Global strategies for reducing the burden from asthma

Abstract

Asthma is one of the most important chronic diseases in childhood. For several decades, a steady increase in prevalence has been observed worldwide. In the structural collaboration between the Centre for Population Health Services in Edinburgh and the Research Institute CAPHRI of Maastricht we investigated the possibilities for primary prevention of asthma in childhood. We found that a multifaceted approach might be effective in delaying or preventing asthma, whereas a mono-intervention does not seem to have such a protective effect. The most likely explanation is that the development of a multifactorial disease, such as asthma, is extremely difficult, if not impossible, to prevent by eliminating only one risk factor.Underdiagnosis of asthma is still a big problem in primary care. Most patients do not present bronchial symptoms to the general practitioner, even though they have decreased lung function, so they remain unknown and undiagnosed. However, patients who do present with respiratory problems and who have reduced lung function are not always recognised as such. We found that the perception of dyspnoea seems to determine, at least in part, the presentation to the general practitioner with symptoms.These observations show that both the prevention of the development of asthma in early childhood, as well as case finding of asthma in adulthood, do not seem to be very effective in primary care. More research is needed to clarify what steps can be taken to reduce the global burden from asthma.

RItA: The Italian severe/uncontrolled asthma registry

“…This diagnostic delay could be due to the communication difficulties between patients and physicians; indeed, most patients do not report their bronchial symptoms to the general practitioner remaining undiagnosed. On the other hand, patients with respiratory problems and reduced lung function are not always recognized as such, may be due to a lack of guidelines awareness or implementation …”

“…Italian data showed the need for reducing the diagnostic delay, through an early detection of asthma and a subsequent early treatment, in order to improve the long‐term prognosis of these patients, probably preventing the development of long‐term modifications, such as remodeling, with a subsequent further impairment in pulmonary function …”

Bisphenol A Exposure and Asthma Development in School-Age Children: A Longitudinal Study

“…The global prevalence of asthma in children has risen significantly over the recent decades [4], [5]. The exact cause of this increase is not known, but associations with increasing urbanization have been reported [6], [7].…”

Is acupuncture better than sham acupuncture for attenuated airway inflammation and regulated cytokines produced by diverse Th subtypes in chronic OVA inhalation in asthma induced mice

“…It has been reported that the prevalence of asthma is increasing considerably over the past 20 years [2]. Asthma is a chronic pulmonary disease featured by airway inflammation, airway hyperreactivity (AHR) and airway remodeling [3,4].…”