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Free Content Asthma programmes in diverse regions of the world: challenges, successes and lessons learnt

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International surveys have demonstrated that asthma is still underdiagnosed and undertreated in many parts of the world. Despite improvements in the standard of asthma care delivered in many areas, as evidenced by improved global asthma mortality data, much information on projects and programmes undertaken in resourcelimited regions of the world is not in the public domain. The aim of this report is to review projects and programmes in diverse regions around the world so that health care providers, planners and consumers may draw on the successes, failures and lessons learnt. Such real world experiences may contribute to achieving Global Initiative for Asthma goals of asthma control. Asthma projects and programmes in Argentina, Australia, Brazil, China, Japan, Mexico, Philippines, Russia, South Africa and Turkey were discussed by a group of experts in asthma care, the Advancing Asthma Care Network, from their respective countries, over a course of three satellite meetings in 2010. Collective analyses consistently identi ed low rates of dissemination and implementation of national and in- ternational treatment guidelines, low levels of continuing medical education and training of primary health care professionals and access and distribution of inhaled corticosteroids to be major barriers that are critical to the overall success of a national asthma management programme. In the less developed asthma programmes, under-recognition and undertreatment further limited the success of the programmes. Evidence from well-established national asthma management programmes suggests that establishment of a successful programme entails a logical progression through speci c developmental stages, starting with political/stakeholder endorsement and commitment, followed by epidemiological evaluation, evaluation of disease burden, evaluation of access to care and best therapy, and nally optimisation and maintenance therapy for individual patients.
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Document Type: Review Article

Affiliations: 1: Department of Pulmonology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa 2: GlaxoSmithKline, Uxbridge, UK 3: First Department of Internal Medicine, Showa University, Tokyo, Japan 4: Philippine Heart Centre, Quezon City, Philippines 5: Department of Respiratory Medicine and Allergy, Saint-Petersburg Medical Academy for Postgraduate Studies, St Petersburg, Russia 6: Pontificia Universidade Catolica Do Rio Grande Do Sul, Porto Alegre, Brazil 7: Department of Pediatrics, Shanghai No.1 People's Hospital, Shanghai, China 8: Hospital Angeles Centro Medico del Potosi, San Luis Potosí, México 9: Woolcock Institute of Medical Research, Sydney, New South Wales, Australia 10: Chinese-Japanese Friendship Hospital, Beijing, China 11: Hospital Infantil de las Californias, Tijuana Baja California, Mexico 12: Respiratory Medicine Unit, 'O. Alassia' Children's Hospital, Sante Fe, Argentina 13: Paediatric Allergy and Asthma Unit, Hacettepe University, Ankara 14: Department of Chest Disease, Celal Bayar University, Manisa, Turkey 15: Department of Paediatrics and Child Health, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa

Publication date: December 1, 2011

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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