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The management of asthma in children in Papua New Guinea
1Department of Clinical Sciences, University of Papua New Guinea, Port Moresby, Papua New Guinea.
Insights
Advances in asthma management, including inhaler devices, offer effective control for most children. Current therapies, like inhaled steroids and beta-sympathomimetics, can significantly improve outcomes for children with asthma.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Therapeutics
Background:
- Asthma management has evolved due to improved understanding of its causes and progression.
- Newer inhaler devices, such as metered-dose inhalers and nebulizers, have transformed treatment approaches.
Purpose of the Study:
- To review current therapeutic strategies for managing childhood asthma.
- To highlight the efficacy and accessibility of available asthma medications and devices.
Main Methods:
- Review of recent advancements in asthma etiology and pathogenesis.
- Assessment of the utility of metered-dose inhalers and nebulizers in pediatric asthma care.
- Evaluation of inhaled beta-sympathomimetics and inhaled corticosteroids for asthma control.
Main Results:
- Metered-dose inhalers with spacing devices are effective even in children under two years old.
- Inhaled beta-sympathomimetics are sufficient for infrequent episodic asthma.
- Preventive therapy with inhaled steroids is recommended for frequent or chronic asthma.
- Acute severe asthma requires combined inhaled beta-sympathomimetics and short-term steroids.
Conclusions:
- Current therapies allow for a high level of asthma control in most children.
- Medical personnel should recognize diverse asthma presentations beyond wheezing.
- Accessible and affordable treatments can significantly improve the quality of life for children with asthma.
Abstract:
In the last decade advances in knowledge of the aetiology and pathogenesis of asthma, and the availability of metered-dose inhalers and nebulisers, has led to a change in emphasis in both the preventive and curative aspects of the management of children with asthma. Metered-dose inhalers are available in Papua New Guinea, and can be used successfully, with spacing devices, even in children less than 2 years of age. Inhaled beta-sympathomimetics, now widely available and relatively inexpensive, may be all that is required for the majority of children with infrequent episodic asthma. For those with frequent episodic and chronic asthma, preventive therapy with inhaled steroids is available and should be given wherever practicable. In the management of acute severe asthma inhaled beta-sympathomimetics should be combined with a short course of oral or parenteral steroids (covered with isoniazid in areas where tuberculosis is prevalent). Whilst asthma classically presents with wheeze, medical personnel should be aware of its other presentations. It is possible, and should be the aim, to achieve a very high level of control for the majority of asthmatic children using currently available therapy.
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