New Vision (Kampala)

Uganda: Rise in Asthma Cases Worrying

Kampala — ALTHOUGH it is difficult to obtain recent statistics on asthma in Uganda, some doctors have observed an increase in the rate of asthma that they treat, particularly in recent months.

Asthma is overshadowed by diseases like malaria, but it is still one of the top 10 paediatric illnesses that children suffer from in Uganda. Asthma is a genetic and chronic disease of the airways, in which the airways are often inflamed and react strongly to allergies or irritations.

It is typically outgrown after childhood, though some adults continue to suffer from asthma. As children grow up, the size of their lungs increases, making breathing easier.

"It's quite common since April," said Dr Macrine Nyisomeh, a doctor at the International Medical Centre in Kampala. "Asthmatic patients are having more frequent attacks. There was a peak last year, when they were preparing roads for CHOGM. Dust is one of the triggers.

People are blaming the increased frequency on too many cars, repair of roads, and an increase in buildings and new flower gardens coming up."

The first signs of the illness usually manifest when children are very small.

Asthmatic children have very sensitive bronchial tubes or airways, which react strongly to specific environmental triggers by becoming swollen, narrower, and producing extra mucus, which can make it very difficult to breathe.

Between the asthmatic episodes, which the disorder is known for, children often breathe normally, but when they experience a specific environmental trigger, such as dust or pollen, they experience what some call a flare-up or asthma attack.

Children wheeze, cough, feel tightness in their chest, and require medical attention to have their breathing return to normal, according to Dr. Nyisomeh.

There are many different environmental triggers. Dust, fumes, strong perfume, a change in weather, soot, pollen, and heavy exercise can set off an attack.

"They need to identify triggers in the environment, such as dust and pollen," said Yasin Sekamatte, a doctor at the Pearl Medical Clinic in Wandegaya, Kampala.

"They are advised to keep their children from the triggers, and we advise that if the child gets a common cold that they treat it fast and really well. Their kids need to wear coats and sweaters in cold weather, and parents need to know the sign of an acute attack."

When children experience an attack, parents should take them to a clinic or hospital. Doctors use a variety of methods to treat their symptoms, and some of the methods can be taken to the children's home.

Others require more medical supervision. A common form of treatment is an inhaler, which is a plastic tube that holds a container of medicine.

A child holds the inhaler to their mouth and breathes in.

The medicine is vapourised, and it relaxes the airways when the child inhales, allowing the patient to breathe more freely. Inhalers can be purchased in most pharmacies and hospitals, and the cost ranges between sh20,000-50,000.

If an attack is serious, children should go to a hospital or clinic that has a nebuliser. A nebuliser is a machine used to administer medication, typically a drug called ventolin, in the form of a liquid mist to the patient's airways.

Oxygen is pumped into the patient's lungs through a liquid medicine, which is vapourised by the machine, and then inhaled by the person. Nebulisers treat asthma, cystis fibrosis, and other respiratory diseases.

"You can go to the nearest clinic, most have nebulisers," said Sekamatte. "Or you can give an inhaler to child. It will take about 10 minutes to get relief. The child, depending on the age, can know how to use inhalers, but nebulisers are not recommended for common use, though you can purchase them at a clinic for sh50,000-sh160,000."

When Bryane Mutumba, now 23, was young, he was diagnosed as an asthmatic child. In his respiratory system, the airways would become constricted and inflamed in response to environmental triggers, which can range from a change in weather to dust, perfume, or pet dander.

As is common for many asthmatic Ugandan children, his family sought traditional remedies, and his grandmother treated him with local medicine.

Although he sometimes experiences unusual heavy breathing, or feels like his breathing passage is too moist, he credits the use of local medicine for helping him overcome the disorder.

Traditional remedies are common for treating asthma in Uganda, but the issue is controversial among biomedical doctors.

"The problem with traditional remedies is that we don't know the active ingredients, and there is not that much research about them," said Dr Sekamatte of Pearl Medical Clinic in Wandegaya, Kampala. "And there are so many drugs that work.

But very many people use local medicine in combination with other medicine. Sometimes, when the attack comes, they try to use the traditional method before going to the hospital, about 80% of people do."

Some natural remedies used around the world, derived from a variety of cultures, include taking vitamins such as vitamin B6, B12, and C; making teas from oils and roots such as mullein oil, passionflower leaves, and chamomile flowers, eating salmon several times a week and reducing salt.

However, these remedies are controversial and doctors such as Sekamatte urge families to take their children to a clinic or hospital for diagnosis and treatment.

Although statistics are not available for the prevalence of asthma in Uganda, doctors are aware that asthma is a growing problem for children, and urge parents to get their children properly diagnosed and treated.

Without medical attention, the disease can be fatal. With adequate medical care, however, the fatality rate is less than one in 1,000. Asthma is a common ailment in industrialised countries, with between 3% and 6% of citizens suffering from the disease.

New Zealand has the most cases of asthma, with 20% of its population afflicted with the disease. However, asthma occurs in every country.

"There's been an increase in the number of patients (in Uganda) with asthma conditions, and the use of drugs to treat asthma has gone up," said Dr. Sekamatte.

"Asthma affects school performance, and parents need to know if their children are having asthma, and to seek proper treatment. Otherwise, that's when it fatal and the child dies."

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