A nine-year-old boy breathes from a nebuliser as he seeks treatment for his asthma. (Carlos Garcia Rawlins, Reuters)

Too many people in SA die needlessly from asthma

Amy Green
The chronic respiratory disease can be easily controlled and managed with proper diagnosis and the correct preventative medication

Almost 300 South Africans per million die due to asthma each year – the highest reported mortality rate for the condition in the world. This is according to the 2014 Global Asthma Report, which was launched by the Global Asthma Network on Thursday at the 45th Union World Conference on Lung Health in Spain.

Although the authors note that mortality data could not be acquired for many countries, South Africa fared worse than other low- and middle-income countries for which information was available, including the Philippines, Egypt and Mauritius.

Asthma is a chronic respiratory condition in which the airways become inflamed, thickened and constricted, leading to symptoms that can include wheezing, chest tightness, shortness of breath and coughing.

"Can it be prevented or cured? No. This is because, in most cases, we don’t know what causes it," said Guy Marks, a respiratory diseases expert from the International Union Against Tuberculosis and Lung Disease. "It is also the most common chronic disease in children."

But the disease can be easily controlled and managed with the correct medication, he said.

According to a 2013 report in the South African Medical Journal, "under-diagnosis and under-treatment remain problematic as indicated by a large proportion of adolescents with asthma symptoms who have never been diagnosed or who continue to experience severe symptoms despite diagnosis".

As many as 334-million people "of all ages and in all parts of the world" have asthma, causing a "substantial burden to people, often causing reduced quality of life, not only due to its physical effects, but also its psychological and social effects", the report noted.

Inappropriate management of the disease
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Further, avoidable asthma deaths are still occurring due to inappropriate management of asthma, including an over-reliance on reliever medication rather than preventer medication."

Inhaled corticosteroid therapy, taken twice a day, is the recommended "preventer" medication whereas another inhaled therapy, ventolin, is used to relieve acute symptoms during an asthma attack, according to Marks. Relying on ventolin alone increases the chances of an asthma patient experiencing acute asthma attacks, being hospitalised and ultimately dying, he said.

Although data on the estimated burden asthma places on countries and individuals is largely available, it is still not known why hospital admissions and mortality associated with the condition are so high in many countries, including in South Africa, according to the report.

Amy Green attended the 45th Union World Conference on Lung Health as part of a National Press Foundation- funded fellowship

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