Prof. Olayinka Olufunke Adeyeye is a Lung Health Improvement Expert and the Head of Department (HOD), Department of Medicine, Lagos State University College of Medicine (LASUCOM), Ikeja, Lagos. She spoke to ITREALMS' PAUL ADUNWOKE to mark World Asthma Day 2022, with the theme: ‘Closing Gaps in Asthma Care’. She outlined some interventions capable of reducing preventable suffering as well as the costs incurred by treating uncontrolled asthma.
What is asthma?
Asthma is a chronic respiratory condition in which the airways are inflamed, the muscles of the airways contract and the linings of the airway are twitchy, swollen and the lumen becomes smaller with limitation to airflow. The sufferer has cough, episodic breathlessness, chest tightness and Noisy breathing (wheeze). This occurs on and off and may get better with or without treatment.
What are the causes of asthma?
Asthma results from a complex interaction between genetics and environment. Some types of asthma are inherited, some run in families, in which some members have what is call atopy. This includes itchy eyes, recurrent running nose and some skin disease (atopic dermatitis).
Interaction with the environment lead to development of symptoms such environmental factors include air pollution (both indoor and out- door), the dust mite, cockroaches allergen, in the younger age more males are affected compared to females, but after 14 years more females. Obesity also increases likelihood of developing asthma. Exposure to certain triggers can lead to development of asthma symptoms in those that are already predisposed.
What are the signs and symptoms of asthma?
Chronic cough particularly at night, episodic breathlessness, chest tightness, wheezy sounds while breathing are common symptoms. These may be associated with specific triggers such as exposure to dust, exercise among others. Some patients may complain of cold that frequently become chesty.
How many persons affected by asthma in Nigeria yearly?
It is estimated that asthma affect between 10.7-13 per cent of people aged 13-14 years. About 13 million Nigerians have been documented to suffer from asthma.
How many Nigerians die of asthma every year?
All over the world according to World Health Organisation (WHO), asthma caused 461000 deaths in 2019, most deaths reported were in developed countries due to advancement in diagnosis and treatment. It is difficult to estimate the amount of death from asthma in Nigeria, but we know that most asthma-related deaths occur in low and lower-middle income countries, where under-diagnosis and
under-treatment is a challenge.
How many have access to asthma treatments?
Very few patients have access to asthma treatment. Drugs for managing asthma are expensive in Nigeria. There is limited access to asthma medication to most of the asthma patients that are poor.
What do you think government need to do to reduce asthma cases in Nigeria?
There is need to increase the awareness of the public about asthma so that many of the identified gaps in asthma care can be addressed. Government needs to partner with pharmaceutical companies to make
available low-cost medicine for asthma sufferer. The schools need to be empowered to support children with asthma. This will bridge some of the gaps.
The theme closing the gap of asthma, what message is it passing across?
There are lots of gaps in asthma care, which continue to impact negatively on outcome of the disease. Some of these inequalities include assess to diagnosis and treatment, disparity in care between those with low socioeconomic status and those that are wealthy, gaps in communications while linking health care facilities for care of asthma, (referral system).
There are gaps in the knowledge available to people about asthma and treatment. There are gaps in the knowledge about asthma amongst health care professionals. There are gaps in government prioritisation of asthma as a chronic condition with significant impact on life of the sufferers. There exist gaps in the prescribing, use, adherence and ability to use these devices.
There is also need for the general public’s (non-asthmatics) and non-health care professional to be aware and understanding that asthma is a chronic (not acute) disease. There is still a huge gap in bringing scientific evidence to impact on the actual delivery of care for people with asthma. On this world asthma day we join the rest of the world to intensify our campaign to bridge some of these gaps.
Does Asthma have prevention and how can one prevent it?
Asthma has no cure but there are steps one can take to control the symptoms and in fact prevent the symptoms. This includes, avoidance of triggers, not smoking and not exposed to tobacco smoke, breathing in clean air both indoor and outdoors avoid rugs in home, wash curtains and bedding regularly, clean surface with damp cloths, avoid dusty areas, change air filters of AC regularly, clean fan among others. Use of preventer medications are been empowered about the condition with appropriate knowledge.
What are the possible treatments?
Asthma cannot be cured but it can be totally controlled. This involve both patients, family, school, community and healthcare partnerships. Treatment of an asthmatic is not only with medication.
There must be good and continuous education about the disease, the long-term nature and the need for the sufferer to take charge. He or she needs to know about triggers, dust, cold, change in weather, exercise, emotional issues all can increase the symptoms. They should avoid some drugs e.g. (NSAID- Nonsteroidal anti-inflammatory drugs) for pain relief, B blockers among others.
The support that needs to be provided by schools, teachers, peers among others is important drug treatment include reliever medications and preventer medications.
The preventer medications are those that the patients must use every day whether or not they have any symptoms while the reliever medications are use only when they have symptoms to ameliorate it.
Unfortunately, in our environment, many asthma sufferers are under diagnosed, and under treated. consequently, they suffer immense discomfort, frequent hospitalisation, absenteeism from work and school with even the risk of death from a severe attack largely due to huge ignorance about the disease
What is your advice to the members of the public?
Asthma is common. Asthma sufferers can have good quality of life, they can be productive and be symptom free. They need to partner with their doctors to achieve total control. It is not a thing to be ashamed of. An asthmatic will need clean environment, understand his triggers and avoid them. He or she will need to have daily preventer medications and reliever medications to be used, when necessary, asthma need not limit anyone's aspiration, with total control. There is need for more awareness about asthma. This is the most common chronic disease in childhood, the school environment and the community are important target for improved asthma awareness and education.
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