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- Global burden of asthma among children (2014)
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The Asthma Control Questionnaire (ACQ) was developed to measure the primary goals of asthma management as identified by international guidelines. All guidelines indicate that to achieve good control, treatment should minimise day- and night-time symptoms, activity limitation, airway narrowing and re...scue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity. Three independent studies have provided evidence that the ACQ is valid for measuring asthma control and has strong measurement properties for use both in clinical practice and research. In addition, the smallest change in score that can be considered clinically important has been determined.
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Considerable energy has been expended over the last two decades in developing methods for identifying the presence of asthma among participants in population studies. The objective of this endeavour has commonly been to enable epidemiological research on risk factors for asthma, with the ultimate ai...m of preventing the disease. However, there are other reasons for measuring the prevalence of asthma in populations, including the desire to assess the burden of disease attributable to asthma, to track changes over time, and to compare the prevalence among population groups defined by geographical, demographic or social factors. Two major international collaborative studies arising from this work have made major contributions to our knowledge about asthma
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Worldwide, studies on asthma prevalence have shown major rises over the last 30 years. The impact on the burden of asthma is being increasingly recognised. In some countries in Latin America, the prevalence of asthma is among the highest in the world. Asthma admissions are very common in children, l...eading to high costs for the health systems of those countries. Unfortunately, Latin America has limited resources to pay for appropriate treatment. The main goals of the international guidelines for asthma treatment are not being met. However, asthma programmes operating in some countries are showing promising results in reducing asthma admissions and consequently decreasing the burden of asthma. Local adaptation of international guidelines must be implemented in order to decrease costs and optimise outcomes.
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A worldwide increase in the prevalence of asthma has been reported in recent years. With an increase in prevalence comes an increased burden of disease in terms of morbidity, mortality and compromised quality of life. The economic burden in terms of utilisation of healthcare resources and limitation... of the earning capacity of the individuals and families is an added problem. Various indicators such as disability-adjusted life years and healthy life years have been used to define the economic burden. The data from Asian countries regarding these parameters is scarce, underlining the need for systematic studies in these countries, especially those that are resource poor. The purpose of this review is to highlight the varying prevalence of asthma in Asia and to assess the likely economic burden for the future.
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Health economics is receiving more attention as decisionmakers — including purchasers, physicians and patients seek a more comprehensive understanding of the impact of adopting new health care strategies in developed and developing countries. Formal economic evaluation is playing an increasingly i...mportant role in health care decision-making, including that related to asthma.
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A 20-year follow-up study on chronic respiratory effects of exposure to cotton dust
Wang, X-R.; Zhang, H-X.; Sun, B-X.; et al.
European Respiratory Journal, part of the European Respiratory Society (ERS)
(2005)
CC2
The article "A 20-year follow-up study on chronic respiratory effects of exposure to cotton dust" evaluates the long-term impact of cotton dust exposure on respiratory health. It followed a cohort of Chinese cotton and silk workers from 1981 to 2001, comparing lung function and symptoms. Results sho...wed that cotton workers experienced greater declines in lung function and persistent respiratory symptoms compared to silk workers. The study found that exposure to airborne endotoxins in cotton dust was strongly linked to chronic respiratory impairment. It highlighted that stopping exposure helped improve lung function, particularly in non-smoking men, while smokers continued to show negative effects.
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The Asthma Control Questionnaire (ACQ)1 was developed and validated to measure the primary clinical goal of asthma management as identified by international guidelines. They indicate that to achieve good control, treatment should minimise day and night time symptoms, activity limitation, airway narr...owing and rescue bronchodilator use and thus reduce the risk of life-threatening exacerbations and long-term morbidity. The importance of including all aspects of control in the assessment of individual patients was emphasised by a recent factor analysis which showed that clinical asthma is composed of distinct components which are not closely correlated with each other.6 However, in some studies it may not be possible to collect airway calibre or short-acting β2-agonists data. Previous analysis of non-clinical trial data suggested that when ACQ scores are analysed as group data, the heterogeneity of the way in which individual patients present with inadequate control is lost in the estimation of the mean and the need to measure each individual component of asthma control may become unnecessary. In this analysis, ACQ data from a clinical trial was used to evaluate the measurement properties (reliability, responsiveness, validity and interpretability), of three shortened versions of the ACQ. In addition, we have examined whether the precision and accuracy of estimating the effect of the intervention on asthma control was maintained when the two questions concerning airway calibre and short-acting β2-agonists use were omitted from the trial analysis.
