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Key facts
- Asthma is a major noncommunicable disease (NCD), affecting both children and adults, and is the most common chronic disease among children.
- Inflammation and narrowing of the small airways in the lungs cause asthma symptoms, which can be any combination of cough, wheeze, shortness of breath and chest tightness.
- Asthma affected an estimated 262 million people in 2019 (1) and caused 455 000 deaths.
- Inhaled medication can control asthma symptoms and allow people with asthma to lead a normal, active life.
- Avoiding asthma triggers can also help to reduce asthma symptoms.
- Most asthma-related deaths occur in low- and lower-middle-income countries, where under-diagnosis and under-treatment is a challenge.
- WHO is committed to improving the diagnosis, treatment and monitoring of asthma to reduce the global burden of NCDs and make progress towards universal health coverage.
Asthma education is a critical tool to improve the lives of people living with asthma around the globe.
Asthma is a chronic respiratory disease which affects children and adults. There are over 250 million people living with asthma worldwide and in 2019 asthma caused an estimated 455 000 deaths. Most premature asthma deaths occur in low- and middle-income countries (LMICs), where underdiagnosis and undertreatment are common.
Living with asthma can be challenging, but with the right education it is possible to manage it successfully using medication and other measures.
“It is vital that we 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,” said Dr Bente Mikkelsen, Director of the Department of Noncommunicable Diseases, Rehabilitation and Disability at WHO.
Education will increase understanding of the condition for people living with asthma and their families, and empower them to manage their treatment.
Common topics include:
- what asthma is and what is happening in the lungs
- symptoms of asthma
- how to use asthma medicines correctly
- how to reduce exposure to asthma triggers, such as tobacco smoke and air pollution
- how to assess asthma control and manage their condition when asthma symptoms worsen.
This information, ideally including a personalized asthma action plan, can be provided by doctors, nurses, pharmacists or other health care professionals. There are also examples of asthma education being delivered through schools or peer-support groups. With the growing use of digital technology, mobile phones and digital applications can be used to support asthma education.
Empowering people living with asthma to self-manage their condition can
- improve adherence to medicines among people living with asthma
- reduce asthma-related emergency care visits and hospitalization
- reduce health care costs
- reduce asthma-related absence from school and work.
Beyond providing information for people living with asthma and their families, there are other important groups to address.
It is critical that health care workers have the necessary knowledge and skills to diagnose and manage asthma and to provide appropriate support for their patients. Asthma is often misdiagnosed, as pneumonia or tuberculosis for example, and treatment may be outdated or inappropriate, such as using oral or intravenous medicines in preference to inhalers.
Policy-makers and health care 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.
The Global Alliance against Chronic Respiratory Diseases (GARD) is a WHO-convened network committed to reducing the global burden of chronic respiratory diseases, focusing on LMICs. GARD member organizations are working together to share good practice and resources for asthma education and to develop simple messages to support healthcare providers and people living with asthma.
“The Global Initiative for Asthma (GINA) emphasizes the need to empower people with asthma with the appropriate education to manage their disease, and the vital role of healthcare professionals in providing this information. GINA is committed to work together with other GARD members to boost our collective efforts and impact in this critical area,” said Professor Arzu Yorgancioglu, Chair of the Global Initiative for Asthma.
A collection of asthma education resources from WHO and GARD members can be found in this thematic collection on the WHO Knowledge Action Portal on NCDs.
Symptoms
Symptoms of asthma can vary from person to person. Symptoms sometimes get significantly worse. This is known as an asthma attack. Symptoms are often worse at night or during exercise.
Common symptoms of asthma include:
- a persistent cough, especially at night
- wheezing when exhaling and sometimes when inhaling
- shortness of breath or difficulty breathing, sometimes even when resting
- chest tightness, making it difficult to breathe deeply.
Some people will have worse symptoms when they have a cold or during changes in the weather. Other triggers can include dust, smoke, fumes, grass and tree pollen, animal fur and feathers, strong soaps and perfume.
Symptoms can be caused by other conditions as well. People with symptoms should talk to a healthcare provider.
Causes
Many factors have been linked to an increased risk of developing asthma, although it is often difficult to find a single, direct cause.
- Asthma is more likely if other family members also have asthma – particularly a close relative, such as a parent or sibling.
- Asthma is more likely in people who have other allergic conditions, such as eczema and rhinitis (hay fever).
- Urbanization is associated with increased asthma prevalence, probably due to multiple lifestyle factors.
- Events in early life affect the developing lungs and can increase the risk of asthma. These include low birth weight, prematurity, exposure to tobacco smoke and other sources of air pollution, as well as viral respiratory infections.
- Exposure to a range of environmental allergens and irritants are also thought to increase the risk of asthma, including indoor and outdoor air pollution, house dust mites, moulds, and occupational exposure to chemicals, fumes or dust.
- Children and adults who are overweight or obese are at a greater risk of asthma.
Treatment
Asthma cannot be cured but there are several treatments available. The most common treatment is to use an inhaler, which delivers medication directly to the lungs.
Inhalers can help control the disease and enable people with asthma to enjoy a normal, active life.
There are two main types of inhaler:
- bronchodilators (such as salbutamol), that open the air passages and relieve symptoms; and
- steroids (such as beclometasone) that reduce inflammation in the air passages, which improves asthma symptoms and reduces the risk of severe asthma attacks and death.
People with asthma may need to use their inhaler every day. Their treatment will depend on the frequency of symptoms and the types of inhalers available.
Using an inhaler can be difficult, especially for children and during emergency situations. Using a spacer device makes it easier to use an aerosol inhaler. This helps the medicine to reach the lungs more easily. A spacer is a plastic container with a mouthpiece or mask at one end and a hole for the inhaler in the other. A homemade spacer, made from a 500ml plastic bottle, can be as effective as commercially manufactured spacers.
Access to inhalers is a problem in many countries. In 2021, bronchodilators were available in public primary health care facilities in half of low- and low-middle income countries, and steroid inhalers available in one third.
It is also important to raise community awareness to reduce the myths and stigma associated with asthma in some settings.
Self-care
People with asthma and their families need education to understand more about their asthma. This includes their treatment options, triggers to avoid, and how to manage their symptoms at home.
It is important for people with asthma to know how to increase their treatment when their symptoms are worsening to avoid a serious attack. Healthcare providers may give an asthma action plan to help people with asthma to take greater control of their treatment.
