Etniciteit en verwijzing voor astma naar de kinderarts in Amsterdam West

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Acute bacterial infections of the lower respiratory tract in children from low-income countries

Acute bacterial infection of the lower respiratory tract is a major cause of morbidity and mortality in children and is responsible for 4 million childhood deaths each year. Most of these deaths are caused by pneumonia and occur in the youngest children in the poorest parts of the world. Severe pneumonia is also much more common in low-income countries and is associated with malnutrition, coincident diseases (e.g. human immunodeficiency virus infection), crowding, low levels of health care and high nasopharyngeal carriage of bacterial pathogens. Streptococcus pneumoniae and Haemophilus influenzae are the leading bacterial causes of pneumonia worldwide but Staphylococcus aureus and Gram-negative bacilli are not infrequently encountered as aetiological organisms in low-income countries. The major challenge is early diagnosis for timely management with appropriate antibiotic treatment, and although controlled trials have shown that standardised antibiotic treatment reduces pneumonia mortality considerably, its efficacy is limited by the emergence of penicillin and cotrimoxazole resistance. Widespread active immunization with protein-conjugate vaccines against Streptococcus pneumoniae and Haemophilus influenzae is therefore the best hope for limiting the spread of these organisms and reducing the morbidity and mortality of childhood pneumonia in low-income countries. (C) 2000 Lippincott Williams & Wilkins

Asthma beliefs among mothers and children from different ethnic origins living in Amsterdam, the Netherlands

Background. Doctors and patients hold varying beliefs concerning illness and treatment. Patients' and families' explanatory models (EMs) vary according to personality and sociocultural factors. In a multi-ethnic society, it is becoming increasingly significant that doctors understand the different beliefs of their patients in order to improve patient/doctor communication as well as patient adherence to treatment. Methods. Twelve focus groups were formed, consisting of 40 children diagnosed with asthma, as well as 28 mothers of these children. These groups included mothers and children of different ethnicities who were living in Amsterdam, the Netherlands. In order to understand the beliefs that both mothers and children hold regarding asthma and its treatment, the explanatory models were analysed and compared. Results. Study findings show that mothers and children, regardless of ethnicity and age, have their own EMs. Overall, there is a great deal of uncertainty related to the causes, consequences, problems, and symptoms of asthma and its treatment. It also seems that many concerns and feelings of discomfort are the result of lack of knowledge. For instance, the fact that asthma is not seen as a chronic disease requiring daily intake of an inhaled corticosteroid, but rather as an acute phenomenon triggered by various factors, may be very relevant for clinical practice. This particular belief might suggest an explanation for non-adherent behaviour. Conclusion. A thorough understanding of the mothers' and children's beliefs regarding the illness and its treatment is an important aspect in the management of asthma. Gaining an understanding of these beliefs will provide a foundation for a solid clinician-patient/family partnership in asthma care. Although ethnic differences were observed, the similarities between the mothers' and children's beliefs in this multi-ethnic population were striking. In particular, a common belief is that asthma is considered an acute rather than a chronic condition. In addition, there is a lack of knowledge about the course and the self-management of asthma. Health care providers should be aware of these commonly held beliefs, and this information could be shared in educational programs. © 2008 van Dellen et al; licensee BioMed Central Ltd. Chemicals / CAS: salbutamol, 18559-94-

Health-related quality of life in children with asthma from different ethnic origins

This study aimed to identify and explain differences in health-related quality of life (QoL) between immigrant and non-immigrant children with asthma. In 274 children (7-17 years of age) generic and asthma-related QoL were assessed. The association between ethnicity and QoL was studied in linear regression model analyses. For the asthma-related QoL, unadjusted analyses showed significant ethnic differences. The non-immigrant children had the highest scores, which implies a better QoL. After adjusting for asthma control and socioeconomic status (SES), ethnic differences disappeared. These results suggest that immigrant children have a similar QoL to that of non-immigrant children from a comparable SES, when their asthma is under control. Copyright © 2007 Informa Healthcare