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The global burden of asthma: executive summary of the GINA Dissemination Committee report
Masoli, M.; Fabian, D.; Holt, S.; Beasley, R.
European Journal of allergy and clinical immunology: Volume59, Issue5 May 2004 Pages 469-478
(2004)
CC2
It is estimated that as many as 300 million people of all ages, and all ethnic backgrounds, suffer from asthma and the burden of this disease to governments, health care systems, families, and patients is increasing worldwide. In 1989 the Global Initiative for Asthma (GINA) program was initiated in ...an effort to raise awareness among public health and government officials, health care workers, and the general public that asthma was on the increase. The GINA program recommends a management program based on the best available scientific evidence to provide effective medical care for asthma tailored to local health care systems and resources.
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Asthma guidelines indicate that the goal of treatment should be optimum asthma control. In a busy clinic practice with limited time and resources, there is need for a simple method for assessing asthma control with or without lung function testing.
Health and Quality of Life Outcomes
Van der Molen, T.; Willemse, B.; Schokker, S.; et al.
Health and Quality of Life Outcomes
(2003)
CC2
The new Global Obstructive Lung Disease (GOLD) guidelines advice to focus treatment in Chronic Obstructive Pulmonary Disease (COPD) on improvement of functional state, prevention of disease progression and minimization of symptoms. So far no validated questionnaires are available to measure symptom ...and functional state in daily clinical practice. The aim of this study was to develop and validate the Clinical COPD Questionnaire (CCQ).
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The prevalance of asthma an allergy, defined as immunologically mediated hypersensitivity, is increasing. It is estimated that over 20% of the world population suffers from IgE-mediated allergic disease, such as allergic asthma, allergic rhinitis and allergic conjunctivitis, atopic eczema/atopic der...matitis, and anaphylaxis. Asthma, which in more than 50% of adults and in at least 80% of affected children is allergic, occurs in around 5-15% in the paediatric population. Asthma it estimated by the World Health Organization (WHO) to affect about 150 million people worldwide, placing an enormous strain on health resources in many countries, and is a major cause of hospitalizations for chronic diseases in children in the western wolrd.
Information may be derived from areas where a rapid increase in disease has occured, to from the basis for prevention strategies in areas where the prevalence of these diseases is still low. Where current expert opinion is still divided, where future research is required, or studies have provided negative results, the available information may prevent the implementation of unnecessary, restrictive, and costly avoidance strategies.
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The increasing prevalence of childhood asthma in the developed world is a cause for concern. A so-called Western lifestyle has been the factor most commonly cited to explain this worrying increase in asthma prevalence. Early studies in a limited number of African countries showed a very low rural pr...evalence of childhood asthma, especially where children lived according to a traditional lifestyle. These same studies showed that asthma was not uncommon in urbanized African children. There has been an
increasing tendency over the past 20 years for those in rural communities to move to the large urban centers. This article analyses the urban-rural differences and factors that influence the development of asthma in susceptible children.
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he aetiology of asthma and allergic disease remains poorly understood, despite considerable research. The International Study of Asthma and Allergies in Childhood (ISAAC), was founded to maximize the value of epidemiological research into asthma and allergic disease, by establishing a standardized m...ethodology and facilitating international collaboration. Its specific aims are: 1) to describe the prevalence and severity of asthma, rhinitis and eczema in children living in different centres, and to make comparisons within and between countries; 2) to obtain baseline measures for assessment of future trends in the prevalence and severity of these diseases; and 3) to provide a framework for further aetiological research into genetic, lifestyle, environmental, and medical care factors affecting these diseases. The ISAAC design comprises three phases. Phase 1 uses core questionnaires designed to assess the prevalence and severity of asthma and allergic disease in defined populations. Phase 2 will investigate possible aetiological factors, particularly those suggested by the findings of Phase 1. Phase 3 will be a repetition of Phase 1 to assess trends in prevalence.
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