Asthma prevention needs new data

Monday 11 May 2015

Asthma prevention needs new data

New Zealand’s asthma rate was one of the highest in the world, but an up to date assessment cannot be done due to a lack of data.

“For New Zealand adults the prevalence of asthma symptoms (how common they are in a population) was last measured this way 22 years ago when it was 22 percent,” says Head of the University of Auckland’s Paediatrics Department, Professor Innes Asher.

For primary school children and adolescents the asthma symptom data is 13 years old with rates of 22 percent and 27 percent respectively, the third highest rates the world.

Although NZ’s high asthma death rate has fallen dramatically over the last three decades, WHO data from 2001-2010 shows NZ with the highest rate among high-income countries for people dying from asthma aged between 5 and 34 years. That’s worse than the United States of America, United Kingdom and Australia.

“Astonishingly, NZ has no standard of care for asthma; asthma guidelines for children and adults are long expired; access to asthma education is patchy; and there is no national asthma strategy,” says Professor Asher. “The NZ Asthma Foundation is actively working in all these areas.”

When last estimated in 1999, the economic burden of asthma in NZ was high, totalling $825 million, ($125 million direct/$700 million indirect costs), with costs for those with the most severe disease five times greater than those with mild asthma.

“NZ also has no information on the costs of asthma by ethnicity, which is likely to be disproportionately distributed,” she says.“We want to know is if this picture is changing, so that asthma care can be appropriately focussed and delivered.”

Environmental factors relevant to NZ which may adversely affect asthma need further exploration including high intensity truck traffic exposure, tobacco smoke exposure, damp and mould in homes; Paracetamol use in infancy, antibiotic use in infancy, higher burger/fast food intake, obesity, and watching television for long hours, says Professor Asher.

“Favourable associations have been found with fresh fruit and vegetable intake, milk and egg consumption. All these associations require further investigation and monitoring over time,” she says. “None have yet provided firm targets for interventions apart from tobacco.”

The Global Asthma Network, led by Professor Innes Asher, at the University of Auckland, is poised to begin a new Global Surveillance: Prevalence, Severity and Risk Factor Study.

NZ has several centres from the 285 centres in 120 countries involved but this work will not proceed unless long-term funding is found to continue the central coordination.

In 2012 the leader of WHO, Dr Margaret Chan, said “Accurate assessment of the global, regional and country health situation and trends is critical for evidence-based decision making in public health…. The real need is to close the data gaps”.

The world burden of disease from asthma is high – asthma is the fourteenth most important disorder in terms of global years lived with a disability. Quality asthma management can be amazingly effective, reducing the suffering from asthma, loss of learning opportunities, improving work attendance and productivity, and lessening the risk of death from asthma.

The Global Asthma Report 2014 www.globalasthmareport.org summarises the strategies which are needed to achieve such good outcomes.

The Global Asthma Network urgently needs funding to continue to close the data gaps for asthma.

The central coordination centre is located at the University of Auckland and continuity of funding is required for two staff. Donations can be made through the website https://www.givingtoauckland.org.nz/en/FundPages/global-asthma-network.html

ENDS

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