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The reader acknowledges that this report is intended as an evidence-based asthma management strategy, for the use of health professionals and policy-makers. It is based, to the best of our knowledge, on current best evidence and medical knowledge an
...
d practice at the date of publication. When assessing and treating patients, health professionals are strongly advised to use their own professional judgment, and to take into account local or national regulations and guidelines. GINA cannot be held liable or responsible for inappropriate healthcare associated with the use of this document, including any use which is not in accordance with applicable local or national regulations or guidelines.
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The article "An Official ATS Workshop Report: Issues in Screening for Asthma in Children" summarizes discussions from a workshop organized by the American Thoracic Society (ATS) on the challenges of asthma
...
screening in children. The report reviews the effectiveness of population-based asthma screening programs, highlights the limitations of current methods, and discusses case detection as an alternative. It assesses asthma's impact as a public health issue, explores the feasibility of screening tests, and examines the economic and practical challenges. The workshop concludes that broad population-based screening may not be justified without better evidence and targeted efforts to improve follow-up care and treatment access.
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Asthma is the most common chronic disease in children globally. The Global Asthma Network (GAN) Phase I study aimed to determine if the worldwide burden of
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asthma symptoms is changing.
This updated cross-sectional study used the same methods as the International study of Asthma and Allergies in Childhood (ISAAC) Phase III. Asthma symptoms were assessed from centres that completed GAN Phase I and ISAAC Phase I (1993–95), ISAAC Phase III (2001–03), or both. We included individuals from two age groups (children aged 6–7 years and adolescents aged 13–14 years) who self-completed written questionnaires at school. We estimated the 10-year rate of change in prevalence of current wheeze, severe asthma symptoms, ever having asthma, exercise wheeze, and night cough (defined by core questions in the questionnaire) for each centre, and we estimated trends across world regions and income levels using mixed-effects linear regression models with region and country income level as confounders.
Overall, 119 795 participants from 27 centres in 14 countries were included: 74 361 adolescents (response rate 90%) and 45 434 children (response rate 79%). About one in ten individuals of both age groups had wheeze in the preceding year, of whom almost half had severe symptoms. Most centres showed a change in prevalence of 2 SE or more between ISAAC Phase III to GAN Phase I. Over the 27-year period (1993–2020), adolescents showed a significant decrease in percentage point prevalence per decade in severe asthma symptoms (–0·37, 95% CI –0·69 to –0·04) and an increase in ever having asthma (1·25, 0·67 to 1·83) and night cough (4·25, 3·06 to 5·44), which was also found in children (3·21, 1·80 to 4·62). The prevalence of current wheeze decreased in low-income countries (–1·37, –2·47 to –0·27], in children and –1·67, –2·70 to –0·64, in adolescents) and increased in lower-middle-income countries (1·99, 0·33 to 3·66, in children and 1·69, 0·13 to 3·25, in adolescents), but it was stable in upper-middle-income and high-income countries.
Trends in prevalence and severity of asthma symptoms over the past three decades varied by age group, country income, region, and centre. The high worldwide burden of severe asthma symptoms would be mitigated by enabling access to effective therapies for asthma.
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Asthma is chronic inflammation of the airways in the lungs.
In asthma, the airways in the lung narrow due to swelling of
the mucosa, increased mucus production, and spasm of the airways.
Several challenges face asthma management in Egypt, including the high percentage of uncontrolled patients, inadequate compliance, and overuse of short-acting beta-agonists (SABAs) leading to increased ast
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hma-related morbidity and mortality. In this regard, the recent Global Initiative for Asthma (GINA) recommendations included inhaled corticosteroids containing therapy for mild asthma. Local healthcare systems and healthcare professionals (HCPs) often experience practical challenges when implementing global guidelines.
