Asthma care in sub-Saharan Africa: Mind the gap!
| Abstract | “Closing gaps in asthma care” is the theme for World Asthma Day 2022. Nowhere are the gaps wider between reality and the ideal, than in sub-Saharan Africa in terms of diagnostics, treatment options, and the underpinning evidence for these. Asthma is the most common chronic disease in children and adolescents globally and one of the most common chronic diseases in adults.[1-3] The World Health Organization (WHO) and others have highlighted asthma as an underappreciated cause of poverty in low- and middle-income countries that hold back economic and social development, erode the health and well-being of those affected, and have a negative impact on families and societies.[4-6] Asthma is a recognized cause of catastrophic health expenditure and a threat to universal health coverage.[7] The WHO succinctly states “that in children with asthma, poverty aggravates asthma and asthma aggravates poverty.”[8] Children miss out on education, adults lose days at work and the costs of medicines, emergency visits, and hospitalization are major financial burdens not only for individuals and their families but also for struggling health systems.[4-8] Asthma prevalence has been increasing across Africa: In 1990, about 11.7% (74 million including 34.1 million children) of the population had asthma; by 2010, this had increased to 12.8% (119 million including 49.7 million children).[9] Despite the high prevalence, there are limited data about the burden and determinants of asthma in sub-Saharan Africa.[10,11] Asthma morbidity in sub-Saharan Africa today is further compounded by myths and stigma; however, a positive lesson of history from high-income counties is that these can be overcome.[12-14] Asthma is underdiagnosed and undertreated in sub-Saharan Africa, and consequently, the burden of severe asthma symptoms and mortality rates are disproportionately high, for example, the Ugandan asthma mortality rate of 19 deaths per 1000 person-years is 90 times that of the UK: [15] In Uganda, a low-income sub-Saharan African country, only 33% of a cohort of people with asthma had controlled asthma, 33% were taking inhaled controller medications, and 60% had ≥1 exacerbations a year.[15] In under 5-year-old children with asthma symptoms, over 90% were diagnosed with pneumonia and treated with antibiotics, thus missing opportunities to address the true underlying issues.[16] |
| Date of Publication | 02 May 2022 |
| URL | https://patsjournal.org/asthma-care-in-sub-saharan-africa-mind-the-gap |
| DOI | 10.25259/JPATS_12_2022 |
Tag:Asthma
