Report:“The global burden of asthma: executive summary of the GINA Dissemination Committee Report”
1.) Masoli, Fabian, Holt, Beasley and Global Initiative for Asthma (GINA) Program, “The global burden of asthma: executive summary of the GINA Dissemination Committee Report”, Allergy: European Journal of Allergy and Clinical Immunology, Volume 59, Issue 5(2004):469-478, accessed 18 September 2015, doi:10.1111/j.1398-9995.2004.00526.x.
-Abstract:
Global burden of asthma – summary
1. Asthma is one of the most common chronic diseases in the world. It is estimated that around 300 million people in the world currently have asthma. Considerably higher estimates can be obtained with less conservative criteria for the diagnosis of clinical asthma.
2. The international patterns of asthma prevalence are not explained by the current knowledge of the causation of asthma. Research into the causation of asthma, and the efficacy of primary and secondary intervention strategies, represent key priority areas in the field of asthma research.
3. Asthma has become more common in both children and adults around the world in recent decades. The increase in the prevalence of asthma has been associated with an increase in atopic sensitization, and is paralleled by similar increases in other allergic disorders such as eczema and rhinitis.
4. The rate of asthma increases as communities adopt western lifestyles and become urbanized. With the projected increase in the proportion of the world’s population that is urban from 45% to 59% in 2025, there is likely to be a marked increase in the number of asthmatics worldwide over the next two decades. It is estimated that there may be an additional 100 million persons with asthma by 2025.
5. In many areas of the world persons with asthma do not have access to basic asthma medications or medical care. Increasing the economic wealth and improving the distribution of resources between and within countries represent important priorities to enable better healthcare to be provided.
6. The number of disability-adjusted life years (DALYs) lost due to asthma worldwide has been estimated to be currently about 15 million per year. Worldwide, asthma accounts for around 1% of all DALYs lost, which reflects the high prevalence and severity of asthma. The number of DALYs lost due to asthma is similar to that for diabetes, cirrhosis of the liver, or schizophrenia.
7. The burden of asthma in many countries is of sufficient magnitude to warrant its recognition as a priority disorder in government health strategies. Particular resources need to be provided to improve the care of disadvantaged groups with high morbidity, including certain racial groups and those who are poorly educated, live in large cities, or are poor. Resources also need to be provided to address preventable factors, such as air pollution, that trigger
exacerbations of asthma.
8. It is estimated that asthma accounts for about 1 in every 250 deaths worldwide. Many of the deaths are preventable, being due to suboptimal long-term medical care and delay in obtaining help during the final attack.
9. The economic cost of asthma is considerable both in terms of direct medical costs (such as hospital admissions and cost of pharmaceuticals) and indirect medical costs (such as time lost from work and premature death).
10. Until there is a greater understanding of the factors that cause asthma and novel public health and pharmacological measures become available to reduce the prevalence of asthma, the priority is to ensure that cost-effective management approaches which have been proven to reduce morbidity and mortality are available to as many persons as possible with asthma worldwide (Masoli, et.al 2004).
2.) The authors of this publication work in similar fields of asthma research. Masoli, Fabian, and Holt all worked under Beasley at the Medical Research Institute of New Zealand.
Masoli specializes in inhaled asthma medication and treatment of asthma (Plymouth 2015).
It should be noted that little information was readily available on Fabian.
Holt specializes in the economic impact of asthma on New Zealand (Holt 2001).
Beasley specializes in asthma treatment research and the effects of asthma as an international epidemic (Otago 2015).
3.)The main findings of this report are; asthma cause a significant financial burden, and is difficult to treat because of disparities in diagnosis and availability of resources.
4.)The financial burden is categorized by the cost of healthcare, pharmaceuticals and DALYs (disability adjusted life years) lost to asthma each year. Approximately 15 millions DALYs are lost each year to asthma, about 1% of the worldwide total.
Asthma is difficult to diagnose because there is no definitive method of determining if someone has asthma. For example, wheezing is one of the key symptoms looked for in asthma patients, but it is determined over a year’s basis and levels of severity are not well defined.
Access to resources is a key determinant in asthma treatment. The availability of affordable medications and professional medical attention is vastly different across the globe. Also, many people don’t go to get asthma treated until it has reached a severe level.
