- Asthma is a common condition affecting about 15% of children and 1 in 20 adults.
- It is twice as common in boys as girls.
- It is a long standing chronic condition.
- It is variable, with different severities but all asthma can be well controlled.
- It is not curable but can be controlled by proper medication.
- Contrary to common belief, exercise is good for asthmatics.
- Asthma is caused by an inflammation of the airways (breathing tubes).
- The swelling of the airways, which is the result of inflammation, causes the airways to be narrowed.
- During an acute asthma attack, the airways are further narrowed by the contraction of the airway muscles. This is referred to as bronchospasm.
- Both the airway inflammation and muscle contraction is best treated by breathing medicine into the airways.
- Asthma can be controlled to the extent that people do not have attacks.
About asthma medicines
- People with asthma need medicines to treat the bronchospasm – these medicines are referred to as relievers. Examples of relievers include Asthavent, Ventolin, Venteze, Berotec.
- Medicines that treat the inflammation are referred to as controllers. Examples of controllers include Budeflam, Beclate, Flixotide, Ventzone, Inflammide and Singulai.
- If a reliever is required more than 2 x per week, then the asthma isn't under control and further medical advice is required.
Classic symptoms include coughing, wheezing, tightness of the chest, and increased effort during breathing, increased respiratory rate and inefficient gaseous exchange.
There are no conclusively proven reasons for asthma and there are no obvious reasons as to why there's an increase of incidence.
Many believe that asthma is a psychosomatic disease. Medical experts now agree this is a myth, although they concede that stress can exacerbate the condition.
There is also the question about genetics. If both parents are asthmatics, the chances are high that your child will have it too. However, two non-asthmatic parents can easily have an asthmatic child because the condition appears to be linked to the environment. If children are not being correctly diagnosed, it could mean that diagnosis might be missed resulting in under-treatment and problems in later life.
The vast majority of asthma sufferers are undiagnosed, yet if they keep the condition under control, they can enjoy a better quality of life. They do not have to be inactive or incapacitated.
Wheezing in infancy
- Wheezing during the first five years of life is extremely common and up to 50% of all children will experience at least one attack of wheezing during that time
- This group of wheezing children has varying symptoms and not all will go on to develop asthma. It can be very difficult to identify the small percentage of early wheezes that will go on to develop asthma
- There is now good evidence suggesting that wheezing with lower respiratory tract illnesses in the first three years of life has a good outcome and only about a third of these will still be wheezing at the age of nine years
- On the other hand we also know that more or less 60 % of asthma symptoms start between 6 months and 3 years after birth. A small proportion have symptoms prior to 6 months of age and the rest in later life
- It is very important to identify the infant who has the predisposition for asthma. This can be very difficult at any age as the doctor has to rely on certain known risk factors for early wheezing and asthma to try and identify the child that will go on to develop classic asthma
Risk factors for asthma
- Risk factors can be:
- Personal characteristics inherited or acquired
- Environmental characteristics
- Age and sex:
- Asthma can develop at any age and has to be considered in every child presenting with wheezing
- Males tend to predominate in the youngest age group, the sexes are equally represented from age 12 - 14, and females predominate through the rest of the age range
- Family history:
- Asthma in a child is more likely if one parent has asthma, and even more likely if both parents have asthma. Identical twins are more likely than non-identical twins to both develop asthma.
- Although some studies suggest racial differences in prevalence of asthma, socio-economic and environmental differences must be taken into account when conclusions are made in this regard.
- Socio-economic status: Asthma is more common in urban compared to rural communities and in more affluent than in poorer communities
- Cigarette smoking:
- Inhalation of cigarette smoke during pregnancy has been linked with abnormal lung functions, airway hyper-reactivity and allergy in the newborn.Tobacco smoke is also an important trigger factor for asthma attacks.
- Viral infections:
- Viral infections are important triggers for asthma attacks: thus it is recommended that people with asthma have a flu vaccine every year.
- About half of all asthmatics have evidence of allergy to aero-allergens.
- Early allergen exposure:
- There is increasing evidence that early exposure to inhaled allergens (house dust mites, moulds, cats, cockroach, pollen) in the genetically predisposed infant may lead to asthma. The increase in the prevalence of allergy when born in a specific month of the year can also be attributed to early exposure to the prevailing allergen at that specific time.
The National Asthma Education Programme (NAEP) is a non-profit organisation that aims to disseminate impartial information about asthma diagnosis and treatment to health professionals and the South African public. It also runs courses, workshops, and meetings for the public and professionals. NAEP (The National Asthma Education Programme) was first launched in 1989 by Key Opinion Leaders in South Africa and is part of an international organisation/drive which subscribes to guidelines set out by GINA (Global Initiative for Asthma), SATS (South African Thoracic Society) and ALLSA (Allergy Society of Asthma).