S Jayasooriya, M Stolbrink, E M Khoo, I T Sunte, J I Awuru, M Cohen, D C Lam, A Spanevello, D Visca, R Centis, G B Migliori, A C Ayuk, J A Buendia, B I Awokola, B E Del-Rio-Navarro, S Muteti-Fana, M Lao-Araya, P Chiarella, H Badellino, S W Somwe, M P Anand, J R Garcí-Corzo, A Bekele, M E Soto-Martinez, B H M Ngahane, M Florin, K Voyi, K Tabbah, B Bakki, A Alexander, B L Garba, E M Salvador, G B Fischer, A G Falade, Zorica ŽivkoviĆ, S J Romero-Tapia, G E Erhabor, H Zar, B Gemicioglu, H V Brandão, X Kurhasani, N El-Sharif, V Singh, J C Ranasinghe, S T Kudagammana, M R Masjedi, J N Velásquez, A Jain, I Cherrez-Ojeda, L F M Valdeavellano, R M Gómez, E Mesonjesi, B M Morfin-Maciel, A E Ndikum, G B Mukiibi, B K Reddy, O Yusuf, S Taright-Mahi, J V Mérida-Palacio, S K Kabra, E Nkhama, N R Filho, V B Zhjegi, K Mortimer, S Rylance, R R Masekela
BACKGROUND: The aim of these clinical standards is to aid the diagnosis and management of asthma in low-resource settings in low- and middle-income countries (LMICs). METHODS: A panel of 52 experts in the field of asthma in LMICs participated in a two-stage Delphi process to establish and reach a consensus on the clinical standards. RESULTS: Eighteen clinical standards were defined: Standard 1, Every individual with symptoms and signs compatible with asthma should undergo a clinical assessment; Standard 2, In individuals (>6 years) with a clinical assessment supportive of a diagnosis of asthma, a hand-held spirometry measurement should be used to confirm variable expiratory airflow limitation by demonstrating an acute response to a bronchodilator; Standard 3, Pre- and post-bronchodilator spirometry should be performed in individuals (>6 years) to support diagnosis before treatment is commenced if there is diagnostic uncertainty; Standard 4, Individuals with an acute exacerbation of asthma and clinical signs of hypoxaemia or increased work of breathing should be given supplementary oxygen to maintain saturation at 94-98%; Standard 5, Inhaled short-acting beta-2 agonists (SABAs) should be used as an emergency reliever in individuals with asthma via an appropriate spacer device for metered-dose inhalers; Standard 6, Short-course oral corticosteroids should be administered in appropriate doses to individuals having moderate to severe acute asthma exacerbations (minimum 3-5 days); Standard 7, Individuals having a severe asthma exacerbation should receive emergency care, including oxygen therapy, systemic corticosteroids, inhaled bronchodilators (e...
September 1, 2023: International Journal of Tuberculosis and Lung Disease