Centers for Disease Control and Prevention (CDC) identifies asthma as a disease that affects the lungs. Characteristics of asthma are difficulties in breathing, wheezing sound, tightness in the chest, and coughing that elevates in the night and morning hours (Centers for Disease Control and Prevention, 2019). The Office of Disease Prevention and Health Promotion (ODPHP) describes asthma as a chronic respiratory disorder that causes inflammation of the airways with reversible recurring episodes of difficulties in breathing initiated by the obstruction and constriction of the airways (Office of Disease Prevention and Health Promotion, 2020).
Data and Statistics
The CDC data indicates that in 2017, the number of persons living with asthma was approximately 25 million, with six million being children below 18 years and 19 million being adults. Females were more affected than males, at 15 million in comparison to 10 million males. On a racial basis, Blacks were the most affected at 10.1 percent, followed by Whites at 8.1 percent and Hispanics at 6.4 percent. There was a correlation between poverty and asthma, with 11.7 percent of persons living at below 100 percent poverty level having asthma. The poverty level correlation shows the figures dropping proportionally with persons above 450 percent poverty level, recording only 6.8 percent of asthma infections (Centers for Disease Control and Prevention, 2019). The ODPHP reports that the cost of asthma management is annually estimated at 20.7 billion dollars, with over 12 million people still being undiagnosed (Office of Disease Prevention and Health Promotion, 2020).
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Health Disparities
Asthma infections are globally reported among persons of all ages, races, and sex. Nonetheless, there exist disparities in the prevalence rates and mortality rates for the minority groups and persons from lower economic class. Groups with higher cases of asthma include children, women, African Americans, Puerto Ricans, inhabitants of the northeastern side of Untied States, persons living below 100% poverty level, and employers with exposure to asthma triggers (Office of Disease Prevention and Health Promotion, 2020).
Prevention Strategies, Complementary, and Alternative Health Therapies
Prevention strategies for asthma begin with immunization. Diseases caused by influenza, such as pneumonia, are prone among persons with asthma. It is, therefore, advisable to have prompt vaccination to prevent influenza infections that may deteriorate asthma condition. The seasonal flu vaccine, trivalent inactivated influenza vaccine, is given to anyone above six months old and living with asthma. Double injections are administered to children above six months with no vaccination history. H1N1 2009 monovalent vaccine is also recommended for asthma patients between 6 months old to 64 years (Centers for Disease Control and Prevention, 2019).
Since asthma symptoms are often triggered by allergies, avoiding sources of allergy is a major way through which asthma attacks are prevented. An example of allergies is tobacco smoke, which elevates the chances of respiratory infections and the wheezing symptom of asthma. Additionally, smoking among parents increases the chances of asthma infection in children. Environmental triggers include air pollution from gases and pollen, cold weather, and high humidity (Dharmage, Perret, & Custovic, 2019). Atopy is also a class of allergic hypersensitivity that triggers asthma. Examples of reactions under this category are eczema and hay fever. During atopy reactions, immunoglobin (IgE) antibodies are produced beyond the required levels, thus triggering asthma. Perimenstrual asthma (PMA) has also been reported in females. Persons with asthma who use aspirin during their menstrual cycle have a higher chance of triggering PMA (Zainab, Akram, Daniyal, & Riaz, 2019, p. 4).
The use of health care guided tests on patients with asthma is also a vital tool in the prevention of occurrences. The two helpful tests in asthma prevention are the asthma control questionnaires test and the lung function assessment test. Questionnaire 19, with a set of seven questions, prompts patients to recall symptoms suffered, activity limitation, and frequency within a week. Each response is weighted on a scale of 0 to 6, and the final patient score averaged. A high-value score indicates the severity and poor management, thus giving doctors and patients important information on improvement and prevention of attacks. A related test, the Asthma Control Test 21, prompts questions within four weeks with outcome score, also offering guidance on the management plan. In patients who do not recognize minor symptoms, periodic lung function assessment offers reprieve in the monitoring and prevention process (Fergeson, Patel, & Lockey, 2017).
