Variations and Misconceptions of Asthma Terminology, Triggers and Therapy among the Caregivers of Asthmatic Children in Makkah, Saudi Arabia
Asthma is the most common chronic disease of childhood leading to an ongoing burden on the emergency departments all around the world. The present study was conducted with the aim to assess the awareness and misconceptions related to the terminology, triggers and management among the caregivers of asthmatic children in Makkah, Saudi Arabia. An observational cross-sectional study was conducted among the asthmatic children above 6 months of age at the Maternity and Children’s Hospital in Makkah, Saudi Arabia during the period between March 2018 and July 2018. Data were collected by a structured questionnaire that includes demographic data, knowledge and awareness of the terminology, severity, triggers, follow-up and management of the disease with a focus on Metered-Dose Inhalers (MDIs), nebulizer therapy and Inhaled Cortico-Steroids (ICS). A total 242 children were included in the study 64.5% were males, 35.5% were females. A majority (71.5%) of caregivers believed that nebulizers are more effective than MDIs to treat their children. Among the 242 children, 47.1% use spacer devices regularly and only 40.5% of them have used ICS. The main reason for not using steroid inhalers and spacer devices as stated by most caregivers (68% and 49.3% respectively). was “never recommended by physicians”. 73.1% of the children had no Asthma follow up outside the ED. 73.7% of caregivers who reported having a smoker in their homes did not know the harmful effects of smoking on their children. Many misconceptions about the terminologies, triggers, the nature of the ED medications and outpatient treatment were found among the caregivers of the children included in the study. Physicians poor adherence to current asthma treatment guidelines and the lack of well structured follow up and educational programs may be contributing to the caregivers inconsistencies with outpatient treatment and follow up.
- Ferrante G, La Grutta S. The burden of pediatric asthma. Front Pediatr. 2018; 6:186. https://doi.org/10.3389/fped.2018.00186. PMid: 29988370, PMCid: PMC6023992.
- Pearson WS, Goates SA, Harrykissoon SD, Miller SA. Statebased Medicaid costs for pediatric asthma emergency department visits. Prev. Chronic. Dis. 2014; 11:E108. https://doi.org/10.5888/pcd11.140139. PMid: 24967830, PMCid: PMC4075488.
- Bin-Saeed AA. Caregiver knowledge and its relationship to asthma control among children in Saudi Arabia. J. Asthma. 2014; 51(8):870-75. https://doi.org/10.3109/02770903.2014 .906608. PMid: 24654707.
- Herzog R, Cunningham‐Rundles S. Pediatric asthma: Natural history, assessment, and treatment. Mt. Sinai. J. Med. 2011; 78(5):645-60. https://doi.org/10.1002/msj.20285. PMid: 21913196, PMCid: PMC3172616.
- Fu L-S, Tsai M-C. Asthma exacerbation in children: A practical review. Pediatrics and Neonatology. 2014; 55(2):83-91. https://doi.org/10.1016/j.pedneo.2013.07.004. PMid: 24211086, PMCid: PMC7102856.
- Al-Jahdali HH, Al-Hajjaj MS, Alanezi MO, Zeitoni MO, Al-Tasan TH. Asthma control assessment using asthma control test among patients attending 5 tertiary care hospitals in Saudi Arabia. Saudi Med. J. 2008; 29(5):714-17.
- Schatz M, Rachelefsky G, Krishnan JA. Follow-up after acute asthma episodes: What improves future outcomes? Proc. Am. Thorac. Soc. 2009; 6(4):386-93. https://doi.org/10.1513/pats.P09ST6. PMid: 19675349.
- Wolf FM, Guevara JP, Grum CM, Clark NM, Cates CJ. Educational interventions for asthma in children.
- Cochrane Database Syst. Rev. 2003: CD000326. https://doi.org/10.1002/14651858. CD000326. PMid: 12535395.
- Gajanan G, Padbidri VS, Chaudhury A. Assessment of knowledge and attitude of parents towards the allergy and bronchial asthma in their children. Inter. J. Med. Public Health. 2016; 6(3):121-25. https://doi.org/10.5530/ijmedph.2016.3.5.
- Al Binali A, Mahfouz A, Al Fifi S, Naser S, Al Gelban K. Asthma knowledge and behaviours among mothers of asthmatic children in Aseer, South-West Saudi Arabia. Eastern Mediterranean Health J. 2010; 16(11):1153-58. https://doi.org/10.26719/2010.16.11.1153.
