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Published on: November 4, 2010
Guideline for the management of chronic asthma in children--2009 update
C Motala1, R J Green, A I Manjra
1Division of Allergy, Department of Paediatrics and Child Health, University of Cape Town and Red Cross War Memorial Children's Hospital, Cape Town. cassim.motala@uct.ac.za
Insights
This revised guideline offers updated strategies for diagnosing and managing childhood asthma in South Africa. It emphasizes evidence-based treatments and improved asthma control for better patient outcomes.
Area of Science:
- Pediatric Pulmonology
- Clinical Practice Guidelines
- Respiratory Medicine
Background:
- The South African Childhood Asthma Working Group (SACAWG) guideline is 10 years old, necessitating an update.
- Diagnosis of asthma in young children presents ongoing challenges.
- New evidence and treatment paradigms have emerged in asthma management.
Purpose of the Study:
- To revise the existing guideline for diagnosing and managing chronic asthma in children.
- To incorporate evidence-based treatments and new approaches to asthma control.
- To promote a higher standard of asthma care and uniformity in management.
Main Methods:
- A comprehensive literature review was conducted by a multidisciplinary working group.
- Recommendations are classified by evidence category (A, B, C, D).
Main Results:
- The revised guideline addresses diagnostic approaches, environmental control, and treatment options.
- It includes updated definitions of asthma control and strategies to achieve it.
- Emphasis is placed on assessing asthma control to guide treatment adjustments.
Conclusions:
- The guideline provides an appropriate diagnostic approach for childhood asthma.
- It outlines environmental control measures and current treatment options.
- Strategies for achieving and maintaining asthma control are detailed.
Objective:
To revise the guideline for the diagnosis and management of chronic asthma in children in view of the following considerations: the existing South African Childhood Asthma Working Group (SACAWG) guideline was produced 10 years ago; diagnosis of asthma in young children remains a challenge; evidence-based treatment is the new paradigm; new treatment approaches to achieving and maintaining control; therapeutic roles of several medications have evolved; more studies and data on treatment in young children; new medications and formulations; a change of emphasis in assessing asthma control to guide treatment changes. The main aim of the guideline is to promote a better standard of treatment based on understanding of the pathophysiology and pharmacotherapy of asthma, and encouraging uniformity in asthma management.
Evidence:
A detailed literature review by a working group of clinicians from relevant disciplines. The strategies recommended are classified according to the evidence category in Appendix B, and denoted as Evidence A, B, C and D.
Recommendations:
These include an appropriate diagnostic approach, environmental control measures, treatment options, definition of asthma control, and strategies to achieve control.
Endorsement:
The guideline document was endorsed by the South African Thoracic Society (SATS), the National Asthma Education Programme (NAEP), the South African Paediatric Association (SAPA) and the South African Academy of Family Practice.
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