5.) “Asthma was the 25th leading cause of disability-adjusted life years (DALYs) lost worldwide in 2001.”
“The first [issue] is that self-reported current wheezing is not diagnostic of asthma in an individual. Wheezing is not a symptom specific to the diagnosis of asthma and there is no agreed way of grading the severity or frequency of wheezing symptoms to identify the presence of asthma.”
“The burden of asthma in many countries is of sufficient magnitude to warrant its recognition as a priority disorder in government health strategies. Particular resources need to be provided to improve the care of disadvantaged groups with high morbidity, including certain racial groups and those who are poorly educated, live in large cities, or are poor. Resources also need to be provided to address preventable factors, such as air pollution, that trigger exacerbations of asthma.”
6.) A main tool in assessing the prevalence of asthma symptoms around the world was a standardized written survey given out in many different areas. The Beasley group compiled data from ISAAC (International Study of Asthma and Allergies in Childhood) and ECRHS (European Community Respiratory Health Survey) to support their findings. It should be noted that the two studies did not cover all the regions shown in the Beasley report. For the uncovered regions, data was taken from other asthma studies that used a standardized written survey system as well.
7.) Health disparities and equity issues are cited as main barriers (#1, 5, and 6) to curing asthma. Socio-economic differences (average wealth, infrastructure, etc.) between where asthma remediations are developed to where the remediations are put into action leads to unbalanced efforts and failed attempts. Also, the differences in access to health care, and at what level (availability of doctors, education levels) plays a major role in asthma healthcare. A lack of health care infrastructure can also lead to many people not seeking regular treatment for asthma, and instead only seeking treatment in extreme cases.
8.) This report has been cited extensively over many different kinds of asthma research, from studying the behavioral to biochemical causes of asthma. This report’s aggregate of international data was likely used to set parameters of studies and explain the overall status of asthma at the time of the report (2004).
A few of the areas where this report has been cited are listed below.
Victor E. Ortega, Eugene R. Bleecker, Murray and Nadel's Textbook of Respiratory Medicine, 2016
W. Checkley, C. L. Robinson, L. M. Baumann, N. N. Hansel, K. M. Romero, S. L. Pollard, R. A. Wise, R. H. Gilman, E. Mougey,J. J. Lima, 25-hydroxy vitamin D levels are associated with childhood asthma in a population-based study in Peru, Clinical & Experimental Allergy, 2015, 45, 1
Ellen S. Koster, Daphne Philbert, Nina A. Winters, Marcel L. Bouvy, Adolescents’ inhaled corticosteroid adherence: the importance of treatment perceptions and medication knowledge, Journal of Asthma, 2015, 52, 4, 431
M.G. Rajanandh, An Overview and Update on Asthma and its Management, Journal of Medical Sciences, 2015, 15, 3, 122
9.) The bibliography suggests that many different international and regional studies were compiled to create this report. Also, the World Health Organization was cited often, mostly to compare the report’s findings on asthma mortality to WHO’s (the report’s were generally lower).
10.)
The comparison made between written asthma surveys and video surveys by Crane, et.al, showed that the concept of “wheezing”, as a non-colloquial term in many languages, was understood at varied levels by participants. Interestingly, when showed a video of wheezing, participants often understood it differently than participants in the same area who had taken a written survey. This shows that the written survey method of evaluating asthma levels has more variation than known before, and there is an alternate method available (Crane 2003).
Atopic sensitization is being studied in conjunction with asthma and allergy research. Atopic sensitization or being “hyper allergic”, along with other asthma and allergy symptoms was found to be less likely by those “raised on a farm”, also known as a rural, agrarian based lifestyle (Alfven 2006).
The WHO strategy for prevention and control of chronic respiratory diseases stated that respiratory illness and asthma, especially among children and adolescents, is on the rise and will continue if action is not taken. WHO targeted pollution, especially indoor air pollution and secondhand smoke, as major contributors (WHO 2001).
