Asthma is a major non-communicable disease (NCD), affecting both children and adults, and is the most common chronic disease among children.

Inflammation and narrowing of the small airways in the lungs cause asthma symptoms, which can be any combination of cough, wheeze, shortness of breath and chest tightness.

Asthma affected an estimated 262 million people in 2019 (1) and caused 455 000 deaths.

DEFINITION

Asthma is a chronic lung disease affecting people of all ages. It is caused by inflammation and muscle tightening around the airways, which makes it harder to breathe. Symptoms can include coughing, wheezing, shortness of breath and chest tightness. These symptoms can be mild or severe and can come and go over time

SIGNS AND SYMPTOMS OF ASTHMA

Common Asthma Symptoms:

• Coughing: This is a common symptom, often worse at night or in the early morning. The cough may be dry or produce mucus. 
• Wheezing: This is a whistling or squeaky sound when exhaling, often heard due to narrowed airways. 
• Shortness of breath: Difficulty breathing or feeling breathless, even when resting. 
• Chest tightness o r pain: A feeling of pressure or tightness in the chest that makes it hard to breathe deeply. 
• Waking up at night due to breathing problems: This can be a sign that asthma is not well-controlled. 
• Other symptoms: Rapid breathing, fatigue, and a drop in peak flow meter reading (if used) can also be indicators. 

Asthma Triggers:

• Allergens: Pertain to substances like pollen, dust mites, or pet dander that can trigger symptoms. 
• Irritants: Substances like smoke, pollution, or strong odors that can irritate the airways. 
• Exercise: Physical exertion can trigger symptoms in some individuals with asthma. 
• Viral infections: Respiratory infections like colds or the flu can worsen asthma symptoms. 

Severe Asthma Symptoms (Asthma Attack):

• Severe wheezing: A loud, high-pitched whistling sound when breathing.
• Severe coughing: Persistent, uncontrolled coughing.
• Difficulty breathing: Gasping for air or struggling to get enough oxygen.
• Blue lips or fingernails: A sign of low oxygen levels in the blood.
• Confusion or drowsiness: A sign of severe oxygen deprivation.
• Fainting: Loss of consciousness due to severe asthma. 

RISK FACTOR OF ASTHMA

Asthma risk factors can be broadly categorized into genetic predisposition, environmental exposures, and lifestyle choices. A combination of these factors can increase an individual’s likelihood of developing asthma. 

Genetic Predisposition:

• Family history:

Having a family history of asthma or allergies (such as eczema, hay fever) increases the risk. 

• Specific genes:

Certain genes have been identified as potentially contributing to asthma development. 

Environmental Exposures:

• Allergens:

Exposure to allergens like pollen, dust mites, pet dander, and mold can trigger asthma symptoms in susceptible individuals. 

• Air pollution:

Exposure to air pollution, including pollutants like ozone, particulate matter, and smog, can increase asthma risk and worsen existing symptoms. 

• Tobacco smoke:

Exposure to tobacco smoke, including both active smoking and secondhand smoke, is a significant risk factor for asthma development. 

• Occupational hazards:

Exposure to chemicals, fumes, and dust in the workplace can trigger or worsen asthma. 

• Respiratory infections:

Certain respiratory infections, particularly in early childhood, can increase the risk of developing asthma. 

• Other environmental factors:

Exposure to irritants like certain foods or chemicals can also trigger asthma symptoms. 

Lifestyle Choices:

• Obesity: Obesity is associated with an increased risk of asthma and can make it more difficult to control. 
• Smoking: Smoking is a major risk factor for asthma and can worsen symptoms. 
• Stress: Strong emotions and stress can trigger asthma attacks. 
• Lack of physical activity: A sedentary lifestyle can contribute to obesity, which is a risk factor for asthma. 

Other Factors:

• Low birth weight or prematurity:

Babies born prematurely or with low birth weight may be at higher risk of developing asthma. 

• Allergic conditions:

Having allergies, such as eczema or hay fever, can increase the risk of developing asthma. 

• Race/Ethnicity:

Certain racial and ethnic groups, such as Black or African American and Puerto Rican individuals, have a higher prevalence of asthma. 

• Sex:

Boys are more likely to develop asthma as children, while in adults, asthma is more common among women. 

TREATMENT AND MANAGEMENT OF ASTHMA

Asthma management and treatment focuses on controlling symptoms and preventing severe attacks through a combination of medication and lifestyle adjustments. While there’s no cure, effective treatment allows individuals to live normal, active lives. 

