Asthma in pakistan
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Asthma in pakistan Presentation Transcript

  • 1. Asthma in Pakistan Nayyar R. Kazmi
  • 2.
    • It’s a chronic inflammatory condition of the airways, characterized by inflammation in the small airways, narrowing of airways and excessive mucus production resulting in difficulty in breathing, cough and wheeze.
    • Presents with a wide spectrum of signs and symptoms.
  • 3. Burden of Disease
    • More common in the developed countries
    • Also increasing in the developing countries
    • Pakistan
      • Adults prevalence 5-10%
      • Children 19% (ISAG Study)
  • 4.  
  • 5. World map of the prevalence of clinical asthma (Global Burden of Asthma, 2004).
  • 6.
    • Responsible for 70% of pediatric hospital admissions in winter and spring season.
    • Responsible for approximately 40% of emergency adult admissions in spring season.
  • 7. Etiology
    • Allergic disorder
    • Either caused by Atopy or bronchial hyperresponsiveness in susceptible individuals.
  • 8.
    • Allergic Factors
      • Airborne Pollens
      • Environmental Toxicants
      • Molds
      • House dust
      • Animal dander
      • Feather pillows
      • Smoke
  • 9.
    • Other Factors
      • Smoke and other pollutants
      • Infections (viral)
      • Aspirin
      • Exercise
      • Sinusitis
      • GERD
      • Sleep (PEFR lowest at 4.00 am)
  • 10.  
  • 11. Risk Factors
    • Positive Family History
    • Viral Lower respiratory Infections during infancy
    • Lack of Breast Feeding
    • Pets in the home
    • Dusty Atmosphere
  • 12. Why the Asthma Prevalence in increasing
    • Increased in utero exposure to antigenic challenge
    • Increased incidence of childhood and infancy viral respiratory infections
    • Increased environmental pollution
  • 13. Screening criteria
    • All cases of chronic cough with/without wheeze
    • Cases of seasonal exacerbations of respiratory infections
    • Cases of cough not responding to conventional therapies.
  • 14. FLCF Criteria
    • PEFR is a simple cost effective tool for assessing Asthma in FLCF’s.
    • Spirometry facilities at DHQ level
      • FEV1/ FVC less than 80%.
  • 15. Mainstay of Treatment
    • Steroids
    • Bronchodilators
    • Prevention
  • 16.  
  • 17.  
  • 18. Public Health Measures
    • A good reporting system on Asthma (incorporation into the national HMIS)
    • Asthma treatment centres at local FLCF’s (Drugs, Equipment, training)
    • Asthma health education ( incorporation into School health system)
  • 19. Public Health Measures (Contd)
    • Environmental sanitation
    • Regulations on smoke and Tobacco control.
    • Promotion of use of nasal air filters
    • Ban on growing of known severe polligenic wild mulberry trees