Asthma patients have been urged to ensure the inhalers they buy have two key components that are critical in the management of the disease.
Jacqueline Kagima, a doctor at Kenyatta National Hospital, said an inhaler must have inhalable corticosteroids and bronchodilators, otherwise, it will not serve the purpose. Corticosteroids are steroid hormones known for their anti-inflammatory and immunosuppressive properties. They can be produced naturally or synthetically.
On the other hand, bronchodilators are medications used to widen the airways in the lungs, making it easier to breathe. They are known for relaxing muscles around the airways to allow more air to flow in and out.
Dr Kagima, who spoke during an interview with Citizen TV on Wednesday, May 14, warned patients against using 'blue inhalers' that lack the two components.
She said it is the affordability of 'blue inhalers' that has made asthmatic patients prefer them, yet they lack the two vital components and therefore are not helpful.
Dr Kagima said clinicians often recommend the blue inhaler for children. However, they give an additional inhaler containing the inhalable corticosteroid. On the other hand, adults are often given one inhaler that contains both the corticosteroid and the bronchodilator.
Corticosteroids are used to treat a wide range of conditions, including asthma, allergies, eczema, and inflammatory bowel disease. A bronchodilator is commonly used to treat conditions such as asthma, Chronic Obstructive Pulmonary Disease (COPD), and chronic bronchitis.
"If you are asthmatic, you need an inhaled corticosteroid and bronchodilators, period. There is a tendency that some patients are given inhalers that don't have inhaled corticosteroids. It is a steroid that is inhalable, that's the standard of asthma management, whether you are mild, moderate, or severe," she said.
Kagima added, "There is a blue inhaler that is given a lot. It has no corticosteroid in it, and it is not an optimal treatment. This inhaler is very affordable because people get it at Ksh200 and Ksh400, but this inhaler does not do anything to treat the asthma."
The medic stressed the need for stricter regulations to ensure patients are given the right type of inhaler in medical facilities such as pharmacies for the effective management of the disease. However, she has also urged asthma patients to be vigilant and ensure they purchase inhalers that have the two components.
Asthma is a noncommunicable disease (NCD) that affects people of all ages. It is caused by Inflammation and muscle tightening around the airways, making it harder for one to breathe.
According to the World Health Organisation (WHO), the disease has affected an estimated 262 million people worldwide and has caused the passing away of 455,000 people as of 2019.
Symptoms of the disease vary from person to person and are often worse at night or during physical exercise. Some common types of asthma symptoms include a persistent cough, especially at night; wheezing when exhaling and inhaling; difficulty in breathing, and chest tightness.
According to the doctor, non-modifiable factors such as genetics and modifiable risk factors such as air pollution, infection, smoking, allergies, obesity, and occupational exposures are some of the key factors that cause the disease, which is said to have a prevalence rate of 7.5 per cent in the country.
"We think that the prevalence is higher than we have because the studies that we have done on the disease have only covered a few counties, she stated.
"We have modifiable risk factors that we can change and non-modifiable risk factors that we cannot change, because if I come from a family that has a relative with asthma, I have a higher risk of developing asthma, and there is nothing I can do about that. and then there are the non-modifiable risk factors, such as air pollution, which are making these diseases increase in prevalence," she stated.
Asthma is categorised into three types: Mild, Moderate, and Severe asthma. According to Kagima, the classification of the disease is important for doctors to determine the level of treatment they are going to administer to a patient. For instance, a patient who has severe asthma, clinicians will often receive a stronger dose of medication compared to those with mild and moderate asthma.
However, in the process of treatment, there is a common flaw. Sometimes, when a clinician prescribes medication to an asthmatic patient, commonly an inhaler, the patient often uses these devices the wrong way, and as a result, if not checked, doctors may think that the patient has severe asthma, whereas the medicine has not been inhaled into the respiratory system effectively.
According to the doctors, if not properly managed, patients who have the mild type of asthma are likely to progress drastically to severe asthma, thus making the management and treatment of the disease much more difficult.
Asthma is not curable; however, proper management can downturn the severity of the disease to an extent that some patients don't need to use inhalers for a long time
"If I am a patient, I just want my clinician to know whether I have asthma or not because I have got asthma. We use the same medication to titrate the doses a little higher if you have more severe asthma, and if you have severe asthma, we will have to see how you are using your inhaler," she stated.
"If you have mild asthma and you are not managed properly, the chances of you progressing to severe asthma are very high. So, once asthmatic, you need proper management, treatment, and follow-up; otherwise, you will definitely progress to severe asthma," she added.
