Benralizumab in Severe Eosinophilic Asthma and Chronic Rhinosinusitis with Nasal Polyps: The Real-World, Multi-Country RANS Observational Study.

Purpose: Real-world evidence of benralizumab effectiveness on nasal polyps (NP) and asthma outcomes in patients with severe eosinophilic asthma (SEA) and comorbid chronic rhinosinusitis with NP are limited. The objective of this study was to assess NP and asthma outcomes in benralizumab-treated patients with SEA and comorbid NP in a real-world setting. Patients and Methods: RANS was a retrospective, multi-country observational study (ClinicalTrials.gov: NCT05180357) using medical chart reviews of adults with SEA and comorbid NP. Total NP Score (NPS), SinoNasal Outcome Test-22 (SNOT-22) total score, annualized exacerbation rate (AER), and 6-item Asthma Control Questionnaire (ACQ-6) and Asthma Control Test (ACT) scores during the 12 months pre-index (baseline) and post-index (follow-up) were measured. Clinically meaningful improvement from baseline following treatment, in terms of total NPS (≥1-point reduction), SNOT-22 total (≥8.9-point reduction), ACQ-6 (≥0.5-point reduction) or ACT (≥3-point increase) scores, were reported. Results: A total of 233 patients were included. Baseline mean (standard deviation [SD]) NPS and SNOT-22 total scores were 3.8 (2.4) and 47.5 (22.6), respectively. The mean change (95% confidence interval [CI]) from baseline was -1.2 (-1.7, -0.6) for NPS, and -19.8 (-23.6, -15.9) for SNOT-22. The AER (95% CI) was 1.2 (0.96, 1.41) at baseline and 0.2 (0.13, 0.28) at follow-up. Mean (SD) ACQ-6 and ACT scores were 1.6 (1.3) and 15.0 (5.2) at baseline and 0.8 (1.0) and 22.0 (3.9) at follow-up, respectively. The proportion of patients who achieved clinically meaningful improvements in NPS, SNOT-22 total, ACQ-6, and ACT scores was 49.1%, 67.6%, 56.6%, and 81.1%, respectively. Conclusion: In this real-world study, improvements in NP and asthma outcomes in patients with SEA and comorbid NP were observed during the 12 months following benralizumab initiation.

Assessment of snakebite management practices at Meserani Juu in Monduli District, Northern Tanzania.

BACKGROUND: Snakebite envenoming represents a tragically neglected tropical disease mostly affecting poor people living in remote areas of developing countries, primarily in sub-Saharan Africa. Anti-snake venom (ASV) is the only approved specific treatment for systemic envenoming from snakebite, but it remains largely unavailable in many parts of developing countries. There is paucity of data on snakebite management practice in Tanzania. This study aimed at assessing the community management practices of snakebite and availability of anti-snake venom in the public health facilities in Monduli District, Northern Tanzania. METHODS: A cross sectional study was carried out between May and June, 2018 involving 67 victims, 147 other household members, and 35 public health facilities. A structured questionnaire, respondent interview, and health facility report/document review were considered during data collection. Clean data were analyzed using SPSS version 20. RESULTS: Sixty-seven snakebite victims and 147 other household members were interviewed during a household survey. All snakebite cases reported to having visited a health facility after snakebite with the majority 55/67 (82.1%) reporting the use, prior attendance to medical care, of some form of local treatment such as tourniquets 13 (19.4%), local incision 11 (16.4%), and snakestone 7 (10.4%). None of the public health facilities in Monduli District attended a snakebite case and had never stocked anti-snake venom products. In this area, 45 snakebite cases were reported to be managed at Meserani snake park clinic where anti-snake venom products were available and provided for free in the period between January 2017 and December 2017. CONCLUSION: Majority of the snakebite cases at Meserani Juu relied on local methods for the management of snake bites of which most are of unknown efficacy and safety. Furthermore, none of the primary public health facilities in Monduli District stocked antivenom despite being a habitat for different kinds of venomous snakes. The government and local non-government organizations should collaborate so as to improve the anti-snake venom availability and the provision of snakebite preventive and management awareness programs, especially to the rural communities.

Effect of a smoking cessation educational intervention on knowledge and confidence of pharmacy students versus community leaders

Background: Training programs of various intensities and durations have been implemented to assist healthcare providers and students in leading smokers in a quit attempt. While some training programs have been developed to help community leaders provide these services, the focus for community leaders has been to assist with recruitment efforts. Objective: The objective of this study was to compare knowledge and confidence of students and community members before and after a smoking cessation educational intervention. Methods: After approval from the institutional review board, pharmacy students and community members were recruited for two-hour educational interventions. Topics covered included smoking health risks, benefits of quitting, behavioral, cognitive, and stress-management techniques, smoking cessation medications, and how to start a formal class. Pre- and post-intervention survey instruments were given to all participants with comparisons made via Student's or Paired T-tests, as appropriate. Results: Knowledge scores increased significantly (p<0.05) after the educational intervention for pharmacy students (n=30) and community members (n=8). Confidence scores increased significantly for pharmacy students (p<0.05), but not for community members. Pharmacy students had significantly greater knowledge score changes (53.7%, pre-intervention; 81.8%, post-intervention; p<0.05) versus community members (32.1%, pre-intervention; 50.1%, post-intervention; p<0.05). When comparing individual confidence questions, only scores evaluating the change in confidence for providing counseling were higher for students versus community members (2.13 vs. 1.8, respectively; p<0.05). Conclusions: Pharmacy students and community leaders exhibited increased knowledge after a smoking cessation educational intervention, and pharmacy students had increased confidence scores. All confidence scores did not change significantly for community members. Developing coalitions between healthcare providers and community leaders, focusing on the roles of each, may be productive in initiating smoking cessation programs

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