Keeping allergy on the agenda: integrated guidelines for respiratory disease in developing countries


Dr R. G. English
The University of Cape Town Lung Institute
George Street
Mowbray 7700
Cape Town
South Africa


Background:  Efforts to improve the care of patients with asthma and allergic conditions is in some developing countries being overwhelmed by the burden of tuberculosis, HIV/AIDS and other infectious diseases. Innovative approaches are required to ensure that these diseases are not neglected.

Methods:  The Practical Approach to Lung Health in South Africa is an example of a syndromic integrated algorithm-based diagnostic and management tool for priority chronic respiratory diseases and tuberculosis. It was developed for the needs of nurse care practitioners in poorly-resourced and predominantly rural clinics and includes allergic diseases and asthma. Its diagnostic accuracy and effectiveness at improving the care offered to patients with asthma and rhinitis has been confirmed in two large studies performed in primary care clinics.

Discussion and conclusion:  An integrated approach to the management of allergic diseases alongside other priority lung diseases may hold the key to ensuring that the needs of patients with these diseases gain and maintain recognition, and that health resources are appropriately allocated in developing countries.