Asthma mortality rampant in developing countries

CNS image Library/2014
Clarity Sibanda, CNS Correspondent, Zimbabwe
The statistics on asthma are indeed worrying, as it is estimated that globally nearly 300 million are living with the illness and nearly 250,000 are said to die prematurely every year from the condition. It is disheartening to note that this public health issue affects high and low income countries equally, but the burden of mortality falls most heavily on the developing world where some 80% of asthma-related deaths occur. Third world countries like Zimbabwe are ineptly facing the asthma scourge.

According to the latest WHO data published in April 2011, deaths due to asthma in Zimbabwe reached 662 or 0.39% of total deaths. An age adjusted death rate of 10.80 per 100,000 of population puts Zimbabwe at number 57 position.

27 years old Sizo Dube (says he has suffered from the disease since his childhood years and the illness continues to take a toll on his social and economic life as he has to absent himself from work, especially during the winter season which ushers in colds and flu--the common triggers for asthma.

“Asthma is a painful illness and sometimes I have to absent myself from work for several days. With Zimbabwe‘s dwindling economy that has been marred by retrenchments, I am now living in fear of losing my job due to my frequent absentism especially during chilly days,” says Dube.

What is asthma?

Asthma is a disease affecting the airways that carry air to and from our lungs. The inside walls of the airways of a person living with asthma are swollen or inflamed. This inflammation makes the airways extremely sensitive to irritations and increases one’s susceptibility to an allergic reaction.

As inflammation causes the airways to become narrower, less air can pass through them, both to and from the lungs. Symptoms of this narrowing include wheezing (a hissing sound while breathing), chest tightness, breathing problems, and coughing. People with asthma usually experience these symptoms more frequently during the night and the early morning.

Asthma is caused by a cocktail of problems that include tobacco smoking, obesity, and stress among others. Asthma can also be hereditary and can also be triggered by exercise and other activities that make one breathe harder. But with proper treatment and care a child with exercise-induced asthma does not need to limit his or her overall physical activity.

Tobacco smoking has been linked to a higher risk of asthma. In addition, children of mothers who smoke, as well as people exposed to second-hand smoke have a higher risk of getting asthma. Adolescent smoking has also been associated with increase in asthma risk; hence people have been urged to minimize tobacco smoking.

Women not spared

In their findings reported in the American Journal of Respiratory and Critical Care Medicine (November 2012 issue), researchers from Haukeland University Hospital in Bergen, Norway found out that a woman’s respiratory symptoms, including those of asthma, tend to worsen between day 10 to 22 of her menstrual cycle. The authors added that wheezing symptom severity dipped during ovulation (days 14 to 16). Patients with asthma, regular smokers and those with a BMI (body mass index) of more than 23 tend to experience more coughs immediately after ovulation.

Head researcher, Ferenc Macsali, MD, said "The effects of the menstrual cycle on respiratory symptoms in the general population have not been well studied. In a cohort of nearly 4,000 women, we found large and consistent changes in respiratory symptoms according to menstrual cycle phase, and, in addition, these patterns varied according to body mass index, asthma, and smoking status."

What to do during an attack

An asthma attack can occur anywhere. While the mortality rate of the disease is lower than that for other chronic diseases, an attack can lead to serious health issues or may even result in death, as it is characterized by the swelling of the bronchial tubes which reduce the flow of air into and out of the lungs and the production of mucus, which can further disrupt breathing.

The question, therefore, on everyone‘s lips is how do we treat the illness?

University of Sydney‘s Professor Guy Marks , who is also a member of the Board of Directors of International Union Against Tuberculosis and Lung Disease (The Union), shared with Citizen News Service (CNS) some of the challenges that doctors face in diagnosing and treating asthma and said that though so far there is no cure for asthma, but with the correct usage of prescribed medication, one can manage the illness.

“There is no long term cure on the horizon. The best we can hope for in the short-term is better access to, and better targeting of, preventer/controller medications that can reduce the symptoms and disability and, mostly importantly, reduce risk of future poor outcomes (such as hospitalization, permanent disability and/or premature death)’’, says Professor Mark.  

It is not all gloomy for the people living with asthma, as they can minimize the attacks by taking prescribed medication, using an inhaler, and avoiding triggers and environmental conditions conducive to aggravating asthma attacks. Daily management of the disease must include following a doctor or healthcare professional backed action plan, which can include daily medicinal regimens and monitoring breathing. There is also need for regular vaccination for influenza and pneumonia as it has been noted that people with asthma are prone to cold.

This year‘s World Asthma Day which is an annual event organized by the Global Initiative for Asthma (GINA) to improve asthma awareness and care around the world took place on Tuesday, May 5, 2015 and ran under the theme "You Can Control Your Asthma,” and the illness is indeed controllable as long as one takes the prescribed medication and precautions.

Clarity Sibanda, Citizen News Service - CNS
19 May 2015