Solé Dirceu, Aranda Carolina Sanchez, Wandalsen Gustavo Falbo
Division of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Escola Paulista de Medicina, Federal University of São Paulo, Rua dos Otonis, 725 - Vila Clementino, 04025-002 São Paulo, Brazil.
Asthma Res Pract. 2017 May 11;3:4. doi: 10.1186/s40733-017-0032-3. eCollection 2017.
Asthma is reported as one of the most common chronic diseases in childhood, impairing the quality of life of patients and their families and incurring high costs to the healthcare system and society. Despite the development of new drugs and the availability of international treatment guidelines, asthma is still poorly controlled, especially in Latin America. Original and review articles on asthma control or epidemiology with high levels of evidence have been selected for analysis among those published in PubMed referenced journals during the last 20 years, using the following keywords: "asthma control" combined with "Latin America", " epidemiology", "prevalence", "burden", "mortality", "treatment and unmet needs", "children", "adolescents", and "infants". There was a high prevalence and severity of asthma during the period analyzed, especially in children and adolescents. Wheezing in infants was a significant reason for seeking medical care in Latin American health centers. Moreover, the frequent use of quick-relief bronchodilators and oral corticosteroids by these patients indicates the lack of a policy for providing better care for asthmatic patients, as well as poor asthma control. Among adults, studies document poor treatment and control of the disease, as revealed by low adherence to routine anti-inflammatory medications and high rates of emergency care visits and hospitalization. In conclusion, although rare, studies on asthma control in Latin America repeatedly show that patients are inadequately controlled and frequently overestimate their degree of asthma control according to the criteria used by international asthma treatment guidelines. Additional education for doctors and patients is essential for adequate control of this illness, and therefore also for reduction of the individual and social burden of asthma.
据报道，哮喘是儿童期最常见的慢性病之一，它损害患者及其家庭的生活质量，给医疗保健系统和社会带来高昂成本。尽管有新药问世且有国际治疗指南可供参考，但哮喘的控制情况仍然不佳，尤其是在拉丁美洲。我们从过去20年发表在PubMed引用期刊上的文章中，挑选了关于哮喘控制或流行病学且证据水平较高的原创文章和综述文章进行分析，使用了以下关键词：“哮喘控制” 并与 “拉丁美洲”、“流行病学”、“患病率”、“负担”、“死亡率”、“治疗与未满足的需求”、“儿童”、“青少年” 和 “婴儿” 组合。在所分析的时间段内，哮喘的患病率和严重程度都很高，尤其是在儿童和青少年中。婴儿喘息是拉丁美洲医疗中心患者就诊的重要原因。此外，这些患者频繁使用速效支气管扩张剂和口服皮质类固醇，表明缺乏为哮喘患者提供更好护理的政策，以及哮喘控制不佳。在成年人中，研究表明该疾病的治疗和控制情况不佳，这表现为对常规抗炎药物的依从性低以及急诊就诊和住院率高。总之，尽管关于拉丁美洲哮喘控制的研究很少，但反复表明患者的病情控制不足，并且根据国际哮喘治疗指南所采用的标准，患者常常高估自己的哮喘控制程度。对医生和患者进行额外教育对于充分控制这种疾病至关重要，因此对于减轻哮喘的个人和社会负担也很重要。
