Respiratory Diseases

Asthma

Asthma is a chronic disease characterized by recurrent attacks of breathlessness, cough and wheezing which vary in frequency and severity from person to person.


“First sign of disease is ‘persistent cough’. Symptoms may occur several times in a day or week in affected individuals. For some people the symptoms become worse during physical activity or at night. Failure to recognize triggers that lead to a tightened airway can be life threatening and may result in asthma attack, respiratory distress and even death,”

 

Asthma Prevalence

 

Asthma is one of the most chronic diseases in the world affecting more than 300 million people worldwide and causing about 255,000 premature deaths annually. Asthma accounts for at least one in every 250 deaths. Studies reveal that asthma deaths would increase by almost 20% in the next 10 years if urgent action is not taken. Asthma occurs in almost all countries regardless of level of development, however, over 80% of asthma deaths occur in low and middle-income countries.

 

The prevalence of asthma in Pakistan is increasing day-by-day with an annual increase of 5% of which 20% to 30% are children between 13 and 15 years of age. Nearly 20 million people about 12% of Pakistani adult population are already suffering from the disease.

 

Asthma Risk Factors & Prevention

 

Risk factors for developing asthma are having the family history of disease, exposure to indoor/outdoor allergens such as

 

  • House dust mites in bedding, carpets, curtains, stuffed furniture

 

  • Pollution and exposure to cats and dogs in first two years of life

 

  • Cockroaches, and outdoor allergens such as pollens, moulds, tobacco smoke and chemical irritants in the workplace used in farming and hairdressing, in paint, steel, plastics and electronic manufacturing,

 

  • Car paint sprays

 

  • Flour, grain dust and wood dust

 

Key risk factors increase the susceptibility of a person to develop asthma, and also can trigger an asthma attack. It can lead to chronic respiratory diseases (CRDs).”


Other risk factors are living in urban areas, especially the inner city, prenatal exposure to active maternal smoking, exposure to second hand smoke after birth, respiratory infections in childhood like flu and common cold, low birth weight, obesity, persistent allergic rhinitis (common cold), scented cosmetics and some medicines such as aspirin and beta-blockers (medicine for reducing blood pressure). “Nasal allergies alone may affect up to 50% of young Pakistani children, and almost 60 to 80% of these children may develop asthma later in life,”

 

Asthma triggers include cold air, extreme emotion arousal such as anger or fear, laughing, excitement and physical exercise. “At present, no cure is available for asthma, however, there are some very effective medicines available, which, when properly used, can very largely control asthma attacks and allow people to lead normal life. “Asthma that starts in childhood often disappears as child grows up but if it starts in adult life, it is less likely to disappear.”

 

To reduce burden of the disease in Pakistan, we need a comprehensive strategy for its prevention. “Prevention of asthma in children involve efforts to reduce maternal smoking and to motivate mothers for breastfeeding while in adults, it should be directed towards enhancing workplace safety.

 

Recently a task force has been formed jointly by ministries of health and environment, and Allergy, Asthma Institute of Pakistan on prevention, control and environmental risk reduction of asthma in the country. However, a number of health experts are of the view that a task force on the subject might not come up with desired results instead awareness campaign among public is need of the time.


There is no cure for asthma at present and to reduce its burden, the only preventive measure is to create public awareness and motivate them to avoid asthma triggers.

 

Individuals should reduce level of exposure to common risk factors particularly avoiding smoking and environmental smoke; damp housing conditions, indoor air pollutants and keeping indoor humidity low. Food allergies in children may be prevented by breastfeeding exclusively until six months. Healthy weight must be maintained. Pets should be kept out of bedroom and vacuum cleaning of house should be done frequently.


Upper airways diseases (e.g. allergic rhinitis) must be treated. Get rid of dust collectors including heavy drapes, carpeting and stuffed animals. Control cockroaches with insect sprays. Use airtight allergy proof plastic covers on all mattresses and pillows. Wash all bedding and stuffed animals in hot water every 7-14 days. Avoid allowing odors and sprays in the home.

 

COPD

 

Chronic obstructive pulmonary disease (COPD) is a general name given to a number of conditions including chronic bronchitis and emphysema. The COPD causes the airways in the lungs to become narrower, making it more difficult for the air to move into and out of the lungs.

 

Prevalence

 

The prevalence rate in Pakistan is as high as 2.1 percent in the population aged 40 years and above. Around 33 percent of the subjects have been hospitalised due to their COPD symptoms and similarly 27 percent of the COPD patients visited an emergency room because of their respiratory condition.

 

Risk Factors & Prevention

COPD is secondary to cigarette smoking, other risk factors are

 

  • Waterpipe Smoking

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  • Exposure to biomass fuel burning

 

The condition builds up over the time making breathing and every day activities progressively difficult and increasing the risk factor of heart failure. COPD causes permanent lung damage. Treatment usually involves relieving the symptoms by using an inhaler to make breathing easier. 

 

The most important prevention is to quit smoking and avoid other triggering factors. Better patient education and more effective patient-physician communication are clearly required.

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