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The challenges of diagnosing bronchial asthma in very young infants in Calabar, Nigeria

Atana Uket Ewa, Francis Akpan, Happiness Uko Ntia, Jacintha Okoi-Obuli.

Abstract
Bronchial asthma can start at any age and is suggested by a recurrent nature of cough with or without wheeze. It is sometimes associated with history of atopic disorders in the patient or family members. There is a lack of global epidemiological data in young infants owing to the challenges in their management, including the variability of their wheezing illnesses, which seems to be the main risk factor for the development of persistent asthma. The diagnosis of asthma in this age group is difficult and as a result, it is most often delayed or denied. Many misconceptions concerning asthma in young infants exist among clinicians, who before now believed the diagnosis should be postponed until the child is older. Some parents and caregivers on the other hand, believe asthma is a bad familial disease that should not be attributed to their children, causing further delays in control. This report aims to highlight not only the existence of bronchial asthma in this group of children but the challenges in their diagnosis and prompt treatment by sharing the experiences from our center. Reports of three cases whose initial presentations started in the neonatal period, 6 weeks and 2 months of age respectively. The diagnosis of asthma was initially missed because of their young ages but with a high index of suspicion, prompt diagnosis and correct treatment, all of them are doing well. The very young infants do have asthma with or without family histories. There is therefore need for early diagnosis and prompt treatment of asthma to reduce pulmonary damage. The challenges of diagnosing and treating asthma in this age group are great and warrant a comprehensive approach, involving all stakeholders.

Key words: Atana Uket Ewa, Francis Akpan, Happiness Uko Ntia, Jacintha Okoi-Obuli



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