarl Hospital were approached for enrolment. Mother–infant pairs were followed from birth until 12 months of age. Comprehensive socio‐demographic, nutritional and psychosocial data were collected at birth, two, six and 12 months. Infant anthropometry was analysed as z‐scores for weight and height. Linear regression was used to investigate predictors of birthweight, and linear mixed‐effects models were used to investigate predictors of infant growth. Results Longitudinal anthropometric data from 792 infants were included: 53% were Black African, 47% were mixed race, and 15% were born preterm. Stunting occurred in 13% of infants at 12 months. Maternal height, antenatal alcohol and tobacco use, ethnicity and socioeconomic status were significant predictors of birthweight. In the adjusted mixed‐effects model, birthweight was a significant predictor of growth during the first year of life. Conclusion Birthweight was an important predictor of growth trajectory during infancy. Birthweight and growth were influenced by several important modifiable factors.
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Affiliation(s)
- S Budree
- Department of Paediatrics and Child Health; Red Cross War Memorial Children's Hospital; Cape Town South Africa
- MRC Unit on Child and Adolescent Health; University of Cape Town; Cape Town South Africa
| | - DJ Stein
- Department of Psychiatry & Mental Health; Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders; Cape Town South Africa
| | - K Brittain
- Department of Paediatrics and Child Health; Red Cross War Memorial Children's Hospital; Cape Town South Africa
- MRC Unit on Child and Adolescent Health; University of Cape Town; Cape Town South Africa
| | - E Goddard
- Department of Paediatrics and Child Health; Red Cross War Memorial Children's Hospital; Cape Town South Africa
- MRC Unit on Child and Adolescent Health; University of Cape Town; Cape Town South Africa
| | - N Koen
- Department of Psychiatry & Mental Health; Groote Schuur Hospital; University of Cape Town; Cape Town South Africa
- South African Medical Research Council Unit on Risk and Resilience in Mental Disorders; Cape Town South Africa
| | - W Barnett
- Department of Paediatrics and Child Health; Red Cross War Memorial Children's Hospital; Cape Town South Africa
- MRC Unit on Child and Adolescent Health; University of Cape Town; Cape Town South Africa
| | - L Myer
- Division of Epidemiology and Biostatistics; School of Public Health and Family Medicine; University of Cape Town; Cape Town South Africa
| | - HJ Zar
- Department of Paediatrics and Child Health; Red Cross War Memorial Children's Hospital; Cape Town South Africa
- MRC Unit on Child and Adolescent Health; University of Cape Town; Cape Town South Africa
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Page NA, Seheri LM, Groome MJ, Moyes J, Walaza S, Mphahlele J, Kahn K, Kapongo CN, Zar HJ, Tempia S, Cohen C, Madhi SA. Temporal association of rotavirus vaccination and genotype circulation in South Africa: Observations from 2002 to 2014. Vaccine 2017; 36:7231-7237. [PMID: 29110933 DOI: 10.1016/j.vaccine.2017.10.062] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/16/2017] [Accepted: 10/20/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND Rotavirus vaccination has reduced diarrhoeal morbidity and mortality globally. The monovalent rotavirus vaccine was introduced into the public immunization program in South Africa (SA) in 2009 and led to approximately 50% reduction in rotavirus hospitalization in young children. The aim of this study was to investigate the rotavirus genotype distribution in SA before and after vaccine introduction. MATERIALS AND METHODS In addition to pre-vaccine era surveillance conducted from 2002 to 2008 at Dr George Mukhari Hospital (DGM), rotavirus surveillance among children <5 years hospitalized for acute diarrhoea was established at seven sentinel sites in SA from April 2009 to December 2014. Stool specimens were screened by enzyme immunoassay and rotavirus positive specimens genotyped using standardised methods. RESULTS At DGM, there was a significant decrease in G1 strains from pre-vaccine introduction (34%; 479/1418; 2002-2009) compared to post-vaccine introduction (22%; 37/170; 2010-2014; p for trend <.001). Similarly, there was a significant increase in non-G1P[8] strains at this site (p for trend <.001). In expanded sentinel surveillance, when adjusted for age and site, the odds of rotavirus detection in hospitalized children with diarrhoea declined significantly from 2009 (46%; 423/917) to 2014 (22%; 205/939; p<.001). The odds of G1 detection declined significantly from 2009 (53%; 224/421) to 2010-2011 (26%; 183/703; aOR=0.5; p<.001) and 2012-2014 (9%; 80/905; aOR=0.1; p<.001). Non-G1P[8] strains showed a significant increase from 2009 (33%; 139/421) to 2012-2014 (52%; 473/905; aOR=2.5; p<.001). CONCLUSIONS Rotavirus vaccination of children was associated with temporal changes in circulating genotypes. Despite these temporal changes in circulating genotypes, the overall reduction in rotavirus disease in South Africa remains significant.
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Affiliation(s)
- N A Page
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Department of Medical Virology, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
| | - L M Seheri
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa, South Africa
| | - M J Groome
- Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of Witwatersrand, Johannesburg, South Africa
| | - J Moyes
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - S Walaza
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - J Mphahlele
- South African Medical Research Council/Diarrhoeal Pathogens Research Unit, Sefako Makgatho Health Sciences University, Medunsa, South Africa
| | - K Kahn
- MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt), School of Public Health, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - C N Kapongo
- Department of Paediatrics, Ngwelezane Hospital, Empangeni, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health/MRC Unit on Child & Adolescent Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - S Tempia
- Influenza Division, Centers for Disease Control and Prevention, Atlanta, GA, United States; Influenza Program, Centers for Disease Control and Prevention, Pretoria, South Africa; National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - C Cohen
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
| | - S A Madhi
- National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; Medical Research Council: Respiratory and Meningeal Pathogens Research Unit, University of the Witwatersrand, Johannesburg, South Africa; Department of Science and Technology/National Research Foundation: Vaccine Preventable Diseases, University of Witwatersrand, Johannesburg, South Africa
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Bousquet J, Hellings PW, Agache I, Bedbrook A, Bachert C, Bergmann KC, Bewick M, Bindslev-Jensen C, Bosnic-Anticevitch S, Bucca C, Caimmi DP, Camargos PAM, Canonica GW, Casale T, Chavannes NH, Cruz AA, De Carlo G, Dahl R, Demoly P, Devillier P, Fonseca J, Fokkens WJ, Guldemond NA, Haahtela T, Illario M, Just J, Keil T, Klimek L, Kuna P, Larenas-Linnemann D, Morais-Almeida M, Mullol J, Murray R, Naclerio R, O'Hehir RE, Papadopoulos NG, Pawankar R, Potter P, Ryan D, Samolinski B, Schunemann HJ, Sheikh A, Simons FER, Stellato C, Todo-Bom A, Tomazic PV, Valiulis A, Valovirta E, Ventura MT, Wickman M, Young I, Yorgancioglu A, Zuberbier T, Aberer W, Akdis CA, Akdis M, Annesi-Maesano I, Ankri J, Ansotegui IJ, Anto JM, Arnavielhe S, Asarnoj A, Arshad H, Avolio F, Baiardini I, Barbara C, Barbagallo M, Bateman ED, Beghé B, Bel EH, Bennoor KS, Benson M, Białoszewski AZ, Bieber T, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosse I, Bouchard J, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Bunu C, Burte E, Bush A, Caballero-Fonseca F, Calderon MA, Camuzat T, Cardona V, Carreiro-Martins P, Carriazo AM, Carlsen KH, Carr W, Cepeda Sarabia AM, Cesari M, Chatzi L, Chiron R, Chivato T, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, de Sousa JC, Cox L, Crooks G, Custovic A, Dahlen SE, Darsow U, Dedeu T, Deleanu D, Denburg JA, De Vries G, Didier A, Dinh-Xuan AT, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Du Toit G, Dykewicz MS, Eklund P, El-Gamal Y, Ellers E, Emuzyte R, Farrell J, Fink Wagner A, Fiocchi A, Fletcher M, Forastiere F, Gaga M, Gamkrelidze A, Gemicioğlu B, Gereda JE, van Wick RG, González Diaz S, Grisle I, Grouse L, Gutter Z, Guzmán MA, Hellquist-Dahl B, Heinrich J, Horak F, Hourihane JOB, Humbert M, Hyland M, Iaccarino G, Jares EJ, Jeandel C, Johnston SL, Joos G, Jonquet O, Jung KS, Jutel M, Kaidashev I, Khaitov M, Kalayci O, Kalyoncu AF, Kardas P, Keith PK, Kerkhof M, Kerstjens HAM, Khaltaev N, Kogevinas M, Kolek V, Koppelman GH, Kowalski ML, Kuitunen M, Kull I, Kvedariene V, Lambrecht B, Lau S, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen KC, Louis R, Lupinek C, MacNee W, Magar Y, Magnan A, Mahboub B, Maier D, Majer I, Malva J, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Mathieu-Dupas E, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Mercier J, Merk H, Miculinic N, Mihaltan F, Milenkovic B, Millot-Keurinck J, Mohammad Y, Momas I, Mösges R, Muraro A, Namazova-Baranova L, Nadif R, Neffen H, Nekam K, Nieto A, Niggemann B, Nogueira-Silva L, Nogues M, Nyembue TD, Ohta K, Okamoto Y, Okubo K, Olive-Elias M, Ouedraogo S, Paggiaro P, Pali-Schöll I, Palkonen S, Panzner P, Papi A, Park HS, Passalacqua G, Pedersen S, Pereira AM, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Pohl W, Popov TA, Portejoie F, Postma D, Poulsen LK, Price D, Rabe KF, Raciborski F, Roberts G, Robalo-Cordeiro C, Rodenas F, Rodriguez-Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rottem M, Sanchez-Borges M, Sastre-Dominguez J, Scadding GK, Scichilone N, Schmid-Grendelmeier P, Serrano E, Shields M, Siroux V, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Strandberg T, Sunyer J, Thijs C, Triggiani M, Valenta R, Valero A, van Eerd M, van Ganse E, van Hague M, Vandenplas O, Varona LL, Vellas B, Vezzani G, Vazankari T, Viegi G, Vontetsianos T, Wagenmann M, Walker S, Wang DY, Wahn U, Werfel T, Whalley B, Williams DM, Williams S, Wilson N, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M. ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle. Clin Transl Allergy 2016; 6:47. [PMID: 28050247 PMCID: PMC5203711 DOI: 10.1186/s13601-016-0137-4] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2016] [Accepted: 12/05/2016] [Indexed: 12/13/2022] Open
Abstract
The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.
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Affiliation(s)
- J Bousquet
- Montpellier University Hospital, Montpellier, France ; MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France ; CHRU Arnaud de Villeneuve, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
| | - P W Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - A Bedbrook
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - K C Bergmann
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - M Bewick
- iQ4U Consultants Ltd, London, UK
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - S Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - C Bucca
- University Pneumology Unit-AOU Molinette, Hospital City of Health and Science of Torino, Turin, Italy
| | - D P Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - P A M Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G W Canonica
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil ; GARD Executive Committee, Salvador, Bahia Brazil
| | - G De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - R Dahl
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Salvador, Brazil
| | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France ; EPAR U707 INSERM, Paris, France ; EPAR UMR-S UPMC, Paris VI, Paris, France
| | - P Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles, Saint-Quentin, France
| | - J Fonseca
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - N A Guldemond
- Institute of Health Policy and Management IBMG, Erasmus University, Rotterdam, The Netherlands
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - M Illario
- Federico II University Hospital Naples (R&D and DISMET), Naples, Italy
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies, Hôpital d'Enfants Armand-Trousseau (APHP), Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, 75013 Paris, France
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Würzburg, Germany
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, Mexico City, Mexico
| | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisbon, Portugal
| | - J Mullol
- ENT Department, Hospital Clinic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, CIBERES, Universitat de Barcelona, Barcelona, Catalonia Spain
| | - R Murray
- MedScript Ltd, Dundalk, County Louth, Ireland
| | - R Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL USA
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia ; Department of Immunology, Monash University, Melbourne, VIC Australia
| | - N G Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK ; Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - P Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D Ryan
- Woodbrook Medical Centre, Loughborough, UK ; Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - H J Schunemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - A Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh Medical School, Edinburgh, UK
| | - F E R Simons
- Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB Canada
| | - C Stellato
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - A Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - P V Tomazic
- Department of ENT, Medical University of Graz, Graz, Austria
| | - A Valiulis
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Public Health Institute, Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland ; Allergy Clinic, Terveystalo, Turku, Finland
| | - M T Ventura
- Unit of Geriatric Immunoallergology, University of Bari Medical School, Bari, Italy
| | - M Wickman
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - I Young
- Queen's University, Belfast, Northern Ireland, UK
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - T Zuberbier
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany ; Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - I Annesi-Maesano
- EPAR U707 INSERM, Paris, France ; EPAR UMR-S UPMC, Paris VI, Paris, France
| | - J Ankri
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J M Anto
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | | | - A Asarnoj
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatric Pulmonology and Allergy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - H Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | | | - I Baiardini
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - C Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - M Barbagallo
- Geriatric Unit, Department of Internal Medicine (DIBIMIS), University of Palermo, Palermo, Italy
| | - E D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - E H Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, Linköping University, 58185 Linköping, Sweden
| | - A Z Białoszewski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France ; EA 2991, Euromov, University Montpellier, Montpellier, France
| | - F Blasi
- Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca'Granda Ospedale Maggiore Policlinico, University of Milan, Milan, Italy
| | - A L Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | | | | | - L P Boulet
- Quebec Heart and Lung Institute, Laval University, Quebec City, QC Canada
| | - R Bourret
- Montpellier University Hospital, Montpellier, France
| | | | - F Braido
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - A H Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK ; Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J Brozek
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, ON Canada
| | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - C Bunu
- University of Medicine and Pharmacy Victor Babes, Timisoara, Romania
| | - E Burte
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - A Bush
- Royal Brompton Hospital NHS, Imperial College London, London, UK
| | | | - M A Calderon
- Royal Brompton Hospital NHS, Imperial College London, London, UK ; National Heart and Lung Institute, Imperial College London, London, UK
| | - T Camuzat
- Montpellier, Région Languedoc Roussillon France
| | - V Cardona
- S. Allergologia, S. Medicina Interna, Hospital Vall d'Hebron, Barcelona, Spain
| | - P Carreiro-Martins
- CEDOC, Respiratory Research Group, Nova Medical School, Campo dos Martires da Patria, Lisbon, Portugal ; Serviço de Imunoalergologia, Centro Hospitalar de Lisboa Central, EPE, Lisbon, Portugal
| | - A M Carriazo
- Regional Ministry of Health of Andalusia, Seville, Spain
| | - K H Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; University of Oslo, Oslo, Norway
| | - W Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia ; SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Cartagena, Colombia
| | - M Cesari
- Gérontopôle de Toulouse, 31059 Toulouse, France
| | - L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete Greece
| | - R Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - T Chivato
- School of Medicine, University CEU San Pablo, Madrid, Spain
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A G Chuchalin
- Pulmonolory Research Institute FMBA, Moscow, Russia ; GARD Executive Committee, Moscow, Russia
| | - K F Chung
- National Heart and Lung Institute, Imperial College London, London, UK
| | - G Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - J Correia de Sousa
- ICVS/3B's-PT Government Associate Laboratory, Life and Health Sciences, Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - L Cox
- Department of Medicine, Nova Southeastern University, Davie, FL USA
| | - G Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A Custovic
- Department of Pediatric, Imperial College London, London, UK
| | - S E Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Darsow
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany ; ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Munich, Germany
| | - T Dedeu
- AQuAS, Barcelona, Spain ; EUREGHA, European Regional and Local Health Association, Brussels, Belgium
| | - D Deleanu
- Allergology and Immunology Discipline, "Luliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J A Denburg
- Division of Clinical Immunology and Allergy, Department of Medicine, McMaster University, Hamilton, ON Canada
| | | | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A T Dinh-Xuan
- Service de Physiologie Respiratoire, Hôpital Cochin, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - D Dokic
- University Clinic of Pulmology and Allergy, Medical Faculty, Ss Cyril and Methodius University, Skopje, Republic of Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - G Du Toit
- Guy's and St Thomas' NHS Trust, Kings College London, London, UK
| | - M S Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - P Eklund
- Computing Science Department, Umeå University, Umeå, Sweden ; Four Computing Oy, Halikko, Finland
| | - Y El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - E Ellers
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania ; Public Health Institute, Vilnius University, Vilnius, Lithuania ; European Academy of Paediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - J Farrell
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - A Fink Wagner
- Global Allergy and Asthma Platform GAAPP, Altgasse 8-10, 1130 Vienna, Austria
| | - A Fiocchi
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children's Research Hospital Holy See, Rome, Italy
| | | | - F Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - M Gaga
- Athens Chest Hospital, Athens, Greece
| | - A Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - B Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - J E Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - R Gerth van Wick
- Section of Allergology, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - S González Diaz
- Universidad Autónoma de Nuevo León, San Nicolás de los Garza, Mexico
| | - I Grisle
- Center of Tuberculosis and Lung Diseases, Latvian Association of Allergists, Riga, Latvia
| | - L Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, Seattle, WA USA
| | - Z Gutter
- National eHealth Centre, University Hospital Olomouc, Olomouc, Czech Republic
| | - M A Guzmán
- Immunology and Allergy Division Clinical Hospital, University of Chile, Santiago, Chile
| | - B Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - J Heinrich
- Institute of Epidemiology I, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - F Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J O' B Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - M Humbert
- Université Paris-Sud, Le Kremlin Bicêtre, France ; Service de Pneumologie, Hôpital Bicêtre, Le Kremlin Bicêtre, France ; Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - M Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - G Iaccarino
- Department of Medicine and Surgery, University of Salerno, Baronissi, Italy
| | - E J Jares
- Libra Foundation, Buenos Aires, Argentina
| | - C Jeandel
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK ; MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - O Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K S Jung
- Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Gyeonggi-do South Korea
| | - M Jutel
- Department of Clinical Immunology, Wrocław Medical University, Wrocław, Poland
| | - I Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - M Khaitov
- Laboratory of Molecular Immunology, National Research Center, Institute of Immunology, Federal Medicobiological Agency, Moscow, Russia
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, School of Medicine, Hacettepe University, Ankara, Turkey
| | - A F Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - P Kardas
- First Department of Family Medicine, Medical University of Lodz, Lodz, Poland
| | - P K Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, 1280 Main Street West, Hamilton, ON Canada
| | - M Kerkhof
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - H A M Kerstjens
- Department of Pulmonary Diseases, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - M Kogevinas
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M L Kowalski
- Department of Immunology, Rheumatology and Allergy and HARC, Medical University of Lodz, Lodz, Poland
| | - M Kuitunen
- Children's Hospital, University of Helsinki, Helsinki, Finland
| | - I Kull
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - V Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - B Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | | | - L T T Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P Lieberman
- Divisions of Allergy and Immunology, Department of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN USA
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - K C Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - C Lupinek
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - W MacNee
- The Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Y Magar
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A Magnan
- Service de Pneumologie, UMR INSERM, UMR1087 and CNR 6291, l'institut du Thorax, University of Nantes, Nantes, France
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - D Maier
- Biomax Informatics AG, Munich, Germany
| | - I Majer
- Department of Respiratory Medicine, University of Bratislava, Bratislava, Slovakia
| | - J Malva
- Institute of Biomedical Imaging and Life Sciences (IBILI), Faculty of Medicine, University of Coimbra, Coimbra, Portugal ; Ageing@Coimbra EIP-AHA Reference Site, Coimbra, Portugal
| | - P Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | | | - G D Marshall
- Laboratory of Behavioral Immunology Research, Division of Clinical Immunology and Allergy, The University of Mississippi Medical Center, Jackson, MS USA
| | - M R Masjedi
- Tobacco Control Research Centre, Iranian Anti Tobacco Association, Tehran, Iran
| | | | - M Maurer
- Allergy-Centre-Charité, Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E Melén
- Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm, Sweden ; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melo-Gomes
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
| | - J Mercier
- Department of Physiology, CHRU, PhyMedExp, INSERM U1046, CNRS UMR 9214, University Montpellier, Montpellier, France
| | - H Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany
| | | | - F Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia ; Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - J Millot-Keurinck
- Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - Y Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - I Momas
- Department of Public Health and Health Products, EA 4064, Paris Descartes University-Sorbonne Paris Cité, Paris, France ; Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - L Namazova-Baranova
- Scientific Centre of Children's Health Under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R Nadif
- INSERM, U1168, Ageing and Chronic Diseases Epidemiological and Public Health Approaches, 94800 Villejuif, France
| | - H Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - A Nieto
- Neumología y Alergología Infantil, Hospital La Fe, Valencia, Spain
| | - B Niggemann
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - L Nogueira-Silva
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal ; Department of Internal Medicine, Centro Hospitalar Sao Joao, Porto, Portugal
