دورية أكاديمية
Clinical standards for the diagnosis and management of asthma in low- and middle-income countries.
| العنوان: | Clinical standards for the diagnosis and management of asthma in low- and middle-income countries. |
|---|---|
| المؤلفون: | Jayasooriya S; Academic Unit of Primary Care, University of Sheffield, Sheffield., Stolbrink M; Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, UK, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa., Khoo EM; Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia, International Primary Care Respiratory Group, Edinburgh, Scotland, UK., Sunte IT; Global Allergy and Airways Patient Platform, Vienna, Austria., Awuru JI; Global Allergy and Airways Patient Platform, Vienna, Austria., Cohen M; Hospital Centro Médico, Guatemala City, Guatemala, Mexico, Asociación Latinoamericana de Tórax, Montevideo, Uruguay., Lam DC; Department of Medicine, University of Hong Kong, Hong Kong, Asian Pacific Society of Respirology, Hong Kong, China., Spanevello A; Division of Pulmonary Rehabilitation, Istituti Clinici Scientifici Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Tradate, Department of Medicine and Surgery, Respiratory Diseases, University of Insubria, Varese-Como., Visca D; Asociación Latinoamericana de Tórax, Montevideo, Uruguay, Department of Medicine, University of Hong Kong, Hong Kong., Centis R; Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, Tradate, Italy., Migliori GB; Servizio di Epidemiologia Clinica delle Malattie Respiratorie, Istituti Clinici Scientifici Maugeri, Tradate, Italy., Ayuk AC; College of Medicine, University of Nigeria, Enugu, Nigeria., Buendia JA; Affiliation Departamento de Farmacologia y Tóxicologia, Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia., Awokola BI; Medical Research Council, The Gambia at the London School of Tropical Medicine, The Gambia., Del-Rio-Navarro BE; Hospital Infantil de México Federico Gômez, Mexico D.F, Mexico., Muteti-Fana S; Department of Primary Care Sciences, University of Zimbabwe, Harare, Zimbabwe., Lao-Araya M; Division of Allergy and Clinical Immunology, Chian Mai University, Chiang Mai, Thailand., Chiarella P; Health Sciences School, Universidad Peruana de Ciencias Aplicadas, Lima, Peru., Badellino H; Head Pediatric Respiratory Medicine Department, Clinica Regional del Este, San Francisco, Argentina., Somwe SW; Paediatrics and Child Health, University of Lusaka, Lusaka, Zambia., Anand MP; Department of Respiratory Medicine, JSS Medical College, Mysore, India., Garcí-Corzo JR; Department of Pediatrics, Universidad Industrial de Santander, Santander, Colombia., Bekele A; College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia., Soto-Martinez ME; Department of Pediatrics, Universidad de Costa Rica, San Jose, Costa Rica., Ngahane BHM; Douala General Hospital, University of Douala, Douala, Cameroon., Florin M; Institute of Pneumology M. Nasta, Bucharest, Romania., Voyi K; School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa., Tabbah K; College of Medicine, Ajman University, Ajman, United Arab Emirates., Bakki B; University of Maiduguri Teaching Hospital, Maiduguri., Alexander A; Deparment of Medicine, University of Abuja, Abuja., Garba BL; Department of Paediatrics, Usmanu Danfodiyo, University Teaching Hospital, Sokoto, Nigeria., Salvador EM; Deparment of Biological Sciences, Eduardo Mondlane University, Maputo, Mozambique., Fischer GB; University of Medical Sciences, Porto Alegre, RS, Brazil., Falade AG; Department of Paediatrics, University of Ibadan, Ibadan, Nigeria., ŽivkoviĆ Z; Dragiša Mišovic, Childrens Hsopital for Lung Disease and TB, Belgrade, Serbia., Romero-Tapia SJ; Health Sciences, Academic Division, Juarez Autononous, University of Tabasco, Villahermosa, Mexico., Erhabor GE; Department of Medicine, Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria., Zar H; Department of Paediatrics & Child Health & SA MRC Unit on Children & Adolescent Health, Red Cross Childrens