Here’s a breakdown of key aspects:

1. Medications:

• Inhalers:

These deliver medications directly to the lungs, offering targeted relief and control. 

• Quick-relief inhalers (bronchodilators): Open airways and provide immediate symptom relief, like salbutamol.
  • Long-term control inhalers (steroids): Reduce inflammation in the airways, helping to prevent attacks, such as beclometasone. 
• Other Medications:

May include oral or injected corticosteroids, leukotriene modifiers, or biologics in more severe cases. 

• Allergy Medications:

May be necessary for allergic asthma, which is triggered by allergens like pollen, dust mites, or mold. 

• Personal Action Plan:

A doctor or asthma nurse will help you develop a plan that includes your medications, how to monitor your condition, and what to do during an attack. 

2. Lifestyle Adjustments:

• Trigger Avoidance:

Identifying and avoiding triggers like allergens, smoke, and irritants is crucial for preventing attacks. 

• Breathing Exercises:

Can help improve lung function and potentially reduce the need for medication. 

• Stress Management:

Stress can trigger asthma symptoms, so finding healthy ways to manage stress is beneficial. 

3. Emergency Treatment:

• Emergency Room: If you experience a severe asthma attack, seek immediate medical attention.
• Oxygen: May be administered to increase oxygen levels in the blood.
• Quick-relief medicines: Such as albuterol and levalbuterol, are used to open airways.
• Corticosteroids: May be given orally or by injection to reduce inflammation.
• Mechanical Ventilation: In severe cases, a machine may be used to assist with breathing. 

4. Asthma Action Plan:

• A written plan, developed with your doctor or asthma nurse, outlining your medications, how to monitor your asthma, and what to do if you have an attack.
• This plan should include specific actions to take based on your individual needs and the severity of your symptoms. 

5. Self-Management:

• Consistent medication use, even when feeling well, is crucial for maintaining control. 
• Regular monitoring of symptoms and lung function can help you and your doctor adjust your treatment plan as needed. 
• Learning to recognize your personal asthma triggers and taking steps to avoid them is a key part of self-management. 

By combining medication, lifestyle adjustments, and a well-developed asthma action plan, individuals with asthma can effectively manage their condition and live fulfilling lives. 

PREVENTION

Preventing asthma attacks involves identifying and avoiding triggers, using prescribed medications as directed, and following an asthma action plan. Regular check-ups with a healthcare provider are also crucial for managing asthma. 

Preventing Asthma Attacks:

1. 1. Identify and Avoid Triggers:

Common triggers include allergens like pollen, dust mites, and pet dander, as well as irritants like smoke, fumes, and strong fragrances. If you know what triggers your asthma, try to avoid them or minimize exposure. 

• 2. Follow Your Asthma Action Plan:

This plan, developed with your doctor, outlines what to do when you experience asthma symptoms, including which medications to use and when. 

• 3. Take Medications as Prescribed:

This includes both daily preventer medications (like inhaled corticosteroids) and quick-relief medications (like albuterol) for use during attacks. 

• 4. Regular Healthcare Visits:

Regular check-ups with your doctor allow them to monitor your asthma, adjust your treatment plan as needed, and provide education and support. 

• 5. Other Preventive Measures:
  • Get Vaccinated: Flu and pneumonia vaccines can help prevent respiratory infections that can trigger asthma attacks. 
  • Reduce Allergen Exposure: Use allergen-proof mattress and pillow covers, vacuum regularly with a HEPA filter, and keep your home dry to prevent mold growth. 
  • Manage Stress: Stress can trigger asthma symptoms. Practice relaxation techniques or breathing exercises. 
  • Maintain a Healthy Lifestyle: Get regular exercise, maintain a healthy weight, and control heartburn. 

Additional Considerations:

• For Athletes:

If you experience asthma symptoms during exercise, pre-treat with a fast-acting inhaler before exercise, and consider using a daily preventative medication if needed. 

• For Children:

Help your child avoid allergens and irritants, discourage smoking around them, and encourage them to be active. 

• For Pregnant Women:

Avoid exposure to environmental tobacco smoke and consider exclusive breastfeeding, which may help prevent asthma and other allergic conditions. 

CONCLUSION

People with asthma and their families need education to understand more about their asthma. This includes their treatment options, triggers to avoid, and how to manage their symptoms at home.

It is important for people with asthma to know how to increase their treatment when their symptoms are worsening to avoid a serious attack. Healthcare providers may give an asthma action plan to help people with asthma to take greater control of their treatment.