A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

Siduna, W; Bradley, Hazel; Laing, Richard

doi:10.5588/ijtld.20.0172

Cited by 6 publications

(2 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…23 The use of oral medicines, either oral SABA or theophylline, might be a consequence of unavailability or unaffordability of inhaled asthma medicines in some countries. 25 Among children and adolescents, we observed a significant association between use of any oral medication and being in UMICs or LMICs and LICs. However, in HICs, where availability of inhaled medicines should not be a consideration, theophylline was being used in about one in ten adolescents and adults with severe symptoms, indicating other influences beyond economic factors.…”

Section: Discussionmentioning

confidence: 71%

Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study

García‐Marcos

Chiang

Asher

et al. 2023

The Lancet Global Health

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 71%

Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study

García‐Marcos

Chiang

Asher

et al. 2023

The Lancet Global Health

View full text Add to dashboard Cite

“…Lack of affordability and access to appropriate inhaled asthma therapy remains a major challenge [ 73 ]. An analysis of asthma management in 13 sub-Saharan African countries found that only 46% and 38% had inhaled corticosteroids at a primary- and secondary-level health facility, respectively [ 103 ].…”

Section: The African Situationmentioning

confidence: 99%

Social determinants of respiratory health from birth: still of concern in the 21st century?

Bush,

Byrnes,

Chan

et al. 2024

Eur Respir Rev

View full text Add to dashboard Cite

Respiratory symptoms are ubiquitous in children and, even though they may be the harbinger of poor long-term outcomes, are often trivialised. Adverse exposures pre-conception, antenatally and in early childhood have lifetime impacts on respiratory health. For the most part, lung function tracks from the pre-school years at least into late middle age, and airflow obstruction is associated not merely with poor respiratory outcomes but also early all-cause morbidity and mortality. Much would be preventable if social determinants of adverse outcomes were to be addressed. This review presents the perspectives of paediatricians from many different contexts, both high and low income, including Europe, the Americas, Australasia, India, Africa and China. It should be noted that there are islands of poverty within even the highest income settings and, conversely, opulent areas in even the most deprived countries. The heaviest burden of any adverse effects falls on those of the lowest socioeconomic status. Themes include passive exposure to tobacco smoke and indoor and outdoor pollution, across the entire developmental course, and lack of access even to simple affordable medications, let alone the new biologicals. Commonly, disease outcomes are worse in resource-poor areas. Both within and between countries there are avoidable gross disparities in outcomes. Climate change is also bearing down hardest on the poorest children. This review highlights the need for vigorous advocacy for children to improve lifelong health. It also highlights that there are ongoing culturally sensitive interventions to address social determinants of disease which are already benefiting children.

show abstract

Asthma management in low and middle income countries: case for change

et al. 2022

View full text Add to dashboard Cite

Asthma is the most common non-communicable disease in children, and among the most common in adults. The great majority of people with asthma live in low- and middle-income countries (LMICs), where they suffer disproportionately high asthma-related morbidity and mortality. Essential inhaled medications, particularly those containing inhaled corticosteroids (ICS), are often unavailable or unaffordable, and this explains much of the global burden of preventable asthma morbidity and mortality.Guidelines developed for LMICs are generally based on the outdated assumption that patients with asthma symptoms <1–3 times/week do not need (or benefit from) ICS. Even when ICS is prescribed, many patients manage their asthma with oral or inhaled short-acting beta2 agonist (SABA) alone, due to issues of availability and affordability. A single ICS-formoterol inhaler-based approach to asthma management for all severities of asthma, from mild to severe, starting at diagnosis, might overcome SABA overuse/over-reliance and reduce the burden of symptoms and severe exacerbations. However, ICS-formoterol inhalers are currently very poorly available or unaffordable in LMICs. There is a pressing need for pragmatic clinical trial evidence of the feasibility and cost-effectiveness of this and other strategies to improve asthma care in these countries.The global health inequality in asthma care that deprives so many children, adolescents and adults of healthy lives and puts them at increased risk of death – despite the availability of highly effective therapeutic approaches – is unacceptable. A World Health Assembly Resolution on universal access to affordable effective asthma care is needed to focus attention and investment on addressing this need.

show abstract

A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

Cited by 6 publications

References 22 publications

Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study

Asthma management and control in children, adolescents, and adults in 25 countries: a Global Asthma Network Phase I cross-sectional study

Social determinants of respiratory health from birth: still of concern in the 21st century?

Asthma management in low and middle income countries: case for change

Contact Info

Product

Resources

About