| | - M Nogues
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France ; Caisse d'assurance retraite et de la santé au travail du Languedoc-Roussillon (CARSAT-LR), Montpellier, France
| | - T D Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - K Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - M Olive-Elias
- Montpellier University Hospital, Montpellier, France ; Institute of Health Policy and Management IBMG, Erasmus University, Rotterdam, The Netherlands ; Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I Pali-Schöll
- Department of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine, Medical University, Vienna, Austria
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - A Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - G Passalacqua
- Asthma and Allergy Clinic, Humanitas University, Rozzano, Milan, Italy
| | - S Pedersen
- University of Southern Denmark, Kolding, Denmark
| | - A M Pereira
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal ; Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal ; Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Rua Dr. Plácido da Costa, s/n, 4200-450 Porto, Portugal ; Allergy Unit, CUF-Porto Hospital and Institute, Porto, Portugal
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany ; Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R Picard
- Conseil Général de l'Economie, Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - B Pigearias
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - I Pin
- Département de pédiatrie, CHU de Grenoble, Grenoble, France
| | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, Croatia ; School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - W Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna, Austria
| | - T A Popov
- Clinic of Allergy and Asthma, Medical University Sofia, Sofia, Bulgaria
| | - F Portejoie
- MACVIA-France, Contre les MAladies Chroniques pour un VIeillissement Actif en France, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - D Postma
- University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - L K Poulsen
- Laboratory of Medical Allergology, Allergy Clinic, Copenhagen University Hospital at Gentofte, Copenhagen, Denmark
| | - D Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, Scotland, UK ; Research in Real-Life, Cambridge, UK
| | - K F Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, German Center for Lung Research (DZL), Grosshansdorf, Germany ; Department of Medicine, Christian Albrechts University, Airway Research Center North, German Center for Lung Research (DZL), Kiel, Germany
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - G Roberts
- NHS Foundation Trust, University Hospitals of Southampton, Southampton, UK
| | - C Robalo-Cordeiro
- Centre of Pneumology, Coimbra University Hospital, Coimbra, Portugal
| | - F Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | | | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - M Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma de Mallorca, Spain
| | - A Romano
- Allergy Unit, Complesso Integrato Columbus, Rome, Italy
| | - J Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - N Rosario
- Hospital de Clinicas, University of Parana, Curitiba, Brazil
| | - M Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente La Trinidad and Clínica El Avila, Caracas, Venezuela
| | | | - G K Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | | | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - E Serrano
- Otolaryngology and Head and Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - M Shields
- Child Health, Queen's University, Belfast, Northern Ireland, UK ; Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK
| | - V Siroux
- INSERM, Université Grenoble Alpes, IAB, U 1209, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Université Joseph Fourier, Grenoble, France
| | - J C Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa, Asunción, Paraguay
| | - I Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway ; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - H A Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Altgasse 8-10, 1130 Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - P J Sterk
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - T Strandberg
- European Union Geriatric Medicine Society (EUGMS), Helsinki, Finland
| | - J Sunyer
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain ; IMIM (Hospital del Mar Research Institute), Barcelona, Spain ; CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain ; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - C Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - M Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | | | - E van Ganse
- PELyon, Lyon, France ; HESPER 7425, Health Services and Performance Resarch, Université Claude Bernard Lyon, Villeurbanne, France
| | - M van Hague
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden ; Department of Pediatric Pulmonology and Allergy, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden ; University Hospital, Stockholm, Sweden
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - L L Varona
- Philippines Society of Allergy, Asthma and Immunology, Manila, Philippines
| | - B Vellas
- Gérontopôle de Toulouse, 31059 Toulouse, France
| | - G Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S. Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy ; Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - T Vazankari
- Finnish Lung Association (FILHA), Helsinki, Finland
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy ; CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Palermo, Italy
| | | | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - S Walker
- Asthma UK, Mansell Street, London, UK
| | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - U Wahn
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - T Werfel
- Division of Immunodermatology and Allergy Research, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - B Whalley
- School of Psychology, Plymouth University, Plymouth, UK
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
| | | | - N Wilson
- Northern Health Alliance, Newcastle, UK
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - B P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN USA
| | | | - O M Yusuf
- The Allergy and Asthma Institute, Lahore, Pakistan
| | - A Zaidi
- Social Sciences, University of Southampton, Southampton, UK
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, University of Cape Town, Cape Town, South Africa ; MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - M E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - L Zhang
- Department of Otolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, China ; Beijing Institute of Otolaryngology, Beijing, China
| | - N Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
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18
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Howells FM, Donald KA, Roos A, Woods RP, Zar HJ, Narr KL, Stein DJ. Reduced glutamate in white matter of male neonates exposed to alcohol in utero: a (1)H-magnetic resonance spectroscopy study. Metab Brain Dis 2016; 31:1105-12. [PMID: 27311608 PMCID: PMC6465962 DOI: 10.1007/s11011-016-9850-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
Abstract
In utero exposure to alcohol leads to a spectrum of fetal alcohol related disorders (FASD). However, few studies used have used proton magnetic resonance spectroscopy ((1)H-MRS) to understand how neurochemical disturbances relate to the pathophysiology of FASD. Further, no studies to date have assessed brain metabolites in infants exposed to alcohol in utero. We hypothesize that neonates exposed to alcohol in utero will show decreased glutamatergic activity, pre-emptive of their clinical diagnosis or behavioural phenotype. Single voxel (1)H-MRS data, sampled in parietal white and gray matter, were acquired from 36 neonates exposed to alcohol in utero, and 31 control unexposed healthy neonates, in their 2nd-4th week of life. Metabolites relative to creatine with phosophocreatine and metabolites absolute concentrations using a water reference are reported. Male infants exposed to alcohol in utero were found to have reduced concentration of glutamate with glutamine (Glx) in their parietal white matter (PWM), compared to healthy male infants (p = 0.02). Further, male infants exposed to alcohol in utero had reduced concentration and ratio for glutamate (Glu) in their PWM (p = 0.02), compared to healthy male infants and female infants exposed to alcohol in utero. Female infants showed higher relative Glx and Glu ratios for parietal gray matter (PGM, p < 0.01), compared to male infants. We speculate that the decreased Glx and Glu concentrations in PWM are a result of delayed oligodendrocyte maturation, which may be a result of dysfunctional thyroid hormone activity in males exposed to alcohol in utero. Further study is required to elucidate the relationship between Glx and Glu, thyroid hormone activity, and oligodendrocyte maturation in infants exposure to alcohol in utero.
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Affiliation(s)
- F M Howells
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
| | - K A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - A Roos
- Medical Research Council Anxiety and Stress Disorders Unit, University of Stellenbosch, Stellenbosch, South Africa
| | - R P Woods
- Departments of Neurology and of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and University of Cape Town, Cape Town, South Africa
| | - K L Narr
- Departments of Neurology and of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
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19
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Bousquet J, Farrell J, Crooks G, Hellings P, Bel EH, Bewick M, Chavannes NH, de Sousa JC, Cruz AA, Haahtela T, Joos G, Khaltaev N, Malva J, Muraro A, Nogues M, Palkonen S, Pedersen S, Robalo-Cordeiro C, Samolinski B, Strandberg T, Valiulis A, Yorgancioglu A, Zuberbier T, Bedbrook A, Aberer W, Adachi M, Agusti A, Akdis CA, Akdis M, Ankri J, Alonso A, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Bai C, Baiardini I, Bachert C, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Kheder AB, Bennoor KS, Benson M, Bergmann KC, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Blasi F, Boner AL, Bonini M, Bonini S, Bosnic-Anticevitch S, Boulet LP, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Caimmi D, Calderon MA, Calverley PM, Camargos PAM, Canonica GW, Camuzat T, Carlsen KH, Carr W, Carriazo A, Casale T, Cepeda Sarabia AM, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Chung KF, Ciprandi G, Cirule I, Cox L, Costa DJ, Custovic A, Dahl R, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, De Manuel Keenoy E, Demoly P, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fabbri LM, Fletcher M, Fiocchi A, Fink Wagner A, Fonseca J, Fokkens WJ, Forastiere F, Frith P, Gaga M, Gamkrelidze A, Garces J, Garcia-Aymerich J, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grisle I, Grouse L, Gutter Z, Guzmán MA, Heaney LG, Hellquist-Dahl B, Henderson D, Hendry A, Heinrich J, Heve D, Horak F, Hourihane JOB, Howarth P, Humbert M, Hyland ME, Illario M, Ivancevich JC, Jardim JR, Jares EJ, Jeandel C, Jenkins C, Johnston SL, Jonquet O, Julge K, Jung KS, Just J, Kaidashev I, Kaitov MR, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Klimek L, Koffi N’Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Lodrup Carlsen K, Louis R, MacNee W, Magard Y, Magnan A, Mahboub B, Mair A, Majer I, Makela MJ, Manning P, Mara S, Marshall GD, Masjedi MR, Matignon P, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Menzies-Gow A, Merk H, Michel JP, Miculinic N, Mihaltan F, Milenkovic B, Mohammad GMY, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Morgan M, Mösges R, Mullol J, Nafti S, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Ninot G, Nyembue TD, O’Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Panzner P, Papadopoulos N, Papi A, Park HS, Passalacqua G, Pavord I, Pawankar R, Pengelly R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Poethig D, Pohl W, Popov TA, Portejoie F, Potter P, Postma D, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Reitamo S, Rennard S, Rodenas F, Roberts J, Roca J, Rodriguez Mañas L, Rolland C, Roman Rodriguez M, Romano A, Rosado-Pinto J, Rosario N, Rosenwasser L, Rottem M, Ryan D, Sanchez-Borges M, Scadding GK, Schunemann HJ, Serrano E, Schmid-Grendelmeier P, Schulz H, Sheikh A, Shields M, Siafakas N, Sibille Y, Similowski T, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Sterk PJ, Sunyer J, Thijs C, To T, Todo-Bom A, Triggiani M, Valenta R, Valero AL, Valia E, Valovirta E, Van Ganse E, van Hage M, Vandenplas O, Vasankari T, Vellas B, Vestbo J, Vezzani G, Vichyanond P, Viegi G, Vogelmeier C, Vontetsianos T, Wagenmann M, Wallaert B, Walker S, Wang DY, Wahn U, Wickman M, Williams DM, Williams S, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zaidi A, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5). Clin Transl Allergy 2016; 6:29. [PMID: 27478588 PMCID: PMC4966705 DOI: 10.1186/s13601-016-0116-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 06/02/2016] [Indexed: 01/16/2023] Open
Abstract
Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.
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Affiliation(s)
- J. Bousquet
- CHRU, University Hospital, 371 Avenue du Doyen Gaston Giraud, 34295 Montpellier Cedex 5, France
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France
- UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - J. Farrell
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - G. Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - P. Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Louvain, Belgium
- European Academy of Allergy and Clinical Immunology, Zurich, Switzerland
| | - E. H. Bel
- Department of Respiratory Medicine, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
- European Respiratory Society, Lausanne, Switzerland
| | | | - N. H. Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
- International Primary Care Respiratory Group, Westhill, UK
| | - J. Correia de Sousa
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga, Portugal
| | - A. A. Cruz
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
- ProAR – Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brazil
- GARD Executive Committee, Bahia, Brazil
| | - T. Haahtela
- EIP on AHA Commitment for Action, Lisbon, Portugal
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - G. Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - N. Khaltaev
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
| | - J. Malva
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Ageing@Coimbra Reference Site, Coimbra, Portugal
| | - A. Muraro
- European Academy of Allergy and Clinical Immunology, Zurich, Switzerland
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - M. Nogues
- Caisse Assurance Retraite et Santé Au Travail Languedoc-Roussillon (CARSAT-LR), 34000 Montpellier, France
| | - S. Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - S. Pedersen
- University of Southern Denmark, Kolding, Denmark
| | | | - B. Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - T. Strandberg
- Helsinki University, Helsinki University Hospital, Helsinki, Finland
- Center for Life Course Health Research, University of Oulu, Oulu, Finland
- European Union GeriatricMedicine Society, EUGMS, Oslo, Norway
| | - A. Valiulis
- Center of Quality of Life Research, Vilnius University Clinic of Children’s Diseases, Vilnius University Public Health Institute, Vilnius, Lithuania
- European Association of Pediatrics (EAP/UEMS-SP), Brussels, Belgium
| | - A. Yorgancioglu
- Global Alliance Against Chronic Respiratory Diseases (GARD), Cape Town, South Africa
- EIP on AHA Commitment for Action, Lisbon, Portugal
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
- Turkish Thoracic Society, Antalya, Turkey
| | - T. Zuberbier
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - A. Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - W. Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - M. Adachi
- Department of Clinical Research Center, International University of Health and Welfare/Sanno Hospital, Tokyo, Japan
| | - A. Agusti
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - C. A. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M. Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - J. Ankri
- INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, Paris, France
- UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - A. Alonso
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
- CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - I. Annesi-Maesano
- EPAR U707 INSERM, Paris, France
- EPAR UMR-S UPMC, Paris VI, Paris, France
| | - I. J. Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J. M. Anto
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | | | - H. Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - C. Bai
- Shanghai Respiratory Research Institute, Vice President of Respiratory Society, Chinese Medical Association, China and Chinese Alliance Against Lung Cancer, Shanghai, China
| | - I. Baiardini
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - C. Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | | | - C. Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases (PNDR), Lisbon, Portugal
| | - E. D. Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B. Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - A. Ben Kheder
- Service de pneumologie IV, hôpital Abderrahman Mami, Ariana, 2080 Tunis, Tunisia
| | - K. S. Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M. Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, LInköping University, Linköping, Sweden
| | - K. C. Bergmann
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - T. Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - C. Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - L. Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H. Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
- EA 2991, Euromov, University Montpellier, Montpellier, France
| | - F. Blasi
- Department of Pathophysiology and Transplantation, IRCCS Fondazione Ca’Granda Ospedale Maggiore Policlinico, University of Milan, Via F. Sforza 35, Milan, Italy
| | - A. L. Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - M. Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S. Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - S. Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW Australia
| | - L. P. Boulet
- Quebec Heart and Lung Institute, Laval University, Québec City, QC Canada
| | - R. Bourret
- Directeur Général Adjoint, Montpellier University Hospital, Montpellier, France
| | | | - F. Braido
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - A. H. Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C. E. Brightling
- Respiratory Biomedical Unit, Institute of Lung Health, University Hospitals of Leicester NHS Trust, Leicestershire, UK
- Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J. Brozek
- Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC Room 2C16, 1280 Main Street West Hamilton, Hamilton, Canada
| | - R. Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - P. G. Burney
- National Heart and Lung Institute, Imperial College, London, London, UK
- Wellcome Centre for Global Health, Imperial College, London, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College, London, London, UK
| | - A. Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | | | - D. Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - M. A. Calderon
- National Heart and Lung Institute, Imperial College London, Royal Brompton Hospital NHS, London, UK
| | - P. M. Calverley
- Institute of Ageing and Chronic Disease, University of Liverpool and University Hospital Aintree, Liverpool, UK
| | - P. A. M. Camargos
- Department of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - G. W. Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - T. Camuzat
- Région Languedoc Roussillon, Montpellier, France
| | - K. H. Carlsen
- Department of Paediatrics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - W. Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA USA
| | - A. Carriazo
- Regional Ministry of Equality, Health and Social Policies of Andalusia, Seville, Spain
| | - T. Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL USA
| | - A. M. Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia
- Asma e Immunologia, SLaai, Sociedad Latinoamericana de Allergia, Barranquilla, Colombia
| | - L. Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, PO Box 2208, Heraklion, 71003 Crete Greece
| | - Y. Z. Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, China
| | - R. Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - E. Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A. G. Chuchalin
- GARD Executive Committee, Bahia, Brazil
- Pulmonolory Research Institute FMBA, Moscow, Russia
| | - K. F. Chung
- National Heart and Lung Institute, Imperial College, London, London, UK
| | - G. Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - I. Cirule
- Latvian Allergy Association, Riga, Latvia
| | - L. Cox
- Department of Medicine, Nova Southeastern University, Davie, FL USA
| | - D. J. Costa
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - A. Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - R. Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - S. E. Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U. Darsow
- Department of Dermatology and Allergy, Technische Universität München, Munich, Germany
- ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany
| | - G. De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients’ Associations, Brussels, Belgium
| | - F. De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T. Dedeu
- EUREGHA, European Regional and Local Health Association, Brussels, Belgium
- University of Edinburgh, Edinburgh, UK
| | - D. Deleanu
- Allergology and Immunology Discipline, “Iuliu Hatieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - P. Demoly
- EPAR U707 INSERM, Paris, France
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - J. A. Denburg
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON Canada
| | - P. Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, Suresnes, France
| | - A. Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A. T. Dinh-Xuan
- Service de physiologie respiratoire, Hôpital Cochin, Université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - R. Djukanovic
- NIHR Southampton Respiratory Biomedical Research Unit, Faculty of Medicine, University Southampton, Southampton, UK
| | - D. Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, Republic Macedonia
| | - H. Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G. Dray
- Ecole des Mines, Alès, France
| | - R. Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S. R. Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M. S. Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MO USA
| | - Y. El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - R. Emuzyte
- Clinic of Children’s Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | | | | | - A. Fiocchi
- Division of Allergy, Department of Pediatric Medicine, The Bambino Gesù Children’s Research Hospital Holy See, Rome, Italy
| | - A. Fink Wagner
- Global Allergy and Asthma Platform (GAAPP), Altgasse 8-10, 1130 Vienna, Austria
| | - J. Fonseca
- Center for Health Technology and Services Research - CINTESIS, Faculdade de Medicina, Universidade do Porto, Porto, Portugal
- Allergy Unit, CUF Porto Instituto & Hospital, Porto, Portugal
| | - W. J. Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - F. Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - P. Frith
- Repatriation General Hospital, Adelaide, SOUTH AUSTRALIA Australia
| | - M. Gaga
- Athens Chest Hospital, Athens, Greece
| | - A. Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - J. Garces
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - J. Garcia-Aymerich
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | - B. Gemicioğlu
- Department of Pulmonary Diseases, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - J. E. Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - S. González Diaz
- Universidad Autónoma de Nuevo León, San Nicolás De La Garza, Mexico
| | - M. Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - I. Grisle
- Latvian Association of Allergists, Center of Tuberculosis and Lung Diseases, Riga, Latvia
| | - L. Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, St. Louis, MO USA
| | - Z. Gutter
- University Hospital Olomouc – National eHealth Centre, Olomouc, Czech Republic
| | - M. A. Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - L. G. Heaney
- Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen’s University Belfast, Belfast, UK
| | - B. Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - D. Henderson
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Scottish Centre for Telehealth and Telecare, NHS 24, Glasgow, UK
| | - A. Hendry
- NHS Scotland, Edinburgh, Scotland, UK
| | - J. Heinrich
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - D. Heve
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- Agence Régionale de Santé, 34067 Montpellier Cedex 2, France
| | - F. Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J. O’. B. Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - P. Howarth
- University of Southampton Faculty of Medicine, University Hospital Southampton, Southampton, UK
| | - M. Humbert
- Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Université Paris-Sud, Le Kremlin Bicêtre, France
| | - M. E. Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - M. Illario
- Federico II University Hospital/Campania RS, Naples, Italy
