Challenges in the management of bronchial asthma among adults in Nigeria: A systematic review

Inadequate attention given to the management of asthma and ways of improving bronchial asthma control could be an important factor for the rising morbidity and mortality from asthma despite major advances in our understanding of the disease process. There is a paucity of data concerning the challenges faced in the management of asthma in Africa. This review was aimed at highlighting the challenges facing asthma management and to discuss various strategies in improving asthma control in Nigeria. Data were sourced from PubMed, Medline, African Journals Online, Google Scholar, SCOPUS, and by reviewing the references of relevant literature. Additional articles were obtained via communications with colleagues and reviewing the Abstract Books of Nigeria Thoracic Society Annual Scientific Conference from 2005 to 2012. The data search was up-to-date as of December 31, 2012. Challenges in asthma management were found during diagnosis, treatment, and follow-up. There are wide variations in diagnostic criteria for bronchial asthma and lack of standard diagnostic equipment leading to under or misdiagnosis. Treatment challenges include poor communication gap between the health-care providers and the patients, a high-cost and unavailability of essential asthma medications. Poor technique uses for medication devices, especially the inhalational drugs and Lack of National/hospital protocol or guidelines for treating asthma. Several challenges affect asthma management in developing countries, which borders on poverty, inadequate resources, weak health systems, and poor infrastructure. Efforts should be made to address these challenges by the Nigerian government, Nigerian Thoracic Society, pharmaceutical industries, and the health-care workers in general.