The Hindu : Tamil Nadu / Chennai News : Rise in childhood asthma cause for concern

Online edition of India's National Newspaper
Wednesday, May 03, 2006

Tamil Nadu

Tamil Nadu - Chennai

Rise in childhood asthma cause for concern

Staff Reporter

BRIEFING MEDIA: Raj B. Singh, consultant Apollo Hospitals (right), explains aspects of asthma control on the occasion of World Asthma Day along with respiratory physicians Prasanna Kumar Thomas and A. Balachandran in Chennai on Tuesday. — Phot o: S. Thanthoni

CHENNAI: The increase in prevalence of childhood asthma is causing concern in a scenario already skewed by insufficient public awareness and widespread lack of access to optimal treatment.

The findings of the International Study of Asthma and Allergies in Children that profiles the asthma burden in 112 countries show a childhood prevalence of 12 per cent in parts of south India. The ongoing study, which will follow up children upto the age of 12, is expected to better illustrate the problem of childhood asthma.

Experts who addressed a press meet on Tuesday in connection with World Asthma Day focusing on the unmet burden of asthma, suggested that environmental factors could be one of the determinants of higher asthma prevalence down south. The childhood prevalence is more than double the 4 to 5 per cent prevalence for adult asthma documented by whatever little data is available on asthma in the country.

No urban-rural variation

However, in the Indian context, there is no discernible variation in the urban and rural prevalence of the disorder irrespective of the differing triggers. The common triggers include dust, strong fumes and allergens such as pollen, molds and dust mites. Pollution, which has long been linked to asthma, has been found to aggravate, if not exactly cause, asthma, doctors said.

Alongside the growing asthma burden (an estimated 20 million asthmatics in India), what is worrying physicians is the majority's lack of access to the right treatment that include bronchodilators and inhalers. While only a few patients accessed modern treatment, millions depending on State-sector institutions are denied this facility.

The big impediment in broadbasing inhalation procedures is the cost of treatment which works out to around Rs. 300 a month. Raj B. Singh, consultant, Apollo Hospitals, points out that while the amount would appear initially large to put off patients, the investment is more than worth it when weighed against the potential clinic visits and loss of mandays due to asthma.

The Asthma Foundation of India had worked out the next-best option for those who could not afford inhalers. However, the cheaper alternative of taking bronchodilating tablets/oral steroids was associated with risks of side effects, Dr. Singh said. The compromise is to adjust the dose so as to minimise the side effects while resolving the lung inflammation which is the hallmark of asthma.

The important message for asthma patients is to differentiate between `being well' and `feeling well'. A. Balachandran, consultant, Mehta Hospital, said many patients discontinued inhalation as soon as they felt better. The key to keep asthma under control is to follow uninterrupted therapy.

Prasanna Kumar Thomas, consultant, Apollo Clinic, said it is unwise to view asthma as an innocuous disorder. A badly managed asthma can be fatal, he said.

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