Asthma care for children and adolescents in Uganda

INTERVENTION: The unit of randomization will be health facilities in the study area. The method is simple randomization. The primary care facilities of interest have 2 levels; 5 Health Centre IV (HC IV) and 12 Health Centre III (HC III) based on the range of services provided. 4 HC IVs and 4 HC IIIs will be randomly selected to participate in the study. The 4 HC IVs will be randomly allocated to the intervention and control groups in a ratio of 1:1. The same process will be followed for HC IIIs. The total number of study sites will be 8 (4 intervention and 4 control). It is a single‐centre study. The intervention for the first research question (What is the feasibility, acceptability, and effectiveness of routine screening for asthma symptoms among children and adolescents with respiratory illnesses in improving identification of patients with undiagnosed asthma?) is routine screening for asthma symptoms among all children with respiratory symptoms attending the intervention facilities for clinical care. A standard screening tool will be used. In the control arm, children and adolescents with respiratory symptoms will be assessed as usual and no screening tool will be used. To assess if routine screening for asthma symptoms can identify children with undiagnosed asthma, the researchers shall collect baseline data on asthma diagnoses in both the control and intervention health facilities. The baseline data will be asthma diagnoses in the 12 months prior to starting the intervention. The researchers shall also prospectively collect data on asthma diagnoses per month during the study period. They shall then compare the asthma diagnoses between the control and intervention facilities to estimate the difference in asthma diagnoses attributable to routine screening. They shall use a rand CONDITION: Asthma ; Respiratory PRIMARY OUTCOME: The primary outcome for the 1st CRT on routine screening for asthma symptoms is the proportion of asthma diagnoses measured using a questionnaire at the time of enrolment into the study (this trial has only one visit ‐ no follow‐up visits); ; The primary outcome for the 2nd CRT on asthma education delivered by VHTs is asthma control measured using age‐appropriate asthma controls tool at baseline, 1, 3 and 6 months SECONDARY OUTCOME: The secondary outcome measures for the 1st CRT on routine screening for asthma symptoms are:; 1. Symptom severity measured by questionnaire at enrolment; 2. Asthma control scores measured by asthma control test at enrolment; ; The secondary outcome measures for the 2nd CRT on asthma education delivered by VHTs are:; 1. Emergency care visits due to asthma symptoms measured by questionnaire at month 6; 2. Missed workdays by parents/guardians due to asthma in their child measured using a questionnaire at baseline, 1,3 and 6 months; 3. Missed school days (where applicable) due to asthma measured using a questionnaire at baseline, 1,3 and 6 months; 4. Hospitalizations due to asthma measured by questionnaire at month 6 INCLUSION CRITERIA: 1. Children aged 2 months up to 17 years 2. Respiratory symptoms at the time of attending the study health facilities 3. Diagnosis of asthma at enrolment (for CRT on asthma education) 4. Ability to attend follow‐up visits at months 1, 3 and 6 (for the CRT on asthma education)