Child and Adolescent Health Unit, Faculty of Medical Sciences, University of Zimbabwe, P O Box A178, Avondale, Harare, Zimbabwe.
Family Medicine, Global and Public Health Unit, Faculty of Medical Sciences, University of Zimbabwe, P O Box A178, Avondale, Harare, Zimbabwe.
Respir Res. 2022 Sep 19;23(1):254. doi: 10.1186/s12931-022-02170-y.
Asthma is the commonest chronic respiratory tract disease in children. In low-income countries, challenges exist in asthma diagnosis. In surveys done in children, the prevalence of 'asthma' defined by symptoms is high compared to 'doctor diagnosed asthma'. The questions answered by this review are (i) What challenges have been experienced in the diagnosis of asthma in children? (ii) What solutions will address these challenges?
The Arksey and O'Malley's framework for scoping reviews was used for the study methodology, while the PRISMA-ScR checklist guided the reporting process. Electronic databases: PubMed Central, EMBASE and Google Scholar were searched. Primary quantitative and qualitative studies and reviews from 2010 to 2021, from Nigeria, South Africa and Uganda written in English or translated to English, which answered the study questions were included. The author, title, country, study type, methods, purpose, findings and references were captured onto a predefined data collection table. The 'Preview, Question, Read, Summarise' system was used and a narrative report was used to summarise the findings.
A total of 28 studies were included. The causes of under-diagnosis of asthma include lack of community knowledge and perception of asthma, poor accessibility to health care, strained health systems, lack of diagnostic tests including spirometry, low levels of knowledge among health-care workers and lack of or non-implementation of asthma guidelines. Strategies to improve asthma diagnosis will include community and school based education programmes, revision of asthma diagnostic terms, guideline development and implementation and health systems strengthening.
This scoping review provides research evidence for policy makers and health-workers involved in the care of asthmatic children on challenges faced in asthma diagnosis and strategies to improve asthma diagnosis.
哮喘是儿童最常见的慢性呼吸道疾病。在低收入国家，哮喘的诊断存在挑战。在针对儿童进行的调查中，通过症状定义的“哮喘”患病率高于“医生诊断的哮喘”。本综述回答的问题是：（i）在儿童哮喘诊断中遇到了哪些挑战？（ii）有哪些解决方案可以解决这些挑战？
本研究采用阿克塞尔和奥马利的范围综述框架作为研究方法，同时 PRISMA-ScR 清单指导报告过程。检索电子数据库：PubMed Central、EMBASE 和谷歌学术，纳入 2010 年至 2021 年期间来自尼日利亚、南非和乌干达的以英文发表或翻译成英文的原始定量和定性研究以及综述，这些研究回答了研究问题。作者、标题、国家、研究类型、方法、目的、发现和参考文献被捕获到一个预定义的数据收集表中。使用了“预览、提问、阅读、总结”系统，并使用叙述性报告总结研究结果。
共纳入 28 项研究。哮喘诊断不足的原因包括社区对哮喘的知识和认知不足、难以获得医疗保健、卫生系统紧张、缺乏包括肺功能检查在内的诊断测试、卫生保健工作者知识水平低以及缺乏或未实施哮喘指南。改善哮喘诊断的策略将包括社区和学校教育计划、修订哮喘诊断术语、制定和实施指南以及加强卫生系统。
本范围综述为参与哮喘儿童护理的政策制定者和卫生工作者提供了哮喘诊断面临的挑战和改善哮喘诊断的策略方面的研究证据。
