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Pediatric asthma comorbidities: Global impact and unmet needs
Elham Hossny1, Yuichi Adachi2, Eleni Anastasiou3
1Pediatric Allergy, Immunology, and Rheumatology Unit, Children's Hospital, Ain Shams University, Cairo, Egypt.
Insights
Pediatric asthma is often complicated by other health issues like obesity and allergies, impacting treatment. Recognizing and managing these comorbidities improves children's quality of life and asthma control.
Area of Science:
- Pediatric Pulmonology
- Clinical Medicine
- Public Health
Background:
- Limited real-world data exists on comorbidities affecting pediatric asthma, particularly in developing nations.
- This data gap impedes effective diagnosis, treatment, and management of complex pediatric asthma cases.
- Comorbidities significantly influence asthma control, treatment efficacy, and patient outcomes.
Purpose of the Study:
- To describe common comorbid conditions in pediatric asthma.
- To elucidate the evidence for association, impact mechanisms, and treatment benefits of these comorbidities.
- To emphasize the need for individualized care and multidisciplinary management.
Main Methods:
- Review and synthesis of existing literature on pediatric asthma comorbidities.
- Analysis of associations between conditions like obesity, allergies, and dysfunctional breathing with difficult-to-treat asthma.
- Examination of the bidirectional impact of asthma and its comorbidities on child well-being.
Main Results:
- Common comorbidities include obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux.
- These comorbidities are associated with difficult-to-treat asthma and can negatively affect children's mental health and well-being.
- Management requires a multidisciplinary approach to optimize care and reduce reliance on pharmacotherapy.
Conclusions:
- Awareness and management of comorbidities are crucial for individualized pediatric asthma care and improved quality of life.
- A multidisciplinary team approach is essential for identifying and managing comorbidities, potentially reducing over-medication.
- Asthma research and policy should prioritize real-world challenges and interventions for comorbidities, advocating for global asthma control support.
Abstract:
Real-world data on the range and impact of comorbid health conditions that affect pediatric asthma are scant, especially from developing countries. Lack of data hinders effective diagnosis, treatment, and overall management of these complex cases. We, hereby, describe the common pediatric asthma comorbid conditions in terms of evidence for association, potential mechanisms of impact on asthma control, and treatment benefit. Obesity, upper airway allergies, dysfunctional breathing, multiple sensitizations, depressive disorders, food allergy, and gastro-esophageal reflux are common associations with difficult-to-treat asthma. On the other hand, asthma symptoms and/or management may negatively impact the well-being of children through drug adverse effects, worsening of anaphylaxis symptoms, and disturbing mental health. Awareness of these ailments may be crucial for designing the optimum care for each asthmatic child individually and may ultimately improve the quality of life of patients and their families. A multidisciplinary team of physicians is required to identify and manage such comorbidities aiming to mitigate the over-use of asthma pharmacotherapy. Asthma research should target relevant real-world difficulties encountered at clinical practice and focus on interventions that would mitigate the impact of such comorbidities. Finally, policymakers and global healthcare organizations are urged to recognize pediatric asthma control as a healthcare priority and allocate resources for research and clinical interventions. In other words, global asthma control needs support by compassionate scientific partnership.
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