Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota, Colombia.
Department of Pediatric Pulmonology, School of Medicine, Universidad El Bosque, Bogota, Colombia.
Pediatr Pulmonol. 2024 Dec;59(12):3819-3826. doi: 10.1002/ppul.26573. Epub 2023 Jun 28.
To provide a comprehensive overview of disparities in prevalence and outcomes of respiratory diseases and notable challenges for providing optimal treatment to pediatric patients with respiratory diseases living in low- and middle-income countries (LMICs), as an input to help better understand the roots of respiratory health disparities.
We conducted a narrative review of relevant literature published in electronic databases from inception to February 2023 that present data on disparities in prevalence and outcomes of respiratory disease in LMICs. Additionally, we included studies that describe and discuss challenges for providing optimal treatment to pediatric patients with respiratory diseases living in LMICs.
A number of early life exposures have been associated with adverse respiratory outcomes in later life. Several studies have shown marked geographical variations in the prevalence and burden of pediatric asthma, with consistently lower prevalence rates but significantly higher burdens and worse outcomes in LMICs. There is a wide range of challenges that adversely affect the efficient care of children with respiratory diseases that can be classified into three categories: patient-related factors, social/environmental factors, and factors related to healthcare providers or the healthcare system.
Respiratory health disparities in children living in LMICs represent a global public health issue mainly explained by an unequal distribution of preventable and modifiable risk factors for respiratory diseases across different demographic groups.
全面概述呼吸疾病在患病率和结局方面的差异,以及为中低收入国家(LMICs)的儿科呼吸疾病患者提供最佳治疗所面临的显著挑战,为更好地理解呼吸健康差异的根源提供依据。
我们对截至 2023 年 2 月发表于电子数据库的相关文献进行了叙述性综述,这些文献提供了关于 LMICs 中呼吸疾病患病率和结局差异的数据。此外,我们还纳入了描述和讨论为 LMICs 中患有呼吸疾病的儿科患者提供最佳治疗所面临挑战的研究。
一些早期生活暴露与晚年呼吸不良结局有关。多项研究表明,儿科哮喘的患病率和负担在地理上存在显著差异,LMICs 的总体患病率较低,但负担明显更高,结局更差。有一系列挑战对儿童呼吸疾病的有效护理产生不利影响,可以分为三类:患者相关因素、社会/环境因素以及与医疗保健提供者或医疗保健系统相关的因素。
生活在 LMICs 的儿童的呼吸健康差异是一个全球性公共卫生问题,主要归因于不同人群中可预防和可改变的呼吸疾病风险因素分布不均。