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Is childhood asthma still underdiagnosed and undertreated in Istanbul?
Bulent Karadag1, Fazilet Karakoc, Refika Ersu
1Division of Pediatric Pulmonology, Marmara University, Istanbul, Turkey. bkaradag@hotmail.com
Insights
Childhood asthma remains underdiagnosed and undertreated globally. This study highlights significant delays in diagnosis and guideline-adherent treatment for pediatric asthma patients, particularly in younger children.
Area of Science:
- Pediatric Pulmonology
- Asthma Management
- Public Health
Background:
- Childhood asthma is a prevalent respiratory condition often facing challenges in accurate diagnosis and effective treatment.
- Global reports indicate significant underdiagnosis and undertreatment of pediatric asthma cases worldwide.
Purpose of the Study:
- To assess the prevalence of underdiagnosis and undertreatment in children with diagnosed asthma.
- To investigate asthma diagnosis and treatment rates in a Turkish tertiary care setting.
Main Methods:
- A questionnaire survey was conducted among parents of 1134 children diagnosed with asthma.
- Data collected from a tertiary reference outpatient clinic in Turkey.
Main Results:
- A significant proportion of children (58.9%) were diagnosed late, with a median symptom duration of 29.6 months.
- Only 41.1% received a prior asthma diagnosis, and 61.3% received some treatment.
- Critically, only 21.1% of all patients received guideline-adherent asthma treatment, with lower rates in children under 6 years (18.8%).
Conclusions:
- Underdiagnosis and undertreatment of childhood asthma persist as major clinical challenges.
- Preschool children are particularly affected by inadequate asthma management, even post-guideline implementation.
- Urgent improvements in pediatric asthma diagnosis and treatment strategies are necessary.
Background:
Childhood asthma is reported to be underdiagnosed and undertreated worldwide. The purpose of the present study was to investigate the rate of underdiagnosis and undertreatment among children diagnosed with asthma in a tertiary reference center in Turkey.
Methods:
A questionnaire survey was carried out among the parents of 1134 patients diagnosed with asthma in a tertiary reference outpatient clinic.
Results:
Mean age of the patients was 4.9 years (range 1-17 years). Of these children 45.5% had recurrent asthma attacks (average 4.8 attacks per year) and 24.7% had only the symptom of vigorous fits of coughing. Although they had been symptomatic for 29.6 months, only 41.1% were diagnosed as having asthma before admission to the clinic. In this study group 61.3% had received some form of asthma treatment, but only 21.1% of all patients were treated according to the guidelines. The rate of treatment according to guidelines was lower in the children under 6 years of age than older children (18.8 vs 24.2%, respectively, P = 0.02).
Conclusions:
Underdiagnosis and undertreatment of childhood asthma still seem to be a major problem in the management of childhood asthma, especially in preschool children, even after the recommendations of guidelines.
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