1.) Masoli, Fabian, Holt, Beasley and Global Initiative for Asthma (GINA) Program, “The global burden of asthma: executive summary of the GINA Dissemination Committee Report”, Allergy: European Journal of Allergy and Clinical Immunology, Volume 59, Issue 5(2004):469-478, accessed 18 September 2015, doi:10.1111/j.1398-9995.2004.00526.x.
-Abstract:
Global burden of asthma – summary
1. Asthma is one of the most common chronic diseases in the world. It is estimated that around 300 million people in the world currently have asthma. Considerably higher estimates can be obtained with less conservative criteria for the diagnosis of clinical asthma.
2. The international patterns of asthma prevalence are not explained by the current knowledge of the causation of asthma. Research into the causation of asthma, and the efficacy of primary and secondary intervention strategies, represent key priority areas in the field of asthma research.
3. Asthma has become more common in both children and adults around the world in recent decades. The increase in the prevalence of asthma has been associated with an increase in atopic sensitization, and is paralleled by similar increases in other allergic disorders such as eczema and rhinitis.
4. The rate of asthma increases as communities adopt western lifestyles and become urbanized. With the projected increase in the proportion of the world’s population that is urban from 45% to 59% in 2025, there is likely to be a marked increase in the number of asthmatics worldwide over the next two decades. It is estimated that there may be an additional 100 million persons with asthma by 2025.
5. In many areas of the world persons with asthma do not have access to basic asthma medications or medical care. Increasing the economic wealth and improving the distribution of resources between and within countries represent important priorities to enable better healthcare to be provided.
6. The number of disability-adjusted life years (DALYs) lost due to asthma worldwide has been estimated to be currently about 15 million per year. Worldwide, asthma accounts for around 1% of all DALYs lost, which reflects the high prevalence and severity of asthma. The number of DALYs lost due to asthma is similar to that for diabetes, cirrhosis of the liver, or schizophrenia.
7. The burden of asthma in many countries is of sufficient magnitude to warrant its recognition as a priority disorder in government health strategies. Particular resources need to be provided to improve the care of disadvantaged groups with high morbidity, including certain racial groups and those who are poorly educated, live in large cities, or are poor. Resources also need to be provided to address preventable factors, such as air pollution, that trigger
exacerbations of asthma.
8. It is estimated that asthma accounts for about 1 in every 250 deaths worldwide. Many of the deaths are preventable, being due to suboptimal long-term medical care and delay in obtaining help during the final attack.
9. The economic cost of asthma is considerable both in terms of direct medical costs (such as hospital admissions and cost of pharmaceuticals) and indirect medical costs (such as time lost from work and premature death).
10. Until there is a greater understanding of the factors that cause asthma and novel public health and pharmacological measures become available to reduce the prevalence of asthma, the priority is to ensure that cost-effective management approaches which have been proven to reduce morbidity and mortality are available to as many persons as possible with asthma worldwide (Masoli, et.al 2004).
2.) The authors of this publication work in similar fields of asthma research. Masoli, Fabian, and Holt all worked under Beasley at the Medical Research Institute of New Zealand.
Masoli specializes in inhaled asthma medication and treatment of asthma (Plymouth 2015).
It should be noted that little information was readily available on Fabian.
Holt specializes in the economic impact of asthma on New Zealand (Holt 2001).
Beasley specializes in asthma treatment research and the effects of asthma as an international epidemic (Otago 2015).
3.)The main findings of this report are; asthma cause a significant financial burden, and is difficult to treat because of disparities in diagnosis and availability of resources.
4.)The financial burden is categorized by the cost of healthcare, pharmaceuticals and DALYs (disability adjusted life years) lost to asthma each year. Approximately 15 millions DALYs are lost each year to asthma, about 1% of the worldwide total.
Asthma is difficult to diagnose because there is no definitive method of determining if someone has asthma. For example, wheezing is one of the key symptoms looked for in asthma patients, but it is determined over a year’s basis and levels of severity are not well defined.
Access to resources is a key determinant in asthma treatment. The availability of affordable medications and professional medical attention is vastly different across the globe. Also, many people don’t go to get asthma treated until it has reached a severe level.
5.) “Asthma was the 25th leading cause of disability-adjusted life years (DALYs) lost worldwide in 2001.”
