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Improving paediatric asthma care in Zambia

Somwe , Somwe Wa, Jumbe-Marsden, Emilia, Mateyo, Kondwelani, Senkwe, Mutale Nsakashalo, Sotomayor-Ruiz, Maria, Musuku, John, Soriano, Joan B, Ancochea, Julio and Fishman, Mark (2105) Improving paediatric asthma care in Zambia. Bulletin of the World Health Organization, 93 (10). pp. 732-736.


Problem: In 2008, the prevalence of paediatric asthma in Zambia was unknown and the
national treatment guideline was outdated.

Approach: We created an international partnership between Zambian clinicians, the
Zambian Government and a pharmaceutical company to address shortcomings in
asthma treatment. We did two studies, one to estimate prevalence in the capital of
Lusaka and one to assess attitudes and practices of patients. Based on the information
obtained, we educated health workers and the public. The information from the studies
was also used to modernize government policy for paediatric asthma management.

Local setting: The health care system in Zambia is primarily focused on acute care
delivery with a focus on infectious diseases. Comprehensive services for
noncommunicable diseases are lacking. Asthma management relies on treatment of
acute exacerbations instead of disease control.

Relevant changes: Seven percent of children surveyed had asthma (255/3911). Of the
120 patients interviewed, most (82, 68%) used oral short-acting β-agonists for symptom
control; almost half (59, 49%) did not think the symptoms were preventable and 43%
(52/120) thought inhalers were addictive. These misconceptions informed broad-based
educational programmes. We used a train-the-trainer model to educate health care
workers and ran public awareness campaigns. Access to inhalers was increased and
Zambian standard treatment guideline for paediatric asthma was revised to include
steroid inhalers as control treatment.

Lessons learnt: Joint activities were required to change paediatric asthma care in
Zambia. Success will depend on local sustainability, and it may be necessary to shift
resources to mirror the disease burden.

Item Type: Article
Date Deposited: 27 Apr 2016 23:45
Last Modified: 27 Apr 2016 23:45


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