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The development of the Asthma Control Test (ACT), a short, simple, patient-based tool for identifying patients with poorly controlled asthma, was recently described in patients under the routine car
...
e of an asthma specialist.
We sought to evaluate the reliability and validity of the ACT in a longitudinal study of asthmatic patients new to the care of an asthma specialist.
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Asthma is a long term illness of the lungs that causes the airways to become inflamed and produce lots of mucus. Viral infections, cold air, allergens, exercise, and smoke make the airways “twitchy”; they close easily causing
...
asthma attacks with coughing, wheezing and shortness of breath (see what is asthma). Between attacks the airways are inflamed (see what is an allergy).
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Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite gl
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obal efforts, asthma continues to be an important public health problem worldwide, particularly in poorly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.
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The Asthma Control Questionnaire (ACQ) was developed to measure the primary goals of asthma management as identified by international guidelines. All guidelines indicate that to achieve good control
...
, treatment should minimise day- and night-time symptoms, activity limitation, airway narrowing and rescue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity. Three independent studies have provided evidence that the ACQ is valid for measuring asthma control and has strong measurement properties for use both in clinical practice and research. In addition, the smallest change in score that can be considered clinically important has been determined.
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Asthma guidelines indicate that the goal of treatment should be optimum asthma control. In a busy clinic practice with limited time and resources, there is need for a simple method for assessing
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asthma control with or without lung function testing.
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Urbanisation has been associated with temporal and geographical differences in asthma prevalence in low-income and middle-income countries (lMics). however, little is known of the mechanisms by which urbanisation and
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asthma are associated, perhaps explained by the methodological approaches used to assess the urbanisation-asthma relationship.
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Asthma is a very commom condition. It cannot be cured, but can controlled with effective medication, good technique, and good monitoring by the patients are having no or few symptoms, no attacks needingg hospital visits and no or little emergency re
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liever medication use. Another way of assessing asthma control is to do tests that measure the function of your lungs. These tests are sometimes also done to help with the diagnosis of asthma.
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Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study
García-Marcos, L.; Chiang, C. Y.; Asher, I.; et al.
The Lancet Global Health Volume 11, Issue 2e218-e228February 2023
(2023)
CC2
Asthma is one of the most common non-communicable diseases globally. This study aimed to assess asthma medicine use, management plan availability, and disease control in childhood, adolescence, and
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adulthood across different country settings.
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Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the pr
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evalence of asthma is among the highest in the world. Asthma admissions are very common in children, leading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.
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Diagnosing asthma in children represents an important clinical challenge. There is no single gold-standard test to confirm the diagnosis. Consequently, over- and under-diagnosis of asthma is frequen
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t in children. A task force supported by the European Respiratory Society has developed these evidence-based clinical practice guidelines for the diagnosis of asthma in children aged 5–16 years using nine Population, Intervention, Comparator and Outcome (PICO) questions. The task force conducted systematic literature searches for all PICO questions and screened the outputs from these, including relevant full-text articles. All task force members approved the final decision for inclusion of research papers. The task force assessed the quality of the evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
The task force then developed a diagnostic algorithm based on the critical appraisal of the PICO questions, preferences expressed by lay members and test availability. Proposed cut-offs were determined based on the best available evidence. The task force formulated recommendations using the GRADE Evidence to Decision framework.
Based on the critical appraisal of the evidence and the Evidence to Decision framework, the task force recommends spirometry, bronchodilator reversibility testing and exhaled nitric oxide fraction as first-line diagnostic tests in children under investigation for asthma. The task force recommends against diagnosing asthma in children based on clinical history alone or following a single abnormal objective test. Finally, this guideline also proposes a set of research priorities to improve asthma diagnosis in children in the future.
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Asthma is a common breathing condition that affects 20% of all children Asthma tends to run in families, although this is not always the case. You may have seen someone at school who uses an inhale
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r to help them breathe better and control asthma symptoms.
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Asthma usually causes symptoms over a long period and cannot be cured. But asthma can be kept under control so that those affected are able to live enjoying full involvement in sport and all other a
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vtivies. New guidelines for the treatment of asthma put effective control of asthma as the most important goal.
