Prevalence, time trends and treatment practices of asthma in India: the Global Asthma Network study

Abstract

ObjectiveThe objective of the sub-analysis of data from centers across urban areas in India of the Global Asthma Network (GAN) was to study the 1) prevalence of symptoms of asthma in children and adults, 2) change in prevalence of asthma and its trigger factors since the International Study of Asthma and Allergies in Childhood (ISAAC), and, 3) current asthma treatment practice.MethodsIn this cross–sectional, multicenter, school-based, and self-administered questionnaire, responses from children aged 6–7 years, 13–14 years, and their respective parents were analysed.ResultsThe GAN phase I study included 20084 children in the 6–7-year-age group, 25887 children in the 13–14-year-age group, and 81296 parents. The prevalence of wheeze in the past 12 months was 3.16%, 3.63%, and 3.30% in the three groups respectively. In comparison to the ISAAC studies, there was a significant reduction in the prevalence of current wheeze (p<0.001). Bivariate analysis revealed a significant reduction in the prevalence of trigger factors. Almost 82% of current wheezers and 70% of subjects with symptoms of severe asthma were not clinically diagnosed as having asthma. The daily use of inhaled corticosteroid (ICS) was less than 2.5% in subjects with current wheeze and those with symptoms of severe asthma but less than 1% used daily ICS when asthma remained undiagnosed.ConclusionThe prevalence of current wheeze and its causal factors showed a significant reduction compared to previous ISAAC studies. Among subjects with current wheeze and symptoms of severe asthma, the problem of under-diagnosis and under-treatment was high.

Allergic diseases in India – Prevalence, risk factors and current challenges

“…However, the recent multicentre GAN study observed a reduction in the prevalence of asthma from the ISAAC III to GAN I 5,8 . A wide variation in asthma prevalence has been reported in different regions of India ranging from 2% to 23% among school children in ISAAC (2003) and 1%–20% in the GAN study (2019) 1,2,5,8–10 . A wide variation in the prevalence of asthma is seen in the rest of the world as well.…”

“…Asthma: ISAAC study reported key determinants associated with asthma in 6-7-year-olds as maternal smoking, sedentariness, paracetamol in infancy, indoor pollution; and maternal smoking, outdoor pollution, male gender and underweight for 13-14-year-olds. 5,8,14,61 GAN study reported reduced fresh fruit consumption and reduced breastfeeding to be important. 22 The reduced asthma prevalence in GAN may reflect the reduced number of children exposed to air pollution through residing in areas where trucks pass frequently.…”

Time Trends of Greenspaces, Air Pollution, and Asthma Prevalence among Children and Adolescents in India

“…Asthma is multifactorial, and we are yet to understand the causal mechanisms fully; however, genes, the surrounding environment, and behaviors play a part in asthma development [ 7 , 8 , 9 ]. Environmental factors may account for the substantive variations in asthma prevalence across different regions of the world [ 9 , 10 , 11 , 12 ]. Air pollutants, especially from traffic emissions (TRAP), lead to the worsening of existing respiratory symptoms [ 13 , 14 , 15 ] and increase the risk for new-onset asthma [ 16 ].…”

A Pilot Study of Omalizumab to Treat Severe Allergic Asthma in South Indian Population

“…According to the most current Global Burden of Disease report (GBD, 1990(GBD, -2019, 34.3 million Indians are predicted to have asthma, which represents 13.09% of the global burden. In addition, it stated that asthma was to account for 13.2 thousand fatalities in India 5 . In Indians, asthma accounted for 27.9% of DALYs (disability-adjusted life years).…”

“…In Indians, asthma accounted for 27.9% of DALYs (disability-adjusted life years). Overall, compared to the worldwide burden of asthma, India has three times the mortality rate and more than twice the DALYs 5 . In asthma, airways of the lungs constrict due to swelling and accumulation of mucus 1 .…”