Childhood Asthma: Low and Middle-Income Countries Perspective


  • Manuel E. Soto-Martínez Respiratory Department, Hospital Nacional de Niños “Dr. Carlos Sáenz Herrera”, Caja Costarricense Seguro Social, San José; Section of Pediatrics, School of Medicine, Universidad de Costa Rica, San José
  • Manuel E. Soto-Quiros Respiratory Medicine, Section of Pediatrics, Hospital CIMA San José, San José
  • Adnan Custovic National Heart and Lung Institute, Imperial College London, London



Low-Middle Income Countries, Asthma, Asthma Guidelines, Children


Abstract Our aim is to review current asthma epidemiology, achievements from the last 10 years, and persistent challenges of asthma man- agement and control in low-middle income countries (LMICs). Despite global efforts, asthma continues to be an important public health problem worldwide, particularly in poorly resourced settings. Several epidemiological studies in the last decades have shown significant variability in the prevalence of asthma globally, but generally a marked increase in LMICs resulting in significant mor- bidity and mortality. Poverty, air pollution, climate change, exposure to indoor allergens, urbanization and diet are some of the factors that contribute to inadequate control and poor outcomes in developing countries. Although asthma guidelines have been developed to raise awareness and improve asthma diagnosis and treatment, problems with underdiagnosis and undertreatment are still common. In addition, important social, financial, cultural and healthcare barriers are common obstacles in LMICs in achieving control. Given the high burden of asthma in these countries, adaptation and implementation of national asthma guidelines tailored to local needs should be a public health priority. Governmental commitment, education, better health system infrastructure, access to care and effective asthma medications are the cornerstone of achieving success.

Conclusion. Asthma poses significant challenges to LMICs. Whilst there are ongoing efforts in improving asthma diagnosis and decreasing asthma burden in LMICs; reasons for inadequate asthma control are also common and difficult to tackle. Improving asthma diagnosis, access to appropriate treatment and decreasing risk factors should be key goals to reduce asthma morbidity and mortality worldwide.


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How to Cite

Soto-Martínez, M. E., Soto-Quiros, M. E., & Custovic, A. (2020). Childhood Asthma: Low and Middle-Income Countries Perspective. Acta Medica Academica, 49(2), 181–190.

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