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 nor 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 diagnosis is to institute appropriate treatment notably in severe asthma with inhaled corticosteroid therapy, the aim bring to redu ce remodelling lesions of the airways. The minimal effective dose should be defined to minimalise side-effects. The treatment of asthma is not restric ted to pharmacotherapy: attempts should be made to reduce intercurrent vira l infections, domestic pollution (including smoking) and allergenic concent rations. However, as for all chronic diseases, the clinician will encounter poor compliance. The work of education and support of health professionals is fundamental to the management of asthma.