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There is a high prevalence of B. tropicalis allergy in the tropical northern KZN region and a much lower prevalence in the Johannesburg region. Routine testing for B. tropicalis allergy should be employed in northern KZN.

Over the past decade, there has been an increase in new anti-asthma medications, particularly in biological agents recommended for adult asthmatics. [1] Despite the increased access to novel agents, there has been a dearth of data and recommendations on the positioning of these drugs in the paediatric arena. Although children with severe asthma are a smaller component of the total asthmatic population (˂5%), there is a need for evidence-based recommendations for the use of these novel drugs in asthmatic children, as they consume a disproportionate amount of healthcare resources. [2,3] Biological agents are typically recommended for use in specific asthma phenotypes and endotypes, with predefined criteria predicting treatment response. [4,5] The role of asthma comorbidities and asthma education has been emphasised in the most recent international guidelines, with patient adherence and motivation forming a critical part of a package of care for asthma management and successful therapy. [1] The purpose of this continuing medical education article is to review the current literature on novel asthma drugs and to assess the evidence for their use or avoidance in the paediatric age group. The role of asthma education and strategies to improve asthma outcomes are also reviewed. Methods The South African Childhood Asthma Working Group (SACAWG) convened in January 2017 to review the current available literature on novel treatments of asthma and asthma self-management plans (Appendix A). The scientific literature was assigned evidence levels according to the Grades of Recommendation Assessment, Development and Evaluation (GRADE) system (Appendix B). Novel asthma molecules in South Africa Fluticasone furoate/vilanterol Few studies have been done in children with the new combination agent of an inhaled corticosteroid (ICS) and an ultra-long-acting beta-agonist. In 5-11-year-old patients with well-controlled asthma, fluti ca sone furoate/ vilanterol has a similar tolerability, safety profile, pharmacodynamic effect and pharmacokinetic profile as fluticasone furoate alone. [6,7] The new combination drug is currently registered for children >12 years of age and recommended for children with moderate to severe asthma (evidence level B) Tiotropium bromide Tiotropium bromide is a once-daily long-acting anticholinergic drug initially approved for chronic obstructive pulmonary disease This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.