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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Childhood asthma in low income countries: An invisible killer?
Primary Care Respiratory Journal, Volume 21, No. 2, Year 2012
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Description
Bacterial pneumonia has hitherto been considered the key cause of the high respiratory morbidity and mortality in children under five years of age (under-5s) in low-income countries, while asthma has not been stated as a significant reason. This paper explores the definitions and concepts of pneumonia and asthma/wheezing/bronchiolitis and examines whether asthma in under-5s may be confused with pneumonia. Over-diagnosing of bacterial pneumonia can be suspected from the limited association between clinical pneumonia and confirmatory test results such as chest x-ray and microbiological findings and poor treatment results using antibiotics. Moreover, children diagnosed with recurrent pneumonia in infancy were often later diagnosed with asthma. Recent studies showed a 10-15% prevalence of preschool asthma in low-income countries, although under-5s with long-term cough and difficulty breathing remain undiagnosed. New studies demonstrate that approximately 50% of acutely admitted under-5s diagnosed with pneumonia according to Integrated Management of Childhood Illnesses could be re-diagnosed with asthma or wheezing when using re-defined diagnostic criteria and treatment. It is hypothesised that untreated asthma may contribute to respiratory mortality since respiratory syncytial virus (RSV) is an important cause of respiratory death in childhood, and asthma in under-5s is often exacerbated by viral infections, including RSV. Furthermore, acute respiratory treatment failures were predominantly seen in under-5s without fever, which suggests the diagnosis of asthma/wheezing rather than bacterial pneumonia. Ultimately, underlying asthma may have contributed to malnutrition and fatal bacterial pneumonia. In conclusion, preschool asthma in low-income countries may be significantly under-diagnosed and misdiagnosed as pneumonia, and may be the cause of much morbidity and mortality. © 2012 Primary Care Respiratory Society UK. All rights reserved.
Authors & Co-Authors
Ostergaard, Marianne Stubbe
Denmark, Copenhagen
Københavns Universitet
Nantanda, Rebecca
Uganda, Kampala
Makerere University College of Health Sciences
Tumwine, James Kashugyera
Uganda, Kampala
Makerere University College of Health Sciences
Aabenhus, Rune
Denmark, Copenhagen
Københavns Universitet
Statistics
Citations: 48
Authors: 4
Affiliations: 2
Identifiers
Doi:
10.4104/pcrj.2012.00038
ISSN:
14714418
e-ISSN:
14751534
Research Areas
Food Security
Maternal And Child Health
Study Design
Cross Sectional Study