Asthma in India: A growing health crisis needing urgent attention

Asthma in India: A Growing Health Crisis Needing Urgent Attention

Asthma, a chronic respiratory condition, is emerging as a significant public health challenge in India. Despite being preventable and manageable, the country bears a disproportionate burden of asthma-related morbidity and mortality. With over 34 million individuals affected, India accounts for approximately 13% of the global asthma cases.

The Alarming Burden

India's contribution to global asthma mortality is particularly concerning. According to the Global Burden of Disease 2021 Report, the country is responsible for 46% of global asthma deaths.This stark statistic underscores the severity of the issue and the urgent need for comprehensive interventions.

Environmental Triggers: The Role of Air Pollution

Air pollution stands out as a primary environmental trigger exacerbating asthma in India. Both outdoor and indoor pollutants contribute significantly to the disease's prevalence and severity. Traffic-related air pollution (TRAP) is linked to 13% of asthma cases in the country.Additionally, long-term exposure to fine particulate matter (PM2.5) has been associated with a 21.4% increased risk of developing asthma.

Indoor air pollution, often resulting from the use of biomass fuels for cooking and heating, further compounds the problem, especially in rural areas. Children are particularly vulnerable, with studies indicating a strong association between indoor pollutants and the onset of asthma symptoms.

Gaps in Diagnosis and Treatment

A significant challenge in managing asthma in India is the underdiagnosis and inadequate treatment of the condition. Despite the high prevalence, many individuals remain undiagnosed or receive suboptimal care. Notably, over 90% of asthmatics in India do not use inhaled corticosteroids (ICS), the standard treatment for asthma. Instead, there is a reliance on bronchodilator medications, which provide temporary relief but do not address the underlying inflammation.

Socioeconomic factors further exacerbate these issues. Approximately 20% to 30% of asthma patients in India belong to low-income groups, limiting their access to quality healthcare and essential medications. Government hospitals, often the primary source of care for these populations, frequently lack the necessary diagnostic tools and treatments.

Initiatives and Innovations

Recognizing the gravity of the situation, various initiatives have been undertaken to improve asthma care in India. For instance, the state of Rajasthan has implemented a program providing free essential medicines, including asthma inhalers, to patients through government hospitals. This initiative has improved access to treatment, although challenges in patient compliance persist.

Technological advancements are also playing a role in enhancing asthma management. The adoption of smart inhalers and digital health tools is facilitating personalized care and better patient education. However, the reach of these innovations remains limited, primarily benefiting urban populations.

The Path Forward

Addressing the asthma crisis in India requires a multifaceted approach:

Enhanced Public Awareness: Educational campaigns are essential to inform the public about asthma symptoms, triggers, and the importance of adherence to prescribed treatments.

Improved Access to Care: Strengthening the healthcare infrastructure, especially in rural and underserved areas, is crucial. This includes ensuring the availability of diagnostic tools and essential medications.

Policy Interventions: Implementing and enforcing regulations to reduce air pollution can significantly mitigate environmental triggers of asthma.

Research and Data Collection: Investing in research to understand the epidemiology of asthma in India will inform targeted interventions and resource allocation.

TRENDS AND STATISTICS

Recent years have shown some positive trends, although significant challenges remain:

There has been a decline in asthma symptoms over the years, but underdiagnosis continues to be a major issue.

The use of inhaled corticosteroids remains critically low, with fewer than 2.5% of people with current wheeze using them as recommended.

Greater focus is needed on early diagnosis, patient education, and consistent follow-up to ensure long-term management of the disease.

Asthma remains a complex and multifaceted challenge in India. While government schemes and state-level interventions offer some hope, much more needs to be done in terms of education, diagnosis, accessibility, and destigmatisation. Improving the quality of life for asthma patients will require coordinated efforts from healthcare providers, policymakers, and communities alike.

Inputs by Dr. Ankit Nijhara

MBBS, PGDGM (Medicine: Geriatrics)

PGCDM (Diabetes Management)

PGCAT (Thyroid Disorder Management), Consultant, Fortitude Health and Skin Day Care Centre, Consultant Incharge - Aadhya 9 multi-specialty hospital

Conclusion

Asthma poses a significant and growing health challenge in India. The high prevalence, coupled with substantial mortality rates, underscores the need for urgent and comprehensive action. By addressing environmental factors, enhancing healthcare access, and promoting public awareness, India can make significant strides in mitigating the impact of asthma and improving the quality of life for millions of its citizens.