World Asthma Day – May 3rd

Dr. Sofiya Salim Malik, Senior Consultant Pulmonologist, SUT Hospital, Pattom

World asthma day organised by the Global Initiative for asthma (GINA), a WHO collaborative organisation is observed on May 3^rd 2022, to raise awareness of asthma worldwide. The theme for the current year is ‘Closing gaps in Asthma Care’. Asthma cannot be cured but it is possible to control and manage and also prevent Asthma Attacks called exacerbations.

There are a number of gaps in Asthma care which require interventions in order to reduce preventable sufferings as well as costs increased by treating Asthma.

Currents gaps include

• Unequal access to diagnosis and treatment.
• Gaps in care for different Socio-economic ethnic and age group.
• Gaps between wealthy and poor communities.
• Gaps in communication and care across Primary, Secondary and Tertiary care interface.
• Gaps in providing education about Asthma and communications.
• Gaps in knowledge and awareness among health care provides.
• Gaps in prioritisation between Asthma and other long term conditions.
• Gaps in presenting infections and monitoring adherences.
• Gaps in public knowledge about Asthma.
• Gaps in Scientific evidence and actual delivery of care of Asthma patients.
• Implementing recommendations based on scientific evidence is challenging across the globe as they may not be applicable locally. So this theme is a challenge for the International Respiratory Committees to work together and to close the gaps in Asthma care.

What is Asthma?
Asthma is a chronic respiratory problem causing difficulty in breathing, due to narrowing of airways triggered in a sensitive in individual by different factors, which can be environmental or intrinsic.

What causes Asthma?

Asthma is caused by interplay between genetic and environmental factors. Only genetically predisposed individuals develop asthma usually.

Triggers for Asthma

Common triggers are:-

• Dust (Environmental)
• House dust
• House dust mites
• Pollens
• Insects
• Bird droppings
• Fungus
• Adverse extreme temperatures
• Laughter
• Emotions
• Exercise
• Certain drugs

What are the symptoms of Asthma?

• Wheeze
• Chest tightness
• Cough especially at night
• Shortness of breath

How is Asthma diagnosed?

Symptoms: presence of wheeze along with spirometry or lung function test. Lung function test is an effort dependent test carried out before and after taking a bronchodilator medication. If your lung function improve after bronchodilators, it is more likely that the person has Asthma.

Additional tests for asthma

1. Peak flow meter
2. Bronchial challenge test
3. Allergy test
4. Breath nitric oxide test
5. Measuring sputum eosinophil count

Treatment of Asthma

Rx consists of inhaled medications which can be Bronchodilators or Steroids. Drugs for Asthma are divided into two.

1. Rescue/Reliever medications – consists of bronchodilators/steroids or combination.
2. Controller medications – also called preventive, which consists mainly a combination of bronchodilators and steroids.

Avoidance of trigger factors like smoking and exposure to irritants during work will help. Supportive care with oxygen and antihistamines will be necessary during flare up of Asthma due to bacterial infections. Usually cause of infective flare ups are viral infections, needing no antibiotics.

Prevention of Asthma flare ups

• Avoidance of trigger factors
• Quitting smoking
• Following medications regularly as ordered by your doctor
• Vaccination