If it is treated correctly and long enough, asthma in children can be completely controlled, prominent Bulgarian doctors and specialists emphasized on the occasion of the upcoming National Expert Conference on Children's Asthma.
According to modern understandings, asthma is a chronic lung inflammation. It is the most widespread and socially significant disease among non-infectious diseases. Its treatment is expensive and lengthy, and if not treated properly as the patient ages and asthma progresses, it becomes increasingly expensive and ineffective, often leading to hospitalization and disability.
According to data presented at the press conference, there are 2 million potential and current asthmatics in our country, 480 thousand of them - diagnosed. There are 300 million asthma sufferers worldwide, which is many times more than the other most common and socially significant diseases – diabetes (150 million) and AIDS (40 million). The direct and indirect economic costs associated with asthma are also huge – €17.7 billion per year in Europe.
In children, in most cases, asthma is of an allergic nature. It is usually provoked by infections, most often viral. It proceeds atypically. Characteristic symptoms are wheezing, coughing, reduced physical activity in children and night awakenings. In 80% of cases of childhood asthma, the first symptoms occur between the ages of 0 and 5.
According to global epidemiological data, the prevalence of asthma in children is around 10%. In Bulgaria, there are about 15,000 children with mild and moderate persistent asthma. Only 2,500 of them receive controlled therapy every month.
Extremely important for establishing the diagnosis of bronchial asthma and for controlling its treatment, is the functional examination of breathing. It gives information about the type of respiratory failure.
It is known that anti-inflammatory treatment in children with asthma should start early and be sufficiently long-lasting. The selection and dosage of the medications is done according to the stage of development the disease has reached, observing the stepwise approach.
Glucocorticosteroids affect one of the main mechanisms of asthmatic inflammation and are the gold standard in the treatment of asthma. Inhalers do not cause systemic side effects and in most cases are sufficient to control asthma and ensure a normal life for the child.
Sometimes, when treatment with corticosteroids does not give a good enough result and the dose has to be increased to no longer so harmless levels, a new class of medication is switched to leukotriene antagonists. They block one of the main inflammatory mediators in asthma (leukotrienes). Thus, a better control of the disease is ensured and the reduction of the corticosteroid dose is possible.
In Bulgaria, there is already an available medication from the group of leukotriene antagonists (Singulair), which the NHSOK included in its list and pays 100% for children from 1 to 15 years of age. Since September of this year, he has been discharged without a protocol by pulmonologists, allergists and pediatricians. These are the European standards for the treatment of asthma, which are also applied in Bulgaria. The Bulgarian specialists already have 4 years of experience with this type of medication and the results of the initial research are more than encouraging. They show that in inadequately controlled asthma, the addition of a leukotriene antagonist improves ventilatory function, reduces the need for inhalations, improves symptoms not only on the asthmatic side but also on the nasal side. The effect is present in both adults and children, without registering serious and pronounced side effects.
