Okoromah Christy N, Oviawe O
Department of Paediatrics and Child Health, College of Medicine of the University of Lagos, P.M.B 12003, Idi-Araba, Lagos.
Niger Postgrad Med J. 2002 Dec;9(4):221-5.
Underdiagnosis of asthma may lead to inappropriate management including undertreatment, and consequently to high morbidity and mortality. This study aimed at determining the rates of diagnosis and treatment of childhood asthma among medical practitioners. Relevant information on 45 asthmatic children was collected using pre-tested questionnaires. There were 30 (66.7%) males and 15 (33.3%) females (M:F, 2:1). Mean age, average ages for onset of symptoms and diagnosis of asthma were 9.4 years, 1.8 years and 6.6 years respectively. An average of 4 previous medical consultations were undertaken for asthma symptoms, but only 11 (24.4%) cases were labeled as asthma. Alternative diagnostic labels including allergy, bronchitis (wheezy), pneumonia (chest infection), and tuberculosis, were used in 29 (64.4%). Five (11.1%) cases were unlabelled. Alternative labeling for asthma was associated with frequent usage of non-bronchodilator medications including antihistamines, antibiotics, antituberculous drugs, cough mixtures, and herbal concoctions. Only 15 (33.3%) cases received bronchodilators, rarely prescribed regularly in the absence of asthma label. This study reveals low diagnosis and treatment rates for asthma, emphasising the need to audit the management of childhood asthma among medical practitioners, with the view of providing information.
哮喘的漏诊可能导致包括治疗不足在内的不恰当管理，进而导致高发病率和高死亡率。本研究旨在确定医生中儿童哮喘的诊断率和治疗率。使用预先测试的问卷收集了45名哮喘儿童的相关信息。其中男性30名（66.7%），女性15名（33.3%）（男:女为2:1）。平均年龄、哮喘症状出现的平均年龄和哮喘诊断的平均年龄分别为9.4岁、1.8岁和6.6岁。因哮喘症状平均此前进行了4次就医咨询，但只有11例（24.4%）被诊断为哮喘。29例（64.4%）使用了包括过敏、支气管炎（喘息性）、肺炎（肺部感染）和结核病在内的其他诊断标签。5例（11.1%）未贴标签。哮喘的替代标签与频繁使用非支气管扩张剂药物有关，包括抗组胺药、抗生素、抗结核药、止咳合剂和草药制剂。只有15例（33.3%）患者接受了支气管扩张剂治疗，在没有哮喘标签的情况下很少定期开此类药物。本研究揭示了哮喘的低诊断率和低治疗率，强调有必要对医生中儿童哮喘的管理进行审核，以便提供信息。
