The global figure for children with asthma symptoms is 15 per cent and increasing annually.
It was concerning that the global burden of asthma seemed to be increasing rapidly as the world became more westernised, said asthma researchers, Professor Innes Asher and Philippa Ellwood from The University of Auckland, (along with other members of the Steering Group for the Global Asthma Network), in an article published recently in the prestigious English medical journal, The Lancet.
“It seems unlikely that the hygiene hypothesis alone explains the increases in asthma prevalence that comes with increasing affluence, cleanliness and westernisation,” they said. “Atopy (or a genetic predisposition to allergic hypersensitivity) is a less important factor than previously thought and genetic factors do not explain global asthma variation, indicating that other environmental factors could be responsible.”
“The growing evidence that growing up on a farm or in a rural environment might protect against some forms of asthma indicates that, at least in principle, the causes of the global increases could be both discoverable and preventable,” said Professor Asher.
Further asthma research was clearly needed and needed urgently, before the rest of the world began to have the levels of asthma prevalence present in high-income countries, she said.
While research is continued into the causes of asthma, a great deal could also be done to prevent attacks and improve control of symptoms. These included provision of safe, effective and affordable medicines to relieve and prevent symptoms, prevent severe attacks and reduce the risk of death.
“Many people with asthma who would benefit from these medicines, do not use them at all or if they do use them, do not use them regularly or take them correctly.”
Solutions to reduce the global asthma rate included better and more extensive training of clinicians, nurses, and other health-care workers in the management (and self-management) of asthma, and improvements in access to effective asthma medicines, she said.
“This balanced approach, involving both research and policy initiatives, is needed now. It is particularly important given the global burden of asthma and the global increases in asthma that are likely to occur in the next 20 years, if we change nothing.”
As well as the need for research to identify cost effective medicinesfor asthma, there was a need for an investment in asthma surveillance and research, and for quality assured affordable and accessible asthma drugs.
Health services also needed to be further developed and enhanced for the long-term management and regular follow-up of patients with asthma and other NCDs.
“It’s essential that asthma is an explicit global health priority alongside other global initiatives for the prevention and control of non-communicable diseases (NCDs),” said Professor Asher. “It would be ironic and counter-productive if progress were achieved with other major NCDs, while the looming global epidemic of asthma was ignored.”
Global Asthma Network http://www.globalasthmanetwork.org