Uncovering asthma misconceptions

Asthma is one of the major global health problems, with Low and Low-Middle SDI (Socio-Economic and Demographic Index) countries being the most affected. We know that people who suffer from sudden shortness of breath due to their asthma have to urgently use an inhaler or even go to a hospital in case of severity of the attack.With asthma is affecting more and more children and adults today, experts categorise it as a public health problem.
According to the World Health Organization (WHO), there are around 340 million people suffering from asthma worldwide, and this number is expected to reach 400 million in 2025. with 15 million people being disabled each year and 250,000 deaths (up to 460,000 in 2019).

The first Tuesday of May every year has been designated by the WHO as World Asthma Day since 1998, to raise awareness around the disease. In 2021 it was observed on May 5 on the theme of "Uncovering Asthma Misconceptions".

Before we talk about misconceptions, we need to know more about asthma.

What is asthma?

Asthma is a chronic, non-communicable disease that is not caused by an infection. Asthma can affect people of any age but is more common in children. Due to Inflammation and narrowing of the very small airways called bronchioles in the lungs, because of constricting of muscles in the walls of the airways, the patients suffer shortness of breath, wheezing, coughing, difficulty of breathing and some might even require emergency hospitalization.

Experts have not yet found the exact cause of the disease. However, there are what we call triggers that can increase the risk of asthma. People living with asthma are otherwise healthy and well in their own daily routine activities. But they are predisposed to suffer an asthma attack when exposed to a trigger or allergen. People with a genetic predisposition to asthma are more likely to be allergic to substances like dust mites, pollen, fumes, moulds, secondhand cigarette smoke and air pollution.

Can Asthma Be Cured?

While there is no cure for asthma as of now, there are ways to control and manage asthma, so that those living with asthma can lead a healthy life despite the disease. It is important to use an inhaler containing corticosteroids that provide immediate relief from an asthma attack. Medications that can be used for long-term control are also available to prevent or minimise trigger of asthma. One should avoid the much touted herbal remedies for treating asthma as there is little scientific evidence to prove their efficacy. Still, due to ignorance, many people are swayed by misconceptions surrounding treatment of asthma and undergo unnecessary suffering and lead a poor quality of life in the absence of proper medical treatment.

Misconceptions about asthma

According to Global Initiative for Asthma (GINA) some common myths and facts associated with asthma are:
  • Asthma starts in childhood and continues into adulthood-
In fact, childhood, adolescence, and adulthood can occur at any age.

  • Do not exercise if you have asthma- In fact, with good asthma control, you can get some exercise, and some may even become top athletes.
  • Asthma is infectious- In fact it is not. However, viral respiratory infections (such as common cold and the flu) can trigger asthma attacks. Or In children, asthma is frequently associated with allergy, but asthma which starts adulthood is less often allergic.
  • Asthma can be controlled only by taking large doses of steroids-
In fact, it can be well controlled with inhalers containing minimal amounts of steroids.

Asthma in Myanmar

Even though asthma incidence is very high in developed countries, such as Australia, most asthma-related deaths are found in low-and middle-income countries where treatment and access to drugs are more difficult. According to WHO data published in 2018 asthma deaths in Myanmar reached 12,688 or 3.28% of total deaths. The age adjusted death rate of 33.58 per 100,000 of population ranked Myanmar #1 in the world.

Dr Guy Marks, Professor of Respiratory Medicine, University of New South Wales, and President of the International Union Against Tuberculosis and Lung Disease rightly points out that access to affordable and quality-assured medicines for asthma and the high risk posed by air pollution remain a challenge in low- and middle-income countries, and lead to high morbidity and mortality and high number of asthma attacks in these nations. So an important part of managing asthma and stopping deaths from it is getting access to timely and effective treatment. Affordability remains a major barrier to access to right asthma medication in low and middle income countries like Myanmar.

May 2021
(published in The Standard Time Daily newspaper in Myanmar)