HEALTH TOPICS A TO Z

What is asthma?

Asthma is a chronic disease characterized by recurrent attacks of breathlessness and wheezing, which vary in severity and frequency from person to person. Symptoms may occur several times in a day or week in affected individuals, and for some people become worse during physical activity or at night. During an asthma attack, the lining of the bronchial tubes swell, causing the airways to narrow and reducing the flow of air into and out of the lungs. Recurrent asthma symptoms frequently cause sleeplessness, daytime fatigue, reduced activity levels and school and work absenteeism. Asthma has a relatively low fatality rate compared to other chronic diseases. Facts about Asthma

Facts about Asthma

• According to World Health Organization (WHO) estimates, 300 million people suffer from asthma and 255 000 people died of asthma in 2005.
• Asthma is the most common chronic disease among children.
• Asthma is not just a public health problem for high income countries: it occurs in all countries regardless of level of development. Over 80% of asthma deaths occurs in low and lower-middle income countries.
• Asthma deaths will increase by almost 20% in the next 10 years if urgent action is not taken.
• Asthma is under-diagnosed and under-treated, creating a substantial burden to individuals and families and possibly restricting individuals’ activities for a lifetime.

The causes

Although the fundamental causes of asthma are not completely understood, the strongest risk factors for developing asthma are inhaled asthma triggers. These include:

• indoor allergens (for example house dust mites in bedding, carpets and stuffed furniture, pollution and pet dander)
• outdoor allergens (such as pollens and moulds)
• tobacco smoke
• chemical irritants in the workplace

Other triggers can include cold air, extreme emotional arousal such as anger or fear, and physical exercise. Even certain medications can trigger asthma such as aspirin and other non-steroid anti-inflammatory drugs, and beta-blockers (which are used to treat high blood pressure, heart conditions and migraine).

Urbanization has also been associated with an increase in asthma, however the exact nature of this relationship is unclear. Reducing the asthma burden

Reducing the asthma burden

Although asthma cannot be cured, appropriate management can control the disorder and enable people to enjoy good quality of life.

If symptoms occur, short-term medications are used to relieve them. People with moderate to severe asthma must take long-term medication daily to control the underlying inflammation and prevent symptoms and attacks.

Medication is not the only way to control asthma. It is also important to avoid asthma triggers - stimuli that irritate and inflame the airways. With medical support, each person must learn what triggers he or she should avoid.

Although asthma does not kill on the scale of chronic obstructive pulmonary disease (COPD) or other chronic diseases, failure to use appropriate medications or to adhere to treatment can lead to preventable deaths.

WHO's strategy for prevention and control of asthma

WHO recognizes that asthma is of major public health importance. The Organization plays a role in coordinating international efforts against the disease. The aim of its strategy is to support Member States in their efforts to reduce the toll of disease, disability and premature death related to asthma.

Programme objectives:

• Surveillance to map the magnitude of asthma, analyze its determinants, and monitor trends, with emphasis on poor and disadvantaged populations;
• Primary prevention to reduce the level of exposure of individuals and populations to common risk factors, particularly tobacco smoke, frequent lower respiratory infections during childhood, and environmental air pollution (indoor, outdoor, and occupational);
• Strengthening health care for people with asthma by identifying cost-effective interventions, upgrading standards and accessibility of care at different levels of the health care system.

Global Alliance against Chronic Respiratory Diseases:

The Global Alliance against Chronic Respiratory Diseases (GARD) is part of WHO’s global work to prevent and control asthma. GARD is a voluntary alliance of internationally-recognized organizations, institutions and agencies from a range of countries working towards a common goal of improving global lung health. Its vision is to make the right to breathe freely a reality for all. GARD promotes an integrated approach that capitalizes upon synergies of chronic respiratory diseases with other chronic diseases. GARD focuses specifically on the needs of low and middle income countries and vulnerable populations. The Global Initiative for Asthma (GINA), which was formed in 1992 by WHO and the US-based National Heart, Lung and Blood Institute, is part of GARD, as is the Global Initiative on Allergic Rhinitis and its impact on Asthma (ARIA), in which WHO is a participant. WHO’s Practical Approach to Lung Health (PAL), which is a strategy designed to help primary health care workers better manage respiratory symptoms, is used in GARD’s implementation strategy.

Prevention of Allergy and Allergic Asthma Project:

The Prevention of Allergy and Allergic Asthma Project is an outcome of the joint meeting between WHO and the World Allergy Organization-IAACI (WAO). This approach focuses mainly on different preventive measures for allergy and allergic asthma.

WHO’s work on asthma is part of the overall WHO chronic disease prevention and control framework of the Department of Chronic Diseases and Health Promotion. The strategic objectives of the Department are to raise awareness about the global epidemic of chronic diseases; create healthy environments, especially for poor and disadvantaged populations; slow and reverse trends in common chronic disease risk factors such as unhealthy diet and physical inactivity; and prevent premature deaths and avoidable disability due to major chronic diseases.