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Description

What is Asthma?

  • Asthma is among the major non-communicable diseases.
  • It a lung condition that is characterized by attacks of wheezing and breathlessness that vary in frequency and severity from person to person
  • Asthma often starts in childhood but the disease can also develop in mature adults. The disease is not age-selective because it affects people of all ages

 

Causes of Asthma

  • Asthma is caused by the recurrent swelling and subsequent narrowing of the lungs’ air passages
  • Also, environmental exposure to inhaled particles and substances such as indoor allergens (dust, pet dander, pollution), outdoor allergens (moulds, pollen), air pollution, tobacco smoke, and chemical irritants is also a risk factor.
  • Other triggers of asthma are cold air, physical exercise and emotional arousal (fear and anger).

Signs of Asthma

  • Swelling of the lining of air passages (bronchial tubes) of the lungs (Chronic airway inflammation)
  • Subsequent narrowing of the lungs’ air passages (
  • Reduced flow of air to and out of the lungs (airflow obstruction)
  • Bronchial reactivity

Symptoms of Asthma

  • Breathlessness (shortness of breath)
  • Coughing and wheezing /whistling sound during exhalation
  • Chest pain or tightness
  • Trouble sleeping due to breathlessness, wheezing and coughing
  • Daytime fatigue
  • Reduced activity levels. Work and school absenteeism

Patho-physiology

  • Asthma triggers such as inhaled particles, allergens or cold air cause irritate the airways or cause allergic reactions in the lungs
  • The lining of bronchial tubes swell and this subsequently causes airways to narrow
  • The net effect is the reduction in the flow of air in and out of the lungs causing difficulty in breathing or shortness of breath, coughing and wheezing
  • What is Asthma?

Mode of Transmission

  • Asthma is a non-communicable diseases
  • It is a chronic disease of the bronchial tubes of the lungs which causes them to inflame and narrow; it does not get transmitted from one person to another

Section 2 :EPIDEMIOLOGY OF ASTHMA

Distribution of Asthma in Populations

  • Asthma is a global burden. World Health Organization (WHO) estimates that 339 million people worldwide are affected by Asthma (2018). The disease affects people of all ages in all parts of the world
  • It is the most common chronic disease in children
  • It is a public health problem for both high income and low income countries
  • However, over 80 percent of deaths caused by asthma occurs in low income and lower-middle income countries

Risk of acquiring Asthma

  • Asthma affects people of all ages in all parts of the world, so no populations are more prone to it than others
  • Risk factors include genetic predisposition ( a blood relative such as parent with asthma)
  • Having an allergic condition such as Allergic rhinitis (hay fever) or atopic dermatitis

Risk of acquiring Asthma

  • Exposure to environmental triggers such as smoking, second-hand smoke, exhaust fumes, and other air pollutants
  • Another risk factor is exposure to occupational triggers such as agrochemicals, industrial and beauty chemicals

Incidence and Prevalence of Asthma-what is Asthma?

  • Asthma is often under-diagnosed and un-treated
  • The WHO estimates that fifteen million disability-adjusted life-years are lost every year due to Asthma
  • Over 250,000 deaths are caused by asthma worldwide. Eighty (80) percent of these deaths occur in low income and lower-middle income countries.
  • Over 300 million people worldwide are affected by asthma

Section3: Discussion-what is Asthma?

Diagnoses of Asthma

  • Three pulmonary function tests are used to diagnose asthma. These tests are spirometry, challenge tests and Exhaled nitric oxide test.
  • Spirometry – Simple breathing test that measures how fast and how much air you can blow or exhale out of the lungs. Spirometry is used to determine the amount and severity of airway obstruction
  • Challenge test (False positive) – Methacholine and mannitol agents, when inhaled, cause air passages to spasm and narrow if asthma  is present
  • Exhaled nitric oxide test – A patient breathes into a small machine for 10 seconds. The machine calculates the amount of nitric oxide in the exhaled air. Nitric oxide produced in the lungs is an indicator of inflammation

Standard Treatments

  • Asthma cannot be cured. Appropriate management can control asthma and enable people to live a high quality of life
  • Management is by both short-term and long-term medications
  • Short-term medications like albuterol are fast-acting and used to open airways and making breathing easier
  • Long-term medications such as inhaled corticosteroids are used to control asthma in the long-term. These medications are used on a daily basis to treat airway inflammation. Side effects for corticosteroids include immunosuppression and multi-organ toxicities