- Zaraket R, Al-Tannir MA, Bin Abdulhak AA, Shatila A, Lababidi H. Parental perceptions and beliefs about childhood asthma: A cross-sectional study. Croat. Med. J. 2011; 52(5):637-43. https://doi.org/10.3325/cmj.2011.52.637. PMid: 21990082, PMCid: PMC3195973.
- Al-Moamary MS, Alhaider SA, Al-Hajjaj MS. The Saudi initiative for asthma - 2019 update: Guidelines for the diagnosis and management of asthma in adults and children. Ann. Thoracic Med. 2019; 14(1):3-48.https://doi.org/10.4103/atm.ATM_327_18, https://doi.org/10.4103/1817-1737.173196. PMid: 26933455, PMCid: PMC4748613.
- Weitzman M, Gortmaker S, Walker DK, Sobol A. Maternal smoking and childhood asthma. Pediatrics. 1990; 85(4):505-11.
- Chilmonczyk BA, Salmun LM, Megathlin KN, Neveux LM, Palomaki GE, Knight GJ, et al. Association between exposure to environmental tobacco smoke and exacerbations of asthma in children. New England J. Med. 1993; 328(23):1665-69. https://doi.org/10.1056/NEJM199306103282303. PMid: 8487825.
- Gonzalez MASJ, Gonzalez-Barcala F-J, Pertega S, Sampedro M, Lastres JS, Bamonde L, et al. Impact of parental smoking on childhood asthma. Jornal de Pediatria. 2013; 89(3):29499. https://doi.org/10.1016/j.jped.2012.11.001. PMid: 23684453.
- Hadnadjev M, Ilić M. Smoking and asthma in children. Medicinski Glasnik. 2011; 8(2):266-72.
- Evans D, Levison MJ, Feldman CH, Clark NM, Wasilewski Y, Levin B, et al. The impact of passive smoking on emergency room visits of urban children with asthma. Am Rev. Respiratory Disease. 1987; 135(3):567-72.
- Al-Rawas OA, Al-Maniri AA, Al-Riyami BM. Home exposure to Arabian incense (bakhour) and asthma symptoms in children: A community survey in two regions in Oman. BMC Pulmonary Med. 2009; 9(1):23-27. https://doi.org/10.1186/1471-2466-9-23. PMid:19450289, PMCid: PMC2693130.
- Castro-Rodriguez JA, Rodrigo GJ. Efficacy of inhaled corticosteroids in infants and preschoolers with recurrent wheezing and asthma: A systematic review with metaanalysis. Pediatrics. 2009; 123(3):e519-25. https://doi.org/10.1542/peds.2008-2867. PMid: 19254986.
- Delgado A, Chou KJ, Silver EJ, Crain EF. Nebulizers vs metered-dose inhalers with spacers for bronchodilator therapy to treat wheezing in children aged 2 to 24 months in a pediatric emergency department. Archives of Pediatrics and Adolescent Medicine. 2003; 157(1):76-80. https://doi.org/10.1001/archpedi.157.1.76. PMid: 12517199.
- Jamalvi SW, Raza SJ, Naz F, Shamim S, Jamalvi SM. Management of acute asthma in children using metered dose inhaler and small volume nebulizer. J. Pakistan Med. Assoc. 2006; 56(12):595-99.
- Alhaider S, Alshehri H, Al-Eid K. Replacing nebulizers by MDI-spacers for bronchodilator and inhaled corticosteroid administration: Impact on the utilization of hospital resources. Int. J. Pediatrics and Adolescent Med. 2014; 1(1):26-30. https://doi.org/10.1016/j.ijpam.2014.09.002. PMid: 32289071, PMCid: PMC7104032.
- Abu-Shaheen AK, Nofal A, Heena H. Parental Perceptions and Practices toward Childhood Asthma. Bio. Med. Research International. 2016; Article ID 6364194. 1-7 https://doi.org/10.1155/2016/6364194. PMid: 27843948, PMCid: PMC5097792.
- Zaraket R, Al-Tannir MA, Abdulhak B, Aref A, Shatila A, Lababidi H. Parental perceptions and beliefs about childhood asthma: A cross-sectional study. Croatian. Med. J. 2011; 52(5):637-43. https://doi.org/10.3325/cmj.2011.52.637. PMid: 21990082, PMCid: PMC3195973.
- Cheng NG, Browne GJ, Lam LT, Yeoh R, Oomens M. Spacer compliance after discharge following a mild to moderate asthma attack. Arch. Dis. Child. 2002; 87:302-05. https://doi.org/10.1136/adc.87.4.302. PMid: 12244002, PMCid: PMC1763032.
Abstract Views: 2
PDF Views: 3