oa Current Allergy & Clinical Immunology - Preschool asthma : key messages to the paediatric registrar… - review article

Volume 32 Number 4
  • ISSN : 1609-3607



Preschool asthma is now recognised as a separate entity from other phenotypes of preschool wheezing. South Africa has alarmingly high morbidity and mortality asthma rates, with the prevalence of asthma still rising. Identifying the preschool asthmatic can be challenging – it remains a diagnosis of exclusion and one based on clinical symptomatology. Healthcare practitioners should refrain from prescribing inhaled corticosteroids for prolonged periods, without the efficacy of it. Early (three months after starting treatment) follow-up is indicated to evaluate whether clinical improvement occurs and, if not, early discussion with a pulmonologist or allergist should occur. Well-defined asthma diagnosis and treatment regimes are now available in South Africa but we are not currently adhering to them. Under- and postgraduate students and registrars should familiarise themselves with these guidelines and apply them in daily practice. Asthma should not be treated with a short-acting bronchodilator alone. The majority of asthmatic children should improve with adequate inhaled corticosteroids and, if not, either the basic principles of asthma treatment are being overlooked or the child does not in fact have asthma!

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