Annals of Thoracic Medicine
REVIEW ARTICLE
Year
: 2022  |  Volume : 17  |  Issue : 2  |  Page : 71--80

Challenges and recommendations for the management of asthma in the Middle East and Africa


Mohamed Omar Zeitouni1, Mohamed Saad Al-Moamary2, Marie Louise Coussa3, Moussa Riachy4, Bassam Mahboub5, Fatma AlHuraish6, Mohamed Helmy Zidan7, Mohamed Mostafa Metwally8, Kurtuluş Aksu9, Erdinç Yavuz10, Ismail Sikander Kalla11, Jeremiah Chakaya12, Snouber Abdelmadjid13, Habib Ghedira14 
1 Pulmonary Medicine and Critical Care, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
2 Department of Medicine, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
3 Division of Pulmonary Diseases, Lebanese American University Medical Center-Rizk Hospital, Beirut, Lebanon
4 Department of Pulmonary and Critical Care Medicine, Hotel Dieu De France Hospital, Beirut, Lebanon
5 Department of Pulmonary Medicine, Rashid Hospital, Dubai Academic City, United Arab Emirates
6 Respiratory Unit, Department of Internal Medicine, Al Sabah Hospital, Ministry of Health, Kuwait
7 Department of Chest Diseases, Faculty of Medicine, Alexandria University, Egypt
8 Department of Chest Diseases, Assuit University, Assuit, Egypt
9 Clinic of Chest Diseases, Immunology and Allergic Diseases, Ankara Atatürk Chest Diseases and Chest Surgery Hospital, Ankara, Turkey
10 Department of Family Medicine, Samsun University, Samsun, Turkey
11 Pulmonologist, Suite D2 Ahmed Kathrada Private Hospital, K43 Highway, Lenasisa Ext 8, 1827, South Africa
12 Physician, Fourth Floor Room 404 Fortis Suites, Hospital Road, 00100, Nairobi, Kenya
13 Chest Clinic, Faculty of Medicine,CHU ORAN University of Oran, Oran, Algeria
14 Department of Pathology, CHU Abderrahmen Mami, Ariana, Tunisia

Correspondence Address:
Dr. Mohamed Omar Zeitouni
Pulmonary Medicine and Critical Care, King Faisal Specialist Hospital and Research Center, P.O. Box 3354, Riyadh 11211
Saudi Arabia

Clinical presentation of asthma is variable, and its diagnosis can be a major challenge in routine health-care practice, especially in low-and-middle-income countries. The aim of asthma management is to achieve optimal asthma control and to reduce the risk of asthma exacerbations and mortality. In the Middle East and in Africa (MEA), several patient- and physician-related factors lead to misdiagnosis and suboptimal management of asthma. A panel of experts comprising of specialists as well as general health-care professionals met to identify challenges and provide recommendations for the management of asthma in MEA. The major challenges identified for diagnosis of asthma were lack of adequate knowledge about the disease, lack of specialized diagnostic facilities, limited access to spirometry, and social stigma associated with asthma. The prime challenges for management of asthma in MEA were identified as overreliance on short-acting β-agonists (SABAs), underprescription of inhaled corticosteroids (ICS), nonadherence to prescribed medications, and inadequate insurance coverage for its treatment. The experts endorsed adapting the Global Initiative for Asthma guidelines at country and regional levels for effective management of asthma and to alleviate the overuse of SABAs as reliever medications. Stringent control over SABA use, discouraging over-the-counter availability of SABA, and using as-needed low-dose ICS and formoterol as rescue medications in mild cases were suggested to reduce the overreliance on SABAs. Encouraging SABA alone-free clinical practice in both outpatient and emergency department settings is also imperative. We present the recommendations for the management of asthma along with proposed regional adaptations of international guidelines for MEA.


How to cite this article:
Zeitouni MO, Al-Moamary MS, Coussa ML, Riachy M, Mahboub B, AlHuraish F, Zidan MH, Metwally MM, Aksu K, Yavuz E, Kalla IS, Chakaya J, Abdelmadjid S, Ghedira H. Challenges and recommendations for the management of asthma in the Middle East and Africa.Ann Thorac Med 2022;17:71-80


How to cite this URL:
Zeitouni MO, Al-Moamary MS, Coussa ML, Riachy M, Mahboub B, AlHuraish F, Zidan MH, Metwally MM, Aksu K, Yavuz E, Kalla IS, Chakaya J, Abdelmadjid S, Ghedira H. Challenges and recommendations for the management of asthma in the Middle East and Africa. Ann Thorac Med [serial online] 2022 [cited 2022 Jul 1 ];17:71-80
Available from: https://www.thoracicmedicine.org/article.asp?issn=1817-1737;year=2022;volume=17;issue=2;spage=71;epage=80;aulast=Zeitouni;type=0