Chile
Asthma management has improved
Costa Rica is a small country located in Central America. It has a single National Children’s Hospital, which is a third-level referral centre for all chronic diseases requiring evaluation by a sub-specialist in paediatric pneumology, such as moderate to severe asthma. In addition, Costa Rica has universal access to health care with the availability of asthma essential medicines.
Asthma prevalence in the past 15 years
The prevalence of asthma in Costa Rica is among the highest in the world; and this has been confirmed in recent data from GAN Phase I. When comparing the current prevalence of asthma symptoms reported in ISAAC Phase III (2001-2) with the results obtained in GAN (2017-18), the prevalence decreased significantly from 37.6% to 23.3% in children and from 27.3% to 20.8 % in adolescents.
Asthma management has improved
In 2003, a National Asthma Programme, which consisted of educational meetings at all major public health care centres was implemented in Costa Rica. This programme emphasised in asthma diagnosis, the use of ICS (Beclomethasone) as first-line therapy for asthma control with early use of reliever medications (e.g.salbutamol) during asthma attacks, appropriate referral to asthma specialists for asthma care and the avoidance of common allergens (e.g. dust mite and cockroaches) and other risk factors (e.g. tobacco). Recent studies have shown a marked decrease in hospitalisations and mortality due to asthma in Costa Rica.
Challenges
As in many other LMICs, Costa Rica faces many obstacles in asthma control. Implementation of asthma treatment guidelines and other economic and social barriers must be confronted. Although asthma awareness and control has improved over the years, in the latest GAN report, written asthma management plans were available in just 35% of patients. Efforts in achieving disease control and preventing asthma attacks should be a priority to every heath system.