| | - J. C. Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - J. R. Jardim
- Universidade Federal de Sao Paulo, São Paulo, Brazil
| | | | - C. Jeandel
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France
| | - C. Jenkins
- The George Institute for Global Health, The University of Sydney, Camperdown, Australia
| | - S. L. Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, London, UK
- MRC and Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - O. Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K. Julge
- Children’s Clinic of Tartu University Hospital, Tartu, Estonia
| | - K. S. Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-Do, South Korea
| | - J. Just
- Allergology Department, Centre de l’Asthme et des Allergies, Hôpital d’Enfants Armand-Trousseau (APHP), Paris, France
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d’Epidémiologie et de Santé Publique, Equipe EPAR, 75013 Paris, France
| | - I. Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - M. R. Kaitov
- Federal Medicobiological Agency, Laboratory of Molecular Immunology, Institute of Immunology, National Research Center, Moscow, Russian Federation
| | - O. Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A. F. Kalyoncu
- Immunology and Allergy Division, Department of Chest Diseases, School of Medicine, Hacettepe University, Ankara, Turkey
| | - T. Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - P. K. Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, 1280 Main Street West, Hamilton, Canada
| | - L. Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - B. Koffi N’Goran
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - V. Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G. H. Koppelman
- GRIACResearch Institute, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children’s Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - M. L. Kowalski
- Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, and HARC, Lodz, Poland
| | - I. Kull
- Sachs’ Children’s Hospital, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P. Kuna
- Division of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V. Kvedariene
- Clinic of Infectious, Chest Diseases, Dermatology and Allergology, Vilnius University, Vilnius, Lithuania
| | - B. Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S. Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - D. Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, Ciudad De México, Mexico
| | - D. Laune
- Digi Health, Montpellier, France
| | - L. T. T. Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P. Lieberman
- Divisions of Allergy and Immunology, Departments of Internal Medicine and Pediatrics, University of Tennessee College of Medicine, Germantown, TN USA
| | - B. Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular and Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J. Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 China
| | - K. Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - R. Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - W. MacNee
- Queen’s Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Y. Magard
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A. Magnan
- Service de Pneumologie, UMR INSERM, UMR1087and CNR 6291, l’institut du thorax, University of Nantes, Nantes, France
| | - B. Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - A. Mair
- Scottish Government Health Department, eHealth and Pharmaceuticals, Edinburgh, UK
| | - I. Majer
- Department of Respiratory Medicine, University of Bratislava, Bratislava, Slovakia
| | - M. J. Makela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P. Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | - S. Mara
- Cardiovascular and Thoracic Department, AOU Città della Salute e della Scienza di Torino, Turin, Italy
| | - G. D. Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS USA
| | - M. R. Masjedi
- Respiratory Medicine Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - M. Maurer
- Allergie-Centrum-Charité at the Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S. Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E. Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E. Melo-Gomes
- PNDR/Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E. O. Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA USA
| | | | - H. Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Germany
| | - J. P. Michel
- European Union GeriatricMedicine Society, EUGMS, Oslo, Norway
| | | | - F. Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B. Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - G. M. Y. Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - M. Molimard
- Département de Pharmacologie, CHU de Bordeaux, Universite Bordeaux, INSERM U657, Bordeaux Cedex, France
| | - I. Momas
- Department of Public Health and Biostatistics, EA 4064, Paris Descartes University, Paris, France
- Paris Municipal Department of Social Action, Childhood, and Health, Paris, France
| | | | - M. Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisbon, Portugal
| | - M. Morgan
- National Clinical Director for Respiratory Services, NHS England, Leeds, England, UK
| | - R. Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - J. Mullol
- Sachs’ Children’s Hospital, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Unitat de Rinologia i Clínica de l’Olfacte, Servei d’ORL, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - S. Nafti
- Mustapha Hospital, Algers, Algeria
| | - L. Namazova-Baranova
- Scientific Centre of Children’s Health Under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R. Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL USA
| | - A. Neou
- Allergy-Centre-Charité at the Department of Dermatology, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Secretary General of the Global Allergy and Asthma European Network (GA²LEN), Berlin, Germany
| | - H. Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K. Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - B. Niggemann
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - G. Ninot
- EA4556 Epsylon, Université Montpellier 1, Montpellier, France
| | - T. D. Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - R. E. O’Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, VIC Australia
- Department of Immunology, Monash University, Melbourne, VIC Australia
| | - K. Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y. Okamoto
- Department of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K. Okubo
- Department of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S. Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P. Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I. Pali-Schöll
- Department of Comparative Medicine, Messerli, Research Institute of the University of Veterinary Medicine and Medical University, Vienna, Austria
| | - P. Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - N. Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children’s Hospital, University of Manchester, Manchester, M13 9WL UK
- Allergy Department, 2nd Pediatric Clinic, Athens General Children’s Hospital “P&A Kyriakou”, University of Athens, Athens, 11527 Greece
| | - A. Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H. S. Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - G. Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, IRCCS AOU San Martino-IST, University of Genoa, Genoa, Italy
| | - I. Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - R. Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - R. Pengelly
- Department of Health, Social Services and Public Safety, Belfast, Northern Ireland, UK
| | - O. Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - R. Picard
- Conseil Général de l’Economie. Ministère de l’Economie, de l’Industrie et du Numérique, Paris, France
| | - B. Pigearias
- Société de Pneumologie de Langue Française, Espace francophone de Pneumologie, Paris, France
| | - I. Pin
- Département de pédiatrie, CHU de Grenoble, BP 217, 38043 Grenoble Cedex 9, France
| | - D. Plavec
- Children’s Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - D. Poethig
- Im GerontoLab Europe - Europäische Vereinigung für Vitalität und Aktives Altern (eVAA) e.V., Leipzig, Germany
| | - W. Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Wolkersbergenstraße 1, 1130 Vienna, Austria
| | - T. A. Popov
- Clinic of Allergy and Asthma, Medical University Sofia, 1Sv. Georgi Sofiyski St., 1431 Sofia, Bulgaria
| | - F. Portejoie
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc Roussilon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - P. Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D. Postma
- Department of Pulmonary Medicine and Tuberculosis, GRIAC Research Institute, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - D. Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK
- Research in Real-Life, Cambridge, UK
| | - K. F. Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research (DZL), Grosshansdorf, Germany
- Department of Medicine, Christian Albrechts University, Airway Research Center North, Member of the German Center for Lung Research (DZL), Kiel, Germany
| | - F. Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - F. Radier Pontal
- Conseil Départemental de l’Ordre des Pharmaciens, Maison des Professions Libérales, 34000 Montpellier, France
| | | | - S. Reitamo
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - S. Rennard
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Nebraska Medical Center, Omaha, NE USA
| | - F. Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - J. Roberts
- Salford, Royal NHS Foundation Trust and NHS England North, London, UK
| | - J. Roca
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - L. Rodriguez Mañas
- Hospital Universitario de Getafe-Servicio Madrileño de Salud, Madrid, Spain
| | - C. Rolland
- Association Asthme et Allergie, Paris, France
| | - M. Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma De Mallorca, Spain
| | - A. Romano
- Allergy Unit, Complesso integrato Columbus, Rome, Italy
| | - J. Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisbon, Portugal
| | - N. Rosario
- Hospital de Clinicas, University of Parana, Curitiba, PR Brazil
| | - L. Rosenwasser
- Department of Allergy, Asthma, and Immunology, Children’s Mercy Hospitals and Clinics and Pediatrics, Medicine University of Misouri-Kansas City School of Medicine, Kansas City, MO USA
| | - M. Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - D. Ryan
- Woodbrook Medical Centre, Loughborough, UK
- Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - M. Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad and Clínica El Avila, 6a transversal Urb, Altamira, piso 8, consultorio 803, Caracas, 1060 Venezuela
| | - G. K. Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | - H. J. Schunemann
- Department of Clinical Epidemiology and Biostatistics, McMaster University, HSC Room 2C16, 1280 Main Street West Hamilton, Hamilton, Canada
| | - E. Serrano
- Otolaryngology and Head and Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - P. Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland
| | - H. Schulz
- Helmholtz Zentrum München/Institute of Epidemiology I, Neuherberg, Germany
| | - A. Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, Medical School, The University of Edinburgh, Edinburgh, UK
| | - M. Shields
- Child Health, Queen’s University Belfast and Royal Belfast Hospital for Sick Children, Belfast, UK
| | - N. Siafakas
- Department of Thoracic Medicine, University Hospital of Heraklion, Crete, Greece
| | - Y. Sibille
- University Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium
| | - T. Similowski
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- INSERM, UMR_S 1158 Neurophysiologie Respiratoire Expérimentale et Clinique, Paris, France
- Department R3S, AP-HP, Groupe, Paris, France
| | - F. E. R. Simons
- Department of Pediatrics and Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB Canada
| | - J. C. Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunología, Asunción, Paraguay
| | - I. Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H. A. Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D. Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T. Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal Medicine, Euro-Asian Respiratory Society, Bishkek, Kyrgyzstan
| | - O. Spranger
- Global Allergy and Asthma Platform (GAAPP), Altgasse 8-10, 1130 Vienna, Austria
| | - R. Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, São Paulo, Brazil
| | - P. J. Sterk
- Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J. Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Hospital del Mar Research Institute (IMIM), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
- Department of Experimental and Health Sciences, University of Pompeu Fabra (UPF), Barcelona, Spain
| | - C. Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - T. To
- Sidkkids hospitala and Institute of Health Policy, Management and Evaluation, Toronto, ON Canada
| | - A. Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M. Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R. Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A. L. Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical and Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - E. Valia
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - E. Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - E. Van Ganse
- Unité de Pharmacoépidémiologie, CHU-Lyon - UR 5558 CNRS, Université Claude Bernard, Lyon, Villeurbanne, France
| | - M. van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - O. Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - T. Vasankari
- FILHA, Finnish Lung Association, Helsinki, Finland
| | - B. Vellas
- Gérontopôle, CHU Toulouse, Toulouse, France
| | - J. Vestbo
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK
- University Hospital of South Manchester, Manchester NHS Foundation Trust, Manchester, UK
| | - G. Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy
- Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - P. Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, 10700 Thailand
| | - G. Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Via Trieste 41, 56126 Pisa, Italy
- CNR Institute of Biomedicine and Molecular Immunology “A. Monroy”, Via U. La Malfa 153, 90146 Palermo, Italy
| | - C. Vogelmeier
- Department of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Marburg, Germany
| | | | - M. Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - B. Wallaert
- Hôpital Albert Calmette, CHRU, Lille, France
| | - S. Walker
- Asthma UK, Mansell Street, London, UK
| | - D. Y. Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - U. Wahn
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - M. Wickman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - D. M. Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC USA
| | - S. Williams
- International Primary Care Respiratory Group, Westhill, UK
| | - J. Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UK
| | - B. P. Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN USA
| | - P. K. Yiallouros
- Cyprus International Institute for Environmental and Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
- Department of Pediatrics, Hospital “Archbishop Makarios III”, Nicosia, Cyprus
| | - O. M. Yusuf
- The Allergy and Asthma Institute, Lahore, Pakistan
| | - A. Zaidi
- Social Sciences, University of Southampton, Southampton, UK
| | - H. J. Zar
- Department of Paediatrics and Child Health, Red Cross Children’s Hospital, and MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | | | - L. Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730 China
| | - N. Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120 China
| | - M. Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - J. Mercier
- Department of Physiology, CHRU and Vice President for Research, University Montpellier, Montpellier, France
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Green RJ, Zar HJ. Acute viral bronchiolitis in South Africa: Diagnosis and current management. S Afr Med J 2016; 106:24. [PMID: 27303778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
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White DA, Zar HJ, Madhi SA, Jeena P, Morrow B, Masekela R, Risenga S, Green R. Acute viral bronchiolitis in South Africa: Diagnostic flow. S Afr Med J 2016; 106:25-26. [PMID: 27303779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Bronchiolitis may be diagnosed on the basis of clinical signs and symptoms. In a young child, the diagnosis can be made on the clinical pattern of wheezing and hyperinflation. Clinical symptoms and signs typically start with an upper respiratory prodrome, including rhinorrhoea, low-grade fever, cough and poor feeding, followed 1 - 2 days later by tachypnoea, hyperinflation and wheeze as a consequence of airway inflammation and air trapping.The illness is generally self limiting, but may become more severe and include signs such as grunting, nasal flaring, subcostal chest wall retractions and hypoxaemia. The most reliable clinical feature of bronchiolitis is hyperinflation of the chest, evident by loss of cardiacdullness on percussion, an upper border of the liver pushed down to below the 6th intercostal space, and the presence of a Hoover sign(subcostal recession, which occurs when a flattened diaphragm pulls laterally against the lower chest wall).Measurement of peripheral arterial oxygen saturation is useful to indicate the need for supplemental oxygen. A saturation of <92% at sea level and 90% inland indicates that the child has to be admitted to hospital for supplemental oxygen. Chest radiographs are generally unhelpful and not required in children with a clear clinical diagnosis of bronchiolitis.Blood tests are not needed routinely. Complete blood count tests have not been shown to be useful in diagnosing bronchiolitis or guiding its therapy. Routine measurement of C-reactive protein does not aid in management and nasopharyngeal aspirates are not usually done.Viral testing adds little to routine management. Risk factors in patients with severe bronchiolitis that require hospitalisation and may even cause death, include prematurity, congenital heart disease and congenital lung malformations.
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Zar HJ, Madhi SA, White DA, Masekela R, Risenga S, Lewis H, Feldman C, Morrow B, Jeena P. Acute viral bronchiolitis in South Africa: Strategies for management and prevention. S Afr Med J 2016; 106:27-29. [PMID: 27303780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Management of acute viral bronchiolitis is largely supportive. There is currently no proven effective therapy other than oxygen for hypoxic children. The evidence indicates that there is no routine benefit from inhaled, rapid short-acting bronchodilators, adrenaline or ipratropium bromide for children with acute viral bronchiolitis. Likewise, there is no demonstrated benefit from routine use of inhaled or oral corticosteroids, inhaled hypertonic saline nebulisation, montelukast or antibiotics. The last should be reserved for children with severe disease, when bacterial co-infection is suspected. Prevention of respiratory syncytial virus (RSV) disease remains a challenge. A specific RSV monoclonal antibody, palivizumab, administered as an intramuscular injection, is available for children at risk of severe bronchiolitis, including premature infants, young children with chronic lung disease, immunodeficiency, or haemodynamically significant congenital heart disease. Prophylaxis should be commenced at the start of the RSV season and given monthly during the season. The development of an RSV vaccine may offer a more effective alternative to prevent disease, for which the results of clinical trials are awaited. Education of parents or caregivers and healthcare workers about diagnostic and management strategies should include the following: bronchiolitis is caused by a virus; it is seasonal; it may start as an upper respiratory tract infection with low-grade fever; symptoms are cough and wheeze, often with fast breathing; antibiotics are generally not needed; and the condition is usually self limiting, although symptoms may occur for up to four weeks in some children.
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Gray DM, Workman LJ, Lombard CJ, Jennings T, Innes S, Grobbelaar CJ, Cotton MF, Zar HJ. Isoniazid preventive therapy in HIV-infected children on antiretroviral therapy: a pilot study. Int J Tuberc Lung Dis 2015; 18:322-7. [PMID: 24670570 DOI: 10.5588/ijtld.13.0354] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Tuberculosis (TB) is a common cause of mortality and morbidity in children infected with the human immunodeficiency virus (HIV). Data on isoniazid preventive therapy (IPT) efficacy in HIV-infected children receiving antiretroviral therapy (ART) are inconclusive. OBJECTIVE To assess the efficacy, tolerability and safety of isoniazid (INH) in HIV-infected children on ART. DESIGN A pilot randomised controlled study of INH was undertaken in HIV-infected children on ART. The primary outcome measure was TB disease or death. RESULTS A total of 167 children were randomised to receive INH (n = 85) or placebo (n = 82), and followed for a median of 34 months (interquartile range [IQR] 24-52). The median age was 35 months (IQR 15-65). There was one death in a child on INH and none in the placebo group. Eleven (6.6%) cases of TB occurred, 4 (5%) in the INH and 7 (9%) in the placebo group. Among the TB cases, 5 were culture confirmed-2 in the INH group and 3 in the placebo group, all susceptible to INH. Severe adverse events occurred rarely (n = 6; 2%). CONCLUSION IPT is safe and well tolerated in HIV-infected children on concomitant ART. This study supports the need for a larger study to assess efficacy in HIV-infected children living in TB-endemic areas.
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Affiliation(s)
- D M Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - L J Workman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - C J Lombard
- Biostatistics Unit, Medical Research Council, Cape Town, South Africa
| | - T Jennings
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - S Innes
- Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - C J Grobbelaar
- Anova Health Institute, TC Newman Hospital, Paarl, South Africa
| | - M F Cotton
- Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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Bousquet J, Schunemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW, Casale T, Cruz AA, Demoly P, Hellings P, Valiulis A, Wickman M, Zuberbier T, Bosnic-Anticevitch S, Bedbrook A, Bergmann KC, Caimmi D, Dahl R, Fokkens WJ, Grisle I, Lodrup Carlsen K, Mullol J, Muraro A, Palkonen S, Papadopoulos N, Passalacqua G, Ryan D, Valovirta E, Yorgancioglu A, Aberer W, Agache I, Adachi M, Akdis CA, Akdis M, Annesi-Maesano I, Ansotegui IJ, Anto JM, Arnavielhe S, Arshad H, Baiardini I, Baigenzhin AK, Barbara C, Bateman ED, Beghé B, Bel EH, Ben Kheder A, Bennoor KS, Benson M, Bewick M, Bieber T, Bindslev-Jensen C, Bjermer L, Blain H, Boner AL, Boulet LP, Bonini M, Bonini S, Bosse I, Bourret R, Bousquet PJ, Braido F, Briggs AH, Brightling CE, Brozek J, Buhl R, Burney PG, Bush A, Caballero-Fonseca F, Calderon MA, Camargos PAM, Camuzat T, Carlsen KH, Carr W, Cepeda Sarabia AM, Chavannes NH, Chatzi L, Chen YZ, Chiron R, Chkhartishvili E, Chuchalin AG, Ciprandi G, Cirule I, Correia de Sousa J, Cox L, Crooks G, Costa DJ, Custovic A, Dahlen SE, Darsow U, De Carlo G, De Blay F, Dedeu T, Deleanu D, Denburg JA, Devillier P, Didier A, Dinh-Xuan AT, Dokic D, Douagui H, Dray G, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, Emuzyte R, Fink Wagner A, Fletcher M, Fiocchi A, Forastiere F, Gamkrelidze A, Gemicioğlu B, Gereda JE, González Diaz S, Gotua M, Grouse L, Guzmán MA, Haahtela T, Hellquist-Dahl B, Heinrich J, Horak F, Hourihane JO', Howarth P, Humbert M, Hyland ME, Ivancevich JC, Jares EJ, Johnston SL, Joos G, Jonquet O, Jung KS, Just J, Kaidashev I, Kalayci O, Kalyoncu AF, Keil T, Keith PK, Khaltaev N, Klimek L, Koffi N'Goran B, Kolek V, Koppelman GH, Kowalski ML, Kull I, Kuna P, Kvedariene V, Lambrecht B, Lau S, Larenas-Linnemann D, Laune D, Le LTT, Lieberman P, Lipworth B, Li J, Louis R, Magard Y, Magnan A, Mahboub B, Majer I, Makela MJ, Manning P, De Manuel Keenoy E, Marshall GD, Masjedi MR, Maurer M, Mavale-Manuel S, Melén E, Melo-Gomes E, Meltzer EO, Merk H, Miculinic N, Mihaltan F, Milenkovic B, Mohammad Y, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Mösges R, Namazova-Baranova L, Naclerio R, Neou A, Neffen H, Nekam K, Niggemann B, Nyembue TD, O'Hehir RE, Ohta K, Okamoto Y, Okubo K, Ouedraogo S, Paggiaro P, Pali-Schöll I, Palmer S, Panzner P, Papi A, Park HS, Pavord I, Pawankar R, Pfaar O, Picard R, Pigearias B, Pin I, Plavec D, Pohl W, Popov TA, Portejoie F, Postma D, Potter P, Price D, Rabe KF, Raciborski F, Radier Pontal F, Repka-Ramirez S, Robalo-Cordeiro C, Rolland C, Rosado-Pinto J, Reitamo S, Rodenas F, Roman Rodriguez M, Romano A, Rosario N, Rosenwasser L, Rottem M, Sanchez-Borges M, Scadding GK, Serrano E, Schmid-Grendelmeier P, Sheikh A, Simons FER, Sisul JC, Skrindo I, Smit HA, Solé D, Sooronbaev T, Spranger O, Stelmach R, Strandberg T, Sunyer J, Thijs C, Todo-Bom A, Triggiani M, Valenta R, Valero AL, van Hage M, Vandenplas O, Vezzani G, Vichyanond P, Viegi G, Wagenmann M, Walker S, Wang DY, Wahn U, Williams DM, Wright J, Yawn BP, Yiallouros PK, Yusuf OM, Zar HJ, Zernotti ME, Zhang L, Zhong N, Zidarn M, Mercier J. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation. Allergy 2015; 70:1372-92. [PMID: 26148220 DOI: 10.1111/all.12686] [Citation(s) in RCA: 137] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/28/2015] [Indexed: 12/20/2022]
Abstract
Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.
