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36 February 2025 Inhalation Asthma control in children overestimated by parents, physicians and assessment tools "Uncontrolled asthma is thought to occur in an estimated 44% of children with asthma, aged 5 to 11 years, in the United States. How- ever, a research team is question- ing the accuracy of methods used to determine degrees of asthma control because those methods fail to consider a child's history of asthma exacerbations. e team, led by Kevin Murphy, MD, of Boys Town National Research Hospital, Boys Town, Nebraska, US, conducted the study at multiple sites in the US. Findings were presented at the American College of Allergy, Asthma & Immunology (ACAAI) 2024 Annual Scientific Meeting in October 2024 in Boston, Mas- sachusetts, US. Methods Pulmonology Advisor described the study methods noting the team "used data from the Pedi- atric Asthma Impairment and Risk Questionnaire (Peds-AIRQ) validation study, which was con- ducted at one primary care and six specialty care sites. e study analyzed demographic and clin- ical data from 314 children aged 5 to 11 years. Data considered included the Childhood Asthma Control Test (C-ACT) tests com- pleted by parents/caregivers; physician responses to Global Ini- tiative for Asthma (GINA) symp- tom control questions; ratings of the child's asthma control level by both physicians and parents/ caregivers; and chart-documented exacerbation history data from the prior year." Among the participating children: 28% were 5-6 years of age, 32% were 7-8 years and 40% were 9-11 years; 63% were male; 72% were tigator for Uganda, Pediatrician and Senior Research Scientist, Makerere University, Kampala. "If our data are generalizable, there are millions of adolescents with undiagnosed asthma symp- toms in Sub-Saharan Africa," cau- tioned Gioia Mosler, PhD, Head of Global Health Group and Community Engagement, Queen Mary University of London and the study's research manager. "To improve the poor state of asthma control in Sub-Saharan Africa, potential solutions such as educa- tional programs, better diagnosis, and treatment and screening in schools should be considered." References Content for this article was based on, excerpted and quoted from: *Oyenuga VO, Mosler G, Addo- Yobo E, et al. Asthma symp- toms, severity, and control with and without a clinical diagno- sis of asthma in early adoles- cence in Sub-Saharan Africa: A multi-country, school-based, cross-sectional study. e Lancet Child & Adolescent Health. 2024. 8(12):859-871. doi:10.1016/S2352- 4642(24)00232-3. *McGovern G. Severe asthma symptoms reported by two- thirds of Sub-Saharan African adolescents. Pharmacy Times. November 7, 2024. www. pharmacytimes.com/view/severe- a s t h m a - s y mpt om s -r e p or t e d- by-t wo-thirds-of-sub-sa haran- african-adolescents. *Queen Mary University of Lon- don. Study uncovers the true burden of asthma in African pupils, highlighting need for bet- ter access to asthma diagnosis and care. News release. October 21, 2024. www.eurekalert.org/news- releases/1061823. adolescents who had mild to moderate symptoms. Among 392 adolescents in the second study who were diagnosed with asthma by a health care pro- fessional, approximately 75.0% (n = 294) reported severe asthma symptoms. In addition, 32.0% (n = 94) of the 294 adolescents with severe symptoms reported not using any asthma medication. Additional findings: No access to emergency care Eureka Alert noted that "almost half of students with asthma symptoms were not able to access emergency medical care when it was needed; 45% of students with asthma symptoms had required emergency treatment within the previous year, with a similar pro- portion reporting that had not been available to them. Observations from the investigators "e vast majority of children with asthma can be well con- trolled with inhaled medications," said Jonathan Grigg, MD, Profes- sor of Pediatric Respiratory and Environmental Medicine, Queen Mary University of London. "Our study done in six urban areas in Sub-Saharan Africa shows that a large proportion of children with asthma symptoms have no for- mal diagnosis and are therefore untreated. Health professionals, policy makers and the pharmaceu- tical industry must work together to address this unmet need that has been under recognized for far too long," he added. "Undiagnosed and poorly con- trolled asthma greatly impacts the physical and psychosocial well-being of the affected chil- dren and their caregivers. e high burden of severe undiag- nosed asthma revealed by the ACACIA study requires urgent attention, including access to medicines and diagnostics," commented Rebecca Nantanda, PhD, ACACIA Principal Inves-