Asthma developing countries

Since then, numerous studies have documented that the prevalence of asthma, rhinitis and eczema has been increasing not only in industrialised developed countries [18], but also among affluent people in developing countries... 

The asthma market is thought to be worth some 6 billion worldwide, and consists mainly of inhaled products—bronchodilators and corticosteroids. It is a growing market because the incidence of asthma is increasing, especially in developed countries. It has been postulated that this increase is partly related to overuse of inhaled bronchodilators, which can mask progression of the underlying inflammatory disease process. Current recommendations specify the routine use of anti-inflammatory therapy (e g. inhaled steroids) for mild asthma, with bronchodilators used to relieve acute attacks in more serious cases. 

Asthma is an example of a type 1 hypersensitivity (Chapter 15). The incidence of asthma in the United States (as well as in many other developed countries) has reached epidemic proportions. 

Asthma is a common disease worldwide, affecting more than 300 million individuals in the developed world [1]. The incidence of asthma varies in children worldwide from 2.1% in developing countries such as Albania to 32.2% in the United Kingdom (Fig. 1) [2]. In the United States, a trend of increasing asthma prevalence has occurred since 1980, with a possible plateau after 1997, regardless of gender, age, or ethnic group (Fig. 2) [3]. Approximately 7.1% of the United States population—more than 21 million Americans—currently experience asthma. 

Societal costs of allergy and asthma in developing countries, and the development of these costs. 

Theophylline, a methylxanthine, still is commonly used for asthma pharmacotherapy in many countries. In developed countries, the advent of inhaled glucocorticoids, fi adrenergic receptor agonists, and leukotriene-modifying drugs has diminished theophylhne use significantly, and it has been relegated to a third- or fourth-line treatment in patients whose asthma is otherwise difficult to control. 

There is a spectrum of over 40 different immune-mediated diseases which together aficct greater than 10% of the population in highly developed countries. Each immunc-mediaced disease is unique. However, Thl/Thiy-type diseases like multiple sclerosis or Crohn s disease and Th2-type diseases like asthma appear to be suppressed by helminths. As we learn more about the specific immune dysregulation that occurs in each disease and the diflFerent immune regulatory pathways helminths exploit, we may be able to predia which patients will benefit from helminth exposure. 

Almost half the world s population, and up to 90% of rural households in developing countries, still use solid fuels such as coal, firewood, wood chips, crop residue, and dung cakes for their domestic energy needs (Bruce et al. 2000). Indoor combustion of coal or biomass fuels produces both gases and particulate matter that can affect the development and exacerbation of asthma. The best understood of these substances are particulate matter, carbon monoxide, sulfur oxides, nitrous oxides, volatile organic compounds (e.g., formaldehyde), and polycyclic organic matter such as benzo[a]pyrene. 

Bruce N, Perez-PadiUa R, Albalak R (2000) Indoor air pollution in developing countries a major environmental and pubhc health challenge. Bull World Health Organ 78 1078-1092 Busse WW, Lemanske R1 (2001) Asthma. N Engl 1 Med 344 350-362... 

Asthma is a common disease affecting approx 10% of the population in developed countries, and the prevalence and mortality are rising. The disease has characteristic symptoms, namely intermittent airway obstruction, airway hyperresponsiveness, and increased numbers of activated inflammatory cells and airway structural changes as a result of chronic airway inflammation. The primary underlying abnormality in bronchial asthma is thought to be the unique form of airway inflammation, including particularly eosinophils and mast cells, that gives rise to reversible airway obstruction and hyperresponsiveness. 

Burning waste is sometimes seen by consumers as a convenient way to avoid trips to landfill sites, and the municipal corporation is a serious threat to air quality in some developed and developing countries. Pollutants have been linked to many health concerns, including cancer, disruption of endocrine function, developmental problems, endometriosis, cardiovascular disease, asthma and diabetes. Burning the waste also causes fire hazards, unpleasant odours and chemical fog in addition, the toxic ash can contaminate water supplies [1]. 

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