The week of asthma begins, one of the most prevalent chronic diseases that exist in the world and with the greatest underdiagnosis.
By iProfessional
01/05/2023 – 11,32hs
In Argentina, approximately 4 million people suffer from asthma. There are 15,000 hospitalizations due to asthmatic crises (exacerbations) and, despite having adequate treatment, 400 people still die from asthma a year, according to data from the First Asthma Prevalence Survey (2015). It is estimated that approximately half of those who suffer from the disease do not know it.
According to WHO Global Asthma Report 2022, it is estimated that worldwide asthma affects approximately 9% of children, 11% of adolescents and 6.6% of adults. In previous editions, the report reported the existence of at least 330 million cases in the world, estimating that by 2025 this figure would increase by 100 million in all ages and for all ethnic groups.
The asthma rate increases as communities embrace western lifestyles and become urbanized.
But the economic and humanitarian effects of this disease they are probably higher in developing countries, which account for 80% of global mortality from this cause and where the prevalence has been increasing rapidly in recent years.
Diagnosis and control of asthma, how to achieve it?
Asthma is a disease in which a chronic inflammation of the bronchi is generated, which generates their narrowing. This manifests in the patient as shortness of breath, chest pain or tightness, persistent coughing, or wheezing. These symptoms generate a limitation in daily activities, from sports practice to activities as daily as walking or bathing. The main consequence of this is increased school and work absenteeism.
It should be noted that andIt is a highly variable diseaseboth at the population level (different patients can present different characteristics within the mentioned symptoms) and individual (the same patient can vary the way in which asthma manifests itself over time). In the same way, there are also associated conditions that can worsen symptoms, or be factors that make asthma management difficult, even with adequate treatment (allergic diseases such as chronic rhinitis or dermatitis, chronic sinusitis, gastroesophageal reflux, obesity, concomitant medications, smoking , etc.)
Asthma in Argentina: half of the patients do not know their disease
Even patients with mild asthma suffer from asthma attacks (up to 4 out of 10 patients) and may die as a result of it despite having a diagnosis of mild asthma. However, having such variable symptoms with asymptomatic periods of time, and given the lack of medical education, many patients tend to abandon treatment. This occurs more frequently when patients are incorrectly treated, not treated or not controlled for their pathology. As it is an inflammatory disease, the best treatment is airway anti-inflammatories (topical action inhaled corticosteroids that are safe for the patient and can be used alone or associated with bronchodilators). In many cases, patients do not receive the correct prescription or abandon treatment. Lack of access to medicines is another implicated factor.
Have the asthma under control It means not presenting symptoms, not having limitations for usual physical activities and not needing quick reliever or rescue medication.
He treatment of exacerbations requires the use of systemic corticosteroids (oral or injected route), contributing to the increase in the accumulated doses of said drug, which can cause significant adverse effects or other associated diseases. It should be noted that in the presence of an asthmatic attack, all the available evidence makes it clear that the risk/benefit ratio favors the use of systemic corticosteroids, despite their adverse effects.
National Asthma Law, an opportunity to grow
Faced with the lack of Asthma Programs and Health PoliciesIn order to respond to this great problem, different Scientific Societies are working, such as the Argentine Association of Respiratory Medicine (AAMR), the Argentine Association of Allergy and Clinical Immunology (AAAeIC) and the Argentine Society of Medicine (SAM), the NGO GANOA and the Argentine Association of Patients with Asthma.
Said institutions formed an Advisory group in order to propose the National Asthma Law that allows training, education, prevention and, fundamentally, access to treatment, so that patients can lead a dignified and quality life. The bill was introduced in May 2022 and is waiting to be dealt with.
