BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, with
airway reversibility. Management of chronic inflammation with anti-asthma medication improves asthma control and quality of life.
OBJECTIVES. To provide an evidence-based approach for chronic asthma management in young children and adolescents and provide
guidance on the use of new asthma drugs in children.
METHODS. The South African Childhood Asthma Working Group (SACAWG) convened in January 2017. The asthma treatment task group
reviewed the available scientific literature and international asthma treatment guidelines. The evidence was then graded according to the
Grades of Recommendation Assessment, Development and Evaluation (GRADE) system and recommendations were made based on
scientific evidence and local context. Asthma management recommendations were made for children ˂6 years of age and older children and
adolescents, as well as for stepping up and stepping down of therapy. This review does not include biologics or novel asthma drugs, which
are covered in another CME article in this edition of SAMJ.
CONCLUSIONS. To ensure good response, treatment and adherence, type of medication, device and checking of technique are all critical.
Stepping up of therapy should be done only after ensuring good adherence and technique. Once therapeutic response is achieved,
medication administration has to be stepped down to improve ease of use and avoid unnecessary side-effects.
Asthma may be intermittent or persistent and persistent asthma may be mild, moderate, or severe. Many factors influence asthma severity, both from day-to-day and from month-to-month. In individual patients, asthma severity ...
Apart from medication to control asthmatic inflammation, the education of patients and parents is the most important therapeutic
step in achieving asthma control and normal life. This is a critical, but sadly often ...
Asthma is one of the most common childhood illnesses with which patients will present to general practitioners. Despite this, the
associated mortality and morbidity remain high, particularly in South Africa. This is largely ...