A comparative analysis of asthma treatment guidelines and Essential Medicine Lists in sub-Saharan Africa

Abstract

INTRODUCTION: Asthma is a chronic condition affecting between 300 and 400 million people worldwide. Studies have shown that asthma symptoms can be controlled by the daily use of inhaled corticosteroids (ICS). The management of asthma varies in different settings.METHODS: Asthma management in 13 sub-Saharan African countries was compared to the 2018 Global Initiative for Asthma (GINA) guidelines and the 20th WHO model list of essential medicines (2019). A table with predefined criteria extracted from the international guidelines was used to analyse the content and compare the different treatment guidelines using an Excel spreadsheet.RESULTS: There are variations in the way asthma is diagnosed and treated in different countries. Countries with older treatment guidelines do not have a stepwise approach to assessing severity as stipulated by GINA. Of the 13 countries, only 46% have inhaled ICS at the primary level, 38% have ICS at the secondary level and 16% do not specify.CONCLUSION: The management of asthma varies widely between different countries in sub-Saharan Africa. The noticed variations in approach to care can be explored as an opportunity to harness resources to produce similar and updated guidelines, resulting in uniformity of care across different countries.