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Affiliation(s)
- J Bousquet
- University Hospital, Montpellier, France.,MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,INSERM, VIMA: Ageing and Chronic Diseases, Epidemiological and Public Health Approaches, Paris, France.,UVSQ, UMR-S 1168, Université Versailles St-Quentin-en-Yvelines, Paris, France
| | - H J Schunemann
- Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - J Fonseca
- Center for Research in Health Technologies and Information Systems - CINTESIS, Universidade do Porto, Porto, Portugal.,Allergy Unit, Instituto CUF Porto e Hospital CUF Porto, Porto, Portugal.,Health Information and Decision Sciences Department - CIDES, Faculdade de Medicina, Universidade do Porto, Porto, Portugal.,Faculdade de Medicina da Universidade do Porto, Porto, Portugal
| | - B Samolinski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - C Bachert
- Upper Airways Research Laboratory, ENT Department, Ghent University Hospital, Ghent, Belgium
| | - G W Canonica
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - T Casale
- Division of Allergy/Immunology, University of South Florida, Tampa, FL, USA
| | - A A Cruz
- ProAR - Nucleo de Excelencia em Asma, Federal University of Bahia, Bahia, Brasil.,GARD Executive Committee, Bahia, Brasil
| | - P Demoly
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France.,EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris, France
| | - P Hellings
- Laboratory of Clinical Immunology, Department of Microbiology and Immunology, KU Leuven, Leuven, Belgium
| | - A Valiulis
- Vilnius University Clinic of Children's Diseases, Vilnius, Lithuania
| | - M Wickman
- Sachs' Children's Hospital, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - T Zuberbier
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - S Bosnic-Anticevitch
- Woolcock Institute of Medical Research, University of Sydney and Sydney Local Health District, Glebe, NSW, Australia
| | - A Bedbrook
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - K C Bergmann
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - D Caimmi
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - R Dahl
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Centre, Amsterdam, The Netherlands
| | - I Grisle
- Latvian Association of Allergists, Center of Tuberculosis and Lung Diseases of Latvia, Riga, Latvia
| | - K Lodrup Carlsen
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - J Mullol
- Unitat de Rinologia i Clínica de l'Olfacte, Servei d'ORL, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Catalonia, Spain
| | - A Muraro
- Food Allergy Referral Centre Veneto Region, Department of Women and Child Health, Padua General University Hospital, Padua, Italy
| | - S Palkonen
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - N Papadopoulos
- Center for Pediatrics and Child Health, Institute of Human Development, Royal Manchester Children's Hospital, University of Manchester, Manchester, UK.,Allergy Department, 2nd Pediatric Clinic, Athens General Children's Hospital "P&A Kyriakou", University of Athens, Athens, Greece
| | - G Passalacqua
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - D Ryan
- General Practitioner, Woodbrook Medical Centre, Loughborough, UK.,Honorary Clinical Research Fellow, Allergy and Respiratory Research Group, The University of Edinburgh, Edinburgh, UK
| | - E Valovirta
- Department of Lung Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - A Yorgancioglu
- Department of Pulmonology, Celal Bayar University, Manisa, Turkey
| | - W Aberer
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - I Agache
- Transylvania University Brasov, Brasov, Romania
| | - M Adachi
- Department of Clinical Research Center, International University of Health and Welfare/Sanno Hospital, Tokyo, Japan
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - M Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | | | - I J Ansotegui
- Department of Allergy and Immunology, Hospital Quirón Bizkaia, Erandio, Spain
| | - J M Anto
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Spain.,Department of Experimental and Health Sciences, University of Pompeu Fabra, Barcelona, Spain
| | | | - H Arshad
- David Hide Asthma and Allergy Research Centre, Isle of Wight, UK
| | - I Baiardini
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - C Barbara
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E D Bateman
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - B Beghé
- Section of Respiratory Disease, Department of Oncology, Haematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy
| | - E H Bel
- Department of Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - A Ben Kheder
- Service de Pneumologie IV, Hôpital Abderrahman Mami, Ariana, Tunisie
| | - K S Bennoor
- Department of Respiratory Medicine, National Institute of Diseases of the Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualized Medicine, Department of Pediatrics, Faculty of Medicine, Linköping University, Linköping, Sweden
| | - M Bewick
- Deputy National Medical Director, NHS England, England, UK
| | - T Bieber
- Department of Dermatology and Allergy, Rheinische Friedrich-Wilhelms-University Bonn, Bonn, Germany
| | - C Bindslev-Jensen
- Department of Dermatology and Allergy Centre, Odense University Hospital, Odense, Denmark
| | - L Bjermer
- Department of Respiratory Medicine and Allergology, University Hospital, Lund, Sweden
| | - H Blain
- Department of Geriatrics, Montpellier University Hospital, Montpellier, France.,EA 2991 Movement To Health, Euromov, University Montpellier, Montpellier, France
| | - A L Boner
- Pediatric Department, University of Verona Hospital, Verona, Italy
| | - L P Boulet
- Québec Heart and Lung Institute, Laval University, Québec City, QC, Canada
| | - M Bonini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | - S Bonini
- Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - I Bosse
- Allergist, La Rochelle, France
| | - R Bourret
- Directeur Général Adjoint, Montpellier University Hospital, Montpellier, France
| | - P J Bousquet
- EPAR U707 INSERM, Paris, France.,EPAR UMR-S UPMC, Paris, France
| | - F Braido
- Allergy and Respiratory Diseases Clinic, DIMI, University of Genoa, IRCCS AOU San Martino-IST, Genoa, Italy
| | - A H Briggs
- Health Economics and Health Technology Assessment, Institute of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - C E Brightling
- Institute of Lung Health, Respiratory Biomedical Unit, University Hospitals of Leicester NHS Trust, Leicestershire, UK.,Department of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - J Brozek
- Department of Clinical Epidemiology and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - R Buhl
- Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Mainz, Germany
| | - P G Burney
- National Heart and Lung Institute, Imperial College, London, UK.,Wellcome Centre for Global Health, Imperial College, London, UK.,MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - A Bush
- Imperial College and Royal Brompton Hospital, London, UK
| | | | - M A Calderon
- Imperial College London - National Heart and Lung Institute, Royal Brompton Hospital NHS, London, UK
| | - P A M Camargos
- Federal University of Minas Gerais, Medical School, Department of Pediatrics, Belo Horizonte, Brazil
| | - T Camuzat
- Assitant Director General, Montpellier, France.,Région Languedoc Roussillon, Roussillon, France
| | - K H Carlsen
- Department of Paediatrics, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - W Carr
- Allergy and Asthma Associates of Southern California, Mission Viejo, CA, USA
| | - A M Cepeda Sarabia
- Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia.,SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia, Barranquilla, Colombia
| | - N H Chavannes
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - L Chatzi
- Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Y Z Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, China
| | - R Chiron
- Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - A G Chuchalin
- Pulmonolory Research Institute FMBA, Moscow, Russia.,GARD Executive Committee, Moscow, Russia
| | - G Ciprandi
- Medicine Department, IRCCS-Azienda Ospedaliera Universitaria San Martino, Genoa, Italy
| | - I Cirule
- Latvian Association of Allergists, University Children Hospital of Latvia, Riga, Latvia
| | - J Correia de Sousa
- Life and Health Sciences Research Institute, ICVS, School of Health Sciences, University of Minho, Braga, Portugal
| | - L Cox
- Department of Medicine, Nova Southeastern University, Davie, FL, USA
| | - G Crooks
- European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Glasgow, UK
| | - D J Costa
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France.,Department of Respiratory Diseases, Montpellier University Hospital, Montpellier, France
| | - A Custovic
- Centre for Respiratory Medicine and Allergy, Institute of Inflammation and Repair, University of Manchester and University Hospital of South Manchester, Manchester, UK
| | - S E Dahlen
- The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - U Darsow
- Department of Dermatology and Allergy, Technische Universität Mänchen, Munich, Germany.,ZAUM-Center for Allergy and Environment, Helmholtz Center Munich, Technische Universität München, Munich, Germany
| | - G De Carlo
- EFA European Federation of Allergy and Airways Diseases Patients' Associations, Brussels, Belgium
| | - F De Blay
- Allergy Division, Chest Disease Department, University Hospital of Strasbourg, Strasbourg, France
| | - T Dedeu
- European Regional and Local Health Association, Brussels, Belgium
| | - D Deleanu
- Allergology and Immunology Discipline, "Iuliu Hatieganu" University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - J A Denburg
- Department of Medicine, Division of Clinical Immunology and Allergy, McMaster University, Hamilton, ON, Canada
| | - P Devillier
- Laboratoire de Pharmacologie Respiratoire UPRES EA220, Hôpital Foch, Suresnes Université Versailles Saint-Quentin, Versailles Saint-Quentin, France
| | - A Didier
- Respiratory Diseases Department, Rangueil-Larrey Hospital, Toulouse, France
| | - A T Dinh-Xuan
- Service de physiologie, Hôpital Cochin, Université Paris-Descartes, Assistance publique-Hôpitaux de Paris, Paris, France
| | - D Dokic
- Medical Faculty Skopje, University Clinic of Pulmology and Allergy, Skopje, R. Macedonia
| | - H Douagui
- Service de Pneumo-Allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algers, Algeria
| | - G Dray
- Ecole des Mines, Alès, France
| | - R Dubakiene
- Medical Faculty, Vilnius University, Vilnius, Lithuania
| | - S R Durham
- Allergy and Clinical Immunology Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - M S Dykewicz
- Section of Allergy and Immunology, Saint Louis University School of Medicine, Saint Louis, MI, USA
| | - Y El-Gamal
- Pediatric Allergy and Immunology Unit, Ain Shams University, Cairo, Egypt
| | - R Emuzyte
- Clinic of Children's Diseases, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - A Fink Wagner
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | | | - A Fiocchi
- Allergy Department, The Bambino Gesù Children's Research Hospital Holy see, Rome, Italy
| | - F Forastiere
- Department of Epidemiology, Regional Health Service Lazio Region, Rome, Italy
| | - A Gamkrelidze
- National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - B Gemicioğlu
- Turkish Thoracic Society Asthma-Allergy Working Group, Kocaeli, Turkey
| | - J E Gereda
- Allergy and Immunology Division, Clinica Ricardo Palma, Lima, Peru
| | - S González Diaz
- Sociedad Latinoamericana de Allergia, Asma e Immunologia, Mexico City, Mexico
| | - M Gotua
- Center of Allergy and Immunology, Georgian Association of Allergology and Clinical Immunology, Tbilisi, Georgia
| | - L Grouse
- Faculty of the Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
| | - M A Guzmán
- Immunology and Allergy Division, Clinical Hospital, University of Chile, Santiago, Chile
| | - T Haahtela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - B Hellquist-Dahl
- Department of Respiratory Diseases, Odense University Hospital, Odense, Denmark
| | - J Heinrich
- Institute of Epidemiology I, German Research Centre for Environmental Health, Helmholtz Zentrum München, Neuherberg, Germany
| | - F Horak
- Vienna Challenge Chamber, Vienna, Austria
| | - J O 'b Hourihane
- Department of Paediatrics and Child Health, University College Cork, Cork, Ireland
| | - P Howarth
- University of Southampton Faculty of Medicine, University Hospital Southampton, Southampton, UK
| | - M Humbert
- Université Paris-Sud, Le Kremlin Bicêtre, France.,Service de Pneumologie, Hôpital Bicêtre, Inserm UMR_S999, Le Kremlin Bicêtre, France
| | - M E Hyland
- School of Psychology, Plymouth University, Plymouth, UK
| | - J C Ivancevich
- Servicio de Alergia e Immunologia, Clinica Santa Isabel, Buenos Aires, Argentina
| | - E J Jares
- Libra Foundation, Buenos Aires, Argentina
| | - S L Johnston
- Airway Disease Infection Section, National Heart and Lung Institute, Imperial College, London, UK.,MRC & Asthma UK Centre in Allergic Mechanisms of Asthma, London, UK
| | - G Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - O Jonquet
- Medical Commission, Montpellier University Hospital, Montpellier, France
| | - K S Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - J Just
- Allergology Department, Centre de l'Asthme et des Allergies. Hôpital d'Enfants Armand-Trousseau, Paris, France.,Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Equipe EPAR, Paris, France
| | - I Kaidashev
- Ukrainian Medical Stomatological Academy, Poltava, Ukraine
| | - O Kalayci
- Pediatric Allergy and Asthma Unit, Hacettepe University School of Medicine, Ankara, Turkey
| | - A F Kalyoncu
- School of Medicine, Department of Chest Diseases, Immunology and Allergy Division, Hacettepe University, Ankara, Turkey
| | - T Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
| | - P K Keith
- Department of Medicine, McMaster University, Health Sciences Centre 3V47, Hamilton, ON, Canada
| | | | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - B Koffi N'Goran
- Société de Pneumologie de Langue Française et Espace Francophone de Pneumologie, Paris, France
| | - V Kolek
- Department of Respiratory Medicine, Faculty of Medicine and Dentistry, University Hospital Olomouc, Olomouc, Czech Republic
| | - G H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M L Kowalski
- Department of Immunology, Rheumatology and Allergy, Medical University of Lodz, Lodz, Poland
| | - I Kull
- Sachs' Children's Hospital, Stockholm, Sweden.,Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - P Kuna
- Division of Internal Medicine, Asthma and Allergy, KUNA, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- Pulmonology and Allergology Center, Vilnius University, Vilnius, Lithuania
| | - B Lambrecht
- VIB Inflammation Research Center, Ghent University, Ghent, Belgium
| | - S Lau
- Department for Pediatric Pneumology and Immunology, Charité Medical University, Berlin, Germany
| | - D Larenas-Linnemann
- Clínica de Alergia, Asma y Pediatría, Hospital Médica Sur, México City, México
| | - D Laune
- Digi Health, Montpellier, France
| | - L T T Le
- University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - P Lieberman
- Departments of Internal Medicine and Pediatrics (Divisions of Allergy and Immunology), University of Tennessee College of Medicine, Germantown, TN, USA
| | - B Lipworth
- Scottish Centre for Respiratory Research, Cardiovascular & Diabetes Medicine, Medical Research Institute, Ninewells Hospital, University of Dundee, Dundee, UK
| | - J Li
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - R Louis
- Department of Pulmonary Medicine, CHU Sart-Tilman, Liege, Belgium
| | - Y Magard
- Service de Pneumo-allergologie, Hôpital Saint-Joseph, Paris, France
| | - A Magnan
- Service de Pneumologie, University of Nantes, UMR INSERM, UMR1087/CNR 6291, l'Institut du Thorax, Nantes, France
| | - B Mahboub
- Department of Pulmonary Medicine, Rashid Hospital, Dubai, UAE
| | - I Majer
- Department of Respiratory Medicine, University Hospital, Bratislava, Slovakia
| | - M J Makela
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - P Manning
- Department of Medicine (RCSI), Bon Secours Hospital, Glasnevin, Dublin, Ireland
| | | | - G D Marshall
- Division of Clinical Immunology and Allergy, Laboratory of Behavioral Immunology Research, The University of Mississippi Medical Center, Jackson, MS, USA
| | - M R Masjedi
- Respiratory Disease Research, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - M Maurer
- Allergie-Centrum-Charité at the Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - S Mavale-Manuel
- Department of Paediatrics, Maputo Central Hospital, Maputo, Mozambique
| | - E Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - E Melo-Gomes
- Faculdade de Medicina de Lisboa, Portuguese National Programme for Respiratory Diseases, Lisbon, Portugal
| | - E O Meltzer
- Allergy and Asthma Medical Group and Research Center, San Diego, CA, USA
| | - H Merk
- Hautklinik - Klinik für Dermatologie & Allergologie, Universitätsklinikum der RWTH Aachen, Aachen, Deutschland
| | | | - F Mihaltan
- National Institute of Pneumology M. Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia.,Serbian Association for Asthma and COPD, Belgrade, Serbia
| | - Y Mohammad
- National Center for Research in Chronic Respiratory Diseases, Tishreen University School of Medicine, Latakia, Syria
| | - M Molimard
- Département de Pharmacologie, CHU de Bordeaux, Université Bordeaux, INSERM U657, Bordeaux Cedex, France
| | - I Momas
- Department of Public Health and Biostatistics, Paris Descartes University, Paris, France.,Paris Municipal Department of Social Action, Childhood and Health, Paris, France
| | | | - M Morais-Almeida
- Allergy and Clinical Immunology Department, Hospital CUF-Descobertas, Lisboa, Portugal
| | - R Mösges
- Institute of Medical Statistics, Informatics and Epidemiology, Medical Faculty, University of Cologne, Cologne, Germany
| | - L Namazova-Baranova
- Scientific Centre of Children's Health under the Russian Academy of Medical Sciences, Moscow, Russia
| | - R Naclerio
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medical Center and The Pritzker School of Medicine, The University of Chicago, Chicago, IL, USA
| | - A Neou
- Department of Dermatology and Allergy, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Member of the Global Allergy and Asthma European Network (GA2LEN), Oslo, Norway
| | - H Neffen
- Hospital de Niños Orlando Alassia, Santa Fe, Argentina
| | - K Nekam
- Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - B Niggemann
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - T D Nyembue
- ENT Department, University Hospital of Kinshasa, Kinshasa, Congo
| | - R E O'Hehir
- Department of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Central Clinical School, Monash University, Melbourne, Vic., Australia.,Department of Immunology, Monash University, Melbourne, Vic., Australia
| | - K Ohta
- National Hospital Organization, Tokyo National Hospital, Tokyo, Japan
| | - Y Okamoto
- Depatment of Otorhinolaryngology, Chiba University Hospital, Chiba, Japan
| | - K Okubo
- Depatment of Otolaryngology, Nippon Medical School, Tokyo, Japan
| | - S Ouedraogo
- Centre Hospitalier Universitaire Pédiatrique Charles de Gaulle, Ouagadougou, Burkina Faso
| | - P Paggiaro
- Cardio-Thoracic and Vascular Department, University Hospital of Pisa, Pisa, Italy
| | - I Pali-Schöll
- Dept. of Comparative Medicine, Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University and University Vienna, Vienna, Austria.,Messerli Research Institute of the University of Veterinary Medicine Vienna, Medical University and University Vienna, Vienna, Austria
| | - S Palmer
- Centre for Health Economics, University of York, York, UK
| | - P Panzner
- Department of Immunology and Allergology, Faculty of Medicine and Faculty Hospital in Pilsen, Charles University in Prague, Pilsen, Czech Republic
| | - A Papi
- Respiratory Medicine, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - H S Park
- Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, South Korea
| | - I Pavord
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - R Pawankar
- Department of Pediatrics, Nippon Medical School, Tokyo, Japan
| | - O Pfaar
- Center for Rhinology and Allergology, Wiesbaden, Germany.,Department of Otorhinolaryngology, Head and Neck Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany
| | - R Picard
- Conseil Général de l'Economie. Ministère de l'Economie, de l'Industrie et du Numérique, Paris, France
| | - B Pigearias
- Société de Pneumologie de Langue Française et Espace Francophone de Pneumologie, Paris, France
| | - I Pin
- Département de pédiatrie, CHU de Grenoble, Grenoble cedex 9, France
| | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - W Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Hietzing Hospital, Vienna, Austria
| | - T A Popov
- Clinic of Allergy & Asthma, Medical University Sofia, Sofia, Bulgaria
| | - F Portejoie
- MACVIA-LR, Contre les MAladies Chroniques pour un VIeillissement Actif en Languedoc - Roussillon, European Innovation Partnership on Active and Healthy Ageing Reference Site, Montpellier, France
| | - D Postma
- Department of Pulmonary Medicine and Tuberculosis, GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - P Potter
- Allergy Diagnostic and Clinical Research Unit, University of Cape Town Lung Institute, Cape Town, South Africa
| | - D Price
- Academic Centre of Primary Care, University of Aberdeen, Aberdeen, UK.,Research in Real-Life, Cambridge, UK
| | - K F Rabe
- LungenClinic Grosshansdorf, Airway Research Center North, Member of the German Center for Lung Research, Grosshansdorf, Germany.,Department of Medicine, Christian Albrechts University, Airway Research Center North, Member of the German Center for Lung Research, Kiel, Germany
| | - F Raciborski
- Department of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - F Radier Pontal
- Conseil Départemental de l'Ordre des Pharmaciens, Maison des Professions Libérales, Montpellier, France
| | | | - C Robalo-Cordeiro
- Allergy and Clinical Immunology Department, Hospitais da Universidade de Coimbra, Coimbra, Portugal
| | - C Rolland
- Association Asthme et Allergie, Paris, France
| | - J Rosado-Pinto
- Serviço de Imunoalergologia, Hospital da Luz, Lisboa, Portugal
| | - S Reitamo
- Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - F Rodenas
- Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - M Roman Rodriguez
- Primary Care Respiratory Research Unit, Institutode Investigación Sanitaria de Palma IdisPa, Palma de Mallorca, Spain
| | - A Romano
- Allergy Unit, Complesso Integrato Columbus, Rome, Italy
| | - N Rosario
- Hospital de Clinicas, University of Parana, Parana, Brazil
| | - L Rosenwasser
- Department of Allergy, Asthma and Immunology, Children's Mercy Hospitals and Clinics and Pediatrics and Medicine University of Misouri-Kansas City School of Medicine, Kansas City, MI, USA
| | - M Rottem
- Division of Allergy Asthma and Clinical Immunology, Emek Medical Center, Afula, Israel
| | - M Sanchez-Borges
- Allergy and Clinical Immunology Department, Centro Médico-Docente la, Trinidad, Venezuela.,Clínica El Avila, 6a transversal Urb, Caracas, Venezuela
| | - G K Scadding
- The Royal National TNE Hospital, University College London, London, UK
| | - E Serrano
- Otolaryngology and Head & Neck Surgery, CHU Rangueil-Larrey, Toulouse, France
| | - P Schmid-Grendelmeier
- Allergy Unit, Department of Dermatology, University Hospital of Zurich, Zürich, Switzerland
| | - A Sheikh
- Allergy and Respiratory Research Group, Medical School, Centre for Population Health Sciences, The University of Edinburgh, Edinburgh, UK
| | - F E R Simons
- Department of Pediatrics & Child Health, Department of Immunology, Faculty of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - J C Sisul
- Sociedad Paraguaya de Alergia Asma e Inmunologıa, Paraguay, Paraguay
| | - I Skrindo
- Department of Paediatrics, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - H A Smit
- Julius Center of Health Sciences and Primary Care, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
| | - D Solé
- Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil
| | - T Sooronbaev
- Kyrgyzstan National Centre of Cardiology and Internal medicine, Euro-Asian respiratory Society, Bishkek, Kyrgyzstan
| | - O Spranger
- Global Allergy and Asthma Platform GAAPP, Vienna, Austria
| | - R Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - T Strandberg
- European Union GeriatricMedicine Society, Vienna, Austria
| | - J Sunyer
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,CIBER Epidemiología y Salud Pública, Barcelona, Spain.,Department of Experimental and Health Sciences, University of Pompeu Fabra, Barcelona, Spain
| | - C Thijs
- Department of Epidemiology, CAPHRI School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - A Todo-Bom
- Centre of Pneumology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - M Triggiani
- Division of Allergy and Clinical Immunology, University of Salerno, Salerno, Italy
| | - R Valenta
- Division of Immunopathology, Department of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A L Valero
- Pneumology and Allergy Department, Hospital Clínic, Clinical & Experimental Respiratory Immunoallergy, IDIBAPS, Barcelona, Spain
| | - M van Hage
- Clinical Immunology and Allergy Unit, Department of Medicine Solna, Karolinska Institutet and University Hospital, Stockholm, Sweden
| | - O Vandenplas
- Department of Chest Medicine, Centre Hospitalier Universitaire Dinant-Godinne, Université Catholique de Louvain, Yvoir, Belgium
| | - G Vezzani
- Pulmonary Unit, Department of Cardiology, Thoracic and Vascular Medicine, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy.,Regional Agency for Health and Social Care, Reggio Emilia, Italy
| | - P Vichyanond
- Division of Allergy and Immunology, Department of Pediatrics, Siriraj Hospital, Mahidol University Faculty of Medicine, Bangkok, Thailand
| | - G Viegi
- Pulmonary Environmental Epidemiology Unit, CNR Institute of Clinical Physiology, Pisa, Italy.,CNR Institute of Biomedicine and Molecular Immunology "A. Monroy", Palermo, Italy
| | - M Wagenmann
- Department of Otorhinolaryngology, HNO-Klinik, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | | | - D Y Wang
- Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore City, Singapore
| | - U Wahn
- Pediatric Pneumology and Immunology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - J Wright
- Bradford Institute for Health Research, Bradford Royal Infirmary, Bradford, UJ, USA
| | - B P Yawn
- Department of Research, Olmsted Medical Center, Rochester, MN, USA
| | - P K Yiallouros
- Cyprus International Institute for Environmental & Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.,Department of Pediatrics, Hospital "Archbishop Makarios III", Nicosia, Cyprus
| | - O M Yusuf
- The Allergy and Asthma Institute, Islamabad, Pakistan
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross Children's Hospital, MRC Unit on Child & Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - M E Zernotti
- Universidad Católica de Córdoba, Córdoba, Argentina
| | - L Zhang
- Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - N Zhong
- State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - M Zidarn
- University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - J Mercier
- Vice President for Research, University Montpellier, Montpellier, France
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Zar HJ, Jeena P, Argent A, Gie R, Madhi SA. Diagnosis and management of community—acquired pneumonia in childhood—South African Thoracic Society guidelines. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/10158782.2009.11441336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Cape Town, South Africa MRC Unit on Child and Adolescent Health, University of Cape Town, Cape Town, South Africa
| | - F P Polack
- Department of Pediatrics, Vanderbilt University, Nashville, Tennessee, USA Fundacion INFANT, Buenos Aires, Argentina
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Stein DJ, Koen N, Donald KA, Adnams CM, Koopowitz S, Lund C, Marais A, Myers B, Roos A, Sorsdahl K, Stern M, Tomlinson M, van der Westhuizen C, Vythilingum B, Myer L, Barnett W, Brittain K, Zar HJ. Investigating the psychosocial determinants of child health in Africa: The Drakenstein Child Health Study. J Neurosci Methods 2015; 252:27-35. [PMID: 25797842 DOI: 10.1016/j.jneumeth.2015.03.016] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Revised: 03/11/2015] [Accepted: 03/12/2015] [Indexed: 01/06/2023]
Abstract
BACKGROUND Early life psychobiological and psychosocial factors play a key role in influencing child health outcomes. Longitudinal studies may help elucidate the relevant risk and resilience profiles, and the underlying mechanisms that impact on child health, but there is a paucity of birth cohort data from low and middle-income countries (LMIC). We describe the rationale for and present baseline findings from the psychosocial component of the Drakenstein Child Health Study (DCHS). METHODS We review the psychosocial measures used in the DCHS, a multidisciplinary birth cohort study in a peri-urban area in South Africa, and provide initial data on psychological distress, depression, substance use, and exposure to traumatic stressors and intimate partner violence (IPV). These and other measures will be assessed longitudinally in mothers in order to investigate associations with child neurodevelopmental and health outcomes. RESULTS Baseline psychosocial data is presented for mothers (n=634) and fathers (n=75) who have completed antenatal assessments to date. The sample of pregnant mothers is characterized by multiple psychosocial risk factors, including a high prevalence of psychological distress and depression, high levels of substance use, and high exposure to traumatic stressors and IPV. DISCUSSION These data are consistent with prior South African studies which have documented a high prevalence of a multitude of risk factors during pregnancy. Further longitudinal assessment of mothers and children may clarify the underlying psychobiological and psychosocial mechanisms which impact on child health, and so inform clinical and public health interventions appropriate to the South African and other LMIC contexts.
