Severe childhood asthma in low and middle-income countries

Simple item page
dc.catalogadorgjm
dc.contributor.authorCastro Rodríguez, José Antonio
dc.contributor.authorSoto-Martínez, Manuel E.
dc.contributor.authorRodriguez-Martinez, Carlos E.
dc.contributor.authorMocelin, Helena Teresinha
dc.contributor.authorBueno Fischer, Gilberto
dc.contributor.authorMallol, Javier
dc.date.accessioned2025-06-19T14:40:43Z
dc.date.available2025-06-19T14:40:43Z
dc.date.issued2025
dc.description.abstractSevere asthma is relatively uncommon among children and adolescents in low- and middle-income countries (LMICs), affecting 2.1 % and 4.3 %, respectively. However, it results in significant morbidity and occasional mortality, as well as considerable management challenges compared to high-income countries. Furthermore, nearly 6 % of infants in LMICs experience nighttime symptoms weekly. Socioeconomic inequities and exposure to environmental risk factors contribute to marked variability in prevalence, with children from disadvantaged backgrounds being at a higher risk. In these settings, numerous preventable risk factors have been identified, including exposure to tobacco smoke, indoor and outdoor air pollution (e.g., biomass fuel use), allergens, unhealthy diet, and lifestyle changes associated with urbanization.Nearly half of children with severe asthma in LMICs receive suboptimal treatment. For instance, only 55 % use inhaled corticosteroids (ICS), and while most physicians prefer pressurized metered-dose inhalers, only one-third recommend using spacers. In some countries, oral short-acting beta agonists and theophylline are still used. Compared to fixed-dose ICS/long-acting beta-agonists (LABA) therapy, maintenance and reliever therapy (MART), add-on tiotropium therapy, and triple therapy (ICS + LABA + LAMA) are cost-effective in LMICs. However, biologic therapies are prohibitively expensive and inaccessible in most of these regions, and cost-effectiveness studies have shown that omalizumab and dupilumab are not viable treatment options in LMICs.Key barriers to optimal care include fragmented health systems, limited access to spirometry, and poor treatment adherence. Public health strategies should prioritize improving access to affordable and effective asthma medications, strengthening diagnostic infrastructure in underserved areas, and mitigating modifiable environmental risk factors that contribute to asthma.
dc.format.extent34 páginas
dc.fuente.origenORCID
dc.identifier.doi10.1016/j.prrv.2025.06.002
dc.identifier.urihttps://doi.org/10.1016/j.prrv.2025.06.002
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/104700
dc.information.autorucEscuela de Medicina; Castro Rodríguez, José Antonio; 0000-0002-0708-4281; 113247
dc.language.isoen
dc.nota.accesocontenido parcial
dc.revistaPaediatric Respiratory Reviews
dc.rightsacceso restringido
dc.subjectAdolescents
dc.subjectChildren
dc.subjectCost-effectiveness
dc.subjectLow and middle income countries
dc.subjectRisk factors
dc.subjectSevere asthma
dc.subject.ddc610
dc.subject.deweyMedicina y saludes_ES
dc.subject.ods03 Good health and well-being
dc.subject.odspa03 Salud y bienestar
dc.titleSevere childhood asthma in low and middle-income countries
dc.typepreprint
sipa.codpersvinculados113247
sipa.trazabilidadORCID;2025-06-16
Files
Collections
Artículos de revistas