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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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The Asthma Control Questionnaire (ACQ)1 was developed and validated to measure the primary clinical goal of asthma management as identified by international guidelines. They indicate that to achieve
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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. The importance of including all aspects of control in the assessment of individual patients was emphasised by a recent factor analysis which showed that clinical asthma is composed of distinct components which are not closely correlated with each other.6 However, in some studies it may not be possible to collect airway calibre or short-acting β2-agonists data. Previous analysis of non-clinical trial data suggested that when ACQ scores are analysed as group data, the heterogeneity of the way in which individual patients present with inadequate control is lost in the estimation of the mean and the need to measure each individual component of asthma control may become unnecessary. In this analysis, ACQ data from a clinical trial was used to evaluate the measurement properties (reliability, responsiveness, validity and interpretability), of three shortened versions of the ACQ. In addition, we have examined whether the precision and accuracy of estimating the effect of the intervention on asthma control was maintained when the two questions concerning airway calibre and short-acting β2-agonists use were omitted from the trial analysis.
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The ‘jigsaw puzzle’ approach to building a diagnostic picture of asthma in primary care over time
Ryan, D.; Kocks, J.; Correia de Sousa, J. et al.
International Primary Care Respiratory Group
(2023)
CC
Since there is no single objective diagnostic test for asthma this study suggests an approach of collecting and assembling pieces of clinical information to create a diagnostic picture, like making a jigsaw puzzle. These pieces should include demons
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tration of symptom and airway variability and/or bronchodilator responsiveness over time, to support a clinical diagnosis.
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Under-diagnosis of asthma in ‘under-fives’ may be alleviated by improved inquiry into disease history. We assessed a questionnaire-based screening tool for asthma among 614 ‘under-fives’ wit
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h severe respiratory illness in Uganda. The questionnaire responses were compared to post hoc consensus diagnoses by three pediatricians who were guided by study definitions that were based on medical history, physical examination findings, laboratory and radiological tests, and response to bronchodilators. Children with asthma or bronchiolitis were categorized as “asthma syndrome”. Using this approach, 253 (41.2%) had asthma syndrome. History of and present breathing difficulties and present cough and wheezing was the best performing combination of four questionnaire items [sensitivity 80.8% (95% CI 77.6–84.0); specificity 84.7% (95% CI 81.8–87.6)]. The screening tool for asthma syndrome in ‘under-fives’ may provide a simple, cheap and quick method of identifying children with possible asthma. The validity and reliability of this tool in primary care settings should be tested.
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How to detect signs of Asthma
The aim of the present study was to predict which patients with severe or difficult-to-treat asthma are at highest risk for healthcare utilisation can be predicted so as to optimise clinical management. Data were derived from 2,821 adults with
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asthma enrolled in The Epidemiology and Natural History of Asthma: Outcomes and Treatment Regimens (TENOR) study. Multiple potential predictors were assessed at baseline using a systematic algorithm employing stepwise logistic regression. Outcomes were asthma-related hospitalisations or emergency department (ED) visits within 6 months following baseline.
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Myth: It’s better to ‘tough it out’ without taking asthma medication. The lungs do not get stronger or become better able to deal with asthma if a person tries to work through an attack wi
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thout medication. In fact, the lung inflammation that goes along with an attack (see what is asthma) can cause permanent damage to the lungs. Always use medication according to the Asthma Action Plan. If you have questions, talk with your health care provider.
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Manual:
Know How to Use Your Asthma Inhaler.
Using a metered dose inhaler (inhaler in mouth).
Asthma is a chronic lung disease, which means it cannot be cured. But with the right treatment asthma can be kept under control so that those affected area be to live completely normal lives enjoyin
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gfull involvement in sport and all other activities.
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Asthma:
• is one of the most common respiratory complaints in the world today.
• affects one in ten children (10%) and one in twenty adults (5%)
• can occur for the first time at any age, even in adulthood.
•usually begins before th
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e age of five years. A few children affected will ‘outgrow” it during their teenage years but it usually persists if contracted in adulthood.
• tends to run in families as do related allergic conditions like hay fever and eczema.
• cannot as yet be cured but if kept under control, those affected will be able to live normal lives enjoying full involvement in sport and all other activities.
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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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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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People with asthma should be encouraged to take part in any sport they choose. If someone with asthma is having difficulty with sport, it means their asth
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ma may not be under control. You will need to see your doctor to review your controller treatment and the way you use your medications in oder to allow you to live your life to the full with no limitations on activities or sport.
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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
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, 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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