Hospital, University of Cape Town, Cape Town, South Africa., Gemicioglu B; Department of Pulmonary Diseases, Istanbul University, Cerrahpasa, Turkey., Brandão HV; State University of Feira de Santana, Feira de Santana, BA, Brazil., Kurhasani X; UBT Higher Education Institution, Prishtina, Kosovo., El-Sharif N; Al-Quds University, Jerusalem, Palestine., Singh V; MJ Rajasthan Hospital, Jaipur, India., Ranasinghe JC; Paediatrics Unit, Teaching Hospital Peradeniya, Kandy., Kudagammana ST; Faculty of Medicine, University of Peradeniya, Kandy, Sri Lanka., Masjedi MR; Shahid Beheshti University of Medical Sciences, Tehran, Iran., Velásquez JN; Medical School, Santander Industrial, Bucaramanga, Colombia., Jain A; Department of Community Medicine, Kasturba Medical College, Mangalore., Cherrez-Ojeda I; Universudad Espíritu Santo, Samborondón, Ecuador., Valdeavellano LFM; Asociación Latinoamericana de Tórax, Montevideo, Uruguay, Francisco Morroguín University, Guatemala City, Guatemala., Gómez RM; Faculty of Health Sciences, Catholic University of Salta, Salta, Argentina., Mesonjesi E; Department of Allergy and Clinical Immunology, University Hospital Centre 'Mother Teresa', Tirana, Albania., Morfin-Maciel BM; Hospital San Angel Inn, Mexico DF, Mexico., Ndikum AE; The University of Yaounde 1, Yaounde, Cameroon., Mukiibi GB; Health Concern Initiative, Wakiso, Uganda., Reddy BK; Shishuka Children's Speciality Hospital, Bangalore, India., Yusuf O; The Allergy and Asthma Institute, Islamabad, Pakistan., Taright-Mahi S; Medecin Faculty, Mustapha Universitary Hospital Algiers, Algeria., Mérida-Palacio JV; Centrode Investigación de Enfermedades Alérgicas y Respiratorias SC, Mexico DF, Mexico., Kabra SK; Pediatrics, All India Institute of Medical Sciences, New Delhi, India., Nkhama E; Levy Mwanawasa Medical University, School of Public Health and Environmental Sciences, Lusaka, Zambia., Filho NR; Federal University of Parana, Curitiba, PA, Brazil., Zhjegi VB; Social Medicine, Medical Faculty, University of Prishtina, Prishtina, Kosovo., Mortimer K; University of Cambridge, Cambridge, Imperial College, London, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK, Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa., Rylance S; Department of Non-communicable Diseases, World Health Organization, Geneva, Switzerland., Masekela RR; Department of Paediatrics and Child Health, School of Clinical Medicine, University of KwaZulu Natal, Durban, South Africa. |
| المصدر: | The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease [Int J Tuberc Lung Dis] 2023 Sep 01; Vol. 27 (9), pp. 658-667. |
| نوع المنشور: | Journal Article; Research Support, Non-U.S. Gov't |
| اللغة: | English |
| بيانات الدورية: | Publisher: The Union Country of Publication: France NLM ID: 9706389 Publication Model: Print Cited Medium: Internet ISSN: 1815-7920 (Electronic) Linking ISSN: 10273719 NLM ISO Abbreviation: Int J Tuberc Lung Dis Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: Paris, France : The Union, c1997- |
| مواضيع طبية MeSH: | Developing Countries* , Asthma*/diagnosis , Asthma*/drug therapy, Adolescent ; Adult ; Child ; Humans ; Bronchodilator Agents/therapeutic use ; Albuterol ; Prednisolone |
| مستخلص: | BACKGROUND: The aim of these clinical standards is to aid the diagnosis and management of asthma in low-resource settings in low- and middle-income countries (LMICs). METHODS: A panel of 52 experts in the field of asthma in LMICs participated in a two-stage Delphi process to establish and reach a consensus on the clinical standards. RESULTS: Eighteen clinical standards were defined: Standard 1, Every individual with symptoms and signs compatible with asthma should undergo a clinical assessment; Standard 2, In individuals (>6 years) with a clinical assessment supportive of a diagnosis of asthma, a hand-held spirometry measurement should be used to confirm variable expiratory airflow limitation by demonstrating an acute response to a bronchodilator; Standard 