Acute asthma treatment guidelines: Reducing morbidity and mortality in South Africa

Zar, Heather J.; Lalloo, Umesh

doi:10.7196/samj.6791

Cited by 6 publications

(14 citation statements)

References 18 publications

(32 reference statements)

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“…Previous studies evaluating physicians’ adherence to asthma treatment guidelines did not use scoring methods ( Zar and Lalloo, 2013 ; Desalu et al, 2016 ; Ayuk et al, 2017a ). Data from such studies should; therefore, be interpreted with caution.…”

Section: Methodsmentioning

confidence: 99%

“…The use of asthma treatment guidelines could reduce childhood asthma visits and hospitalizations to the pediatric emergency department, thus saving an estimated $1.3 to $1.59 billion annually in the United States ( Gupta and Weiss, 2009 ; Perry et al, 2019 ), and saving a cumulative national cost of $0.16 billion constituting 0.002% of the national GDP in Nigeria ( Ughasoro et al, 2020 ). Ensuring that asthma treatment guidelines become an integrated and useful part of health care in low-and middle-income countries, however, remains a challenge ( Zar and Lalloo, 2013 ).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines

et al. 2020

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Background Adequate management of childhood acute asthma exacerbation requires optimal non-pharmacotherapy and pharmacotherapy. Global asthma guidelines provide critical information and serves as a quick reference decision-support material for clinicians. Objectives We aimed at evaluating hospital management of childhood acute asthma exacerbation to ascertain its conformity to the global treatment guidelines, and to identify factors that predict short or prolonged observation in the hospital. Method This was a retrospective audit of the management of acute asthma exacerbation in children seen between 01 January 2017 and 31 December 2018 at Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. Relevant data on demography, asthma triggers and severity, functional and clinical diagnoses, types of controller medications used before and after presentation, non-pharmacotherapy and pharmacotherapy instituted during presentation, duration of observation in the hospital, and treatment outcomes were extracted from the case file of each eligible patient. Results A total of 119 children presented with features of suspected acute asthma exacerbations during the study period but only 63 (52.9%) that met the inclusion criteria for the study were included for analysis. The 63 children that were evaluated had mild (47; 74.6%) and moderate (16; 25.4%) acute asthma exacerbations. Their median (interquartile range) age was 8 (5–15) years. More males (36; 57.1%) than females (27; 42.9%) presented with features of the condition. Majority (50; 79.8%) of the patients had at least one trigger factor and of the 73 trigger factors reported, cold weather (19; 26.0%) was the commonest. Nebulized salbutamol (48; 76.5%), in addition to intravenous (23; 57.9%) and oral (17; 42.5%) corticosteroids, was used during hospital treatment. Patients were discharged mostly on short course of oral corticosteroid only (37; 58.8%). Of the 17 major recommendations in the Global Initiative for Asthma (GINA) guidelines, good (5; 29.4%), moderate (7; 41.2%), and poor (5; 29.4%) levels of adherence were observed. Specifically, moderate and poor levels of adherence were observed in the management of 61(96.8%) and 2(3.2%) patients, respectively. The odds of admission for ≤12 h were higher for female children and patients with mild cases. Conclusion Good and moderate adherence levels to 12 of the 17 GINA recommendations were observed in our center. Nonetheless, reinforcement of institutional guidelines for acute asthma management is suggested to further improve the quality of care of childhood acute asthma exacerbations.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines

et al. 2020

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“…1 Pulmonary tuberculosis, bacterial, viral and atypical pneumonias confound the diagnosis of asthma in South Africa where human immunodeficiency virus (HIV) is endemic and overlaps with these infections. 24 Finally, medications such as angiotensin inhibitors, b-stimulants also as eye drops, non-steroidal antiinflammatory drugs and non-prescription aspirin are prescribed in asthma exacerbations, and therefore, in severe asthma. 14…”

Section: Modifiable Risksmentioning

confidence: 99%

Severe asthma in South Africa: A literature review and management approach for primary care

Lion-Cachet

Musonda

Omole

2021

South African Family Practice

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Severe asthma in South Africa (SA) is underappreciated, especially in the primary care setting. This study highlights the epidemiological context of severe asthma as a phenotypic variant. Primary care practitioners, as first-contact medical providers, need grounding in the management of severe asthma based on the precision of diagnosis and negotiated along the 10-point strategy. The underdiagnosis and undertreatment of asthma ought to inform educational programmes and research in this country.

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“…This is partly owing to health systems, such as primary healthcare services that are overwhelmed by communicable respiratory diseases, such as pneumonia or tuberculosis. 3 The burden of asthma is underappreciated in countries like South Africa, where the burden of respiratory diseases such as pneumonia, tuberculosis and human immunodeficiency virus (HIV)-associated lung disease is well known. 3 Asthma is the eighth leading contributor to the burden of disease in South Africa, and is the second most important chronic disease after HIV/acquired immune deficiency syndrome.…”

Section: Introductionmentioning

confidence: 99%

“…3 The burden of asthma is underappreciated in countries like South Africa, where the burden of respiratory diseases such as pneumonia, tuberculosis and human immunodeficiency virus (HIV)-associated lung disease is well known. 3 Asthma is the eighth leading contributor to the burden of disease in South Africa, and is the second most important chronic disease after HIV/acquired immune deficiency syndrome. 3,4 Despite the availability of medication, asthma remains poorly controlled in many patients.…”

Section: Introductionmentioning

confidence: 99%

Approach to asthma in adults

Schellack¹,

Truter

Ntuli

2015

S Afr Fam Pract

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Asthma is a chronic inflammatory disease that causes hyper-responsiveness of the bronchial tree, with reversible airflow obstruction. The condition places a significant burden on our healthcare system. Chronic asthma can cause remodelling of the airway. Patients suffering from asthma should be aware of its signs and symptoms, as well as factors that can precipitate an asthmatic attack. Asthma is mostly classified as either acute or chronic. The diagnosis of asthma is based on identification of both a characteristic pattern of respiratory symptoms and variable expiratory airflow limitation. Treatment is based on how the patient presents, and includes bronchodilators, inhaled corticosteroids and mast cell stabilisers. This article provides an overview of the diagnosis, characterisation and treatment of asthma

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Acute asthma treatment guidelines: Reducing morbidity and mortality in South Africa

Cited by 6 publications

References 18 publications

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines

Severe asthma in South Africa: A literature review and management approach for primary care

Approach to asthma in adults

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