Based on results of our published research: Mohammad Y, Rafea S, Latifeh Y, Haydar T, Jamal H, Alkhayer G, Dib G, AL-Massalmeh MS, AL-Lahham A, Fawaz Y, Nahas LD, El Sony A,
Ellwood P. Global Asthma Network Phase I Syria asthma surveillance and the impact of the war. J Thorac Dis 2023. doi: 10.21037/jtd-23-251
More than 3.7 million students in Syria are starting the 2023-2024 academic year, spread across 14,505 schools. (Ministry of education).
If we consider Global Asthma Network (GAN) phase 1 results for current wheeze : It is 19.8% in adolescents and 10.8% in children ; The Mean is 15% .GINA stated that among wheezers past 12 month half are clinical asthma and the others are trivial wheezers. Accordingly, we could say that 7.5% of school children have clinical asthma. And need daily preventive inhalers, as well as relievers. And if possible spacers.
According to GAN phase 1 survey in Syria, few of them (4%) use corticosteroids inhalers .
We need at list about 150 000 asthma preventer inhaler by month according to the list of essential medicines of WHO. Budesonide and formoterol 100 - 6.5 or inhaled corticosteroids Low, or medium dose. Plus 100,000, salbutamol inhalers.
We will establish a program for asthma in schools in collaboration between our center of research for chronic respiratory diseases -Tishreen university- Collaborating with GARD and WHO – EMRO and the ministry of education for schools and the ministry of Health- Directorate of communicable and non communicable diseases. We will design a multisector committee.
We will be working with our international partners to provide free inhalers(The same of WHO Tuberculosis program).
We will edit documents about asthma (Fact sheets), to be distributed accordingly:
- What should school staff know about asthma: Symptoms, triggers, medications, emergency, stigma on inhalers and corticosteroids, technically how to use inhaler and spacer.
- And a copy of asthma action plan.
- A registry of pupils or students with asthma.
- For children: Asthma action plan with images and writing, and registry daily report of medication use, as well a video on how to use inhalers.
- For the family: What should the family know about asthma: Symptoms, triggers, medications, emergency signs and how to respond to asthma emergencies, stigma on inhalers and corticosteroids, technically how to use inhaler and spacer
- For centers of school health GPs and Nurses: We edited a national practical guide for chronic respiratory diseases with MOH and WHO country office, based on GINA and PEN-WHO. Also dealing with Environmental factors. And the non-need of antibiotics for asthma.They should use it as reference for their work. The patient asthma action plan should be given to every asthmatic. Follow up visits , registry and monitoring should be part of care. Either onsite or by emails or WhatsApp(AI: Artificial Intelligence).
- We will also do a conference with power point presentation at all levels in each region of Syria.
- Educational fact sheets to be distributed to asthma patients by nurses.
- Develop written Emergency Care Plan as needed with family and student input, for schools and health care centers.
-We will create a website , or electronic platform for the team and for families and
Pupils
- we can collaborate with other LMIC who participated to GAN1