Treating childhood asthma

Abstract

Asthma is the most common chronic disease of South African children, affecting 10-20% of the population. It is sometimes difficult to diagnose. Where uncertainty exists, it may be more beneficial to treat the child as asthmatic, and then wean him or her off the medication later once it is under control, than neglect to administer the correct therapy to a true asthmatic. The treatment of asthma is often problematic, not because of lack of access to appropriate medication, but because of the central role played by additional factors, such as patient adherence and administration of medication technique. It is always necessary to treat the child as an individual, but some measures apply in all cases. It is important to allay anxiety about the diagnosis. This is best done by carefully explaining the nature and causes of asthma, what to do if an attack occurs, why medicines are prescribed, and how they are given. Patients must be able to understand the difference between controller and reliever therapy. The importance of regularly using controller medication needs to be emphasised. Time spent on the initial explanation and educating the parents and the child is always well rewarded by the response to treatment. Regular follow-up of these children, preferably by the same doctor, is very important.