The evolving burden of asthma and contemporary advances in management: Implications for clinical practice in Southern Africa

Abstract

Asthma is a rising significant global public health burden especially in the developing countries. The annual prevalence of severe asthma episodes is estimated from 1% to 21% for adults and over 20% for children aged 6–7 years. The prevalence of asthma varies widely around the world, ranging from 0.2% to 21.0% in adults and from 2.8% to 37.6% in 6- to 7-year-old children. The International Study of Asthma and Allergies in Children (ISAAC) reports a significant increase in the global prevalence of asthmatic episodes among children. t was estimated that more than 339 million people had Asthma globally in 2016. It is a common disease among children. The common disease asthma is probably not a single disease, but rather a complex of multiple, separate syndromes that overlap. Most asthma-related deaths occur in low- and lower-middle income countries. According to the World Health Organization (WHO) estimates, there were 417,918 deaths due to asthma at the global level and 24.8 million DALYS attributable to Asthma in in 2016. The WHO has estimated that the economic costs associated with asthma have exceeded those of TB and HIV/AIDS combined, and the Global Initiative for Asthma Program forecasted the number of asthma patients to grow globally to greater than 400 million by the year 2025. Since its first description by Hippocrates, asthma remains a treatable yet incurable disease. It is now clear that asthma is a complex syndrome with variable severity, natural history and response to treatment In Namibia a prevalence of Asthma of 11.2 % has been reported in adult populations. The increase in asthmatic episodes, morbidity and mortality among populations in Africa, Latin America and parts of Asia is a rising public health concern. The development of novel asthma phenotyping & endo typing plus better classification of patients using machine learning and big data have markedly improved asthma treatment outcomes in both children and Adults. Several research groups have developed cluster analyses of phenotypes in severe asthma. These clusters support the importance of disease heterogeneity in asthma and suggest differences in pathophysiologic mechanisms that define these clusters. Precision medicine is "an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.