 "No sooner do the cough and wheeze settle down, than the parents stop the medications…"
-Sarath Paranavitane RESPONSES BY SUBJECT
 Are there any special problems in diagnosing asthma in children? Do they vary by age?
What do you think are the special issues and challenges in treating children with asthma? Do they vary by age?
What questions do parents/carers and patients ask of you?
Which educational strategies work?
Which in your opinion are the top three problems children and parents/carers face in managing asthma in daily life?
RESPONSES BY COUNTRY
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Responses by countrySarath Paranavitane (Sri Lanka):
Are there any special problems in diagnosing asthma in children? Do they vary by age?We don't have many places where there are spirometers; those are some of the limiting factors that we have. There are only a few places in the capitol city of Colombo where they do pulmonary function tests, and there are none in the peripheries. So we have a problem in getting spirometry done for our children. Even peak flow meters are very difficult to come by. Sometimes drug companies provide us with peak flow meters, but what they give is only two or three, which is insufficient to meet the demand. Many patients cannot afford to buy peak flow meters. Cost is another limiting factor in developing countries such as ours. In this scenario, the diagnosis of asthma is clinical, reinforced by the therapeutic response.What do you think are the special issues and challenges in treating children with asthma? Do they vary by age?What happens commonly is that no sooner than the cough and wheeze settle down, then the parents stop the medication, even though I had counselled them not to do so. They come back and say, "They were doing fine with the inhaler, so I stopped it." So I have to restart them on the inhaler again. That's our biggest challenge. The second issue is the cost factor.Which educational strategies work?One-to-one conversation, explaining to parents and children. One problem with the printed material is that it's mostly in English, and very few in Sri Lanka are able to read and comprehend. So the best way is to verbally explain to them, one-to-one.Which in your opinion are the top three problems children and parents/carers face in managing asthma in daily life?
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