Physicians seek comprehensive approach to combat tuberculosis, asthma

Chijioke Iremeka

Medical specialists say respiratory diseases continue to rise in the country, underscoring the necessity for the government to enhance its policies on respiratory diseases such as tuberculosis and asthma in Nigeria.

They noted a reduction in the impact of tuberculosis recently, but expressed serious concern over the increasing severity of asthma, leading to fatalities.

The physicians emphasised that Nigeria must undertake a comprehensive, multi-faceted approach to alleviate the burden of these diseases.

This approach, they said, should combine governmental and individual policies with effective actions.

According to the World Health Organisation, chronic respiratory diseases, including asthma and chronic obstructive pulmonary disease, affect nearly half a billion people worldwide.

The global health body said that these diseases are major causes of death and disability, with COPD being the third leading cause of death globally.

In 2019, the WHO noted that 3.2 million people died from COPD and 500,000 from asthma, saying that despite their significant impact, these diseases have often been overlooked in global health discussions, lacking the necessary recognition and resources.

Respiratory experts who spoke with PUNCH Healthwise in different interviews said that education would increase understanding of the condition for people living with asthma and their families, and empower them to manage their treatment.

Former President of the Thoracic Society of Nigeria, Professor Greg Erhabor, highlighted that common education topics include understanding asthma symptoms, correct usage of asthma medications, and managing asthma when symptoms worsen.

“ Other crucial areas cover the nature of asthma, its impact on the lungs, and strategies to minimise exposure to triggers like tobacco smoke and air pollution”, he said.

Erhabor, who is also the founder and President of the Asthma Care Foundation in Ile-Ife, Osun State, emphasised that healthcare professionals such as doctors, nurses, pharmacists, and others could provide this information along with personalised asthma action plans.

The Professor of Medicine at the Obafemi Awolowo University, Ile-Ife, Osun State, said, “Policy-makers and healthcare planners need to understand the burden of disease, the costs of uncontrolled asthma symptoms and attacks, and the cost-effective treatments available.

“In many LMICs, health facilities lack essential components of asthma care, such as inhalers, which have the potential to transform the lives of people living with asthma. Unfortunately, the cost of this life-saving inhaler has gone beyond the common man on the street.

“Some of these drugs are not manufactured in Nigeria and therefore, the exchange rates determine what their prices are. Hence, there is a need for a comprehensive policy that will ensure that health and education among others are highly subsidised.”

Corroborating his statement, a Pulmonologist, Prof Olufunke Adeyeye, said awareness creation would enable patients to understand how they could access care for their lungs.

Adeyeye, who is also the Head of the Department of Medicine/ Respiratory Unit, Lagos State University Teaching Hospital, Ikeja, said, “We want to engage patients and health care professionals as well as other stakeholders to ensure that patients have access to the right information towards lung health.”

Speaking on why respiratory diseases are on the increase, the lung expert said, “Apart from the skin which is in touch with the environment, we breathe in the air continuously and whatever is in the air finds its way into the body.

“This is why respiratory hygiene is an essential part of medical practice. People must know that droplet infections – sneezing, coughing, spitting everywhere, and all forms of respiratory manoeuvre can lead to widespread infections.

“All these can settle on the table and people can contract it through hand-to-mouth contact, hand-to-nose, hand-to-eye, and these are the ways these diseases are transmitted.

“The lung is in contact with the environment and that is why pollution will be an issue. Smoking will be an issue because all those things go into the body through the respiratory tract. Anything that you can inhale goes into your lungs because they are suspended in the air.”
She added that the major challenge in respiratory medicine is ignorance, saying that people are ignorant of what their exposure could lead to.

The Director of the Department of Noncommunicable Diseases, Rehabilitation and Disability at the WHO, Dr Bente Mikkelsen, said, “We must work together to raise awareness about asthma; too many children and adults are suffering needlessly.

“We must ensure that people living with asthma, and all those involved in their care, have the information they need to achieve the best outcomes.”

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