Challenges in paediatric asthma today.

1 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, and The Children’s Medical Institute, National University Hospital, Singapore Address for Correspondence: Dr Lynette Shek, Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, 5 Lower Kent Ridge Road, Singapore 119074. Email: [email protected] Asthma today affects more than 300 million people worldwide and its prevalence is increasing, particularly among children. The rise in asthma prevalence has been likened to an epidemic, and is expected to afflict up to 400 million people by 2025.1 In Singapore, it is estimated that 1 in 5 children suffer from it. It is a chronic condition with considerable morbidity and mortality, with many asthma patients having a self-perception of poor health.2 The cost of asthma is also high, and is conservatively thought to exceed US$33.93 million per annum in Singapore.3 Over the past few decades, significant improvement in treatment options available and in our understanding of its pathogenesis have revolutionised the way we manage this condition. However, there are still significant challenges to reducing the global burden of asthma, and in preventing its onset in the first place. These include a lack of education on the disease, a lack of infrastructure to manage the condition on a wide scale, underdiagnosis because of misconceptions and fear of long-term effects of asthma medication. In view of the pressing need to improve asthma awareness and education, the Global Initiative for Asthma (GINA) inaugurated the first World Asthma Day in 1998. Since then, it has been observed every first Tuesday in May and celebrated its 10th anniversary on May 1st this year. The primary goal of this day is to improve awareness about the disease among healthcare professionals, the general public and patients affected by it. In Singapore, this event has been marked by public talks, road shows and media activities. Still, more needs to be done to achieve control of asthma so as to enable every child with it to lead a normal, unrestricted life. Some of the challenges faced by doctors will be discussed here.