Childhood Asthma in the under five age group: diagnosis and treatment.

Asthma is the most frequent chronic disease in pediatrics and the increase in its prevalence is a major public health problem. Diagnosis may be diffic ult in the young child, symptomatology most often occurring following a vir al infection. It is important not to ignore a foreign body-in the airways o r fibrocystic disease and asthma remains, particularly in infants, a diagno sis of elimination. Misdiagnosis or insufficient treatment of asthma may ri sk the development of irreversible histological lesions and also could comp romise pulmonary growth and the child's lung reserve. Spacer devices and ne bulisers enable inhaled therapy to be administered to very young children. The value of early dia-gnosis is to institute appropriate treatment notably in severe asthma with inhaled corticosteroid Therapy, the aim being to red uce remodelling lesions of the airways. The minimal effective dose should b e defined to minimalise side effects. The treatment of asthma is not restri cted to pharmacotherapy: attempts should be made to reduce intercurrent vit al infections, domestic pollution (including smoking) and allergenic concen trations. However, as for all chronic diseases, the clinician will encounte r poor compliance. The work of education and support of health professional s is fundamental to the management of asthma.