WHO: Asthma the silent killer for many in rural TZ

Dar es Salaam. The World marked the World Asthma Day last week. Still very little is known about this disease, especially in the rural areas where most people live.

The World Health Organisation (WHO) estimates that 300 million people currently suffer from asthma, almost 50 per cent of them are children. According to the WHO, asthma is a common chronic disease among children.

According to latest WHO data published in April 2011, asthma deaths in Tanzania reached 26,650 or 0.60 per cent of total deaths in the year 2010.

“Asthma is a public health problem not just for high-income countries, it also occurs in all countries regardless of the level of development. Most asthma-related deaths occur in low and middle income countries,” the WHO report states.

According to Medics Dictionary, asthma is a disease that affects the breathing passages of the lungs (bronchioles). It is caused by chronic (ongoing, long-term) inflammation of these passages, which makes the breathing passages, or airways, highly sensitive to various “triggers.”

Because asthma causes resistance, or obstruction, to exhaled air, it is called an obstructive lung disease. The medical term for such lung conditions is chronic obstructive pulmonary disease (COPD).

Mr Meshack Shimwela, president of the Association of Physicians in Tanzania (Aphta) noted at a training session in Dar es Salaam for doctors from various places in the country held recently that increasing numbers of motor vehicles, over population and use of biomass fuel are among the main causes of asthma.

Mr Shimwela detailed that COPD’s and asthma occur due to damage to air paths arising from toxic substances like tobacco and smoke from the burning of biomass for energy.

“Our changing life styles and modernisation are also contributing to the increase in the prevalence of the disease,” he said.

Prevalence of asthma in different countries varies widely, but an estimated 300 million people worldwide suffer from the disease, with the number likely to grow by more than 100 million by 2025.

According a senior doctor at the Muhimbili National Hospital, Ms Hellena Kakumbula, each person with asthma has his or her own unique set of triggers, adding that most triggers cause attacks in some people with asthma and not in others.

Common triggers of asthma attacks include: exposure to tobacco or wood smoke, breathing polluted air, inhaling other respiratory irritants such as perfumes or cleaning products, exposure to airway irritants at the workplace, and breathing in allergy-causing substances (allergens) such as molds, dust, or animal furs.

Others triggers are: exposure to cold, dry weather, emotional excitement or stress, physical exertion or exercise, and allergies, which he described as “the single biggest risk factor.”

“But having a parent, brother, or sister who has the disease (generic disposition) also gives more chances of somebody to be affected by the disease at any age,” elaborated Dr Kakumbula.

The WHO report also noted that workplace conditions such as exposure to fumes, gases or dust may cause more workers to be affected, saying that such conditions are responsible for 11 per cent of asthma cases worldwide. During a recent COPD training, a visiting expert working with an Indian-based Chest Research Foundation (CRF), Dr Rajiv Paliwal, noted that COPD is one of the top five killer diseases in the world.

He detailed that since asthma is a chronic disease, treatment goes on for a very long time. Some people have to stay on treatment for the rest of their lives, adding that the best way to improve one’s condition is learning what should be done to live with the disease.

“I propose usage of inhalers, instead of other medications because they bring relief after a short time,” said Dr Paliwal. He further detailed that medicines go to the airways while medications enter the blood system, causing addiction.

He also stressed on the importance of being aware of the asthma triggers and do what you can to avoid them, “this is the major way of staying away of asthma attacks,” he noted.

Dr Paliwal suggested routine refresher courses for primary healthcare practitioners as well as empirical studies on COPD and asthma prevalence.