Asthma can be controlled -Expert

Experts have warned that asthma which reportedly affects about 15-20 million people in the country is on the increase worldwide. But Dr. Cyril Chukwu, a renowned consultant respiratory physician at the Lagos University Teaching Hospital, says the disease can be controlled though most patients in the country are still uncontrolled despite frequent visits to their doctors or pharmacists.
At a lecture on Asthma care recently, Chukwu described uncontrolled asthma as a serious concern as it causes patients to experience symptoms such as shortness of breath and disturbed sleep. Also, he said, uncontrolled asthma patients use more healthcare resources and because they overestimate their control and under-report their symptoms, it makes it difficult for doctors to assess asthma control correctly.

A Recent survey has also revealed that very few Nigerians could be said to be in control of the dreaded condition. According to the GINA Global Strategy for Asthma Management and Prevention (2007), asthma control means that a person with asthma has:
• No (or minimal) asthma symptoms.
• No waking at night due to asthma.
• No (or minimal) need to use “reliever” medication.
• The ability to do normal physical activity and exercise.
• Normal (or near-normal) lung function test results (PEF and FEV1).
• No (or very infrequent) asthma attacks.
For instance, experts say majority of asthma patients in Nigeria are under-diagnosed and those diagnosed are not receiving adequate management. Also, there is a general low level of awareness about the disease, especially its chronic nature and various strategies for its treatment, even among medical personnel.
Not only that, very few asthmatics in Nigeria know their peak flow. Yet, experts say a peak flow meter remains the key to determining how an individual could tell the exact state of his asthma to be able to prevent an attack. If peak flow numbers are declining, it indicates that the condition is is getting worse and the asthmatic must then act quickly to prevent an attack. Most Nigerian asthmatics have never seen a peak flow meter, acknowledged as a very important part of asthma care plan.
“With the level of asthma care available to Nigerians, it is surprising that the nation does not record very high emergency cases of asthma,” said a general medical practitioner who pleaded anonymity. There are several reasons to agree with him. Apart from ignorance on the part of both the asthmatics and their doctors on how to manage the condition and stay free of attack, many doctors will not consider referring patients to specialists even when their patients no longer respond to basic treatments.
But Dr. Chukwu says asthma needs not result in death in most cases. This is because Guidelinedefined asthma control incorporates a number of parameters, including not waking at night and not using reliever medication more than twice per week, which should make the individual asthmatic live a relatively healthy life.
“ It is important to assess asthma control to prevent exacerbations. With the right treatment approach, asthma care can be improved,” Dr. Chukwu says.