TY - JOUR T1 - Finding the way through the respiratory symptoms jungle: PAL can help JF - European Respiratory Journal JO - Eur Respir J SP - 979 LP - 982 DO - 10.1183/09031936.00116810 VL - 36 IS - 5 AU - M. van den Boom AU - A. Seita AU - S. Ottmani AU - G.B. Migliori Y1 - 2010/11/01 UR - http://erj.ersjournals.com/content/36/5/979.abstract N2 - Strikingly, up to one third of all patients attending primary healthcare (PHC) facilities present with respiratory symptoms and are seeking care 1–4. Underlying causes are wide-ranging, spanning from common cold to pulmonary tumours and their frequencies of occurrence differ widely 1. Whereas >50% of those seeking respiratory care suffer from acute respiratory infections (ARI) 1, tuberculosis (TB), which is still a deadly killer >125 yrs after the discovery of its causing agent, Mycobacterium tuberculosis 5, accounts only for a very small proportion of those consulting with respiratory complaints (often <2%) 1–4, 6, 7. Chronic obstructive pulmonary disease and asthma are encountered more often than TB and less frequently than ARI. However, worldwide asthma prevalence has been on the increase in several settings during the past few decades 8. A common point is that all respiratory diseases, if not diagnosed, treated and managed timely and correctly, are problematic for individuals and public health alike.Another common point is that many respiratory diseases are characterised by similar symptoms; for instance, cough and night sweats can be found in TB, pulmonary tumours and ARIs. Clinicians in PHC facilities, who at the centre of all this, often feel challenged, as finding the right path in a vast jungle of similar respiratory symptoms can be a tedious and misleading endeavour. The complex path constitutes making the correct diagnostic, treatment and management choices for all respiratory patients. Although in many countries helpful guidance exists (in the form of clinical guidelines on how to manage children aged <5 yrs with ARIs 9 and TB patients irrespective of age) 3, there is often no clear indication of how to manage non-TB patients. In fact they account for >97% of all respiratory patients aged ≥5 yrs. … ER -