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Affiliation(s)
- D J Stein
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa.
| | - N Koen
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa
| | - K A Donald
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - C M Adnams
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - S Koopowitz
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - C Lund
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - A Marais
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - B Myers
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, South Africa
| | - A Roos
- Medical Research Council (MRC), Unit on Anxiety & Stress Disorders, South Africa; Department of Psychiatry, Stellenbosch University, South Africa
| | - K Sorsdahl
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - M Stern
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - M Tomlinson
- Department of Psychology, Stellenbosch University, South Africa
| | - C van der Westhuizen
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - B Vythilingum
- Department of Psychiatry and Mental Health, University of Cape Town, South Africa
| | - L Myer
- School of Public Health and Family Medicine, University of Cape Town, South Africa
| | - W Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - K Brittain
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital and Medical Research Council Unit on Child & Adolescent Health, University of Cape Town, South Africa
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Amlabu V, Mulligan C, Jele N, Evans A, Gray D, Zar HJ, McIlleron H, Smith P. Isoniazid/acetylisoniazid urine concentrations: markers of adherence to isoniazid preventive therapy in children. Int J Tuberc Lung Dis 2015; 18:528-30. [PMID: 24903787 DOI: 10.5588/ijtld.13.0730] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The Arkansas colorimetric method monitors adherence to isoniazid (INH) by the detection of INH metabolites in urine. Urine samples 4 h after INH administration in 31 human immunodeficiency virus infected children receiving daily or thrice weekly INH preventive therapy were Arkansas test-positive for 29/31 (94%), while acetylisoniazid (AcINH) was detected in 30/31 (97%) using mass spectrometry. At 24, 48 and 72 h, only 78%, 23% and 0 samples, respectively, were Arkansas-positive, while INH or AcINH was detected in respectively 94%, 69% and 33%. The Arkansas test reliably predicted INH ingestion at a clinic visit 4 h after morning doses, but did not perform well at 24 h.
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Affiliation(s)
- V Amlabu
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - C Mulligan
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - N Jele
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - A Evans
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - D Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - H McIlleron
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - P Smith
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
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Gray DM, Willemse L, Alberts A, Simpson S, Sly PD, Hall GL, Zar HJ. Lung function in African infants: a pilot study. Pediatr Pulmonol 2015; 50:49-54. [PMID: 24339198 PMCID: PMC4312776 DOI: 10.1002/ppul.22965] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 10/14/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND The burden of childhood respiratory illness is large in low and middle income countries (LMICs). Infant lung function (ILF) testing may provide useful information about lung growth and susceptibility to respiratory disease. However, ILF has not been widely available in LMICs settings where the greatest burden of childhood respiratory disease occurs. AIM To implement and evaluate a pilot study of ILF testing in a semi-rural setting in South Africa. METHOD Infant lung function testing was established at a community hospital in South Africa. All measures were done in unsedated infants during sleep. Measurements, made with the infant quietly breathing through a face mask and bacterial filter, included tidal breathing (TBFVL), exhaled nitric oxide (eNO), and sulphur hexafluoride multiple breath washout (MBW) measures using an ultrasonic flow meter and chemoluminescent NO analyzer. RESULTS Twenty infants, mean age of 7.7 (SD 2.9) weeks were tested; 8 (40%) were Black African and 12 (60%) were mixed race. Five (25%) infants were preterm. There were 19 (95%) successful TBFVL and NO tests and 18 (90%) successful MBW tests. The mean tidal volume was 30.5 ml (SD 5.9), respiratory rate 50.2 breaths per minute (SD 8.7), and eNO 10.4 ppb (SD 7.3). The mean MBW measures were: functional residual capacity 71 ml (SD 13) and the lung clearance index 7.6 (SD 0.5). The intra-subject coefficient of variations (CV) of lung function measures were similar to published normative data for Caucasian European infants. CONCLUSION In this study we demonstrate that unsedated infant lung function measures of tidal breathing, MBW, and eNO are feasible in a semi-rural African setting with rates comparable to those reported from high income countries.
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Affiliation(s)
- D M Gray
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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Abstract
The lack of an accurate, rapid diagnostic test for mycobacterium tuberculosis (TB) is a major handicap in the management of spinal TB. GeneXpert, a new, rapid molecular diagnostic test is recommended as the first line investigation for suspected pulmonary TB in areas with a high prevalence of HIV or drug resistance, yet it has not been validated for the diagnosis of musculoskeletal TB. The aim of this study was to assess the accuracy of GeneXpert in diagnosing spinal TB. A prospective clinical study of 69 consecutive adults with suspected spinal TB was conducted at a tertiary hospital in an area with the highest incidence and prevalence of TB in the world. GeneXpert was used on tissue samples of the enrolled patients and its diagnostic accuracy compared with a reference standard of tissue in liquid culture. A total of 71 spine samples from 69 patients (two re-biopsies) were included in the study. The GeneXpert test showed a sensitivity of 95.6% and specificity of 96.2% for spinal TB. The results of the GeneXpert test were available within 48 hours compared with a median of 35 days (IQR 15 to 43) for cultures. All cases of multi-drug resistant TB (MDR TB) were diagnosed accurately with the GeneXpert test. The MDR TB rate was 5.8%.
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Affiliation(s)
- M Held
- Department of Orthopaedic Surgery, University of Cape Town, H49 Old Main Building, Groote Schuur Hospital, Observatory 7925, South Africa
| | - M Laubscher
- Department of Orthopaedic Surgery, University of Cape Town, H49 Old Main Building, Groote Schuur Hospital, Observatory 7925, South Africa
| | - H J Zar
- Department of Pediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, South Africa
| | - R N Dunn
- Department of Orthopaedic Surgery, University of Cape Town, H49 Old Main Building, Groote Schuur Hospital, Observatory 7925, South Africa
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Zar HJ, Barnett W, Myer L, Stein DJ, Nicol MP. Investigating the early-life determinants of illness in Africa: the Drakenstein Child Health Study. Thorax 2014; 70:592-4. [PMID: 25228292 PMCID: PMC5107608 DOI: 10.1136/thoraxjnl-2014-206242] [Citation(s) in RCA: 134] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 08/30/2014] [Indexed: 12/04/2022]
Abstract
Respiratory disease is the predominant cause of illness in children globally. We describe a unique multidisciplinary South African birth cohort, the Drakenstein Child Health Study (DCHS), to investigate the incidence, risk factors, aetiology and long-term impact of early lower respiratory tract infection (LRTI) on child health. Pregnant women from a poor, peri-urban community with high exposure to infectious diseases and environmental risk factors are enrolled with 1000 mother–child pairs followed for at least 5 years. Biomedical, environmental, psychosocial and demographic risk factors are longitudinally measured. Environmental exposures are measured using monitors placed at home visits. Lung function is measured in children at 6 weeks, annually and during LRTI episodes. Microbiological investigations including microbiome and multiplex PCR measures are done longitudinally and at LRTI episodes. The DCHS is a unique African birth cohort study that uses sophisticated measures to comprehensively investigate the early-life determinants of child health in an impoverished area of the world.
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Affiliation(s)
- H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - W Barnett
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - L Myer
- Division of Epidemiology and Biostatistics, School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - D J Stein
- Department of Psychiatry and Mental Health and MRC Unit on Anxiety & Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - M P Nicol
- Department of Clinical Laboratory Sciences, University of Cape Town, Cape Town, South Africa
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Planting NS, Visser GL, Nicol MP, Workman L, Isaacs W, Zar HJ. Safety and efficacy of induced sputum in young children hospitalised with suspected pulmonary tuberculosis. Int J Tuberc Lung Dis 2014; 18:8-12. [PMID: 24365546 DOI: 10.5588/ijtld.13.0132] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Induced sputum (IS) is increasingly used to provide specimens for microbiological confirmation of Mycobacterium tuberculosis. The aim of this study was to investigate the safety of and yield from IS in children hospitalised with suspected pulmonary tuberculosis (PTB). METHODS In a prospective study of children hospitalised with suspected PTB in Cape Town, South Africa, between February 2009 and February 2012, two IS specimens were obtained on consecutive days or at intervals of at least 4 hours. Specimens were investigated for M. tuberculosis using concentrated fluorescent acid-fast smear, liquid culture and GeneXpert(®) MTB/RIF. The safety of IS was assessed by recording clinical signs and symptoms before and for 30 min after sputum induction. RESULTS Among 843 children enrolled, at least one IS was performed for 823 (97.6%). The safety of sputum induction was recorded for 690 children (median age 27.3 months [IQR 13.4-64.2]), representing a total of 1270 IS procedures. Of these, 129 (18.7%) had at least one sputum culture positive for M. tuberculosis. Side effects were epistaxis (249, 19.4%) or wheezing (14, 1.1%). The median drop in oxygen saturation during the IS procedure was 1%. CONCLUSION Sputum induction is a safe and useful method for the microbiological confirmation of tuberculosis (TB) in young children.
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Affiliation(s)
- N S Planting
- Erasmus Medical Centre, Rotterdam, The Netherlands
| | - G L Visser
- Erasmus Medical Centre, Rotterdam, The Netherlands
| | - M P Nicol
- Division of Medical Microbiology, Institute for Infectious Diseases and Molecular Medicine, University of Cape Town, National Health Laboratory Service, Groote Schuur Hospital, Cape Town, South Africa
| | - L Workman
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - W Isaacs
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
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Bousquet J, Addis A, Adcock I, Agache I, Agusti A, Alonso A, Annesi-Maesano I, Anto JM, Bachert C, Baena-Cagnani CE, Bai C, Baigenzhin A, Barbara C, Barnes PJ, Bateman ED, Beck L, Bedbrook A, Bel EH, Benezet O, Bennoor KS, Benson M, Bernabeu-Wittel M, Bewick M, Bindslev-Jensen C, Blain H, Blasi F, Bonini M, Bonini S, Boulet LP, Bourdin A, Bourret R, Bousquet PJ, Brightling CE, Briggs A, Brozek J, Buhl R, Bush A, Caimmi D, Calderon M, Calverley P, Camargos PA, Camuzat T, Canonica GW, Carlsen KH, Casale TB, Cazzola M, Cepeda Sarabia AM, Cesario A, Chen YZ, Chkhartishvili E, Chavannes NH, Chiron R, Chuchalin A, Chung KF, Cox L, Crooks G, Crooks MG, Cruz AA, Custovic A, Dahl R, Dahlen SE, De Blay F, Dedeu T, Deleanu D, Demoly P, Devillier P, Didier A, Dinh-Xuan AT, Djukanovic R, Dokic D, Douagui H, Dubakiene R, Eglin S, Elliot F, Emuzyte R, Fabbri L, Fink Wagner A, Fletcher M, Fokkens WJ, Fonseca J, Franco A, Frith P, Furber A, Gaga M, Garcés J, Garcia-Aymerich J, Gamkrelidze A, Gonzales-Diaz S, Gouzi F, Guzmán MA, Haahtela T, Harrison D, Hayot M, Heaney LG, Heinrich J, Hellings PW, Hooper J, Humbert M, Hyland M, Iaccarino G, Jakovenko D, Jardim JR, Jeandel C, Jenkins C, Johnston SL, Jonquet O, Joos G, Jung KS, Kalayci O, Karunanithi S, Keil T, Khaltaev N, Kolek V, Kowalski ML, Kull I, Kuna P, Kvedariene V, Le LT, Lodrup Carlsen KC, Louis R, MacNee W, Mair A, Majer I, Manning P, de Manuel Keenoy E, Masjedi MR, Melen E, Melo-Gomes E, Menzies-Gow A, Mercier G, Mercier J, Michel JP, Miculinic N, Mihaltan F, Milenkovic B, Molimard M, Momas I, Montilla-Santana A, Morais-Almeida M, Morgan M, N'Diaye M, Nafti S, Nekam K, Neou A, Nicod L, O'Hehir R, Ohta K, Paggiaro P, Palkonen S, Palmer S, Papadopoulos NG, Papi A, Passalacqua G, Pavord I, Pigearias B, Plavec D, Postma DS, Price D, Rabe KF, Radier Pontal F, Redon J, Rennard S, Roberts J, Robine JM, Roca J, Roche N, Rodenas F, Roggeri A, Rolland C, Rosado-Pinto J, Ryan D, Samolinski B, Sanchez-Borges M, Schünemann HJ, Sheikh A, Shields M, Siafakas N, Sibille Y, Similowski T, Small I, Sola-Morales O, Sooronbaev T, Stelmach R, Sterk PJ, Stiris T, Sud P, Tellier V, To T, Todo-Bom A, Triggiani M, Valenta R, Valero AL, Valiulis A, Valovirta E, Van Ganse E, Vandenplas O, Vasankari T, Vestbo J, Vezzani G, Viegi G, Visier L, Vogelmeier C, Vontetsianos T, Wagstaff R, Wahn U, Wallaert B, Whalley B, Wickman M, Williams DM, Wilson N, Yawn BP, Yiallouros PK, Yorgancioglu A, Yusuf OM, Zar HJ, Zhong N, Zidarn M, Zuberbier T. Integrated care pathways for airway diseases (AIRWAYS-ICPs). Eur Respir J 2014; 44:304-23. [PMID: 24925919 DOI: 10.1183/09031936.00014614] [Citation(s) in RCA: 128] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of Integrated Care Pathways for Airway Diseases (AIRWAYS-ICPs) is to launch a collaboration to develop multi-sectoral care pathways for chronic respiratory diseases in European countries and regions. AIRWAYS-ICPs has strategic relevance to the European Union Health Strategy and will add value to existing public health knowledge by: 1) proposing a common framework of care pathways for chronic respiratory diseases, which will facilitate comparability and trans-national initiatives; 2) informing cost-effective policy development, strengthening in particular those on smoking and environmental exposure; 3) aiding risk stratification in chronic disease patients, using a common strategy; 4) having a significant impact on the health of citizens in the short term (reduction of morbidity, improvement of education in children and of work in adults) and in the long-term (healthy ageing); 5) proposing a common simulation tool to assist physicians; and 6) ultimately reducing the healthcare burden (emergency visits, avoidable hospitalisations, disability and costs) while improving quality of life. In the longer term, the incidence of disease may be reduced by innovative prevention strategies. AIRWAYSICPs was initiated by Area 5 of the Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing. All stakeholders are involved (health and social care, patients, and policy makers).
