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Asthma: epidemiology of disease control in Latin America - short review
Dirceu Solé1, Carolina Sanchez Aranda1, Gustavo Falbo Wandalsen1
1Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, Rua dos Otonis, 725 - Vila Clementino, 04025-002 São Paulo, Brazil.
Insights
Asthma remains poorly controlled in Latin America, particularly in children and adolescents, despite available guidelines. Enhanced patient and physician education is crucial to reduce the disease burden.
Area of Science:
- Pulmonology
- Epidemiology
- Public Health
Background:
- Asthma is a prevalent chronic childhood disease impacting quality of life and incurring significant healthcare costs.
- Despite advancements in pharmacotherapy and international guidelines, asthma control remains suboptimal, especially within the Latin American region.
- Poorly controlled asthma contributes to increased healthcare utilization, including emergency visits and hospitalizations, and a substantial societal burden.
Purpose of the Study:
- To analyze the epidemiology and control of asthma in Latin America over the past two decades.
- To identify unmet needs and challenges in asthma management for children, adolescents, and adults in the region.
- To evaluate the prevalence, severity, and treatment patterns of asthma in Latin American populations.
Main Methods:
- A systematic review and analysis of original and review articles published in PubMed-referenced journals over the last 20 years.
- Keywords used included "asthma control" combined with "Latin America", "epidemiology", "prevalence", "burden", "mortality", "treatment and unmet needs", "children", "adolescents", and "infants".
- Studies with high levels of evidence were selected for analysis.
Main Results:
- A high prevalence and severity of asthma were observed, particularly affecting children and adolescents.
- Wheezing in infants frequently led to medical consultations in Latin American health centers.
- Frequent reliance on quick-relief bronchodilators and oral corticosteroids, alongside low adherence to anti-inflammatory medications in adults, indicates poor asthma control and inadequate care policies.
Conclusions:
- Asthma control in Latin America is consistently inadequate, with patients often overestimating their condition control.
- Significant gaps exist in asthma management, necessitating improved adherence to international treatment guidelines.
- Enhanced educational initiatives for both healthcare providers and patients are essential to improve asthma control and mitigate its individual and societal impact.
Abstract:
Asthma is reported as one of the most common chronic diseases in childhood, impairing the quality of life of patients and their families and incurring high costs to the healthcare system and society. Despite the development of new drugs and the availability of international treatment guidelines, asthma is still poorly controlled, especially in Latin America. Original and review articles on asthma control or epidemiology with high levels of evidence have been selected for analysis among those published in PubMed referenced journals during the last 20 years, using the following keywords: "asthma control" combined with "Latin America", " epidemiology", "prevalence", "burden", "mortality", "treatment and unmet needs", "children", "adolescents", and "infants". There was a high prevalence and severity of asthma during the period analyzed, especially in children and adolescents. Wheezing in infants was a significant reason for seeking medical care in Latin American health centers. Moreover, the frequent use of quick-relief bronchodilators and oral corticosteroids by these patients indicates the lack of a policy for providing better care for asthmatic patients, as well as poor asthma control. Among adults, studies document poor treatment and control of the disease, as revealed by low adherence to routine anti-inflammatory medications and high rates of emergency care visits and hospitalization. In conclusion, although rare, studies on asthma control in Latin America repeatedly show that patients are inadequately controlled and frequently overestimate their degree of asthma control according to the criteria used by international asthma treatment guidelines. Additional education for doctors and patients is essential for adequate control of this illness, and therefore also for reduction of the individual and social burden of asthma.
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