Pediatric Asthma in Southern Africa

Abstract

Pediatric asthma has been well researched and actively managed in Southern Africa for many years. From the earliest study of asthma prevalence in 1979 revealing a significant rural -urban asthma gradient to more recent studies suggesting that asthma now abounds in all population and socio-economic groups, Southern Africa has been the subject of a significant number of publications relating to asthma prevalence, etiologies or associations and treatment guidelines. Asthma is now present in 20% of school-children across Southern Africa, but may not have the same etiological factors commonly seen in the West. Southern Africa has areas with a high asthma prevalence, areas with amongst the highest mortality in the world and similar problems to first-world countries with regard to morbidity and cost of disease. Guidelines for asthma management published from South Africa highlight the importance of aiming for complete asthma control and avoiding morbidity, exacerbations and mortality.

Socio-epidemiological Aspects of Respiratory Allergic Diseases in Southern Africa

“…A rise in asthma symptoms was confirmed by the video questionnaire responses, in which the 12-month prevalence of wheezing (6.5 vs 11.2%), exercise-induced wheeze (11.5 vs 13.9%), nocturnal wheeze (3.9 vs 5.3%), nocturnal cough (11.6 vs 19.2%), or severe wheeze (5 vs 7%) had also increased significantly. Overall, there is evidence to confirm that the prevalence of asthma and asthma-related phenotypes (eg, BHR; wheezing) has been increasing in Southern Africa, not only in rural but also in urban settings, 12 which also is not consistent with the hygiene hypothesis.…”

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

“…4 There is a paucity of data, however, on severe asthma in middleaged and older adults in South Africa because of the challenges with diagnosis (asthma -chronic obstructive pulmonary disease [COPD] overlap syndrome) and with conducting epidemiological surveys in this age group. 17 One study, however, conducted by Green et al 6 in 2006 amongst the population living in the highly industrialised Durban metropole confirmed that children and adults both suffered from severe asthma with a prevalence rate of 16%. 6 In 2008, a questionnaire-based survey was conducted by Green et al amongst 710 patients in primary care across South Africa to assess morbidity of the disease in those on controller therapy.…”

“…5 Meanwhile, the morbidity of asthma in HIC is being replicated in all South African populations. 6 In Cape Town, ISAAC revealed that the 12 months prevalence of wheezing increased from 16% -20% between 1995 and 2002. This increase could be suggestive of better awareness, screening and diagnostic techniques.…”

Diet and childhood asthma: review

“…22 Saadeh et al reviewed five cross-sectional studies and one review article which all found that the adherence to the Mediterranean diet was inversely related with atopy in children. 2 Adherence to the Mediterranean diet, and following a healthy dietary pattern by eating more vegetables and fruits, for example, has been shown to be a protective factor for atopic diseases in children in many countries such as Sweden, Greece, and Mexico. 26−28 In addition, a high level of adherence to the Mediterranean diet was a protective factor for current wheezing in children.…”

“…Paediatric asthma has rapidly increased over the past 20 years and is the most common chronic inflammatory childhood disease with almost 20% children and adolescents reporting asthma symptoms in South Africa. 1,2 In two recent surveys of schoolchildren the prevalence of asthma was approximately 12% amongst children aged 6-11, and South Africa ranked 25th among the 93 countries surveyed. 3 The rapid increase in asthma is most likely to be a consequence of changing environmental/ lifestyle rather than genetic influences.…”