Scale of the problem
Between 100 and 150 million people around the world – approximately the equivalent of the population of the Russian Federation – suffer from asthma and this number is increasing. Worldwide, deaths from this condition have reached more than 180,000 people annually.
About 8% of the Swiss population suffers from asthma, compared to only 2% about 25-30 years ago.
In Germany, it is estimated that there are 4 million asthmatics.
In Western Europe as a whole, asthma has doubled in ten years, according to the UCB Institute of Allergy in Belgium.
In the United States, the number of asthmatics has increased by more than 60% since the early 1980s and deaths have doubled to 5,000 a year.
There are approximately 3 million asthmatics in Japan, of which 7% have severe asthma and 30% have moderate asthma.
In Australia, one in six children under 16 is affected.
Asthma is not just a public health problem for developed countries. However, in developing countries the incidence of the disease is very variable.
India has an estimated 15-20 million asthmatics.
In the WHO Western Pacific Region, the incidence varies from more than 50% among children in the Caroline Islands to virtually zero in Papua New Guinea.
In Brazil, Costa Rica, Panama, Peru and Uruguay, the prevalence of asthma symptoms in children varies from 20% to 30%.
In Kenya, it approaches 20%.
In India, rough estimates indicate a prevalence of between 10% and 15% in children aged 5-11 years.
The human and economic burden
Asthma mortality is not comparable in size to the everyday effects of the disease. Although largely avoidable, asthma tends to occur in epidemics and affects young people.
The human and economic burden associated with this condition is serious. The costs of asthma for society could be greatly reduced through concerted international and national action.
Throughout the world, the economic costs associated with asthma are estimated to exceed those of combined TB and HIV / AIDS.
In the United States, for example, the annual costs of asthma care (direct and indirect) exceed US $ 6,000 million.
Currently, Britain spends around 1,800 million dollars on health care for asthma and due to days lost due to illness.
In Australia, the annual direct and indirect medical costs associated with asthma reach almost US $ 460 million.
What is asthma?
Asthma attacks all age groups, but often begins in childhood. It is a disease characterized by recurrent attacks of respiratory distress and wheezing, which vary in severity and frequency from person to person. In an individual, they can occur from hour to hour and day to day.
This condition is due to the inflammation of the air passages in the lungs and affects the sensitivity of the nerve endings in the airways so they become easily irritated.
In an attack, the lining of the passages swell causing the airways to constrict and reduce the flow of air in and out of the lungs.
Asthma can not be cured, but it could also be controlled. The strongest risk factors for developing asthma are exposure, especially in childhood, to indoor allergens (such as house mites in bed, carpets and stuffed furniture, cats and cockroaches) and a family history of asthma or allergy.
A study on the South Atlantic island of Tristan da Cunha, where one in three of the 300 inhabitants has asthma, found that children with asthmatic parents were much more likely to develop the disease.
Exposure to tobacco smoke and exposure to chemical irritants in the workplace are additional risk factors.
Other risk factors include certain drugs (aspirin and other non-steroidal anti-inflammatory drugs), low birth weight and respiratory infection. The weather (cold air), extreme emotional expression and physical exercise can exacerbate asthma.
Urbanization seems to be correlated with an increase in asthma. The nature of the risk is not clear because the studies have not taken into account indoor allergens, although these have been identified as significant risk factors.
Experts are struggling to understand why global rates are, on average, increasing by 50% every decade.
And they are baffled by the isolated incidents involving hundreds of people in a city, suffering from allergies such as hay fever, but who had never had asthma, suddenly being hit by asthma attacks so severe that they needed emergency hospital treatment .
One such incident in London, United Kingdom, in June 1994 saw 640 people go to emergency departments in the middle of an asthma attack.
A similar incident occurred in Melbourne, Australia. Many experts have blamed climatic conditions such as thunderstorms, which break up pollen grains, by releasing starch granules that trigger attacks.
But they do not know why people who suffer from hay fever developed a life-threatening condition without warning.
Because asthma is a chronic condition, it usually requires ongoing medical attention.
Patients with moderate or severe asthma have to take long-term medications daily (for example, anti-inflammatory drugs) to control the underlying inflammation and prevent symptoms and attacks.
If symptoms occur, short-term medications (inhaled short-acting beta2-agonists) are used to relieve them.
Medication is not the only way to control asthma. It is also important to avoid asthma triggers – stimuli that irritate and inflame the airways. Each person must learn what triggers he or she should avoid.
Although asthma does not kill on the scale of chronic obstructive pulmonary diseases (COPD), failure to use appropriate drugs or compliance with treatment, coupled with low recognition of the severity of the problem, can lead to unnecessary deaths, most of which occur outside the hospital
The way forward and the role of WHO
WHO recognizes asthma as a disease of great importance for public health and plays a unique role in coordinating international efforts against the disease. International action is necessary to:
- Increase public awareness of the disease to ensure that patients and health professionals recognize the disease and are aware of the severity of the associated problems;
- Organize and coordinate global epidemiological surveillance to monitor global and regional trends in asthma;
- Develop and implement an optimal strategy for its management and prevention (many studies have shown that this will result in the control of asthma in most patients);
- Stimulate research on the causes of asthma to develop new control strategies and treatment techniques.