Asthma is still poorly controlled in South Africa. In fact, only 6% of asthmatics in this country are symptom-free. And South Africa has the world's fifth highest death rate from the condition.
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This finding is disturbing if one considers the fact that asthma is completely manageable, and that treatment is freely available.
Asthma poorly understood
According to experts, a big hurdle is the fact that patients do not understand that asthma actually involves chronic inflammation of the airways.
They simply see asthma as a sensitivity of the airways – something that "comes and goes" – and they don't realise that the mucus in their lungs won't go away unless they get proper treatment, says Dr Corli Gravett, who manages an asthma and allergy clinic in Gauteng.
Gravette explains that inflammation in the lungs is similar to inflammation in other body parts, such as gout in the toes, for example. The only difference is that inflammation in the lungs cannot be seen, which sometimes makes it difficult for the patient to understand.
The danger is that permanent damage could be done if airway inflammation is left untreated.
To make matters worse, "many patients still have a mental block when it comes to asthma, and think that getting chronic treatment for the condition is going to have a negative impact on their quality of life," Gravett says.
She notes that there is still the misconception that inhaled corticosteroids aren't safe, while many patients fear becoming dependent on inhaler devices.
A relatively new concept
The concept of asthma as a chronic, inflammatory disease is also fairly new to doctors.
This may be one of the reasons why asthma sufferers are also far too often misdiagnosed as having bronchitis or upper respiratory tract infections, and treated with antibiotics and cough suppressants, instead of proper preventer and reliever medication.
"In many cases, the doctor just doesn't make the final asthma diagnosis," Gravett says.
Solutions to the problem
One of the best ways to remedy the problem of misdiagnosis is for patients and doctors to improve their communication.
Patients need to be aware of the fact that co-morbid conditions such as hay fever and sinusitis should be taken into account by their doctors – and should make a point of discussing these conditions with them, Gravett says
"If you have a 'nose', you should tell your doctor… and if your child has eczema or a runny nose, you must also discuss it with your GP," she says.
According to Gravett, the take-home message should be that asthmatics can lead normal lives, but that they should communicate more effectively with their doctors. – (Carine van Rooyen, Health24)
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