Asthma is a chronic inflammatory lung disease characterized by airway narrowing and increased airway responsiveness to a variety of stimuli. Asthma presents with cough, chest tightness, difficulty or shortness of breath (dyspnea) and wheezing usually associated to a certain triggering event.
It is estimated that 300 million people have asthma around the world. It affects about 26 million people in the United States.
Prevalence of asthma is 10% in Kenya compared with international prevalence which is about 2-10%. It is common in urban than rural areas here in Kenya.
It is common in children, more common in male up to the age of 20 years of age where there is no difference in the sexes. After age of 40 years, it becomes common in women.
In Kenya it is common in children going to school especially the cities of Nairobi and Eldoret associated with cold and bad weather as the children go to school as early as 6a.m!
Risk factors of asthma
Interaction of genetic and environmental factors leads to expression of asthma.
The risk factors include genetic predisposition, atopy and airway hyper-responsiveness. Triggers include allergens and irritants such as strong smells, fumes, sprays, dust, upper respiratory infections, drugs such as aspirin, cold air, exercise and hyperventilation, passive smoking, occupational exposure and stress.
It is important to note that asthma is classified into intrinsic asthma whereby there is no family history of asthma or allergies, usually occurs in adulthood following severe respiratory illness and extrinsic asthma whereby there is strong family history of asthma and other allergic illnesses and usually onset at a young age.
Your doctor will take the history from family history to presentation of the disease then examines you. Depending on the findings of the history and the physical examination, investigations may be required to diagnose asthma such as blood tests, imaging, skin test and Spirometry.
Prevention is better than cure and hence avoiding the above triggering factors is the best management.
It should be known that there is no cure for asthma, the condition is just managed.
Maintain normal activity levels including exercise.
It is important to educate the patient and the family about the condition for optimum control of asthma.
Medication is divided into quick relief medication and long term control medications which your doctor will prescribe for you depending on the severity.
Acute asthmatic attack is managed in the accident and emergency department whereby inhaled and intravenous drugs are used. Moderate or severe attack not responding to conventional therapy or it persists for more than 12 hours is termed as Status Asthmaticus depending on the assessment of the doctor, this may require ICU admission.
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