Prevention of Asthma

  • Asthma cannot be prevented. However, a patient can be helped by their medical professional to design a plan to live with their asthmatic condition and prevent asthma attacks
  • The plan can include getting vaccinated for pneumonia and influenza, identifying and avoiding particles and allergens that trigger asthma, identifying and treating asthma attacks early, taking prescribed medication, and constantly be accessible to short-term medications such as albuterol

Current Research into news treatment ways

  1. Study on a new method to treat severe asthma. The study included 200 participants diagnosed with severe asthma. The researchers found that an alternative treatment in the form an “anti-body called dupilumab is effective in treating severe asthma in place of high doses of prednisone (a corticosteroid)
  2. Study on the effective beta2 agonists to use in treatment of asthma. In the study involving patients with recurrent asthma, administration of a small dose of CHF-4226 (2 micro-grams once a day) was found to be as effective as the administration of a big dose of formoterol (12 micro-grams twice a day).

Organizations assisting those affected by Asthma

  • American Lung Association – Is a voluntary health organization that provides information on allergies, asthma, and other respiratory diseases.
  • The National Institute of Allergy and Infectious Diseases- This organization conducts research in allergic asthma. The organization funded the National Inner City Asthma Study whose findings was that the control of indoor allergens improved control of asthma in children living in many cities of the U.S.

SUMMARY

What is Asthma?

  • Asthma is a chronic non-communicable disease that is characterized with persistent attacks of wheezing and breathlessness, which vary in frequency and severity from person to person
  • It is the most common chronic disease in children but it affects people of all ages in all parts of the world
  • It is a public health problem for both high income and low income countries. However, over 80 percent of deaths caused by asthma occurs in low income and lower-middle income countries

Risk factors and Symptoms

  • Risk factors include genetic predisposition ( a blood relative such as parent with asthma) and having an allergic condition such as Allergic rhinitis (hay fever) or atopic dermatitis
  • Symptoms include breathlessness (shortness of breath), Coughing and wheezing /whistling sound during exhalation, Chest pain or tightness

Diagnoses and Standard treatments-w

  • Three pulmonary function tests are used to diagnose asthma. These tests are spirometry, challenge tests and Exhaled nitric oxide test.
  • Asthma has no cure. Standard treatments used to manage asthma include Short-term medications and long-term medications. Short-term medications  such as albuterol are fast-acting and used to open airways and making breathing easier
  • Long-term medications such as inhaled corticosteroids are used to control asthma in the long-term. These medications are used on a daily basis to treat airway inflammation. Side effects for corticosteroids include immunosuppression and multi-organ toxicities

Prevention

  • Prevention strategies include getting vaccinated for pneumonia and influenza, identifying and avoiding particles and allergens that trigger asthma, identifying and treating asthma attacks early, taking prescribed medication, and constantly being accessible to short-term medications such as albuterol

Research and development of new treatment methods

  • An alternative treatment in the form of an anti-body called dupilumab was found to be effective in treating severe asthma in place of high doses of prednisone (a corticosteroid)
  • Development of long-acting beta2 agonists such as CHF-4226 which was found to be more effective in small doses

Others

Classification and Reliever inhalers

  • Asthma severity is classified into 4 groups that are persistent-severe, persistent moderate, persistent mild, and intermittent
  • Reliever inhalers are used to get medications straight to the lungs in the event of an asthma attack. This helps to relax the muscles surrounding the air passages. This causes the air passages to open widely. This enables a person to breathe again

Burden of Asthma, 2010

Asthma Mortality

References

  • Cazzola, M., Segreti, A., & Matera, M. G. (2010). Novel bronchodilators in asthma. Current opinion in pulmonary medicine16(1), 6-12.
  • Chung, K. F. (2016). Dupilumab: a potential new treatment for severe asthmaLancet (London, England)388(10039), 3.
  • Network, G. A. The global asthma report 2018. 2018.
  • Severe, N. (2013). Bronchial asthmaERS Handbook of Paediatric Respiratory Medicine.
  • Noutsios, G. T., & Floros, J. (2014). Childhood asthma: causes, risks, and protective factors; a role of innate immunity. Swiss medical weekly144(5152).