• Common chronic illness in Kenya.
• Often under diagnosed and under treated.
• Symptoms same as Indiana.
• Recurrent, nonproductive cough
• Worse in the evening.
• Treatment is not unique
• Steroids
• Sympathomimetics
• Cromones
• Availability is the problem

Photo courtesy of Boston Public Schools.

• Infectious etiologies are common
• M. tuberculosis
• S. pneumoniae
• S. pyogenes
• S. aureus
• Klebsiella pneumoniae
• Ambeic liver abscess (right sided)
• CHF
• Cirrhosis
• Hypoproteinemia
• Neoplastic disease

Photo courtesy of Loyola University, Chicago