Asthma is often considered a burden of wealthy countries.

However, asthma is a public health problem that is increasing with globalization and modernization. Although diagnoses may differ, symptoms are present across all regions of the world. Sociological, economic and educational differences play a large part in the lack of diagnoses in developing nations.

Despite being a burden to high-income countries, most asthma-related deaths occur in low to middle-income countries.

According to the American Academy of Allergy Asthma and Immunology, an estimated 300 million people worldwide suffer from asthma, with 250,000 annual deaths attributed to the disease.

However, there have not been reliable epidemiological studies to determine the magnitude of the disease in many developing countries.

Asthma is a difficult disease to tackle in developing countries. The limited data and the expense of the problem makes it difficult to diagnose. It typically takes two different asthma exacerbations less than six months apart for an individual to be officially diagnosed by a physician.

This can be troublesome for developing countries who may have as little as one physician for every 10,000 people. Rural locations can also have compliance and testing issues.

However, because the effects of asthma go hand-in-hand with the social determinants of health, impoverished countries are at a high risk for this “wealthy-nation-disease.” Increasing air pollution and rapid industrialization create ideal environments for asthma to thrive. Asthma is further complicated by poor access to medical services and high drug prices.

Chelsea Stone, a student at Drexel University’s School of Public Health, studies epidemiology and focuses on asthma in developing countries.

While Stone was conducting research in Haiti, she found that education was the biggest hurdle to treatment. Only half of the families surveyed in the Croix des Bouquets community knew or had heard of asthma, revealing a large gap in health education. Asthma surveys have to be worded in concise, culturally appropriate ways.

In other asthma studies, rates have varied from 3% to 30% depending on location and survey methods. Solomon, an older man, willingly discussed his asthma with Stone.

Asthma typically beings in early childhood, as it had with Solomon.

He explained that his symptoms are better than they were while living in New York City because of the climate. Solomon was educated on the disease, a significant factor in controlling asthma attacks. Since there wasn’t always medications available or access to the emergency department, Solomon used natural remedies, such as coconut oil, to help with asthma flare-ups.

Asthma education is a substantial part of controlling the disease and preventing asthma-related deaths. Since there is limited data on asthma in developing countries, there is little education as a result.

This lack of research generates an under-diagnosed and under-treated disease.

The burden imposed on individuals and families is restricting and socioeconomically hindering. The availability of modern medications can complicate treatment and management. Even if there is access to an emergency department, they may not be equipped with proper medication to control asthma.

Avoiding asthma triggers all together can also reduce the severity of asthma. Some argue that there is not enough education centered on asthma awareness and signs of these triggers. Asthma education and management should be taught not just at the community level, but also integrated into nation-wide health staff education.

– Maris Brummel

Sources: Elsvier, World Health Organization, NCBI