A professor of medicine, Obafemi Awolowo University, Ile-Ife, Gregory Erhabor, on Wednesday said asthma affects about 339 million people annually with over 500,000 hospitalisation and about 400,000 deaths across the globe.
Erhabor, who is also President, Asthma and Chest Care Foundation, said this in a statement signed on Wednesday to commemorate the World Asthma Day, with the theme: ‘Uncovering Asthma Misconceptions’.
“This theme is apt because it is channeled towards uncovering various myths and misconceptions surrounding asthma with the aim of destigmatising the disease and empowering those with asthma to seek help.”
Reports indicate that, World Asthma Day is one of the World’s Lung Days held internationally on the First Tuesday of May every year. The professor said the incidence of asthma had been rising progressively and developing nations are currently contributing significantly to the increasing global burden of the disease.
“By the year 2025, an estimated 400 million people will be affected. Asthma prevalence is grossly under-reported and undertreated. In Nigeria, an estimated 13 to 15 million people may be asthmatic, however, deaths from asthma are vastly preventable.”
Erhabor noted that Asthma was one of the leading chronic non-communicable respiratory diseases with global impact usually characterised by chronic airway inflammation with history of respiratory symptoms and cough.
“Asthma is one of the commonest causes of presentation at emergency departments and is the third leading cause of preventable hospitalisation. It places a substantial burden on individuals, caregivers, and healthcare systems globally with increasing trends now being seen in developing countries.
Asthma causes a huge cost demand on the individual and national economy, especially as a result of cost of medications, bills accruing from hospitalisation, and loss of income due to absence from work.”
The professor said asthma results from interplay of genetic and environmental factors, noting that when individuals with genetic predisposition get exposed to certain triggers in the environment, they develop symptoms of asthma.
“Triggers include pollens, house dust mite, cold air, spores, fumes, smoke, sprays; exercise and drugs, tobacco smoke, prolonged exposure to air pollution, and agents found at workplace like chemicals, amongst others. The most common trigger remains house dust mite. However, there is new interest in the role of obesity in the development of asthma.”
He said obese adults are 1.6 to 3 times more risk of developing wheeze and asthma.
“Obese individuals have high levels of leptin, which causes impairment of lung function, increased Airway Hyper Responsiveness (AHR), including exercise-induced bronchoconstriction and worsening of asthma symptoms.
Obesity can cause or worsen Gastroesophageal Reflux Disease (GERD) and sleep apnea. These conditions lead to increased risk of developing asthma.” The professor noted that asthma symptoms usually occur at night with cough and breathlessness which disturbs patient’s sleep.
“They can also be worse early in the morning with the peak flow measurements being reduced. This is called the early morning dipping. The combination of these symptoms gives rise to what doctors call the diurnal pattern.”
Erhabor noted that asthma control was the extent to which the effects of asthma can be seen in the patient, or have been reduced or removed by treatment, and a person is said to be controlled if there is no day-time symptoms, no limitation of activity, no nocturnal symptoms, no need for rescue medication, normal lung function and no exacerbation.
“Management of asthma requires partnership between the individual with asthma and the doctor.
The patient needs to be educated on how to discover his/her triggers and how to avoid them, components of the asthma, how to use the medications, inhaler techniques, and the self-management plan. Asthma has been found to be best controlled when asthmatics know their asthma and can be part of its management, a process known as self-management plan.”
According to Erhabor, self-management plan is a way in which you can tie your symptoms to your peak expiratory flow readings and know what to do when the reading is normal or reduced.
“The peak flow reading is usually done using a peak flow meter and asthma medications are best delivered via the inhaled route. Medications used include those that act on the inflammation known as controllers and those that open up the airways known as bronchodilators.
However, during acute asthma attacks, patients receive oxygen, nebulized bronchodilators and systemic steroids.”
The professor added that the Covid-19 pandemic impacts greatly on the respiratory system and many acute asthma patients have been mistaken for COVID-19 patients.
“However, studies show that COVID-19 does not particularly worsen asthma. During this pandemic, patients with asthma need to be trained by their physicians, given a written self-management plan, taught inhaler techniques and how to use personalised peak flow meters, and volumatics.
This will reduce their presentation at the hospital, minimise their risk of exposure to infection to COVID-19 and thereby prevent the worsening of global burden of asthma.”
Erhabor said asthma deaths are vastly preventable and called on Non-Governmental Organisations (NGOs), government parastatals and philanthropists to support the quest against the disease and minimise morbidity and mortality rates in Nigeria.
