Asthma is a significant public health problem impacting millions of patients, families and healthcare systems throughout the world. Asthma remains a growing problem and is poorly controlled1 even though substantial advances in the clinical approach to asthma have been made, with more advanced molecules now available and faster diagnoses possible.
The guidelines of large international initiatives, such as the GINA, and research efforts, including the International Study of Asthma and Allergies in Childhood (ISAAC), among others, have shown a clear pattern: the prevalence and impact of asthma is increasing at alarming rates throughout the world among people of all ages—especially children.2, 3
Estimates indicate that approximately 300 million people of all ages and ethnic origins worldwide suffer from asthma.1 Asthma rates are rising as urbanization increases and lifestyles become more Westernized. It is predicted that there will be an estimated 100 million additional asthma sufferers worldwide by 2025.4
In line with the increases in asthma prevalence, asthma morbidity rates have risen internationally over recent decades, while mortality rates have shown variations in trends.5 In most western countries, mortality rates decreased during the last few decades of the 20th century; a notable exception to this trend, however, was an increase in rates in the United States (US).5 Prevalence and mortality rates in selected countries are shown in Table 1. It is estimated that about one in every 250 deaths worldwide is due to asthma, and that many of these deaths could be prevented by improving suboptimal, long-term medical care, reducing delays in obtaining help during the final exacerbation and improving poor adherence to medication.1, 4
Similarly, as the prevalence of this sometimes fatal disease continues to rise, so too does the corresponding burden reflected in lost productivity, reduced family time and increased healthcare costs. The number of disability adjusted life years lost worldwide is estimated to be 15 million each year — similar to that for diabetes, cirrhosis of the liver, or schizophrenia.4
| Country | Prevalence, % | Fatality rates (per 100,000 asthma patients) |
|---|---|---|
| England | 15.3 | 3.2 |
| Australia | 14.7 | 3.8 |
| Ireland | 14.6 | 3.6 |
| Canada | 14.1 | 1.6 |
| Brazil | 11.4 | 1.8 |
| United States | 10.9 | 5.2 |
| Ecuador | 8.2 | 2.3 |
| South Africa | 8.1 | 18.5 |
| Czech Republic | 8.0 | 4.8 |
| Colombia | 7.4 | 10.1 |
| Germany | 6.9 | 5.1 |
| Japan | 6.7 | 8.7 |
| Chilie | 5.1 | 3.5 |
| Poland | 4.1 | 6.6 |
| Mexico | 3.3 | 14.5 |
| China | 2.1 | 36.7 |
References:
1. Masoli M, Fabian D, Holt S, Beasley R. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy 2004;59:469–478.
2. GINA. Global Initiative for Asthma. www.ginasthma.com. Revised Guidelines 2006
3. ISAAC. Worldwide variations in the prevalence of asthma symptoms: the International Study of Asthma and Allergies in Childhood (ISAAC). Eur Respir J 1998;12:315–335.
4. Masoli M, Fabian D, Holt S, Beasley R. Global Burden of Asthma. Developed for the Global Initiative for Asthma (GINA). 2005.
5. Beasley R. The burden of asthma with specific reference to the United States. J Allergy Clin Immunol 2002;109:S482–S489.