Department of Pediatrics, Section of Pediatric Pulmonary and Sleep Medicine, Pediatric Asthma Research Program, Anschutz Medical Campus, Breathing Institute, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado.
Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia.
Pediatr Pulmonol. 2020 May;55(5):1282-1292. doi: 10.1002/ppul.24713. Epub 2020 Mar 6.
Childhood asthma is a huge global health burden. The spectrum of disease, diagnosis, and management vary depending on where children live in the world and how their community can care for them. Global improvement in diagnosis and management has been unsatisfactory, despite ever more evidence-based guidelines. Guidelines alone are insufficient and need supplementing by government support, changes in policy, access to diagnosis and effective therapy for all children, with research to improve implementation. We propose a worldwide charter for all children with asthma, a roadmap to better education and training which can be adapted for local use. It includes access to effective basic asthma medications. It is not about new expensive medications and biologics as much can be achieved without these. If implemented carefully, the overall cost of care is likely to fall and the global future health and life chance of children with asthma will greatly improve. The key to success will be community involvement together with the local and national development of asthma champions. We call on governments, institutions, and healthcare services to support its implementation.
儿童哮喘是一个全球性的重大健康负担。疾病的谱、诊断和管理因儿童居住的地点和社区对他们的照顾方式而有所不同。尽管有越来越多的循证指南，但全球在诊断和管理方面的改善仍不尽如人意。仅仅依靠指南是不够的，还需要政府的支持、政策的改变、为所有儿童提供诊断和有效治疗的途径，并开展研究以改善实施情况。我们为所有哮喘儿童提出了一个世界性的宪章，制定了一个更好的教育和培训路线图，可以根据当地情况进行调整。它包括获得有效的基本哮喘药物。这并不是关于新的昂贵药物和生物制剂，因为没有这些药物也可以取得很大的成就。如果谨慎实施，护理的总体成本可能会下降，哮喘儿童的全球未来健康和生活机会将大大改善。成功的关键将是社区参与，以及在当地和国家范围内培养哮喘病防治方面的拥护者。我们呼吁政府、机构和医疗服务机构支持其实施。
