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      The Global Impact of Asthma in Adult Populations

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      , MD, MPH 1 , , MD 2
      Annals of Global Health
      Ubiquity Press

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          Abstract

          Asthma is a disease characterized by chronic airway inflammation, leading to intermittent symptoms of wheeze, dyspnea, cough and chest tightness in combination with variable expiratory airway obstruction. Clinical diagnosis is usually established based on the presence of symptoms and documented variability in expiratory airflow limitation as measured by pulmonary function testing. Presently, asthma is a major chronic disease affecting approximately 334 million people worldwide. The epidemic spares no age group, race or ethnicity; however ethnicity and socioeconomic status do influence the prevalence, morbidity and mortality of asthma in the United States and various countries throughout the world. Moreover, asthma places a huge burden at the societal, financial and health-care levels of multiple nations.

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          Asthma costs and social impact

          In recent decades, both asthma prevalence and incidence have been increasing worldwide, not only due to the genetic background, but mainly because of the effect of a wide number of environmental and lifestyle risk factors. In many countries noncommunicable diseases, like asthma, are not yet considered a healthcare priority. This review will analyze and discuss disparities in asthma management in several countries and regions, such as access to healthcare human resources and medications, due to limited financial capacity to develop strategies to control and prevent this chronic disease. This review tries to explore the social and economic burden of asthma impact on society. Although asthma is generally accepted as a costly illness, the total costs to society (direct, indirect and intangible asthma costs) are difficult to estimate, mainly due to different disease definitions and characterizations but also to the use of different methodologies to assess the asthma socio-economic impact in different societies. The asthma costs are very variables from country to country, however we can estimate that a mean cost per patient per year, including all asthmatics (intermittent, mild, moderate and severe asthma) in Europe is $USD 1,900, which seems lower than USA, estimated mean $USD 3,100.
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            Global burden of asthma among children.

            About 334 million people worldwide suffer from asthma, and this figure may be an underestimation. It is the most common chronic disease in children. Asthma is among the top 20 chronic conditions for global ranking of disability-adjusted life years in children; in the mid-childhood ages 5-14 years it is among the top 10 causes. Death rates from asthma in children globally range from 0.0 to 0.7 per 100 000. There are striking global variations in the prevalence of asthma symptoms (wheeze in the past 12 months) in children, with up to 13-fold differences between countries. Although asthma symptoms are more common in many high-income countries (HICs), some low- and middle-income countries (LMICs) also have high levels of asthma symptom prevalence. The highest prevalence of symptoms of severe asthma among children with wheeze in the past 12 months is found in LMICs and not HICs. From the 1990s to the 2000s, asthma symptoms became more common in some high-prevalence centres in HICs; in many cases, the prevalence stayed the same or even decreased. At the same time, many LMICs with large populations showed increases in prevalence, suggesting that the overall world burden is increasing, and that therefore global disparities in asthma prevalence are decreasing. The costs of asthma, where they have been estimated, are relatively high. The global burden of asthma in children, including costs, needs ongoing monitoring using standardised methods.
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              The Asthma-COPD Overlap Syndrome.

              Although in textbooks asthma and chronic obstructive pulmonary disease (COPD) are viewed as distinct disorders, there is increasing awareness that many patients have features of both. This article reviews the asthma-COPD overlap syndrome.
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                Author and article information

                Contributors
                Journal
                Ann Glob Health
                Ann Glob Health
                2214-9996
                Annals of Global Health
                Ubiquity Press
                2214-9996
                22 January 2019
                2019
                : 85
                : 1
                : 2
                Affiliations
                [1 ]Wake Forest Baptist Medical Center, Winston-Salem, NC, US
                [2 ]Albert Einstein College of Medicine, Bronx, NY, US
                Author notes
                Corresponding author: Sumita Sinha, MD ( juan.wisnivesky@ 123456mountsinai.org )
                Article
                10.5334/aogh.2412
                7052341
                30741503
                390e602d-8f89-45d7-921f-0108625b5f25
                Copyright: © 2019 The Author(s)

                This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/.

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