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Affiliation(s)
| | | | | | - J Bousquet
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action UM1, University 1, Montpellier, France Fondation Partenariale, France
| | - A Addis
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Regione Emilia-Romagna, Italy
| | - I Adcock
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NIHR Biomedical Research Unit, London, UK
| | - I Agache
- ARIA, Allergic Rhinitis and Its Impact on Asthma Romanian Alliance Against Chronic Respiratory Diseases Faculty of Medicine, Transylvania University, Brasov, Romania
| | - A Agusti
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - A Alonso
- Hospital Clínic/FCRB, Barcelona, Spain
| | | | - J M Anto
- MeDALL, Mechanisms of the Development of Allergy Centre for Research in Environmental Epidemiology (CREAL), IMIM (Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - C Bachert
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Dept Respiratory Medicine, Ghent University Hospital, Gent, Belgium ENT Dept, Ghent University Hospital, Gent, Belgium
| | - C E Baena-Cagnani
- ARIA, Allergic Rhinitis and Its Impact on Asthma Research Centre in Respiratory Medicine (CIMER), Faculty of Medicine, Catholic University, Cordoba, Argentina
| | - C Bai
- Shanghai Respiratory Research Institute, Chinese Medical Association, Shanghai, China Chinese Alliance against Lung Cancer
| | - A Baigenzhin
- EuroAsian Respiratory Society, Astana City, Kazakhstan
| | - C Barbara
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases
| | - P J Barnes
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NIHR Biomedical Research Unit, London, UK
| | - E D Bateman
- ARIA, Allergic Rhinitis and Its Impact on Asthma Division of Pulmonology, Dept of Medicine, Faculty of Health Sciences, University of Cape Town, South Africa
| | - L Beck
- Health Innovation Centre of Southern Denmark, Region of Southern Denmark, Denmark
| | - A Bedbrook
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - E H Bel
- Academic Medical Centre, University of Amsterdam, The Netherlands
| | - O Benezet
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - K S Bennoor
- ARIA, Allergic Rhinitis and Its Impact on Asthma Bangladesh Lung Foundation and National Institute of Diseases of Chest and Hospital, Dhaka, Bangladesh
| | - M Benson
- Centre for Individualised Medicine, Dept of Clinical and Experimental Sciences, Linköping University, Linköping, Sweden
| | - M Bernabeu-Wittel
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Aura Andalucia, Spain Andalusian Healthcare Service, Spain
| | - M Bewick
- Deputy National Medical Director, NHS England, UK
| | - C Bindslev-Jensen
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, Odense, Denmark
| | - H Blain
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - F Blasi
- ERS, European Respiratory Society, University of Milan, IRCCS Cà Granda, Milan, Italy
| | - M Bonini
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Public Health and Infectious Diseases "Sapienza" University of Rome, Rome, Italy
| | - S Bonini
- ARIA, Allergic Rhinitis and Its Impact on Asthma Second University of Naples and Institute of Translational Medicine, Italian National Research Council, Naples, Italy
| | - L P Boulet
- ARIA, Allergic Rhinitis and Its Impact on Asthma Institut universitaire de cardiologie et de pneumologie de Québec, Université Laval, Québec City, QC, Canada
| | - A Bourdin
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France INSERM, U1046, Montpellier, France
| | - R Bourret
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - P J Bousquet
- ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - C E Brightling
- National Institute for Health Research, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, Leicester, UK
| | - A Briggs
- Health Economics and Health Technology Assessment, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J Brozek
- ARIA, Allergic Rhinitis and Its Impact on Asthma Depts of Clinical Epidemiology, and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - R Buhl
- Pulmonary Dept, III, Medical Centre, Mainz University Hospital, Mainz, Germany
| | - A Bush
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Paediatric Respiratory Medicine, Royal Brompton Hospital and National Heart and Lung Institute, Imperial College, London, UK
| | - D Caimmi
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - M Calderon
- University of Costa Rica, San Jose, Costa Rica Section of Allergy and Clinical Immunology, Imperial College London, Royal Brompton Hospital, London, UK
| | - P Calverley
- Institute of Ageing and Chronic Disease, University of Liverpool and University Hospital Aintree, Liverpool, UK
| | - P A Camargos
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Pediatrics, Medical School, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - T Camuzat
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - G W Canonica
- ARIA, Allergic Rhinitis and Its Impact on Asthma Allergy and Respiratory Diseases, IRCCS San Martino - IST- University of Genoa, Dept of Internal Medicine, Genoa, Italy
| | - K H Carlsen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma NAH, National Allergy Health Programme, Norway University of Oslo and Oslo University Hospital, Dept of Paediatrics, Oslo, Norway
| | - T B Casale
- ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - M Cazzola
- University of Rome "Tor Vergata" Dept of System Medicine, Rome, Italy
| | - A M Cepeda Sarabia
- ARIA, Allergic Rhinitis and Its Impact on Asthma Allergy and Immunology Laboratory, Metropolitan University, Simon Bolivar University, Barranquilla, Colombia SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia
| | - A Cesario
- IRCCS, San Raffaele Pisana, Rome, Italy
| | - Y Z Chen
- National Cooperative Group of Paediatric Research on Asthma, Asthma Clinic and Education Center of the Capital Institute of Pediatrics, Peking and Center for Asthma Research and Education, Beijing, PR China
| | - E Chkhartishvili
- Chachava Clinic, David Tvildiani Medical University-AIETI Medical School, Grigol Robakidze University, Tbilisi, Georgia
| | - N H Chavannes
- ARIA, Allergic Rhinitis and Its Impact on Asthma IPCRG, International Primary Care Respiratory Group Dept of Public Health and Primary Care, Leiden University Medical Center, Leiden, The Netherlands
| | - R Chiron
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma
| | - A Chuchalin
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) Pulmonology Research Institute and Russian Respiratory Society, Moscow, Russia
| | - K F Chung
- National Heart and Lung Institute, Imperial College London and Royal Brompton and Harefield NIHR Biomedical Research Unit, London, UK
| | - L Cox
- ARIA, Allergic Rhinitis and Its Impact on Asthma Nova Southeastern University Osteopathic College of Medicine, Davie, FL, USA
| | - G Crooks
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Glasgow, UK
| | - M G Crooks
- Centre for Cardiovascular and Metabolic Research, Hull York Medical School, Hull, UK
| | - A A Cruz
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) ProAR, Nucleo de Excelencia em Asma, Federal University of Bahia and CNPq, Salvador, Brazil
| | - A Custovic
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology University of Manchester, Manchester, UK
| | - R Dahl
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Dermatology and Allergy Center, Odense Research Center for Anaphylaxis, Odense University Hospital, Odense, Denmark
| | - S E Dahlen
- CfA, The Centre for Allergy Research, The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - F De Blay
- ARIA, Allergic Rhinitis and Its Impact on Asthma SFA, Société française d'Allergologie Strasbourg University, Strasbourg, France
| | - T Dedeu
- EUREGHA, European Regions and Health Authorities, Brussels, Belgium
| | - D Deleanu
- ARIA, Allergic Rhinitis and Its Impact on Asthma Romanian Alliance Against Chronic Respiratory Diseases University of Medicine and Pharmacy Iuliu Hatieganu, Cluj-Napoca, Romania
| | - P Demoly
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action UM1, University 1, Montpellier, France
| | - P Devillier
- ARIA, Allergic Rhinitis and Its Impact on Asthma UPRES, EA 220, Université Versailles Saint Quentin, Hôpital Foch, Suresnes, France
| | - A Didier
- SPLF, Société de Pneumologie de Langue Française Dept of Respiratory Medicine, University of Toulouse, Toulouse, France
| | - A T Dinh-Xuan
- Service de Physiologie, Paris Descartes University EA 2511, Hôpital Cochin, Assistance Publique Hôpitaux de Paris, Paris, France
| | - R Djukanovic
- University Southampton Faculty of Medicine and NIHR Southampton Respiratory Biomedical Research Unit, Southampton, UK
| | - D Dokic
- ARIA, Allergic Rhinitis and Its Impact on Asthma University Clinic of Pulmology and Allergy, University "Ss. Cyril and Methodius", Skopje, Macedonia
| | - H Douagui
- ARIA, Allergic Rhinitis and Its Impact on Asthma Service de pneumo-allergologie, Centre Hospitalo-Universitaire de Béni-Messous, Algiers, Algeria
| | - R Dubakiene
- ARIA, Allergic Rhinitis and Its Impact on Asthma LSACI, Lithuanian Society of Allergology and Clinical Immunology Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - S Eglin
- NHS R&D North West, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK
| | - F Elliot
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, NHS Scotland, Edinburgh, UK
| | - R Emuzyte
- ARIA, Allergic Rhinitis and Its Impact on Asthma LSACI, Lithuanian Society of Allergology and Clinical Immunology Vilnius University Faculty of Medicine, Vilnius, Lithuania
| | - L Fabbri
- Dept of Oncology, Haematology and Respiratory Diseases, Policlinic of Modena, University of Modena and Reggio Emilia, Modena, Italy
| | - A Fink Wagner
- GAAPP, Global Allergy and Asthma Patient Platform, Vienna, Austria
| | - M Fletcher
- GARD, Global Alliance against Chronic Respiratory Diseases (WHO) Education for Health, Warwick, UK
| | - W J Fokkens
- ARIA, Allergic Rhinitis and Its Impact on Asthma Academic Medical Centre, University of Amsterdam, The Netherlands European Rhinology Society
| | - J Fonseca
- ARIA, Allergic Rhinitis and Its Impact on Asthma PNDR, Portuguese National Programme for Respiratory Diseases Porto Age-Up Consortium, Porto, Portugal Dept of Health Information and Decision Sciences and CINTESIS, Porto University Medical School, Allergy, Hospital S. Joao and Instituto and Hospital CUF Porto, Porto, Portugal
| | - A Franco
- Internal and Geriatric Medicine, University of Nice - Sophia Antipolis, Nice, France
| | - P Frith
- Repatriation General Hospital, Adelaide, Australia
| | - A Furber
- Director of Public Health, Wakefield Council, Wakefield, UK
| | - M Gaga
- 7th Respiratory Medicine Dept and Asthma Centre, Athens Chest Hospital, Athens, Greece
| | - J Garcés
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Valencia, Spain Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - J Garcia-Aymerich
- MeDALL, Mechanisms of the Development of Allergy Centre for Research in Environmental Epidemiology (CREAL), IMIM (Hospital del Mar Medical Research Institute, Universitat Pompeu Fabra (UPF), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - A Gamkrelidze
- ARIA, Allergic Rhinitis and Its Impact on Asthma National Center for Disease Control and Public Health of Georgia, Tbilisi, Georgia
| | - S Gonzales-Diaz
- ARIA, Allergic Rhinitis and Its Impact on Asthma SLaai, Sociedad Latinoamericana de Allergia, Asma e Immunologia
| | - F Gouzi
- University Hospital Montpellier, Montpellier, France INSERM, U1046, Montpellier, France
| | - M A Guzmán
- ARIA, Allergic Rhinitis and Its Impact on Asthma Immunology and Allergology Division, Dept of Medicine, Clinical Hospital University of Chile, Santiago, Chile
| | - T Haahtela
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Allergy, Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - D Harrison
- Director of Public Health for Blackburn with Darwen, Blackburn, UK
| | - M Hayot
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - L G Heaney
- Centre for Infection and Immunity, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - J Heinrich
- MeDALL, Mechanisms of the Development of Allergy
| | - P W Hellings
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology Dept of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - J Hooper
- Director of Public Health for Kirklees, Huddersfield, UK
| | - M Humbert
- SPLF, Société de Pneumologie de Langue Française
| | - M Hyland
- School of Psychology, University of Plymouth, Plymouth, UK
| | - G Iaccarino
- EIP on AHA Reference Site, Regione-Campania, Italy Dept of Medicine and Surgery, University of Salerno, Salerno, Italy IRCCS Multimedica, Milan, Italy
| | - D Jakovenko
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - J R Jardim
- Respiratory Diseases, Escola Paulista de Medicina of Federal University of Sao Paulo, Sao Paulo, Brazil
| | - C Jeandel
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - C Jenkins
- The George Institute for Global Health and The University of Sydney, Sydney, Australia
| | - S L Johnston
- ARIA, Allergic Rhinitis and Its Impact on Asthma Airway Disease Infection Section, National Heart and Lung Institute, Imperial College London, London, UK
| | - O Jonquet
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - G Joos
- Dept Respiratory Medicine, Ghent University Hospital, Gent, Belgium
| | - K S Jung
- Hallym University College of Medicine, Hallym University Sacred Heart Hospital, Gyeonggi-do, South Korea
| | - O Kalayci
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology GARD-Turkey, Global Alliance against Chronic Respiratory Diseases (GARD), Turkey Hacettepe University School of Medicine, Paediatric Allergy and Asthma Unit, Hacettepe, Ankara, Turkey
| | | | - T Keil
- MeDALL, Mechanisms of the Development of Allergy Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - N Khaltaev
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO)
| | - V Kolek
- CARO, Czech Alliance against Chronic Respiratory Diseases
| | - M L Kowalski
- Dept Immunology, Rheumatology and Allergy, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - I Kull
- MeDALL, Mechanisms of the Development of Allergy Karolinska Institutet, Dept of Clinical Science and Education, Institute of Environmental Medicine, Stockholm, Sweden
| | - P Kuna
- ARIA, Allergic Rhinitis and Its Impact on Asthma EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action GARD, Global Alliance against Chronic Respiratory Diseases (WHO) Polastma, Poland Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland
| | - V Kvedariene
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology LSACI, Lithuanian Society of Allergology and Clinical Immunology Pulmonology and Allergology Center, Vilnius University, Vilnius, Lithuania
| | - L T Le
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) University of Medicine and Pharmacy, Hochiminh City, Vietnam
| | - K C Lodrup Carlsen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma NAH, National Allergy Health Programme, Norway University of Oslo and Oslo University Hospital, Dept of Paediatrics, Oslo, Norway
| | - R Louis
- CHU Liege, GIGA I Research Center, University of Liege, Liege, Belgium
| | - W MacNee
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - A Mair
- Directorate of Finance, eHealth and Pharmaceuticals, Scottish Government Health Dept, Edinburgh, UK
| | - I Majer
- University of Bratislava, Bratislava, Slovakia
| | - P Manning
- Dept of Medicine, Royal College of Surgeons in Ireland (Medical School) Bon Secours Hospital, Dublin, Ireland
| | - E de Manuel Keenoy
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site Kronikgune, Basque Region, Spain
| | - M R Masjedi
- Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Science, Tehran, Iran
| | - E Melen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Karolinska Institutet, Dept of Clinical Science and Education, Institute of Environmental Medicine, Stockholm, Sweden
| | - E Melo-Gomes
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases
| | | | - G Mercier
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - J Mercier
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action UM1, University 1, Montpellier, France
| | - J P Michel
- Geneva Medical School and University Hospitals, Geneva, Switzerland
| | - N Miculinic
- University Hospital for Pulmonary Diseases, Jordanovac, Zagreb, Croatia
| | - F Mihaltan
- ARIA, Allergic Rhinitis and Its Impact on Asthma Romanian Alliance Against Chronic Respiratory Diseases Institute of Pneumology Marius Nasta, Bucharest, Romania
| | - B Milenkovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia Serbian Alliance against Chronic Respiratory Diseases Association for Asthma and COPD in Serbia
| | | | - I Momas
- Paris Descartes University, Dept of Public Health and Biostatistics, EA 4064 and Paris Municipal, Dept of Social Action, Childhood and Health, Paris, France
| | - A Montilla-Santana
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Aura Andalucia, Spain
| | - M Morais-Almeida
- Immunoallergy Dept, Hospital CUF-Descobertas, Lisbon, Portugal SPAIC, Sociedade Portuguesa de Alergologia e Imunologia Clínica, Portugal
| | - M Morgan
- Respiratory National Clinical Director, NHS England, UK
| | - M N'Diaye
- Service de Médecine Interne et Pathologies Professionnelles, Hôpital Polyclinique de Dakar (IHS), Dakar, Sénégal
| | - S Nafti
- ARIA, Allergic Rhinitis and Its Impact on Asthma Mustapha Hospital, Algiers, Algeria
| | - K Nekam
- ARIA, Allergic Rhinitis and Its Impact on Asthma Hospital of the Hospitaller Brothers in Buda, Budapest, Hungary
| | - A Neou
- GALEN, Global Allergy and Asthma European Network Charité University Hospital, Allergy Centre Charité, Berlin, Germany
| | - L Nicod
- Service de Pneumologie, 1011 CHUV-Lausanne, Lausanne, Switerland
| | - R O'Hehir
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Allergy, Immunology and Respiratory Medicine, Alfred Hospital and Monash University, Melbourne, Australia
| | - K Ohta
- ARIA, Allergic Rhinitis and Its Impact on Asthma National Hospital Organization, Tokyo National Hospital and Teikyo University School of Medicine, Tokyo, Japan
| | - P Paggiaro
- Cardio-Thoracic and Vascular Dept, University Hospital of Pisa, Pisa, Italy
| | - S Palkonen
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma EFA, European Federation of Allergy and Airways Diseases patients' association
| | - S Palmer
- Centre for Reviews and Dissemination (CRD), University of York, York, UK
| | - N G Papadopoulos
- ARIA, Allergic Rhinitis and Its Impact on Asthma EAACI, European Academy of Allergy and Clinical Immunology University of Manchester, Manchester, UK Allergy Dept, 2nd Paediatric Clinic, University of Athens, Athens, Greece
| | - A Papi
- Ferrara University, Ferrara, Italy
| | - G Passalacqua
- ARIA, Allergic Rhinitis and Its Impact on Asthma Allergy and Respiratory Diseases, IRCCS San Martino - IST- University of Genoa, Dept of Internal Medicine, Genoa, Italy
| | - I Pavord
- NDM Research Building, University of Oxford, Oxford, UK
| | | | - D Plavec
- Children's Hospital Srebrnjak, Zagreb, School of Medicine, University J.J. Strossmayer, Osijek, Croatia
| | - D S Postma
- MeDALL, Mechanisms of the Development of Allergy University of Groningen, Dept of Pulmonology, GRIAC Research Institute University Medical Center Groningen, Groningen, The Netherlands
| | - D Price
- ARIA, Allergic Rhinitis and Its Impact on Asthma IPCRG, International Primary Care Respiratory Group Academic Primary Care, University of Aberdeen, Aberdeen, UK
| | - K F Rabe
- Christian Albrechts University Kiel, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research (DZL), Germany
| | - F Radier Pontal
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France
| | - J Redon
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site Research Institute INCLIVA, University of Valencia, CIBERObn, Health Institute Carlos III, Madrid, Spain
| | - S Rennard
- University of Nebraska Medical Center, Division of Pulmonary, Critical Care, Sleep and Allergy, Nebraska Medical Center, Omaha, NE, USA
| | - J Roberts
- Respiratory Nurse Consultant, Salford Royal NHS Foundation Trust, Salford, UK
| | - J M Robine
- MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France INSERM, U710 and 988, Montpellier, France
| | - J Roca
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - N Roche
- Pneumologie, AP-HP, Hôpital Cochin - Site Val de Grâce, Université Paris Descartes and SPLF, Société de Pneumologie de Langue Française, Paris, France
| | - F Rodenas
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, Reference Site, Valencia, Spain Polibienestar Research Institute, University of Valencia, Valencia, Spain
| | - A Roggeri
- Arcispedale, S.Maria Nuova Hospital, Reggio Emilia, Italy
| | - C Rolland
- Association Asthme et Allergies, Boulogne-Billancourt, France
| | - J Rosado-Pinto
- ARIA, Allergic Rhinitis and Its Impact on Asthma EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action PNDR, Portuguese National Programme for Respiratory Diseases GARD, Global Alliance against Chronic Respiratory Diseases (WHO)
| | - D Ryan
- ARIA, Allergic Rhinitis and Its Impact on Asthma IPCRG, International Primary Care Respiratory Group Woodbrook Medical Centre, Loughborough, UK Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK
| | - B Samolinski
- EIP on AHA, European Innovation Partnership on Active and Healthy Ageing, B3 Commitment for Action Dept of Internal Medicine, Asthma and Allergy, Barlicki University Hospital, Medical University of Lodz, Lodz, Poland Dept of Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, Poland
| | - M Sanchez-Borges
- Dept of Allergy and Clinical Immunology, Centro Medico-Docente La Trinidad, Caracas, Venezuela
| | - H J Schünemann
- Depts of Clinical Epidemiology, and Biostatistics and Medicine, McMaster University, Hamilton, ON, Canada
