Updated 12 July 2016

Why is asthma still killing South Africans?

Asthma is fairly common but why does South Africa have the world's fourth highest death rate if effective treatments are available?


A night-time cough. Shortness of breath. A wheezing chest. Feeling very tired or weak when exercising. These are all symptoms of asthma which, when left untreated, can lead to death. 

But surely no one dies of asthma in 2015? There must be effective treatments?

Think again. South Africa finds itself in the shameful position of having the fourth highest death rate in the world for this respiratory ailment, with most deaths happening to those between 5 and 35 years old.

But that’s not the worst of it. Due to environmental and other factors the number of people suffering from asthma is actually rising.

Of the estimated 4.1 million South Africans with asthma, 1.5% die of this condition annually.

What exactly is asthma?

“Asthma is a form of bronchitis caused by an allergic inflammation, which means that the bronchi and the lower airways of the respiratory system become inflamed to irritants and allergens. This response to irritants and allergens, which are largely influenced by genetics, can be triggered by environmental conditions, like pet dander, pollens, fungal spores, air pollution; and occupational exposures, such as spray painting.” – Dr Justus Kilian

What causes it?

There are numerous theories about what causes asthma but there is general agreement that in the majority of people, asthma begins as a genetically induced allergic disease linked to the IgE gene. It is likely that if someone in your family is asthmatic, you will develop the disease.

Once you have this genetic predisposition, a variety of environmental factors may trigger an attack:

Pollens, foods and food additives, dust and dust mites, mould and feathers, including down and feather pillows and duvets. Animal dander – small scales from animal hair or feathers – as well as saliva and urine from feathered and furred animals and cockroaches also triggers asthma. Irritants in the air like dirt, cigarette smoke, gases and aerosol sprays can also cause someone to have an asthma attack.

This differs from occupational asthma, in which adults, who are not necessarily predisposed to the disease, develop asthma from exposure to substances in the workplace, like solvents, wood-dust, flour or chemicals.

Treating asthma

Treatment of asthma revolves around two factors: preventative environmental control and medication to prevent or treat the condition.

Environmental control means avoiding things that will trigger an asthma attack, like cigarette smoke or dust.

Medication is the mainstay of asthma treatment and the type and amount of medication prescribed to each patient will differ.

It is always best to consult a physician if you suspect that you or a loved one is suffering from asthma. 


Ask the Expert

Asthma Expert

Professor Keertan Dheda has received of several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others.Read his full biography at the University of Cape Town Lung Institute

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