Assessment of the Current Practice of Asthma Exacerbation Management in Different Health Settings in Cairo

Abstract

Asthma is a common chronic disorder of the airways that is characterized by variable and recurring symptoms, airflow obstruction, bronchial hyper-responsiveness, and an underlying inflammation. The interaction of these features of asthma determines the clinical manifestations and severity of asthma and the response to treatment. Asthma guidelines used in the United States and internationally classify disease to 4 categories : Intermittent asthma , Mild persistent asthma , Moderate persistent asthma and Severe persistent asthma Pathogenisis of bronchial asthma includes Bronchoconstriction, Airway edema, Airway hyperresponsiveness then Airway remodeling Asthma is one of the most common major non-communicable diseases and for many, has a substantial impact on quality of life. 300 million people have asthma worldwide There is a large geographical variation in asthma prevalence, severity, and mortality. While asthma prevalence is higher in high income countries, most asthma-related mortality occurs in low-middle income countries The prevalence of asthma in the Middle East is lower than most developed countries. However, there is not enough longitudinal data to estimate the trend over time. Asthma can lead to premature death, hospital stays, reduced productivity and quality of life. Overall, global asthma-related costs are high and significantly vary across countries, depending on several factors, such as the type of health system, financial resources on Public Health and methods of data collection. Severe exacerbations of asthma are life-threatening medical emergencies, which are most safely managed in an acute care setting e.g. emergency department. A brief history and physical examination should be conducted concurrently with the prompt initiation of therapy. History should include time of onset and cause, severity of asthma symptoms, any symptoms of anaphylaxis, riskfactors for asthma-related death, all current reliever and controller medications Physical examination The physical examination should assess signs of exacerbation severity, complicating factors and Signs of alternative conditions.