Mar 5, 2008 - Bronchiolitis obliterans organizing pneumonia: Pathogenesis, clinical features, imaging and therapy review. Al-Ghanem Sara, Al-Jahdali ...
Krayem: First National Symposium on Sleep Disorders, Jeddah
Volume 3 - Issue 2 - April-June 2008
Contents Editorial Bronchial asthma in developing countries: A major social and economic burden Mohamed S. Al-Hajjaj ................................................................................................................................................................... 39
Original Articles Does consanguinity increase the risk of bronchial asthma in children? Mohammad I. El Mouzan, Abdullah A. Al Salloum, Abdullah S. Al Herbish, Ahmad A. Al Omar, Mansour M. Qurachi ................ 41
Validation of the Arabic version of the asthma control test H. Lababidi, A. Hijaoui, M. Zarzour .............................................................................................................................................. 44
Unconventional therapy use among asthma patients in a tertiary care center in Riyadh, Saudi Arabia Mohamed S Al Moamary .............................................................................................................................................................. 48
Knowledge and practice of spirometry among pediatricians in Riyadh, Kingdom of Saudi Arabia Muslim Mohammed Al-Saadi ........................................................................................................................................................ 52
Brief Report Hypocalcemia in a Saudi intensive care unit Mobeen Iqbal, Rifat Rehmani, Mohammad Hijazi, Ayman Abdulaziz, Sayed Kashif ...................................................................... 57
Case Reports Hypogenetic lung syndrome in an adolescent: Imaging findings with short review Mohamed Firoze Ahamed, Fahad Al Hameed .............................................................................................................................. 60
Extramedullary paraspinal hematopoiesis in hereditary spherocytosis P. Gogia, R. Goel, S. Nayar ........................................................................................................................................................... 64
Review Article Bronchiolitis obliterans organizing pneumonia: Pathogenesis, clinical features, imaging and therapy review Al-Ghanem Sara, Al-Jahdali Hamdan, Bamefleh Hanaa, Khan Ali Nawaz ...................................................................................... 67
Conference Summary The First National Symposium on Sleep Disorders, Jeddah, Saudi Arabia: January 30-31, 2008 Ayman Krayem .............................................................................................................................................................................. 76
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Review EditorialArticle
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Bronchial asthma in developing countries: A major social and economic burden Mohamed S. Al-Hajjaj Respiratory Division, Medical Department, College of Medicine, King Saud University, Riyadh, KSA
B
ronchial asthma is a disease that is becoming a major health issue in many developing countries. Many factors may have contributed to the rise of the problem of bronchial asthma. Increasing air pollution, fast modernization, and widespread construction work are some of the reasons for asthma to thrive. The situation is complicated by poor access to medical services, high price of effective drugs, and poor health education among the affected population. Increased urbanization may have modified the traditionally low incidence of bronchial asthma in the Third World. Diets becoming more westernized, improvement in standard of living, decrease in exercise rates, more dust mites, and more pollution have been blamed.[1] There have not been reliable epidemiological studies to define the magnitude of the problem in many developing countries. Rates vary between 3% and 30%, depending on the location and methods of survey. The authors of the International Study of Asthma and Allergies in Childhood (ISAAC) have reported their results of phase III of the worldwide study on the trends in the prevalence of asthma symptoms. Findings indicate that international differences in the prevalence of symptoms of asthma have decreased, particularly in the age group of 13 to 14 years. They concluded that increases in the prevalence of symptoms of asthma in Africa, Latin America, and parts of Asia indicate that the global burden of asthma is continuing to rise, but the global differences in prevalence are decreasing.[2]
Correspondence to: Prof. Mohamed S. Al-Hajjaj, P. O. Box 106911, Riyadh 11676, KSA E-mail: msalhajjaj@gmail. com Submission: 05-03-08 Accepted: 05-03-08
In drug therapy, there are often major misunderstandings and lack of awareness among asthma patients about bronchial asthma. Many patients have steroid phobia. Others have fear of side effects or getting ‘used to’ or ‘addicted to’ inhalers, and many others may overuse or abuse these medications. Updated guidelines on bronchial asthma have been recently issued by two major international bodies, namely, GINA and NAEEP.[3,4] Both have not addressed the problems related to developing
Annals of Thoracic Medicine - Vol 3, Issue 2, April-June 2008
countries. It is therefore of utmost importance that medical societies and health authorities adopt a local version of such guidelines to stress upon aspects of the disease that are related to local practices or to situations specific to local population. Use of herbal remedies or local nonconventional practices that may not be effective or may be even harmful to patients should be discouraged. Other issues are the need to address the availability and the prices of new asthma drugs and to try to choose less expensive forms or sources of medications. Watson et al. investigated the applicability of therapeutic aspects of published international asthma management guidelines in developing countries. They concluded that many asthma patients in developing countries are not receiving adequate treatment because the required drugs are not available in their area or are prohibitively expensive.[5] Therefore, major responsibility lies upon the shoulders of health authorities and local medical societies to set up continuous health education programs to improve asthma management and to clarify to patients the merits of the drugs used for treatment and to alleviate any fears of using them. The Saudi Thoracic Society has established continuous and sustained programs focusing on educating the general practice doctors with regard to the most appropriate and recommended management of bronchial asthma. Local guidelines are currently under preparation and will be published in the coming few months. Public education is being addressed by printing and distribution of thousands of simple and easy-to-understand brochures.
References 1.
2.
Ramos RG, Talbott EO, Youk A, Karol MH. Community urbanization and hospitalization of adults for asthma. J Environ Health 2006;68:2632,44. Pearce N, Aït-Khaled N, Beasley R, Mallol J, Keil
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Al-Hajjaj: Bronchial asthma developing countries Sara et al.:inBOOP
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U, Mitchell E, et al. Worldwide trends in the prevalence of asthma symptoms: Phase III of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax 2007;62:758-66. Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, et al. Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J 2008;31:143-78.
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National Asthma Education and Prevention Program. Expert Panel Report 3 (EPR-3): Guidelines for the Diagnosis and Management of Asthma-Summary Report 2007. J Allergy Clin Immunol 2007;120:S94-138. Watson JP, Lewis RA. Is asthma treatment affordable in developing countries? Thorax 1997;52:605-7.
Annals of Thoracic Medicine - Vol 3, Issue 2, April-June 2008
