Bronchial asthma: the Indian scene

Abstract

Although asthma is a global disease, there are important differences in epidemiology, clinical spectrum and management practices in India. Some of these issues have been reviewed in this article. The prevalence of 'ever asthma' was reported in 2.4% in a population study on 73,605 individuals conducted simultaneously at four major centres in India with the use of a single definition and uniform methodology employing a validated questionnaire. Of the several risk factors which were found to be significant, exposure to environmental tobacco smoke during childhood alone or both during childhood and adulthood was important in the development of and in increasing morbidity from asthma. Many other triggers and risk factors which include local aeroallergens and air pollutants have been identified. Allergic bronchopulmonary aspergillosis is an important cause of difficult to treat asthma and almost half of these patients receive antitubercular treatment at some stage. Simplified consensus guidelines based on international guidelines and local practices have been developed for use at the primary and secondary levels of healthcare. The prevalence of asthma in India is somewhat similar to that seen in other Asian countries. Consensus management guidelines adapted from standard international guidelines adequately address the local concerns and issues.