Publication:

Management of asthma in children under 36 months by physicians in university hospitals of Antananarivo, Madagascar

Background Asthma is one of the most common chronic conditions in paediatrics. The main objective of this study was to describe the management of asthma in children under 36 months of age by doctors working in paediatric wards in Antananarivo hospitals.

Methods This was a descriptive survey carried out in the form of a questionnaire among doctors practicing in the paediatric wards of Antananarivo Hospital Centers from February 2022 to February 2023.

Results Fifty-two doctors were surveyed, giving a participation rate of 86.7%. Chest X-rays (88.5%) and allergy tests (32.6%) were the most frequently prescribed complementary examinations. For the treatment of an asthma attack, doctors prescribed salbutamol spray or nebulizer combined with corticosteroid. Inhaled corticosteroids were the most widely prescribed background treatment (75%), and all doctors practiced therapeutic education. The causes of under-diagnosis reported were confusion between bronchiolitis and asthma in infants, and the atypical presentation of the attack. The most common difficulties encountered were related to financial problems, parents' low level of education (94.9%) and inadequate technical facilities (66.7%).

Conclusions To improve the management of asthma in children, it is necessary to provide continuing medical education, draw up a standardized management protocol for all paediatric departments, improve technical facilities and set up an asthma school for parents.