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Mild Child Asthma Can Still Be Deadly

One in three fatal asthma attacks worldwide involves a child with a mild form of the disease, and nearly half of all parents are unaware of the risk, according to a global survey presented Wednesday.

The report said the findings exposed a critical information gap between doctors who treat asthma and parents of youngsters diagnosed with the condition.

"Many patients with asthma underestimate their disease severity and overestimate their degree of asthma control," the European Academy of Allergology and Clinical Immunology warned.

Dr. G. Walter Canonica of the University of Genoa in Italy said the survey underscored how effective treatment "is a shared responsibility requiring continuous communication among physicians and children with asthma and their parents."

Experts said that with each decade, the prevalence of asthma increased 50 percent. Worldwide, more than 300 million people are afflicted, the Global Initiative for Asthma says.

The World Health Organization said 255,000 people died from asthma in 2005 and that deaths are projected to rise by almost 20 percent in the next 10 years without urgent action.

"Asthma is an enormous global health problem," said Dr. Nikolai Khaltaev of WHO's chronic respiratory diseases department. He said the U.N. agency was looking forward to studying the new report.

Asthma is a chronic lung disease caused by airway inflammation, and certain stimuli cause the windpipe to become obstructed. Symptoms include wheezing, coughing and a tightened airway that causes shortness of breath and can be life-threatening. Allergies are responsible for more than 50 percent of asthma in adults.

Treatment for the condition costs society more than that for tuberculosis and HIV/AIDS combined, the European Academy said.

Its survey of 5,482 asthma patients, their doctors and the parents of young sufferers focused on cases in Britain, Canada, France, Germany, Italy, Japan, Spain, Switzerland and the United States.

The academy said the report — issued at its annual conference in Vienna — was the first sweeping global survey of what parents do and don't know about the hazards of asthma.

Many parents cut back on treatments such as drug inhalers when their children suffer side-effects, the study found. Others switch medications or discontinue treatment altogether, it said, cautioning that doing so "can be dangerous and greatly impact health outcomes."

Reducing or stopping treatment usually means a child's condition worsens, the report warned.

"More than three-fourths of children who are not compliant with their asthma treatment all the time experience at least one of the following: increased symptoms (66 percent), limited physical activity (48 percent), nighttime awakenings (46 percent) and more frequent asthma attacks or exacerbations (40 percent)," it said.

Patients who don't follow doctors' orders end up with 38 percent more visits to physicians and are 14 percent more likely to wind up in an emergency room or to be hospitalized, the survey said.

Experts said that although 59 percent of parents say they comply with their doctors' instructions all the time, only 9 percent of physicians believe them based on the child's symptoms.

Parents and doctors both complain that the other doesn't initiate discussions about treatment and side-effects.

"Patients with asthma, parents, and the physicians who treat them should pay close attention to the findings from this survey, which show that the way we currently treat asthma is unsatisfactory," said Dr. Erkka Valovirta, a pediatrics specialist at Finland's Turku Allergy Center.

Khaltaev said asthma is a preventable chronic respiratory disease with the most important risk factors including air pollution, allergens and tobacco smoke.

WHO encourages the best possible relationship between doctor and patient in controlling asthma, he said.

"In the case of children the health care provider-parent-child relationship is key," Khaltaev told The Associated Press. "Knowledge and understanding is crucial, as well-educated parents will in turn create children who are well-educated about their disease and how to properly control it."

"With proper asthma control there is no reason why a child cannot live life to the full," he added. "There are many Olympic champions who have well-controlled asthma."

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