| | - A Sheikh
- Allergy and Respiratory Research Group, Centre for Population Health Sciences, The University of Edinburgh, Medical School, Edinburgh, UK Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital/Harvard Medical School, Boston, MA, USA
| | - M Shields
- Child Health, Queen's University Belfast and Royal Belfast Hospital for Sick Children, Belfast, UK
| | - N Siafakas
- Dept of Thoracic Medicine, University Hospital of Heraklion, Heraklion, Greece
| | - Y Sibille
- University Hospital of Mont-Godinne, Catholic University of Louvain, Yvoir, Belgium
| | - T Similowski
- Sorbonne Universités, UPMC Univ Paris 06, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France AP-HP, Groupe Hospitalier Pitié-Salpêtrière Charles Foix, Service de Pneumologie et Réanimation Médicale (Département "R3S"), Paris, France Fonds de Dotation Recherche en Santé Respiratoire - Fondation du Souffle, Paris, France
| | - I Small
- National Advisory Group, Respiratory Managed Clinical Networks in Scotland
| | - O Sola-Morales
- HITT, Health Institute for Technology Transfer, Barcelona, Spain
| | - T Sooronbaev
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD, Global Alliance against Chronic Respiratory Diseases (WHO) EuroAsian Respiratory Society, Bishkek, Kyrgyzstan National Centre Cardiology and Internal Medicine, Bishkek, Kyrgyzstan
| | - R Stelmach
- Pulmonary Division, InCor (Heart Institute), Hospital da Clinicas da Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil
| | - P J Sterk
- Academic Medical Centre, University of Amsterdam, The Netherlands
| | - T Stiris
- Dept of Neonatal Intensive Care, Oslo University Hospital, Ulleval, Faculty of Medicine, University of Oslo, Oslo, Norway European Academy of Paediatrics (EAP-UEMS)
| | - P Sud
- Regional Medical Manager (North), NHS England, UK
| | - V Tellier
- Observatoire wallon de la santé, Direction générale opérationnelle Pouvoirs locaux, action sociale et Santé, Service public de Wallonie, Belgium
| | - T To
- GARD, Global Alliance against Chronic Respiratory Diseases (WHO)
| | - A Todo-Bom
- Immunoallergy Dept, Coimbra University Hospital, Coimbra, Portugal
| | - M Triggiani
- Dept of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - R Valenta
- ARIA, Allergic Rhinitis and Its Impact on Asthma Dept of Pathophysiology and Allergy Research, Centre of Pathophysiology, Infectology and Immunology, Medical University of Vienna, Vienna, Austria
| | - A L Valero
- Thorax Institute, Hospital Clinic, IDIBAPS, University of Barcelona and CIBER Enfermedades Respiratorias, Barcelona, Spain
| | - A Valiulis
- ARIA, Allergic Rhinitis and Its Impact on Asthma LSACI, Lithuanian Society of Allergology and Clinical Immunology Vilnius University Faculty of Medicine, Vilnius, Lithuania European Academy of Paediatrics (EAP-UEMS) LACRD, Lithuanian National Alliance Against Chronic Respiratory Diseases
| | - E Valovirta
- Dept of Lung Diseases and Clinical Allergology, University of Turku, Finland
| | - E Van Ganse
- Pharmacoepidemiology Unit and Respiratory Medicine, CHU-Lyon and UMR CNRS 5558, Claude-Bernard University Lyon, Lyon, France
| | - O Vandenplas
- ARIA, Allergic Rhinitis and Its Impact on Asthma INSERM, UMR_S 1158 "Neurophysiologie Respiratoire Expérimentale et Clinique", Paris, France
| | | | - J Vestbo
- Respiratory and Allergy Research Group, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK Dept of Respiratory Medicine J, Odense University Hospital, Odense, Denmark
| | - G Vezzani
- EIP on AHA B3 Action Group (Delivering Integrated Care Models), Regional Agency for Health and Social Care, Arcispedale S.Maria Nuova/IRCCS, Research Hospital, Reggio Emilia, Italy
| | - G Viegi
- CNR, Institutes of Biomedicine and Molecular Immunology (IBIM), Palermo, and of Clinical Physiology (IFC), Pisa, Italy
| | - L Visier
- University Hospital Montpellier, Montpellier, France MACVIA-LR, Fighting Chronic Diseases for Healthy Ageing, Région Languedoc Roussillon, France UM1, University 1, Montpellier, France
| | - C Vogelmeier
- German Center for Lung Research (DZL), Dept of Medicine, Pulmonary and Critical Care Medicine, University Medical Center Giessen and Marburg, Philipps-University Marburg, Germany
| | | | - R Wagstaff
- Acting Director of Public Health, Cumbria County Council, Carlisle, UK
| | - U Wahn
- Charité University Hospital, Allergy Centre Charité, Berlin, Germany
| | - B Wallaert
- SFA, Société française d'Allergologie Hôpital Albert Calmette, CHRU, Lille, France
| | - B Whalley
- School of Psychology, University of Plymouth, Plymouth, UK
| | - M Wickman
- MeDALL, Mechanisms of the Development of Allergy ARIA, Allergic Rhinitis and Its Impact on Asthma Karolinska Institutet, Dept of Clinical Science and Education, Institute of Environmental Medicine, Stockholm, Sweden
| | - D M Williams
- Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, USA
| | - N Wilson
- North of England EU Health Partnership, UK
| | - B P Yawn
- ARIA, Allergic Rhinitis and Its Impact on Asthma Olmsted Medical Center, Dept of Research and University of Minnesota, Dept of Family and Community Health, Rochester, MN, USA
| | - P K Yiallouros
- ARIA, Allergic Rhinitis and Its Impact on Asthma Cyprus International Institute for Environmental and Public Health in Association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus
| | - A Yorgancioglu
- ARIA, Allergic Rhinitis and Its Impact on Asthma GARD-Turkey, Global Alliance against Chronic Respiratory Diseases (GARD), Turkey
| | - O M Yusuf
- GARD, Global Alliance against Chronic Respiratory Diseases (WHO) The Allergy and Asthma Institute, Pakistan
| | - H J Zar
- Dept of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa
| | - N Zhong
- Guangzhou Institute of Respiratory Diseases and State Key Laboratory of Respiratory Diseases, Guangzhou Medical College, Guangzhou, China
| | - M Zidarn
- ARIA, Allergic Rhinitis and Its Impact on Asthma University Clinic of Respiratory and Allergic Diseases, Golnik, Slovenia
| | - T Zuberbier
- GALEN, Global Allergy and Asthma European Network Charité University Hospital, Allergy Centre Charité, Berlin, Germany
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Abstract
Pneumonia remains the leading cause of childhood mortality and the most common reason for adult hospitalisation in low and middle income countries, despite advances in preventative and management strategies. In the last decade, pneumonia mortality in children has fallen to approximately 1.3 million cases in 2011, with most deaths occurring in low income countries. Important recent advances include more widespread implementation of protein-polysaccharide conjugate vaccines against Haemophilus influenzae type B and Streptococcus pneumoniae, implementation of case-management algorithms and better prevention and treatment of HIV. Determining the aetiology of pneumonia is challenging in the absence of reliable diagnostic tests. High uptake of new bacterial conjugate vaccines may impact on pneumonia burden, aetiology and empiric therapy but implementation in immunisation programmes in many low and middle income countries remains an obstacle. Widespread implementation of currently effective preventative and management strategies for pneumonia remains challenging in many low and middle income countries.
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Affiliation(s)
- H J Zar
- Department of Paediatrics and Child Health, Red Cross War Memorial Childrens Hospital, University of Cape Town, , Cape Town, South Africa
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le Roux SM, Cotton MF, Myer L, le Roux DM, Schaaf HS, Lombard CJ, Zar HJ. Safety of long-term isoniazid preventive therapy in children with HIV: a comparison of two dosing schedules. Int J Tuberc Lung Dis 2012; 17:26-31. [PMID: 23146410 DOI: 10.5588/ijtld.11.0820] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
SETTING Two paediatric hospitals in Cape Town, South Africa. OBJECTIVE To investigate the incidence of and risk factors for severe liver injury in human immunodeficiency virus (HIV) infected children receiving long-term isoniazid preventive therapy (IPT). DESIGN Randomised trial of IPT or placebo given daily or thrice weekly to HIV-infected children aged ≥8 weeks; placebo was discontinued early. Alanine transaminase (ALT) was measured at baseline, 6-monthly and during illness: an increase of ≥10 times the upper limit of normal defined severe liver injury. RESULTS Of 324 children enrolled, 297 (91.6%) received IPT (559.1 person-years [py]). Baseline median age was 23 months (interquartile range [IQR] 9.5-48.6) and median CD4%, 20% (IQR 13.6-26.9). A total of 207 (63.9%) children received combination antiretroviral therapy: 19 developed severe liver injury, 16 while receiving IPT. Among these there were 8 cases of viral hepatitis (5 with hepatitis A), 2 antiretroviral-induced liver injuries and 1 case of abdominal tuberculosis. IPT-related severe liver injury occurred in 1.7% (5/297, 0.78/100 py). No child developed hepatic failure; one died of an unrelated cause. All surviving children subsequently tolerated IPT. CONCLUSIONS This study suggests that long-term IPT has a low toxicity risk in HIV-infected children. In the absence of chronic viral hepatitis, IPT can be safely re-introduced following recovery from liver injury.
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Affiliation(s)
- S M le Roux
- Department of Paediatrics and Child Health, University of Cape Town, Cape Town, South Africa.
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Bousquet J, Schünemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, Bonini S, Boulet LP, Bousquet PJ, Brozek JL, Canonica GW, Casale TB, Cruz AA, Fokkens WJ, Fonseca JA, van Wijk RG, Grouse L, Haahtela T, Khaltaev N, Kuna P, Lockey RF, Lodrup Carlsen KC, Mullol J, Naclerio R, O'Hehir RE, Ohta K, Palkonen S, Papadopoulos NG, Passalacqua G, Pawankar R, Price D, Ryan D, Simons FER, Togias A, Williams D, Yorgancioglu A, Yusuf OM, Aberer W, Adachi M, Agache I, Aït-Khaled N, Akdis CA, Andrianarisoa A, Annesi-Maesano I, Ansotegui IJ, Baiardini I, Bateman ED, Bedbrook A, Beghé B, Beji M, Bel EH, Ben Kheder A, Bennoor KS, Bergmann KC, Berrissoul F, Bieber T, Bindslev Jensen C, Blaiss MS, Boner AL, Bouchard J, Braido F, Brightling CE, Bush A, Caballero F, Calderon MA, Calvo MA, Camargos PAM, Caraballo LR, Carlsen KH, Carr W, Cepeda AM, Cesario A, Chavannes NH, Chen YZ, Chiriac AM, Chivato Pérez T, Chkhartishvili E, Ciprandi G, Costa DJ, Cox L, Custovic A, Dahl R, Darsow U, De Blay F, Deleanu D, Denburg JA, Devillier P, Didi T, Dokic D, Dolen WK, Douagui H, Dubakiene R, Durham SR, Dykewicz MS, El-Gamal Y, El-Meziane A, Emuzyte R, Fiocchi A, Fletcher M, Fukuda T, Gamkrelidze A, Gereda JE, González Diaz S, Gotua M, Guzmán MA, Hellings PW, Hellquist-Dahl B, Horak F, Hourihane JO, Howarth P, Humbert M, Ivancevich JC, Jackson C, Just J, Kalayci O, Kaliner MA, Kalyoncu AF, Keil T, Keith PK, Khayat G, Kim YY, Koffi N'goran B, Koppelman GH, Kowalski ML, Kull I, Kvedariene V, Larenas-Linnemann D, Le LT, Lemière C, Li J, Lieberman P, Lipworth B, Mahboub B, Makela MJ, Martin F, Marshall GD, Martinez FD, Masjedi MR, Maurer M, Mavale-Manuel S, Mazon A, Melen E, Meltzer EO, Mendez NH, Merk H, Mihaltan F, Mohammad Y, Morais-Almeida M, Muraro A, Nafti S, Namazova-Baranova L, Nekam K, Neou A, Niggemann B, Nizankowska-Mogilnicka E, Nyembue TD, Okamoto Y, Okubo K, Orru MP, Ouedraogo S, Ozdemir C, Panzner P, Pali-Schöll I, Park HS, Pigearias B, Pohl W, Popov TA, Postma DS, Potter P, Rabe KF, Ratomaharo J, Reitamo S, Ring J, Roberts R, Rogala B, Romano A, Roman Rodriguez M, Rosado-Pinto J, Rosenwasser L, Rottem M, Sanchez-Borges M, Scadding GK, Schmid-Grendelmeier P, Sheikh A, Sisul JC, Solé D, Sooronbaev T, Spicak V, Spranger O, Stein RT, Stoloff SW, Sunyer J, Szczeklik A, Todo-Bom A, Toskala E, Tremblay Y, Valenta R, Valero AL, Valeyre D, Valiulis A, Valovirta E, Van Cauwenberge P, Vandenplas O, van Weel C, Vichyanond P, Viegi G, Wang DY, Wickman M, Wöhrl S, Wright J, Yawn BP, Yiallouros PK, Zar HJ, Zernotti ME, Zhong N, Zidarn M, Zuberbier T, Burney PG, Johnston SL, Warner JO. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol 2012; 130:1049-62. [PMID: 23040884 DOI: 10.1016/j.jaci.2012.07.053] [Citation(s) in RCA: 358] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Revised: 07/24/2012] [Accepted: 07/27/2012] [Indexed: 02/07/2023]
Abstract
Allergic rhinitis (AR) and asthma represent global health problems for all age groups. Asthma and rhinitis frequently coexist in the same subjects. Allergic Rhinitis and its Impact on Asthma (ARIA) was initiated during a World Health Organization workshop in 1999 (published in 2001). ARIA has reclassified AR as mild/moderate-severe and intermittent/persistent. This classification closely reflects patients' needs and underlines the close relationship between rhinitis and asthma. Patients, clinicians, and other health care professionals are confronted with various treatment choices for the management of AR. This contributes to considerable variation in clinical practice, and worldwide, patients, clinicians, and other health care professionals are faced with uncertainty about the relative merits and downsides of the various treatment options. In its 2010 Revision, ARIA developed clinical practice guidelines for the management of AR and asthma comorbidities based on the Grading of Recommendation, Assessment, Development and Evaluation (GRADE) system. ARIA is disseminated and implemented in more than 50 countries of the world. Ten years after the publication of the ARIA World Health Organization workshop report, it is important to make a summary of its achievements and identify the still unmet clinical, research, and implementation needs to strengthen the 2011 European Union Priority on allergy and asthma in children.
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Bousquet J, Anto JM, Demoly P, Schünemann HJ, Togias A, Akdis M, Auffray C, Bachert C, Bieber T, Bousquet PJ, Carlsen KH, Casale TB, Cruz AA, Keil T, Lodrup Carlsen KC, Maurer M, Ohta K, Papadopoulos NG, Roman Rodriguez M, Samolinski B, Agache I, Andrianarisoa A, Ang CS, Annesi-Maesano I, Ballester F, Baena-Cagnani CE, Basagaña X, Bateman ED, Bel EH, Bedbrook A, Beghé B, Beji M, Ben Kheder A, Benet M, Bennoor KS, Bergmann KC, Berrissoul F, Bindslev Jensen C, Bleecker ER, Bonini S, Boner AL, Boulet LP, Brightling CE, Brozek JL, Bush A, Busse WW, Camargos PAM, Canonica GW, Carr W, Cesario A, Chen YZ, Chiriac AM, Costa DJ, Cox L, Custovic A, Dahl R, Darsow U, Didi T, Dolen WK, Douagui H, Dubakiene R, El-Meziane A, Fonseca JA, Fokkens WJ, Fthenou E, Gamkrelidze A, Garcia-Aymerich J, Gerth van Wijk R, Gimeno-Santos E, Guerra S, Haahtela T, Haddad H, Hellings PW, Hellquist-Dahl B, Hohmann C, Howarth P, Hourihane JO, Humbert M, Jacquemin B, Just J, Kalayci O, Kaliner MA, Kauffmann F, Kerkhof M, Khayat G, Koffi N'Goran B, Kogevinas M, Koppelman GH, Kowalski ML, Kull I, Kuna P, Larenas D, Lavi I, Le LT, Lieberman P, Lipworth B, Mahboub B, Makela MJ, Martin F, Martinez FD, Marshall GD, Mazon A, Melen E, Meltzer EO, Mihaltan F, Mohammad Y, Mohammadi A, Momas I, Morais-Almeida M, Mullol J, Muraro A, Naclerio R, Nafti S, Namazova-Baranova L, Nawijn MC, Nyembue TD, Oddie S, O'Hehir RE, Okamoto Y, Orru MP, Ozdemir C, Ouedraogo GS, Palkonen S, Panzner P, Passalacqua G, Pawankar R, Pigearias B, Pin I, Pinart M, Pison C, Popov TA, Porta D, Postma DS, Price D, Rabe KF, Ratomaharo J, Reitamo S, Rezagui D, Ring J, Roberts R, Roca J, Rogala B, Romano A, Rosado-Pinto J, Ryan D, Sanchez-Borges M, Scadding GK, Sheikh A, Simons FER, Siroux V, Schmid-Grendelmeier PD, Smit HA, Sooronbaev T, Stein RT, Sterk PJ, Sunyer J, Terreehorst I, Toskala E, Tremblay Y, Valenta R, Valeyre D, Vandenplas O, van Weel C, Vassilaki M, Varraso R, Viegi G, Wang DY, Wickman M, Williams D, Wöhrl S, Wright J, Yorgancioglu A, Yusuf OM, Zar HJ, Zernotti ME, Zidarn M, Zhong N, Zuberbier T. Severe chronic allergic (and related) diseases: a uniform approach--a MeDALL--GA2LEN--ARIA position paper. Int Arch Allergy Immunol 2012; 158:216-31. [PMID: 22382913 DOI: 10.1159/000332924] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Concepts of disease severity, activity, control and responsiveness to treatment are linked but different. Severity refers to the loss of function of the organs induced by the disease process or to the occurrence of severe acute exacerbations. Severity may vary over time and needs regular follow-up. Control is the degree to which therapy goals are currently met. These concepts have evolved over time for asthma in guidelines, task forces or consensus meetings. The aim of this paper is to generalize the approach of the uniform definition of severe asthma presented to WHO for chronic allergic and associated diseases (rhinitis, chronic rhinosinusitis, chronic urticaria and atopic dermatitis) in order to have a uniform definition of severity, control and risk, usable in most situations. It is based on the appropriate diagnosis, availability and accessibility of treatments, treatment responsiveness and associated factors such as comorbidities and risk factors. This uniform definition will allow a better definition of the phenotypes of severe allergic (and related) diseases for clinical practice, research (including epidemiology), public health purposes, education and the discovery of novel therapies.
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Affiliation(s)
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- Centre Hospitalier Universitaire Montpellier, Montpellier Cedex 05, France.
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Moore HA, Apolles P, de Villiers PJT, Zar HJ. Sputum induction for microbiological diagnosis of childhood pulmonary tuberculosis in a community setting. Int J Tuberc Lung Dis 2012; 15:1185-90, i. [PMID: 21943843 DOI: 10.5588/ijtld.10.0681] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
SETTING Sputum induction has increasingly enabled microbiological confirmation of pulmonary tuberculosis (PTB) in hospitalised children, but it has not been evaluated in a community setting. OBJECTIVE To investigate the yield, feasibility and safety of sputum induction for the diagnosis of TB in children in a primary health care facility. DESIGN A prospective study in a primary health care clinic in South Africa from April 2007 to June 2009. Consecutive children with clinically suspected PTB, with a household adult PTB contact or human immunodeficiency virus infected with respiratory symptoms were enrolled. History, clinical examination, tuberculin skin test and chest X-ray results were recorded. Two sequential induced sputum specimens were obtained for smear and culture. RESULTS A total of 270 children were enrolled (median age 38 months); sputum induction was successful in 269 (99%); 65 (24%) children were clinically diagnosed, of whom 11 (16.9%) were microbiologically confirmed. An additional 18 children not clinically diagnosed had microbiological confirmation of PTB and were placed on TB treatment thereafter, increasing the diagnostic yield by 21.6%, from 65 to 83 cases. Sputum induction procedures were well tolerated; no major adverse events occurred. CONCLUSION Sputum induction is feasible and safe in a community setting. Sputum induction was useful for making a microbiological diagnosis, increasing the number of children diagnosed and treated for PTB.
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Affiliation(s)
- H A Moore
- Kuyasa Clinic, Khayelitsha, Cape Town, South Africa.
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Lalloo UG, Walters RD, Adachi M, de Guia T, Emelyanov A, Fritscher CC, Hong J, Jimenez C, King GG, Lin J, Loaiza A, Nadeau G, Neffen H, Sekerel BE, Yorgancioğlu A, Zar HJ. Asthma programmes in diverse regions of the world: challenges, successes and lessons learnt. Int J Tuberc Lung Dis 2011; 15:1574-87. [PMID: 21888756 DOI: 10.5588/ijtld.11.0289] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
International surveys have demonstrated that asthma is still underdiagnosed and undertreated in many parts of the world. Despite improvements in the standard of asthma care delivered in many areas, as evidenced by improved global asthma mortality data, much information on projects and programmes undertaken in resource-limited regions of the world is not in the public domain. The aim of this report is to review projects and programmes in diverse regions around the world so that health care providers, planners and consumers may draw on the successes, failures and lessons learnt. Such real world experiences may contribute to achieving Global Initiative for Asthma goals of asthma control. Asthma projects and programmes in Argentina, Australia, Brazil, China, Japan, Mexico, Philippines, Russia, South Africa and Turkey were discussed by a group of experts in asthma care, the Advancing Asthma Care Network, from their respective countries, over a course of three satellite meetings in 2010. Collective analyses consistently identified low rates of dissemination and implementation of national and international treatment guidelines, low levels of continuing medical education and training of primary health care professionals and access and distribution of inhaled corticosteroids to be major barriers that are critical to the overall success of a national asthma management programme. In the less developed asthma programmes, under-recognition and undertreatment further limited the success of the programmes. Evidence from well-established national asthma management programmes suggests that establishment of a successful programme entails a logical progression through specific developmental stages, starting with political/stakeholder endorsement and commitment, followed by epidemiological evaluation, evaluation of disease burden, evaluation of access to care and best therapy, and finally optimisation and maintenance therapy for individual patients.