3, Pre- and post-bronchodilator spirometry should be performed in individuals (>6 years) to support diagnosis before treatment is commenced if there is diagnostic uncertainty; Standard 4, Individuals with an acute exacerbation of asthma and clinical signs of hypoxaemia or increased work of breathing should be given supplementary oxygen to maintain saturation at 94-98%; Standard 5, Inhaled short-acting beta-2 agonists (SABAs) should be used as an emergency reliever in individuals with asthma via an appropriate spacer device for metered-dose inhalers; Standard 6, Short-course oral corticosteroids should be administered in appropriate doses to individuals having moderate to severe acute asthma exacerbations (minimum 3-5 days); Standard 7, Individuals having a severe asthma exacerbation should receive emergency care, including oxygen therapy, systemic corticosteroids, inhaled bronchodilators (e.g., salbutamol with or without ipratropium bromide) and a single dose of intravenous magnesium sulphate should be considered; Standard 8, All individuals with asthma should receive education about asthma and a personalised action plan; Standard 9, Inhaled medications (excluding dry-powder devices) should be administered via an appropriate spacer device in both adults and children. Children aged 0-3 years will require the spacer to be coupled to a face mask; Standard 10, Children aged <5 years with asthma should receive a SABA as-needed at step 1 and an inhaled corticosteroid (ICS) to cover periods of wheezing due to respiratory viral infections, and SABA as-needed and daily ICS from step 2 upwards; Standard 11, Children aged 6-11 years with asthma should receive an ICS taken whenever an inhaled SABA is used; Standard 12, All adolescents aged 12-18 years and adults with asthma should receive a combination inhaler (ICS and rapid onset of action long-acting beta-agonist [LABA] such as budesonide-formoterol), where available, to be used either as-needed (for mild asthma) or as both maintenance and reliever therapy, for moderate to severe asthma; Standard 13, Inhaled SABA alone for the management of patients aged >12 years is not recommended as it is associated with increased risk of morbidity and mortality. It should only be used where there is no access to ICS.The following standards (14-18) are for settings where there is no access to inhaled medicines. Standard 14, Patients without access to corticosteroids should be provided with a single short course of emergency oral prednisolone; Standard 15, Oral SABA for symptomatic relief should be used only if no inhaled SABA is available. Adjust to the individual's lowest beneficial dose to minimise adverse effects; Standard 16, Oral leukotriene receptor antagonists (LTRA) can be used as a preventive medication and is preferable to the use of long-term oral systemic corticosteroids; Standard 17, In exceptional circumstances, when there is a high risk of mortality from exacerbations, low-dose oral prednisolone daily or on alternate days may be considered on a case-by-case basis; Standard 18. Oral theophylline should be restricted for use in situations where it is the only bronchodilator treatment option available. CONCLUSION: These first consensus-based clinical standards for asthma management in LMICs are intended to help clinicians provide the most effective care for people in resource-limited settings. |
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| معلومات مُعتمدة: | United Kingdom WT_ Wellcome Trust; 001 International WHO_ World Health Organization |
| المشرفين على المادة: | 0 (Bronchodilator Agents) QF8SVZ843E (Albuterol) 9PHQ9Y1OLM (Prednisolone) |
| تواريخ الأحداث: | Date Created: 20230823 Date Completed: 20230824 Latest Revision: 20231214 |
| رمز التحديث: | 20231215 |
| مُعرف محوري في PubMed: | PMC10443788 |
| DOI: | 10.5588/ijtld.23.0203 |
| PMID: | 37608484 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1815-7920 |
|---|---|
| DOI: | 10.5588/ijtld.23.0203 |