Number of Kuwaitis with asthma continues to soar
KUWAIT: Kuwait doctors are warning of a continual rise in the number of patients suffering from asthma, a disorder that causes the airways of the lungs to swell and narrow, leading to shortness of breath, chest tightness, and coughing, estimating that prevalence has risen to approximately 17 percent of the population. A recent global asthma prevalence study published this year found that global prevalence rates of doctor diagnosed asthma, clinical/treated asthma and wheezing in adults were 4.3 percent, 4.5 percent and 8.6 percent respectively. Commenting on the sidelines of the Middle East Asthma and Allergy meeting (MEAAM) taking place 21 – 22 December in Dubai where local, regional and international experts are meeting to discuss asthma management and treatment, Dr Ali Alenizi, Head of Department for Allergic Diseases at Al Rashed Allergy Clinic in Kuwait, commented that the figure is continuing to surge ahead of global prevalence. The annual cost of treating a case of moderate asthma in Kuwait is $562, while deaths attributed to the disease can be traced to a number of factors including an underestimation of its severity, delayed treatment in acute episodes, and unsatisfactory management.
The same study mentions that Kuwait ranks 13thamong 65 countries in the prevalence of symptoms of asthma in children, with a prevalence of current wheeze of 16 percent amongst Kuwaiti children – higher than other countries in the Arab world where similar surveys were conducted such as Oman, Morocco and Lebanon. Studies also show that many patients with asthma remain poorly treated when symptoms of asthma worsen. Anecdotal evidence also suggests that as many as half of the patients diagnosed with asthma are not controlled properly according to Dr Alenizi, a number reflected in other parts of the Middle East. Dr Bassam Mahboub, Vice President of the Emirates Allergy and Respiratory Society, estimates that around 13 percent of the UAE population lives with the disorder that causes the airways of the lungs to swell and narrow, leading to wheezing, shortness of breath, chest tightness and coughing. "One of the biggest problems is that there is a perceived lack of need for medication until symptoms occur, and then patients rush to the emergency department because the symptoms, such as shortness of breath, are frightening – this creates unnecessary stress on the patient and also an unnecessary burden on emergency resources," commented Dr Mahboub.
Approximately 60 percent of asthma patients suffer from allergic asthma, and concerning for local doctors is the 10 percent of asthma patients that suffer from severe persistent allergic asthma that are not adequately controlled by conventional therapies – the consequences for the lack of control in the patients could result in death, according to the author of a new local study on the disease. "There have been recent advancements in the treatment of uncontrolled severe persistent allergic asthma in the form of a monoclonal anti-IgE antibody, omalizumab. We found that over the course of four years, 83% of the patients we treated with omalizumab had significant clinical improvement in their asthma control – which is very promising," said Dr Wagih Djazmati, Consultant and Head, Respiratory Division, SKMC, who is presenting the findings of his new study at the MEAAM. Omalizumab works by binding to IgE – a natural substance found in the body – thus preventing it from binding to mast cells, and consequently the release of mediators that can cause inflammation is stopped. "Severe asthmatics require regular and multiple treatments, and monitoring, and while I recommend to asthmatics that they come in to see me every three to six months, I need to see patients with severe asthma every month as the disease is extremely unpredictable and needs regular monitoring, particularly in uncontrolled patients," said Dr Mahboub.
Asthma is caused by inflammation in the airways, and when an attack occurs, the muscles surrounding the airways become tight and the lining of the air passages swells, reducing the amount of air that can pass by. An attack can be triggered by animals, changes in weather, dust and tobacco smoke – of particular concern to the region. "Around 20 to 25 percent of asthmatics are smokers, which is deeply troubling as smoke can trigger an attack. For this region as well, sandstorms and dust mites are prevalent here, and worsen in the humidity – which is during most of the year," added Dr Djamatzi.
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