Prevalence Of Asthma Increasing In Africa - Economic Factors Continue To Limit Effective Care

Main Category: Respiratory / Asthma
Article Date: 13 May 2007 - 1:00 PDT

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Scarcity of economic resources and lack of access to healthcare hinder effective management of asthma in Africa*, according to a report released today, World Asthma Day. The Global Burden of Asthma Report, which details the prevalence, morbidity, and mortality of asthma in 20 regions around the world, reveals a number of alarming facts about the burden of this chronic respiratory disease in Africa.

The prevalence of asthma throughout Africa has increased markedly in recent years, having previously been uncommon over most parts of the continent. For example, in 1975 a study of over 1,000 people in rural Gambia found no cases of asthma, but in 1997 a study of a rural Gambian population showed that 3% reported asthma symptoms. It is anticipated that, with continued urbanization and increasing Westernization of lifestyles, the burden of asthma in Africa will continue to increase considerably in the coming decade.

Prevalence data are lacking for many countries in Africa, but the authors of the Global Burden of Asthma Report estimate that nearly 50 million Africans currently have asthma. The prevalence of the disease is greatest, about 8% of the population, in Southern Africa. Elsewhere on the continent, the overall prevalence of asthma is currently low, although marked variations occur within many countries. For example, more than 5 times as many people in the coastal urban areas of Algeria have asthma, compared with the rural mountain areas of the country. Throughout Africa, the prevalence of asthma is generally higher in urban than in rural areas, and in more affluent communities.

Asthma is a chronic lung disease characterized by recurrent breathing problems and symptoms such as breathlessness, wheezing, chest tightness, and coughing. Asthma symptoms vary over time, and also differ in severity from one individual to another. When it is not effectively treated, asthma often leads to hospitalization, missed work and school, limitations on physical activity, sleepless nights and in some cases death.

One of the authors of the Global Burden of Asthma Report, Professor Richard Beasley, of the Medical Research Institute of New Zealand, comments, "Social and economic factors including the limited access to health care are major contributors to morbidity and mortality from asthma throughout Africa." The most prominent public health concerns over much of the continent remain poor nutrition, poor housing, and infectious diseases, especially HIV/AIDS. In addition, the overlap of asthma symptomatology with tuberculosis, pneumonia, and other pulmonary infections - which remain common and important respiratory problems over much of the continent - presents a problem for diagnosis of the disease.

"In a number of countries in Africa inhaled beta-agonist and glucocorticosteroid therapy are not included in national essential drug lists, even though they are now recommended for inclusion by the WHO," adds Professor Beasley. "These challenges indicate a need for implementation of locally modified asthma management guidelines in the region." Such guidelines must take into account local circumstances, such as drug availability and cost and other healthcare resources. A national education program in South Africa, based on locally adapted guidelines, represents a simple and practical model for other countries in Africa to follow.

Asthma is now one of the world's most common long-term conditions, according to the Global Burden of Asthma Report. The disease is estimated to affect as many as 300 million people worldwide - a number that could increase by a further 100 million by 2025.

The Global Burden of Asthma Report is a comprehensive survey of the prevalence and impact of asthma around the world, based on standardized data collected in epidemiology studies in more than 80 countries. This groundbreaking report has been written by Richard Beasley, Matthew Masoli, Denise Fabian, and Shaun Holt, of the Medical Research Institute of New Zealand and the University of Southampton in the UK. Initial results of the Report were released on World Asthma Day 2003; the Report is being released in full today.

The Report was commissioned by the Global Initiative for Asthma (GINA), an effort launched in 1993 to work with healthcare professionals and public health officials around the world to reduce the burden of asthma. Guidelines for the diagnosis and management of asthma prepared by GINA have been adapted for use in a variety of settings worldwide, illustrating how asthma management programs can be tailored to fit the local culture and level of resources available.

GINA also sponsors World Asthma Day, held each year on the first Tuesday in May. This event aims to raise awareness of asthma around the world and encourage individual countries to take urgent action and make asthma a major health priority within their own regions.

*In the Global Burden of Asthma Report, the region "North Africa" includes the following countries: Algeria, Chad, Egypt, Libya, Morocco, Niger, Sudan, and Tunisia. The region "West Africa" includes: Benin, Burkina Faso, Cameroon, Cape Verde, Central African Republic, Equatorial Guinea, Gabon, Gambia, Guinea, Guinea-Bissau, Ivory Coast, Liberia, Mali, Mauritania, Nigeria, Senegal, Sierra Leone, Togo, and Western Sahara. "East Africa" includes: Burundi, Djibouti, Eritrea, Ethiopia, Kenya, Madagascar, Malawi, Mauritius, Mozambique, Rwanda, Somalia, Tanzania, and Uganda. "Southern Africa" includes: Angola, Botswana, Congo, Namibia, South Africa, Swaziland, Zaire, Zambia, and Zimbabwe.

www.ginasthma.org

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