Is a silent asthma epidemic sweeping the continent of Africa?

Mark
Written By Mark

A recent study found that millions of teenagers across Africa may be struggling with asthma without knowing it because they have not received a diagnosis from a doctor, and therefore are not receiving the necessary treatments, according to a report by colleague Shola Lawal on the Al Jazeera English website.

The results of the study were published last week in the medical journal The Lancet, and are extremely important for a continent that has produced little data on the extent of asthma, even though the condition is one of the most common causes of chronic respiratory death on the continent, and writer Shola Lawal wrote about it on the Al Jazeera website. English.

Asthma, which affects the lungs and causes breathing difficulties, often begins in childhood or adolescence. It is a condition that affects many teenagers around the world with an estimated 76 million young people suffering from it in 2019.

There is no definitive cure for asthma that develops in childhood, but treatment can relieve symptoms, which often persist into adulthood, according to scientists.

Researchers led by scientists at Queen Mary University of London (QMUL) discovered that 12% of adolescents in six African countries suffer from severe asthma symptoms, but the vast majority of them (80%) have not been diagnosed by a health expert.

The study, conducted from 2018 to 2021, focused on 20,000 children between the ages of 12 and 14 in schools located in urban areas: Blantyre in Malawi, Durban in South Africa, Harare in Zimbabwe, Kampala in Uganda, and Kumasi in Ghana. Lagos in Nigeria. Durban had the highest number of pupils with asthma symptoms while Blantyre had the lowest.

The study also found that a third of students who had already been diagnosed with asthma and were experiencing severe symptoms did not use any medication to control the condition because they did not see their condition as serious and had poor knowledge of asthma treatments.

“Adolescence is the period of life with the highest prevalence of asthma,” Gioia Mosler of Queen Mary University of London, who served as research director of the study, told Al Jazeera.com.

The researchers said it was not possible to generalize the results due to the different conditions in each African city. However, if their findings are extrapolated, it could mean that about 15 million teens have undiagnosed asthma symptoms in sub-Saharan Africa, Mosler noted.

Causes of asthma

Asthma can be caused by pollen, dust, or particles from burning waste or other materials. Symptoms often include difficulty breathing, wheezing, chest tightness, and coughing.

Although severe asthma is rare, it can lead to death. About 455,000 people died from this condition in 2019, according to the World Health Organization, most of them in low- and middle-income countries.

Mortality rates in Africa are not clear despite country-level studies. ​​In Uganda, for example, deaths due to asthma were estimated at about 19 deaths per thousand people annually. By contrast, Mexico recorded 10.41 deaths per 100,000 people, according to studies.

The exact causes of asthma are unknown, but asthma can be hereditary. Environmental factors such as changes in weather and air pollution are common triggers associated with the development of asthma.

In African cities, the high number of asthma cases has been linked to the continent’s rapid urbanization and rising pollution.

At least two-thirds of the world’s population lives in cities. However, Africa has the fastest rate of urbanization in the world (3.5% growth per year compared to 1.8% on average) with megacities expanding and small towns growing.

While this provides economic opportunities, the expansion of urban centers also means more polluted air caused by energy use, vehicle exhaust, uncollected waste and a host of other factors that can lead to asthma.

The high incidence of asthma in South Africa is likely linked to rising cases of bronchitis, according to the Clean Air Fund. The country relies on polluting coal plants for electricity, and has one of the worst levels of air pollution in Africa.

Researchers say the climate crisis is also causing more cases of asthma. According to experts, there may be an increase in exposure of vulnerable children to dust and forest fires that are increasing globally due to global warming.

Some studies have shown that there are disproportionately higher numbers of premature deaths and severe cases of asthma in African and other low-income countries due largely to inadequate health care systems, leading to underdiagnosis and undertreatment.

How is asthma treated?

Asthma is ideally treated in two ways: short-acting inhalers or tablets that widen the airways and allow more air into the lungs during an attack. There are also long-term treatments that can also come in the form of preventive inhalers or tablets used daily to prevent attacks.

However, the researchers said that in most African countries, asthma cases are treated on a crisis-by-crisis basis rather than controlled long-term.

Treatment costs, even for short-term relief, are high. In Nigeria, which is suffering from one of the worst economic crises in a generation, the costs of inhalers have nearly tripled in the past year alone from about 2,800 naira ($1.70) to 7,500 naira ($4.57). During the recession, pharmaceutical giant GlaxoSmithKline exited the country, and this caused a scarcity of its highly sought-after brand of inhalers.

What is the solution?

In the longer term, the World Health Organization says controlling air quality in cities is essential to reducing the number of people with asthma.

On the other hand, the researchers call on African governments to invest more in asthma treatments: both in long-term and short-term relief medicines rather than just pouring money into quick-reliefs.

One way to combat under-screening in particular is to raise awareness of asthma among students in schools, said Mosler of Queen Mary University of London.

“Mobile clinics that visit schools can be a very effective way of screening,” Mosler added, referring to a method that she noted has been tested in low-care areas of the United States with some success.