Childhood asthma must be properly managed

WINTER sees chest problems being more commonly reported to medical practitioners around the country.

One of the most common chronic chest problems occurring among both adults and children at this time of the year is asthma, which is often triggered by infections such as the common cold.

It has been estimated that between six and 10 percent of South Africans have asthma.

‘That relates to a considerable number of people,’ says Dr Steve Ponde, a paediatric pulmonologist who practises at Netcare Waterfall City Hospital in Midrand

‘Fortunately, the great majority of asthma cases are mild and easily managed by a family doctor or paediatrician.’

He says evidence suggests that South Africa does have a relatively high child mortality rate related to asthma when compared to other countries.

‘This highlights some of the potential dangers of severe and complex forms of the condition, as well as the importance of careful medical management of these cases.’

Managing asthma

He says children whose asthma is well managed tend to require fewer emergency visits, are able to concentrate better at school and are better able to lead a normal, active lifestyle.

Although asthma is not curable, some children’s symptoms do disappear later in life and it can be well controlled so that the patient is able to live a completely normal lifestyle.

Asthma treatment is safe and your doctor will look to use the lowest medicine doses necessary to achieve control.

How is it diagnosed?

Asthma is a chronic inflammatory condition characterised by a recurrent or chronic cough, and/or shortness of breath with exercise.

In severe cases it can prevent the child from participating in activities, prevent them from thriving and have a severely negative impact on their lifestyle.

‘Asthma is almost always owing to an underlying allergy and is therefore strongly associated with eczema, food allergy or allergic rhinitis,’ says Dr Ponde.

‘The child’s doctor will take a detailed history, do a thorough physical examination and may require tests such as x-rays, allergy tests and lung function tests.

‘Using the test results, the doctor will in most cases be able to make a firm and accurate diagnosis of asthma, although in some complex cases this can be more tricky.’

The allergy connection

Dr Ponde says it should be remembered that asthma almost always occurs in the context of allergy and therefore your little one may already be showing signs of allergy, and that the propensity for allergy is inherited. Parents who suffer allergy problems should be sure to look out for signs of it in their children.

‘The younger the child is, the more careful your doctor needs to be in differentiating asthma from other conditions.

‘This is especially true in children younger than four years old where there is failure to thrive, no clinical allergy detected and the child does not respond to asthma treatment.’

According to Dr Ponde, the conditions that can mimic asthma in young children are recurrent viral infections, chronic infectious tuberculosis (TB), a weakened immune system and reflux. Sometimes, the problem could even be related to the child having aspirated (breathed in) a foreign body.

‘Blood tests for allergy, immunity, TB, nutrition and cystic fibrosis may also be undertaken.

‘These tests are important in establishing a firm diagnosis of asthma and assisting in avoiding the triggers of asthma and allergy.’

Common triggers

Asthmatics may react to strong scents and aromas such as cigarette smoke, perfume or detergents, as well as colourants and preservatives in treats and cool drinks, and even silent acid reflux could trigger episodes of cough.

Environmental pollution is a well-known trigger of asthma.

In addition, it is vital that all children receive the full set of available vaccines.

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