Amidst severe air pollution, a concerning surge in respiratory diseases, particularly asthma-related, grips India. According to a report published in 2022, the total burden of asthma in India is 34.3 million, accounting for 13.09% of the global burden. From 150,000 deaths in 1990, the asthma related toll has now surpassed 200,000, persistently rising*.
 
Most fatalities occur in adulthood, indicating a lack of childhood diagnoses and treatment, necessitating urgent awareness among parents and children about ‘Early Detection and Early Treatment’.

What is going on?

When kids with asthma have lots of asthma attacks, it can harm how well their lungs work as they will grow. If we don't treat the swelling in their airways when they're young, it can make their lungs weaker as they get older. This can cause a problem where it's hard for them to breathe out, and it doesn't get better. This bad change in their airways makes them lose their lung function faster when they grow up, and it can make them have breathing problems as adults.

This makes Asthma as much a serious social issue as it is a medical issue.

Why is it happening?

First and foremost, the lack of awareness. The majority of patients and their caregivers are not simply not aware of the long-term ramifications of this condition. In a country like India financial constraints coupled with insufficient access to basic medicines add to the burden. Data from a study done in 2021, by Global Asthma Network showed a significant decline in symptoms of asthma compared to previous studies. The study highlighted underdiagnosis and under-treatment in children and adults with asthma. The study revealed that an alarming 82% of individuals experiencing wheezing and 70% of those displaying severe asthma symptoms had not received an official diagnosis of asthma from a medical professional. Furthermore, the issue of under-treatment was brought to light, with less than 9% of individuals diagnosed by doctors with wheezing or severe asthma using daily inhaled corticosteroids (ICS), across various age groups.

The factors contributing to this underdiagnosis and under-treatment are multifaceted. They include limited access to medical facilities, socioeconomic challenges such as poverty and low levels of education, patient ignorance, improper medication administration techniques, non-adherence to prescribed treatments, and inadequate communication skills among healthcare providers.
Also, the stigma associated with asthma often leads parents to conceal the diagnosis, resulting in sporadic medication usage, typically only during symptomatic episodes or when discomfort becomes intolerable.

These findings underscore the considerable morbidity associated with asthma and the strain it places on healthcare resources. Addressing this issue is of paramount importance, particularly within the context of asthma education programs, as it holds significant clinical implications in terms of treatment compliance.

What can we do?

Although people can make changes to their lifestyle to reduce symptoms, there are limitations to what individuals can achieve in the short term when it comes to avoiding air pollution, managing genetic factors, or handling environmental triggers like pollen and mites. This is where the idea of "Early Detection & Early Treatment” comes into picture led by technology and social interventions.

Creating awareness and removing the stigma attached to Asthma - These are the two most important things that we can do. Parents need to be aware that even a simple night cough can be a symptom of asthma or any respiratory problem. The other aspect is to make sure that the medication is followed through properly with or without any symptoms.

Effective use of Nebulizers can be another way to help our children navigate asthma. Nebulizers, owing to the precision in lung medication, can play an important role in managing respiratory ailments as kids can be hypersensitive to dosages and slight variations in medication dosage can impact symptom control.

Here are some reasons why nebulizers may be a better option for children:

• Coordination with inhalers can be difficult for some children, but nebulizers don't require as much coordination.
• Nebulizers are suitable for children of all ages.
• Regular dosing protocols with nebulizers can reduce the frequency of hospital visits, as the instances of severe flare-ups decrease.

Children with asthma require access to nebulizers more than adults do. This is because treating asthma at a young age is crucial. In many cases, doctors prescribe medication to young children, but their parents may stop the medication prematurely due to myths surrounding the side effects of these drugs. It is essential that children continue their medication until the doctor advises it to stop. If discontinued before the appropriate dosages, it can cause symptoms to reoccur and also result in remodeling of airways which might lead to further worsening of asthma in children.

It's crucial to remember that nebulizers should always be utilized in conjunction with a comprehensive treatment plan and under the supervision of a healthcare professional. By collaborating closely with their healthcare provider, individuals can ensure that their nebulizer is being used safely and effectively in treating their respiratory symptoms.

The Myths

A prevailing myth suggests that respiratory problems in children are a phase they will naturally outgrow. While some respiratory conditions, such as transient wheezing, might be temporary, others like asthma or chronic bronchitis can persist into adolescence and adulthood. Early diagnosis and appropriate management are crucial to ensure children receive the necessary care and support for optimal lung health.

Also, there is a persistent myth that the use of nebulizers for respiratory treatments can lead to addiction. In reality, Nebulizers are not addictive, and their use is strictly regulated by healthcare professionals to provide targeted and controlled medication doses. They are a valuable tool in managing respiratory conditions, helping individuals breathe more comfortably and efficiently.

Breaking down these misconceptions

Breaking down these misconceptions including the myth about nebulizers being addictive, is a crucial step towards building a healthier future for individuals with respiratory diseases led by "Early Detection and Early Treatment”.

The focus needs to be on stressing the importance of early detection and prompt treatment, ensuring respiratory well-being for children through timely and appropriate medication.

Dispelling these myths about respiratory diseases is essential for fostering a more informed and compassionate society. By understanding that respiratory diseases are diverse in their causes and can affect people of all ages and backgrounds, we can work towards creating a supportive and technologically-enabled environment that promotes awareness, prevention, and effective management of these conditions. Early detection of respiratory diseases is key, leading to prompt treatment and improved outcomes.

I feel education and awareness can come in handy and can create a real difference. We need education programs, especially in schools. During such outreach, we can impart knowledge about asthma to parents and teachers alike and emphasize the importance of early medication from a medical perspective. Simultaneously, we can provide school children with simpler information using comics and other engaging materials, making it easier for them to understand what asthma is and how to manage it. If we can establish model schools in each area and promote these initiatives, it could have an immense positive impact on the respiratory health burden and its management in India.

The approach should aim to include teachers to enhance their understanding of asthma and equip them to actively participate in managing the condition alongside their parents and healthcare providers.

--Issue 64--