It was hypothesized that a health education program for children with asthma aged 8-11 years that was delivered in elementary schools, would increase children's asthma management skills, self-efficacy and influence on parents' management decisions; reduce school absences and improve school performance. The study population consisted of 239 low-income, predominantly Hispanic and black children from 12 elementary schools (six experimental and six control) in New York City. Parents did not attend educational sessions but received written materials. The program emphasized the child's responsibility for recognizing symptoms and taking appropriate management steps. Follow-up data obtained one year after the program showed that compared to controls experimental group children had higher scores on an index of asthma management (p less than 0.05), greater self-efficacy with respect to asthma management skills (p less than 0.05), more influence on parents' asthma management decisions (p less than 0.05), better grades in school (p = 0.05), and fewer episodes of asthma (p less than 0.01) of shorter average duration (p less than 0.01). No differences were observed for changes in number of school absences. These findings show that asthma health education designed for delivery to children can significantly increase management skills, reduce symptoms of asthma, and improve school performance.

Nearly 1 in 6 patients receiving ART in a resource-constrained setting had discontinued follow-up over a 15-month period. Early mortality was high, especially in those with profound immunosuppression. Improving access to care and streamlining patient tracking may improve ART outcomes.

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Pulmonary tuberculosis (PTB) and pneumococcal community-acquired pneumonia (PCAP) are common causes of lower respiratory tract infections in HIV-seropositive patients and may have similar clinical and radiological features. This study aimed to assess the value of serum procalcitonin (PCT) and C-reactive protein (CRP) levels in HIV-seropositive patients with pneumonia, and to investigate their potential role in differentiating pneumococcal from mycobacterial infections.HIV-seropositive patients admitted with pneumonia were evaluated prospectively, 34 with PTB and 33 with PCAP.All 33 patients in the PCAP group and 20 of 34 patients in the PTB group had elevated PCT levels (.0.1 ng?mL -1 ). All patients in both groups had elevated CRP levels (.10 mg?L -1). The PTB group had significantly lower CD4 T-lymphocyte counts, lower CRP levels, lower white cell counts, and lower PCT levels than the PCAP group. Receiver operating characteristic analysis showed that optimal discrimination between PTB and PCAP could be performed at a cut-off point of 3 ng?mL -1 for PCT (sensitivity 81.8%; specificity 82.35%) and 246 mg?L -1 for CRP (sensitivity 78.8%; specificity 82.3%).In conclusion, HIV-seropositive patients with pneumococcal community-acquired pneumonia had significantly higher procalcitonin and C-reactive protein levels than those with pulmonary tuberculosis. A procalcitonin level .3 ng?mL -1 and a C-reactive protein level .246 mg?L -1 were both highly predictive of pneumococcal infection.