Main Elements
Asthma is an important non-communicable disease (NCD) affecting both children and adults and is the most common chronic disease among children.
Inflammation and narrowing of the small airways in the lungs cause asthma symptoms, which can be any combination of coughing, wheezing, shortness of breath and chest tightness.
Asthma affected an estimated 262 million people in 2019 (1) and caused 455,000 deaths.
Inhaled medicines can control asthma symptoms and allow people with asthma to lead a normal, active life.
Avoiding asthma triggers can also help reduce asthma symptoms.
Most asthma-related deaths occur in low- and middle-low income countries, where underdiagnosis and inadequate treatment are a problem.
WHO is committed to improving the diagnosis, treatment and monitoring of asthma to reduce the global burden of non-communicable diseases and make progress towards universal health coverage.
Overview
Asthma is a chronic lung disease that affects people of all ages. It is caused by inflammation and muscle tension around the airways, which makes breathing difficult.
Although asthma can be a serious condition, it can be managed with the right treatment. People with asthma symptoms should talk to a health professional.
Impact
Asthma is often inadequately diagnosed and insufficiently treated, especially in low and middle-income countries.
Individuals with untreated asthma may experience sleep disorders, fatigue, and poor concentration during the day. Asthma patients and their families may miss school and work, creating a financial impact on both the family and the broader community. In severe cases, individuals with asthma may need to seek urgent healthcare, leading to hospitalization for treatment and monitoring. In the most severe cases, asthma can lead to death.
Symptoms
Symptoms of asthma can vary from person to person and sometimes worsen significantly. This is known as an asthma crisis. Symptoms are often worse at night or during exercise.
Common symptoms of asthma include:
- Persistent cough, especially at night
- Wheezing while breathing out and sometimes while breathing in
- Shortness of breath or difficulty breathing, even at rest sometimes
- Tightness in the chest, making deep breathing difficult.
- Some individuals may experience worse symptoms when they have a cold or during changes in the weather. Other triggers include dust, smoke, fumes, grass and tree pollens, animal fur and feathers, strong soaps, and perfumes.
- Other conditions can also cause symptoms. Individuals experiencing symptoms should consult a healthcare facility.
Causes
While finding a single direct cause is often challenging, various factors are associated with an increased risk of developing asthma.
If other family members, especially close relatives such as parents or siblings, have asthma, the likelihood of developing asthma is higher.
Asthma is more likely in individuals with other allergic conditions such as eczema and rhinitis (hay fever).
Urbanization is likely associated with increased asthma prevalence, possibly due to various lifestyle factors.
Events in early life can affect developing lungs and increase the risk of asthma. These events include low birth weight, prematurity, exposure to tobacco smoke and other sources of air pollution, as well as viral respiratory infections.
Both indoor and outdoor air pollution, exposure to environmental allergens and irritants, including dust mites, molds, chemicals, smoke, or occupational dust, are believed to increase the risk of asthma.
Children and adults who are overweight or obese are at a higher risk of asthma.
Treatment
Asthma is not curable, but there are several treatments available. The most common treatment involves using an inhaler that delivers the medication directly to the lungs.
Respiratory devices can help control the disease and enable individuals with asthma to lead a normal, active life.
There are two main types of inhalers:
Bronchodilators (such as salbutamol) that open the airways and alleviate symptoms; and steroids (such as beclometasone) that reduce inflammation in the airways, improving asthma symptoms and reducing the risk of severe asthma attacks and death.
Individuals with asthma may need to use their inhaler every day. The treatment will depend on the frequency of symptoms and the type of inhaler available.
Using an inhaler can be challenging, especially for children and in emergency situations. Using a spacer makes using an aerosol inhaler device easier. It is a plastic device with a mouthpiece or mask at one end and a hole for the inhaler at the other end. A homemade spacer made from a 500 ml plastic bottle can be as effective as commercially produced spacers.
Access to respiratory devices is a challenge in many countries. In 2021, bronchodilators were available in half of the primary health facilities and steroid inhalers in one-third of low- and middle-income countries.
Raising community awareness to reduce myths and stigma related to asthma is also important.
Self-Care
Individuals with asthma and their families need education to learn more about their condition. This includes understanding treatment options, avoiding triggers, and managing symptoms at home.
It is crucial for individuals with asthma to know how to increase their treatment when symptoms worsen to avoid a severe crisis. Healthcare providers can provide an asthma action plan to help individuals better control their treatments.
WHO Response
Asthma is included in the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases and the United Nations 2030 Sustainable Development Agenda.
WHO is taking action to expand the diagnosis and treatment of asthma in various ways.
Reducing exposure to tobacco smoke is important for both primary prevention and disease management of asthma. WHO initiatives in this area, such as the Framework Convention on Tobacco Control, MPOWER, and mTobacco Quit, enable progress.
The Global Alliance Against Chronic Respiratory Diseases (GARD) contributes to WHO's efforts to prevent and control chronic respiratory diseases. GARD is a voluntary alliance of national and international organizations and agencies dedicated to the vision of a world where everyone breathes freely.
References
1. Global Burden of Disease 2019: A systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396(10258):1204-22.
