Introduction
Asthma is one of the most common chronic respiratory conditions affecting millions of people worldwide. It is characterized by inflammation and narrowing of the airways, which causes breathing difficulties. Asthma attacks can be triggered by a variety of factors, including allergens, exercise, stress, and respiratory infections.
According to the Australian Institute of Health and Welfare, asthma is one of the most common long-term conditions that affect children in Australia (Australian Institute of Health and Welfare, 2020). Besides, in 1998, children in Australia were found to be more likely to have recurring wheezes than those born in other places (Robertson et al., 1998). Several factors contribute to the development of asthma in children. Exposure to allergens such as dust, pollen, and animal dander can trigger asthma; other triggers may include air pollution, cold air, exercise, and viral infections. Asthma can have a significant impact on a child’s quality of life, and it can also lead to hospitalization and death in severe cases.
This paper will discuss the research on asthma prevention in Australian children, particularly the identification of atopy, the link between early-life viral infections and asthma, and the impact of air pollution, damp housing, gas stoves, and other factors. It will also focus on the aspects of asthma management, acute asthma treatment, and issues with treating the condition. Finally, the hypothesis on the psychological consequences and underlying asthma mechanisms will be made.
Asthma Prevention
Preventing asthma is the most effective way of decreasing the percentage of children who suffer from this condition. One particular piece of research focuses on identifying asthma in children in order to prevent or predict the disease. Sly, Boner, Bjorksten, and Bush (2008) emphasize the importance of understanding the development of atopic asthma, which is influenced by gene-environment interactions happening in the prenatal and postnatal period.
Researchers claim that physicians in Australia do not possess sufficient knowledge in this sphere. The research points out some of the interactions that impact asthma development, including increased or decreased exposure to certain allergens. For instance, reduced exposure to microbial lipopolysaccharides present in house dust in the early stages of life may contribute to a higher risk of asthma development (Sly et al., 2008). On the other hand, asthma prevention can be traced back even earlier to the prenatal period.
Evidence from an Australian birth cohort found that a mother’s lifestyle is closely associated with wheezing in children after birth (Ahmad et al., 2021). A mother’s health, including her own asthma diagnosis, can also contribute to asthma development in children. Thus, proper medical monitoring and an appropriate lifestyle during pregnancy can reduce the risk significantly. A significant part of the research is dedicated to finding the link between early-life viral infections and asthma development. The correlation was apparent; however, it was unclear whether viral infections caused asthma directly or simply impacted the child’s predisposition to asthma by accelerating the development of the condition (Sly et al., 2010).
Data from the Western Australian Pregnancy Cohort suggested that lower and upper respiratory infections increased the asthma risk insignificantly. Sly, Kusel, and Holt (2010) found that it is the combination of factors, including viral infections, that acts as an asthma catalyst. These factors include the virus damaging the airways, the virus unmasking the already existing predisposition, the child’s immune system’s inability to set the appropriate antiviral defense, and smoking or chemical exposure (Sly et al., 2010).
Decreasing air pollution is seen as another preventive factor in the research conducted by Jalaludin, O’Toole, and Leeder. Their study found a correlation between the increasing NO2 levels in Sydney and the number of asthma hospital visits (Jalaludin et al., 2002). Thus, it is concluded that it is necessary to control NO2 levels in order to ensure asthma prevention in Sydney as well as in other Australian cities. Another study conducted in Brisbane also found that asthma can be exacerbated a few hours after exposure to O3, NO2, PM2.5, or PM10 (Cheng et al., 2022).
Knibbs et al. (2018) found that exposure to gas stoves and damp housing contributes to the rise of asthma in Australian children. Thus, the preventive strategy would be to decrease this exposure. The general poor home environment is another contributing factor: in Australian households with smoking parents, the risk of asthma development is higher; thus, by reducing tobacco smoke exposure, it is possible to prevent the condition (Shahunja et al., 2022).
Asthma Treatment
The treatment of asthma in Australian children involves various strategies to control symptoms. As indicated by the National Asthma Council Australia (2019), these strategies include the use of inhalers, nebulizers, and oral medications such as leukotriene modifiers and corticosteroids. In severe cases, hospitalization may be required for close monitoring and administration of intravenous medications. The Australian Asthma Handbook recommends medication management and lifestyle modifications, such as avoiding triggers like smoke, dust mites, pollen, and pets (National Asthma Council Australia, 2019).
Other research conducted on possible asthma treatment is the treatment for acute asthma, which is a potentially life-threatening condition for Australian children. As indicated by Wark and Hilton (2015), it is indispensable to monitor anyone with an asthma diagnosis closely. For children at risk of acute asthma, it is necessary to provide access to inhaled salbutamol. It is also necessary to prescribe a three-day course of systemic corticosteroids to children older than six years old after an acute asthma episode (Wark & Hilton, 2015).
After the first acute asthma case, it is advisable to monitor the patient, adding the use of corticosteroids in some cases (Wark & Hilton, 2015). It was demonstrated in 1995 that Australian caregivers had little understanding of how to react to symptoms and in what cases the child needed medical help (Henry et al., 1995), and the situation was similar in 2021 (Kelada et al., 2021). Thus, it is crucial to raise the family’s awareness of what their actions should be in daily life treatment as well as in cases when acute symptoms are manifested.
Although it is advised to take preventive medication and monitor the condition regularly and closely, some studies have demonstrated that a high percentage of Australian children diagnosed with asthma do not take it. Poulos, Toelle, and Marks (2005) found that a quarter of the studied children diagnosed with asthma had not taken the necessary medication in the previous month. This study also mentions that another Melbourne survey discovered that 50% of the children only used intermittent medication (Poulos et al., 2005). In 2015, it was also found that 17.9% of Australian children diagnosed with asthma were not controlled in any way (Charles et al., 2015).This indicates that the number of children receiving regular treatment is not sufficient.
Areas of Improvement in Research
One of the identified gaps in the reviewed research is the lack of research on condition management in terms of its psychological consequences. Asthma affects a child psychologically in various ways, as it can cause feelings of anxiety, fear, and frustration (Collins et al., 2008). Australian school children with asthma may feel isolated from their peers due to their inability to participate in physical activities; they may also experience shame due to the need for frequent medication and inhaler use (Collins et al., 2008). Thus, it is important to research how proper psychological assistance can help manage the symptoms.
Another research gap is the identification of novel therapeutic targets. Current treatment focuses on inflammation and the constriction of airways, but there may be other underlying mechanisms contributing to asthma symptoms that have not been identified. The hypothesis for the psychological consequences management research could be that effective psychological help reduces the risk of the manifestation of the physical symptoms of asthma. By comparing two groups of children diagnosed with asthma, one of which receives regular psychological assistance, this hypothesis could be tested.
Regarding the hypothesis of underlying mechanisms, it could be tested whether the body’s immune response could be regulated. By conducting more tests on immune system treatment and monitoring the body’s reaction and mechanisms of asthma, it would be possible to see whether that is a promising therapeutic target.
Conclusion
Studies dedicated to asthma prevention reveal that asthma can be predicted and prevented by identifying atopy and paying attention to early-life viral infections. Decreasing exposure to polluted air and gas stoves, as well as properly monitoring a pregnant woman’s health, also helps with asthma prevention. In terms of the treatment, it was shown that an insufficient percentage of children take medication regularly. Finally, it was hypothesized that there is a link between psychological treatment and physical symptoms; it was also assumed that regulating the body’s immune response could be another way of treating the condition.
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