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Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The diagnosis of asthma in young children is li
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mited by the inability to perform objective lung function testing in this group of patients and the wide variety of conditions that can phenotypically present with asthma-like symptoms.
This article provides an evidence-based approach for clinicians to accurately diagnose asthma in young children and to assess the level of control to guide therapeutic decisions.
The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 with task groups, each headed by a section leader, constituting the editorial committee on assessment of asthma epidemiology, diagnosis, control, treatments, novel treatments and self-management plans. The asthma diagnosis and control task groups reviewed the available scientific literature and assigned evidence according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system, providing recommendations based on current evidence.
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Asthma is the most common chronic illness of childhood. The prevalence is rising and the mortality and morbidity from asthma are unacceptably high in South Africa. This article emphasizes the import
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ance to make a correct diagnosis based, most importantly, on the clinical history and supported by investigations. Further, the appropriate drug and device must be chosen to achieve good asthma control. It explains that patients must be followed up regularly and their asthma control must be assessed so that the treatment can then be adjusted according to the level of control. Additionally, Asthma education and adherence are important components of management of the condition.
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The epidemiology of wheeze in children, when assessed by questionnaires, is dependent on parents' understanding of the term “wheeze”.
In a questionnaire survey of a random population sample of 4,236 children aged 6–10 yrs, parents' definition of wheeze was assessed. Predictors of a correct
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definition were determined and the potential impact of incorrect answers on prevalence estimates from the survey was assessed.
Current wheeze was reported by 13.2% of children. Overall, 83.5% of parents correctly identified “whistling or squeaking” as the definition of wheeze; the proportion was higher for parents reporting wheezy children (90.4%). Frequent attacks of reported wheeze (adjusted odds ratio (OR) 3.0), maternal history of asthma (OR 1.5) and maternal education (OR 1.5) were significantly associated with a correct answer, while the converse was found for South Asian ethnicity (OR 0.6), first language not English (OR 0.6) and living in a deprived neighbourhood (OR 0.6).
In summary, the present study showed that misunderstanding could lead to an important bias in assessing the prevalence of wheeze, resulting in an underestimation in children from South Asian and deprived family backgrounds. Prevalence estimates for the most severe categories of wheeze might be less affected by this bias and questionnaire surveys on wheeze should incorporate measures of parents' understanding of the term wheeze.
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You can’t cure asthma. However, you can take steps to control the disease and prevent its symptoms. For example:
-Learn about your asthma and ways to control it
-Follow your written
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asthma action plan
-Use medicines as your doctor prescribes (Here’s how to use your inhaler device)
-Identify and try to avoid things that make your asthma worse
-Keep track of your asthma symptoms and level of control
-Get regular checkups for your asthma
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Asthma is a long term illness of the lungs that causes the tubes that carry air into and out of the lungs (airways) to become swollen (inflamed) and produce lots of thick mucus.
In a person with asthma
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, the lung swelling (inflammation) makes the airways “twitchy”; this means they close easily with certain things like viral infections, cold air, allergens, exercise, and smoke.
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People with asthma (PWA) generally are considered at higher risk from respiratory infections, as is seen annually with influenza. At the outset of the COVID-19 pandemic, PWA were widely assumed to be at increased risk from COVID-19. However, as data
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emerged throughout 2020, the association between asthma and COVID-19 appeared less clear.
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In the European Union, over 20 million people suffer from asthma. During the 1990s there was a rapid decrease in asthma mortality, probably related to the increased use of inhaled corticosteroids (I
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CS). However, during the last decade, asthma mortality rates have plateaued, and a consistently high proportion of patients have uncontrolled asthma. As a result, many patients with asthma still have impaired quality of life and suffer from chronic respiratory symptoms, often including night-time symptoms, causing sleep disturbance, excessive daytime sleepiness and decreased work productivity.
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Asthma is the commonest chronic respiratory tract disease in children. In low-income countries, challenges exist in asthma diagnosis. In surveys done in children, the prevalence of ‘
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asthma’ defined by symptoms is high compared to ‘doctor diagnosed asthma’. The questions answered by this review are What challenges have been experienced in the diagnosis of asthma in children? What solutions will address these challenges?
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