Asthma is a major burden to health systems and families in Latin America and the burden of asthma is greatest amongst the urban poor who often have limited access to medicines and health care.

Quito city

There are high rates of sickness and hospital attendance rates relating to asthma attacks, and a need to improve health access for individuals with asthma attacks in underprivileged urban populations and to manage their asthma better, including improving access to asthma medications.

St George’s, University of London has been awarded £2 million by the NIHR to undertake a project entitled “Asthma Attacks Causes and Prevention Study in Urban Latin America”. The study is taking place in two South American countries: Ecuador and Brazil.

In Ecuador, we are doing a prospective observational study to identify potential causes of recurrence of asthma attacks among children and adolescents in three cities, while in Brazil we are conducting a cluster-randomised clustered trial in the city of Salvador with the aim of improving asthma management among adults with severe asthma and to use the expertise of an established programme of specialised asthma care to build capacity of the primary health teams in Salvador to manage adults with severe asthma.

This international project is being co-led at St George’s by Professor Phil Cooper, Prof Alvaro Cruz at the Federal University of Bahia, Salvador, Brazil, and by Dr Natalia Romero at the International University in Quito, Ecuador. Max Bachmann, professor of public health at University of East Anglia, is also part of the team. The research team at St George’s includes Dr Michael Perkin– an expert in paediatric allergy – and Dr Irina Chis Ster, who leads the statistical aspects of the studies from design to data analyses.