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Affiliation(s)
- U G Lalloo
- Department of Pulmonology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
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Frigati LJ, Kranzer K, Cotton MF, Schaaf HS, Lombard CJ, Zar HJ. The impact of isoniazid preventive therapy and antiretroviral therapy on tuberculosis in children infected with HIV in a high tuberculosis incidence setting. Thorax 2011; 66:496-501. [PMID: 21460373 DOI: 10.1136/thx.2010.156752] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
BACKGROUND Tuberculosis (TB) is a major cause of morbidity and mortality among children infected with HIV. Strategies to prevent TB in children include isoniazid preventive therapy (IPT) and antiretroviral therapy (ART). IPT and ART have been reported to reduce TB incidence in adults but there are few studies in children. OBJECTIVE To investigate the combined effect of IPT and ART on TB risk in children infected with HIV. METHODS A cohort analysis was done within a prospective, double-blinded, placebo-controlled trial of isoniazid (INH) compared with placebo in children infected with HIV in Cape Town, South Africa, a high TB incidence setting. In May 2004 the placebo arm was terminated and all children were switched to INH. ART was not widely available at the start of the study, but children were started on ART following the establishment of the national ART program in 2004. Data were analysed using Cox proportional hazard regression. RESULTS After adjusting for age, nutritional status and immunodeficiency at enrolment, INH alone, ART alone and INH combined with ART reduced the risk of TB disease by 0.22 (95% CI 0.09 to 0.53), 0.32 (95% CI 0.07 to 1.55) and 0.11 (95% CI 0.04 to 0.32) respectively. INH reduced the risk of TB disease in children on ART by 0.23 (95% CI 0.05 to 1.00). CONCLUSIONS The finding that IPT may offer additional protection in children on ART has significant public health implications because this offers a possible strategy for reducing TB in children infected with HIV. Widespread use of this strategy will however require screening of children for active TB disease. Trial registration Trial registration-Clinical Trials NCT00330304.
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Affiliation(s)
- L J Frigati
- Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, Klipfontein Road, Rondebosch 7700, South Africa.
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Bousquet J, Schünemann HJ, Zuberbier T, Bachert C, Baena-Cagnani CE, Bousquet PJ, Brozek J, Canonica GW, Casale TB, Demoly P, Gerth van Wijk R, Ohta K, Bateman ED, Calderon M, Cruz AA, Dolen WK, Haughney J, Lockey RF, Lötvall J, O'Byrne P, Spranger O, Togias A, Bonini S, Boulet LP, Camargos P, Carlsen KH, Chavannes NH, Delgado L, Durham SR, Fokkens WJ, Fonseca J, Haahtela T, Kalayci O, Kowalski ML, Larenas-Linnemann D, Li J, Mohammad Y, Mullol J, Naclerio R, O'Hehir RE, Papadopoulos N, Passalacqua G, Rabe KF, Pawankar R, Ryan D, Samolinski B, Simons FER, Valovirta E, Yorgancioglu A, Yusuf OM, Agache I, Aït-Khaled N, Annesi-Maesano I, Beghe B, Ben Kheder A, Blaiss MS, Boakye DA, Bouchard J, Burney PG, Busse WW, Chan-Yeung M, Chen Y, Chuchalin AG, Costa DJ, Custovic A, Dahl R, Denburg J, Douagui H, Emuzyte R, Grouse L, Humbert M, Jackson C, Johnston SL, Kaliner MA, Keith PK, Kim YY, Klossek JM, Kuna P, Le LT, Lemiere C, Lipworth B, Mahboub B, Malo JL, Marshall GD, Mavale-Manuel S, Meltzer EO, Morais-Almeida M, Motala C, Naspitz C, Nekam K, Niggemann B, Nizankowska-Mogilnicka E, Okamoto Y, Orru MP, Ouedraogo S, Palkonen S, Popov TA, Price D, Rosado-Pinto J, Scadding GK, Sooronbaev TM, Stoloff SW, Toskala E, van Cauwenberge P, Vandenplas O, van Weel C, Viegi G, Virchow JC, Wang DY, Wickman M, Williams D, Yawn BP, Zar HJ, Zernotti M, Zhong N. Development and implementation of guidelines in allergic rhinitis – an ARIA-GA2LEN paper. Allergy 2010; 65:1212-21. [PMID: 20887423 DOI: 10.1111/j.1398-9995.2010.02439.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The links between asthma and rhinitis are well characterized. The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines stress the importance of these links and provide guidance for their prevention and treatment. Despite effective treatments being available, too few patients receive appropriate medical care for both diseases. Most patients with rhinitis and asthma consult primary care physicians and therefore these physicians are encouraged to understand and use ARIA guidelines. Patients should also be informed about these guidelines to raise their awareness of optimal care and increase control of the two related diseases. To apply these guidelines, clinicians and patients need to understand how and why the recommendations were made. The goal of the ARIA guidelines is to provide recommendations about the best management options for most patients in most situations. These recommendations should be based on the best available evidence. Making recommendations requires the assessment of the quality of available evidence, deciding on the balance between benefits and downsides, consideration of patients’ values and preferences, and, if applicable, resource implications. Guidelines must be updated as new management options become available or important new evidence emerges. Transparent reporting of guidelines facilitates understanding and acceptance, but implementation strategies need to be improved.
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Affiliation(s)
- Jean Bousquet
- University Hospital, Hôpital Arnaud de Villeneuve, Montpellier Cedex 5, France.
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Pitcher RD, Beningfield SJ, Zar HJ. Chest radiographic features of lymphocytic interstitial pneumonitis in HIV-infected children. Clin Radiol 2009; 65:150-4. [PMID: 20103438 DOI: 10.1016/j.crad.2009.10.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2009] [Revised: 09/12/2009] [Accepted: 10/05/2009] [Indexed: 11/18/2022]
Abstract
AIM To review the radiological features of biopsy-proven lymphocytic interstitial pneumonitis (LIP) in human immunodeficiency virus (HIV)-infected children and establish whether these are based on systematic radiological analysis, and to investigate whether more specific radiological diagnostic criteria can be developed. MATERIALS AND METHODS A Medline search of English-language articles on the radiological features of biopsy-proven LIP in HIV-infected children was conducted for the period 1982 to 2007 inclusive. Radiological findings were compared with the Centers for Disease Control and Prevention (CDC) criteria for a presumptive diagnosis of LIP. RESULTS Pulmonary pathology was recorded as "diffuse" and "bilateral" in 125 (97.6%) of 128 reported cases of LIP. Twenty-five different terms were used to describe the pulmonary parenchyma. In 96 (75%), the terminology was consistent with CDC diagnostic criteria. Radiological evolution was documented in 43 (33.5%). Persistent focal opacification superimposed on diffuse pulmonary nodularity was demonstrated in 10 (7.8%). The method of radiological evaluation was described in six (4.6%). In no instance was the terminology defined. CONCLUSION The radiological features of LIP have not been systematically analysed. However, CDC criteria remain reliable, allowing diagnosis of at least 75% of cases. The sensitivity of these criteria may be increased by including cases with persistent focal pulmonary opacification superimposed on diffuse nodularity. Longitudinal studies utilizing standardized radiographic analysis are needed to elucidate the natural history of LIP.
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Affiliation(s)
- R D Pitcher
- Division of Paediatric Radiology, Red Cross War Memorial Children's Hospital, Department of Radiation Medicine, University of Cape Town, South Africa.
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Motala C, Green RJ, Manjra AI, Potter PC, Zar HJ. Guideline for the management of chronic asthma in children--2009 update. S Afr Med J 2009; 99:898-912. [PMID: 20455316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
OBJECTIVE To revise the guideline for the diagnosis and management of chronic asthma in children in view of the following considerations: the existing South African Childhood Asthma Working Group (SACAWG) guideline was produced 10 years ago; diagnosis of asthma in young children remains a challenge; evidence-based treatment is the new paradigm; new treatment approaches to achieving and maintaining control; therapeutic roles of several medications have evolved; more studies and data on treatment in young children; new medications and formulations; a change of emphasis in assessing asthma control to guide treatment changes. The main aim of the guideline is to promote a better standard of treatment based on understanding of the pathophysiology and pharmacotherapy of asthma, and encouraging uniformity in asthma management. EVIDENCE A detailed literature review by a working group of clinicians from relevant disciplines. The strategies recommended are classified according to the evidence category in Appendix B, and denoted as Evidence A, B, C and D. RECOMMENDATIONS These include an appropriate diagnostic approach, environmental control measures, treatment options, definition of asthma control, and strategies to achieve control. ENDORSEMENT The guideline document was endorsed by the South African Thoracic Society (SATS), the National Asthma Education Programme (NAEP), the South African Paediatric Association (SAPA) and the South African Academy of Family Practice.
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Affiliation(s)
- C Motala
- Division of Allergy, Department of Paediatrics and Child Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town.
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Hatherill M, Hawkridge T, Zar HJ, Whitelaw A, Tameris M, Workman L, Geiter L, Hanekom WA, Hussey G. Induced sputum or gastric lavage for community-based diagnosis of childhood pulmonary tuberculosis? Arch Dis Child 2009; 94:195-201. [PMID: 18829621 DOI: 10.1136/adc.2007.136929] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the diagnostic yield of Mycobacterium tuberculosis from induced sputum (IS) and gastric lavage (GL) among children in a community setting. METHODS Specimen-collection methods for bacteriological confirmation of pulmonary tuberculosis (PTB) were compared during a tuberculosis vaccine trial near Cape Town, South Africa (2001-2006). Children with a tuberculosis contact or compatible symptoms were investigated for suspected PTB. Diagnostic yields from 764 paired IS and GL specimens were compared in 191 culture-confirmed cases. MEASUREMENTS AND MAIN RESULTS The crude yield of M tuberculosis was 10.4%, n = 108 by IS (5.8%) and n = 127 by GL (6.8%), from a total of 194 cases, of which three had incomplete IS/GL specimen pairs. Agreement between IS and GL was poor (kappa = 0.31). The comparative yield of a single IS sample (38%) was equivalent to a single GL sample (42%), with a difference in yield of -4% (95% CI -15% to +7%). The combined yield of same-day IS and GL specimens (67%) was equivalent to two consecutive GL specimens (66%), with a difference in yield of 1% (95% CI -9% to 11%), but significantly greater than two consecutive IS specimens (55%), with a difference in yield of 12% (95% CI 2% to 21%). The adjusted odds of a M tuberculosis culture were increased by a positive tuberculin skin test or chest radiograph compatible with PTB. CONCLUSIONS In this community setting, the diagnostic yield of a single IS sample was equivalent to that of a single GL sample. The optimal diagnostic yield may be obtained from paired IS and GL specimens taken on a single day or two GL specimens taken on consecutive days.
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Affiliation(s)
- M Hatherill
- South African Tuberculosis Vaccine Initiative (SATVI), Institute of Infectious Disease and Molecular Medicine (IIDMM), University of Cape Town, Cape Town, South Africa.
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Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald JM, Gibson P, Ohta K, O'Byrne P, Pedersen SE, Pizzichini E, Sullivan SD, Wenzel SE, Zar HJ. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008; 31:143-78. [PMID: 18166595 DOI: 10.1183/09031936.00138707] [Citation(s) in RCA: 1960] [Impact Index Per Article: 122.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Asthma is a serious health problem throughout the world. During the past two decades, many scientific advances have improved our understanding of asthma and ability to manage and control it effectively. However, recommendations for asthma care need to be adapted to local conditions, resources and services. Since it was formed in 1993, the Global Initiative for Asthma, a network of individuals, organisations and public health officials, has played a leading role in disseminating information about the care of patients with asthma based on a process of continuous review of published scientific investigations. A comprehensive workshop report entitled "A Global Strategy for Asthma Management and Prevention", first published in 1995, has been widely adopted, translated and reproduced, and forms the basis for many national guidelines. The 2006 report contains important new themes. First, it asserts that "it is reasonable to expect that in most patients with asthma, control of the disease can and should be achieved and maintained," and recommends a change in approach to asthma management, with asthma control, rather than asthma severity, being the focus of treatment decisions. The importance of the patient-care giver partnership and guided self-management, along with setting goals for treatment, are also emphasised.
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Affiliation(s)
- E D Bateman
- University of Cape Town Lung Institute, PO Box 34560, Groote School, 7700 Mowbray, Cape Town, South Africa.
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Pitcher RD, Zar HJ. Radiographic features of paediatric pneumocystis pneumonia -- a historical perspective. Clin Radiol 2008; 63:666-72. [PMID: 18455558 DOI: 10.1016/j.crad.2007.08.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2007] [Revised: 08/16/2007] [Accepted: 08/24/2007] [Indexed: 11/18/2022]
Abstract
AIM To determine differences between the plain radiographic features of paediatric pneumocystis pneumonia (PCP) recorded before the emergence of human immunodeficiency virus (HIV) in 1982 and those documented in the HIV era. To establish differences in the radiographic features of PCP documented in HIV-infected children in developed and developing countries. METHOD A Medline search of articles was conducted from 1950 to 2006, using the terms "pneumocystis pneumonia in children" and "chest radiographic features" or "bilateral opacification" or "lobar consolidation" or "asymmetrical opacification" or "pneumatocoeles" or "cavities" or "pneumothorax" or "pneumomediastinum" or "pleural effusion" or "mediastinal adenopathy" or "nodules" or "normal chest radiography". Appropriate articles were retrieved, radiological data extracted, reference lists examined and hand searches of referenced articles conducted. RESULTS Diffuse bilateral "ground-glass" or alveolar pulmonary opacification, which may show some asymmetry, has been consistently documented as the commonest radiographic finding in childhood PCP throughout the period under review. The less common radiological features of PCP in children are similar to those in adults. In developed countries, PCP-related pulmonary air cysts have been reported at an earlier age in HIV-infected children, compared with uninfected children. PCP-related air cysts, pneumothorax, and pneumomediastinum have been reported in children in developed but not in developing countries. CONCLUSION The radiological features of paediatric PCP documented before the HIV epidemic are similar to those recorded in the HIV era. Further study of the determinants of the uncommon radiographic features in children is warranted.
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Affiliation(s)
- R D Pitcher
- Division of Paediatric Radiology, Red Cross War Memorial Children's Hospital, School of Child and Adolescent Health, University of Cape Town, Cape Town, South Africa.
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Green RJ, Feldman C, Schoub B, Richards GA, Madhi SA, Zar HJ, Lalloo U, Klugman K, Phillips D, Cameron NA, Eggers RR. Influenza guideline for South Africa--update 2008. S Afr Med J 2008; 98:224-230. [PMID: 18652399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE The South African Thoracic Society, in conjunction with interested stakeholders, published a Guideline for Influenza Management in Adults in 1999. This year the South African Thoracic Society (SATS) identified the need to revise that guideline for the following reasons: * To indicate the viral strains that are to be incorporated into the vaccine for the 2008 season * To add important new data regarding treatment of influenza * To add a section on influenza in children * To clarify issues in managing and preventing influenza in HIV-infected individuals. INFLUENZA VIRUS The influenza virus genus belongs to the family orthomyxoviridae. The haemagglutinin (HA) protein is the outermost protein, responsible for attachment to the host receptor, and is critical in determining the host's immune response to the virus. Changes in the antigenic epitopes of HA therefore allow the virus to escape the host's specific immune response. The genus is classified into three types, A, B and C, on the basis of the antigenic epitopes of the nucleoprotein (NP). Type A, which is widespread in nature in birds and mammals, is the most important type clinically and epidemiologically. It is further divided into subtypes on the basis of the antigenic epitopes of the HA and neuraminidase (NA) proteins. Each of the human subtypes H1N1, H2N2 and H3N2 are further subdivided into strains on the basis of more subtle antigenic properties of the HA protein. INFLUENZA VACCINATION Influenza vaccine is the mainstay of influenza prevention strategies. All persons who are at high risk of influenza and its complications because of underlying medical conditions or who are receiving regular medical care for conditions such as chronic pulmonary and cardiac disease, chronic renal diseases, neuromuscular diseases, diabetes mellitus and similar metabolic disorders, and individuals who are immunosuppressed (including HIV-infected persons with CD4 counts above 100 cells/microl and HIV-infected children with CD4 counts >15%), should be vaccinated. Vaccines should be given from at least 2 months prior to the onset of autumn (March in South Africa). The recommended vaccine formulation for 2008 is: * A/Solomon Islands/3/2006 (H1N1) (IVR-145) * A/Brisbane/10/2007 (H3N2) (IVR-147) * B/Florida/4/2006 or B/Brisbane/3/2007. TREATMENT OF INFLUENZA Influenza illness is characterised by the acute onset of systemic and respiratory signs occurring in autumn or winter. Recommendations for the Prevention and Control of Influenza have indicated that neither amantadine nor rimantadine should be used for the treatment or chemoprophylaxis of influenza A. NA inhibitors are an important adjunct to influenza vaccination, in both the prevention and treatment of influenza. Because of concerns about the possibility of the development of viral resistance with overuse of these agents, it is recommended that NA inhibitors in the treatment of influenza should be reserved for high-risk or sicker influenza patients.
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Affiliation(s)
- R J Green
- Department of Paediatrics and Child Health, University of Pretoria, Pretoria.
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Green RJ, Zar HJ, Bateman ED. Asthma--is survival good enough? S Afr Med J 2007; 97:172-4. [PMID: 17440659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Affiliation(s)
- R J Green
- Department of Paediatrics and Child Health, University of Pretoria, South Africa.
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Ait-Khaled N, Odhiambo J, Pearce N, Adjoh KS, Maesano IA, Benhabyles B, Bouhayad Z, Bahati E, Camara L, Catteau C, El Sony A, Esamai FO, Hypolite IE, Melaku K, Musa OA, Ng'ang'a L, Onadeko BO, Saad O, Jerray M, Kayembe JM, Koffi NB, Khaldi F, Kuaban C, Voyi K, M'Boussa J, Sow O, Tidjani O, Zar HJ. Prevalence of symptoms of asthma, rhinitis and eczema in 13- to 14-year-old children in Africa: the International Study of Asthma and Allergies in Childhood Phase III. Allergy 2007; 62:247-58. [PMID: 17298341 DOI: 10.1111/j.1398-9995.2007.01325.x] [Citation(s) in RCA: 142] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Phase I of the International Study of Asthma and Allergies in Childhood has provided valuable information regarding international prevalence patterns and potential risk factors in the development of asthma, allergic rhinoconjunctivitis and eczema. However, in Phase I, only six African countries were involved (Algeria, Tunisia, Morocco, Kenya, South Africa and Ethiopia). Phase III, conducted 5-6 years later, enrolled 22 centres in 16 countries including the majority of the centres involved in Phase I and new centres in Morocco, Tunisia, Democratic Republic of Congo, Togo, Sudan, Cameroon, Gabon, Reunion Island and South Africa. There were considerable variations between the various centres of Africa in the prevalence of the main symptoms of the three conditions: wheeze (4.0-21.5%), allergic rhinoconjunctivitis (7.2-27.3%) and eczema (4.7-23.0%). There was a large variation both between countries and between centres in the same country. Several centres, including Cape Town (20.3%), Polokwane (18.0%), Reunion Island (21.5%), Brazzaville (19.9%), Nairobi (18.0%), Urban Ivory Coast (19.3%) and Conakry (18.6%) showed relatively high asthma symptom prevalences, similar to those in western Europe. There were also a number of centres showing high symptom prevalences for allergic rhinoconjunctivitis (Cape Town, Reunion Island, Brazzaville, Eldoret, Urban Ivory Coast, Conakry, Casablanca, Wilays of Algiers, Sousse and Eldoret) and eczema (Brazzaville, Eldoret, Addis Ababa, Urban Ivory Coast, Conakry, Marrakech and Casablanca).
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Affiliation(s)
- N Ait-Khaled
- International Union Against Tuberculosis and Lung Disease, Paris, France
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