“The first [issue] is that self-reported current wheezing is not diagnostic of asthma in an individual. Wheezing is not a symptom specific to the diagnosis of asthma and there is no agreed way of grading the severity or frequency of wheezing symptoms to identify the presence of asthma.”
“The burden of asthma in many countries is of sufficient magnitude to warrant its recognition as a priority disorder in government health strategies. Particular resources need to be provided to improve the care of disadvantaged groups with high morbidity, including certain racial groups and those who are poorly educated, live in large cities, or are poor. Resources also need to be provided to address preventable factors, such as air pollution, that trigger exacerbations of asthma.”
6.) A main tool in assessing the prevalence of asthma symptoms around the world was a standardized written survey given out in many different areas. The Beasley group compiled data from ISAAC (International Study of Asthma and Allergies in Childhood) and ECRHS (European Community Respiratory Health Survey) to support their findings. It should be noted that the two studies did not cover all the regions shown in the Beasley report. For the uncovered regions, data was taken from other asthma studies that used a standardized written survey system as well.
7.) Health disparities and equity issues are cited as main barriers (#1, 5, and 6) to curing asthma. Socio-economic differences (average wealth, infrastructure, etc.) between where asthma remediations are developed to where the remediations are put into action leads to unbalanced efforts and failed attempts. Also, the differences in access to health care, and at what level (availability of doctors, education levels) plays a major role in asthma healthcare. A lack of health care infrastructure can also lead to many people not seeking regular treatment for asthma, and instead only seeking treatment in extreme cases.
8.) This report has been cited extensively over many different kinds of asthma research, from studying the behavioral to biochemical causes of asthma. This report’s aggregate of international data was likely used to set parameters of studies and explain the overall status of asthma at the time of the report (2004).
A few of the areas where this report has been cited are listed below.
Victor E. Ortega, Eugene R. Bleecker, Murray and Nadel's Textbook of Respiratory Medicine, 2016
W. Checkley, C. L. Robinson, L. M. Baumann, N. N. Hansel, K. M. Romero, S. L. Pollard, R. A. Wise, R. H. Gilman, E. Mougey,J. J. Lima, 25-hydroxy vitamin D levels are associated with childhood asthma in a population-based study in Peru, Clinical & Experimental Allergy, 2015, 45, 1
Ellen S. Koster, Daphne Philbert, Nina A. Winters, Marcel L. Bouvy, Adolescents’ inhaled corticosteroid adherence: the importance of treatment perceptions and medication knowledge, Journal of Asthma, 2015, 52, 4, 431
M.G. Rajanandh, An Overview and Update on Asthma and its Management, Journal of Medical Sciences, 2015, 15, 3, 122
9.) The bibliography suggests that many different international and regional studies were compiled to create this report. Also, the World Health Organization was cited often, mostly to compare the report’s findings on asthma mortality to WHO’s (the report’s were generally lower).
10.)
The comparison made between written asthma surveys and video surveys by Crane, et.al, showed that the concept of “wheezing”, as a non-colloquial term in many languages, was understood at varied levels by participants. Interestingly, when showed a video of wheezing, participants often understood it differently than participants in the same area who had taken a written survey. This shows that the written survey method of evaluating asthma levels has more variation than known before, and there is an alternate method available (Crane 2003).
Atopic sensitization is being studied in conjunction with asthma and allergy research. Atopic sensitization or being “hyper allergic”, along with other asthma and allergy symptoms was found to be less likely by those “raised on a farm”, also known as a rural, agrarian based lifestyle (Alfven 2006).
The WHO strategy for prevention and control of chronic respiratory diseases stated that respiratory illness and asthma, especially among children and adolescents, is on the rise and will continue if action is not taken. WHO targeted pollution, especially indoor air pollution and secondhand smoke, as major contributors (WHO 2001).
The Global Burden of Asthma 2004 __http://onlinelibrary.wiley.com/doi/10.1111/j.1398-9995.2004.00526.x/epdf__
Crane 2003 http://www.ncbi.nlm.nih.gov/pubmed/12662001
Alfven 2006 __http://www.ncbi.nlm.nih.gov/pubmed/16512802__
WHO 2001 __http://www.who.int/respiratory/publications/WHO_MNC_CRA_02.1.pdf__