Contemporary Research and Clinical Studies
Currently, asthma has no curative drugs, thus leaving an open door for more research on diagnostics, risk factors, and effects of the disease on vulnerable persons. One such promising studies conducted is on the use of lung sound analysis in the diagnosis of asthma. Shimoda, Obase, Nagasaka, Kishikawa, and Asai (2019) use the sound power ratio of the lungs during expiration and inspiration to successfully determine the index of inflammation in patients, which is a useful parameter in asthma treatment. On risk factors, research on a large patient cohort confirms the presence of risk factors affecting patient outcomes on a global scale. The factors include the wrong use of the inhaler and poor adherence to medical prescriptions (Tomisa, Horváth, Szalai, Müller, & Tamási, 2019). Even more exciting research, by Bláfoss, Hansen, Ali, and Ulrik (2019), looks at the potential effects of female asthma and atopy on the fertility of affected persons. The research shows a trend that indicates a reduction in fertility among females who have female asthma. However, the condition shows no correlation with the number of offspring born of the affected females.
Pathophysiologic Effects and Management
Stimuli often initiate asthma. Adverse stimuli have several effects on the tubular structures of the respiratory system. They include narrowing of the tubes, thus leading to either fixed obstruction or variable obstruction that changes over time and medication (Adcock & Mumby, 2019. The system may also experience inflammation, infections, and acquisition of abnormal characteristics, such as being dry, wet, or accumulated with particles. These effects may result in an increased risk of further asthma attacks and the progression of wheezing into eosinophilic atopic asthma (Bush, 2019, p. 4).
A stepwise approach is the best route taken in the management and treatment of asthma. The plan involves the classification of severity into classes. The four levels, intermittent, persistent-mild, persistent-moderate, and persistent-severe, dictate the strength of the dosage given to patients. A patient steps up the dosage strength until symptoms are managed and then steps down the strength of the dose. The stepwise approach aims to manage symptoms of asthma with the lowest possible dosage (Tay, Lee, & Hew, 2018).
References
Adcock, I. M., & Mumby, S. (2019). Pathophysiology of severe asthma. Severe Asthma , 132-151. doi:10.1183/2312508x.10023318
Bláfoss, J., Hansen, A. V., Ali, Z., & Ulrik, C. S. (2019). Female asthma and atopy impact on fertility: A systematic review. Journal of Asthma and Allergy , Volume 12 , 205-211. doi:10.2147/jaa.s203576
Bush, A. (2019). Pathophysiological mechanisms of asthma. Frontiers in Pediatrics , 7 . doi:10.3389/fped.2019.00068
Centers for Disease Control and Prevention. (2019, October 18). Asthma. Retrieved January 14, 2020, from https://www.cdc.gov/asthma/default.htm
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019). Epidemiology of asthma in children and adults. Frontiers in Pediatrics , 7 . doi:10.3389/fped.2019.00246
Fergeson, J. E., Patel, S. S., & Lockey, R. F. (2017). Acute asthma, prognosis, and treatment. Journal of Allergy and Clinical Immunology , 139 (2), 438-447. doi:10.1016/j.jaci.2016.06.054
Office of Disease Prevention and Health Promotion. (2020, January 12). Respiratory diseases. Retrieved January 14, 2020, from https://www.healthypeople.gov/2020/topics-objectives/topic/respiratory-diseases
Shimoda, T., Obase, Y., Nagasaka, Y., Kishikawa, R., & Asai, S. (2019). Lung sound analysis provides a useful index for both airway narrowing and airway inflammation in patients with bronchial asthma. Journal of Asthma and Allergy , 12 , 323-329. doi:10.2147/jaa.s216877
Tay, T. R., Lee, J. W., & Hew, M. (2018). Diagnosis of severe asthma. Medical Journal of Australia , 209 (S2). doi:10.5694/mja18.00125
Tomisa, G., Horváth, A., Szalai, Z., Müller, V., & Tamási, L. (2019). Prevalence and impact of risk factors for poor asthma outcomes in a large, specialist-managed patient cohort: A real-life study. Journal of Asthma and Allergy , Volume 12 , 297-307. doi:10.2147/jaa.s211246
Zainab, R., Akram, M., Daniyal, M., & Riaz, M. (2019). Awareness and current therapeutics of asthma. Dose-Response , 17 (3), 155932581987090. doi:10.1177/1559325819870900
