Proper management can help children to outgrow asthma

Asthma occurs when there is an obstruction of the airways that carry air to and from the lungs, or when there is a swelling or an inflammation of the airways and hyper-responsiveness.

Most of the time, it is noticed in very early childhood. Asthma is not just one particular disease condition; it is a range of conditions. Cases of asthma in children between ages two and six is commonest, while the least percentage one finds is between 12 and 16 years, when the majority of them would have outgrown it.

Those who still have asthma at that teenage age are likely to have it into adulthood. About 60 per cent of children with asthma are less than six years; the remaining 40 per cent will be in children between seven years and 16 years of age.

The child should be taken to the hospital for regular check up every three to six months. That would help to ensure that the child does not suffer many of the problems resulting from the disease.

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Asthma could affect the psychology and even growth of the child if not properly managed. But if managed and treated properly, the child could outgrow it. Again, the parents should comply with the prescription that accompanies drugs given by the doctor.

They should not wait until the child has the symptoms before they give the medications.

Causes

Hereditary factor is also important to know if a child is susceptible to asthma. For example, if there is a family history of it, that is, if someone in that family is asthmatic or has reactive conditions, such as particular allergies, it could lead to asthma or what is also called hyper-reactive airway disease.

The majority of children outgrow asthma later in their teenage years.

Industrial/air pollution triggers asthma. Also, the more developed a place is, the more likely they would have a higher rate of asthma cases. Cities like Lagos would be expected to have a high rate of asthma cases.

Effluents from cars and industries have also been associated with asthma. It also depends on other factors, including hereditary and the person’s predisposition to allergies and certain conditions.

Fumes from generators used in residential areas, or smoke from firewood have all been implicated as trigger factors.

Some people can actually have it without any hereditary link, but they are in the minority.

I will use the experience of one of my patients to narrate the shortage of asthma facilities in Nigeria.

Mrs. A.Y brought her six-year-old with symptoms and signs suggestive of asthma. She had been to two other hospitals where she was told that her son had asthma.

After I took her son’s medical history, family history of asthma and the complaints (symptoms) similar to asthma, I proceeded to examine the young boy.

He was very cooperative, I ordered some blood test for infections, blood count and allergy. They all came out negative, even the chest X-ray was normal.

I explained to her that her son would have a provisional diagnosis of childhood asthma. She requested a confirmation. I explained to her that the definite diagnosis of asthma would be on the result of a lung function test from a spirometer or a simple peak flow meter.

She was not pleased as she insisted on having the lung function test done. Unfortunately, after visiting other hospitals for the spirometry, she came back telling me that she was disappointed with the health care system in the country.

According to her, none of the five specialist hospitals, two children hospitals and one public teaching hospital she visited had a functioning spirometer.

A spirometer is an apparatus for measuring the volume of air inspired and expired by the lungs. A spirometer measures ventilation, the movement of air into and out of the lungs. It is used in diagnosing different types of abnormal ventilation patterns.

The test is very simple and it involves asking the patient to take in a big breath and then blow as hard and long as he or she can into a machine with a meter that reads the lung volumes.

Lack of this equipment has compromised the definite diagnosis of asthma in the nation’s hospitals. Government must look into it.

Back to Asthma.

Signs and symptoms

The child has difficulty in breathing or shortness of breath, cough, which is worse at night. It also depends on the degree of severity of the asthma. But the first signs are breathlessness and cough, pigeon chest – the chest may look bloated like that of a pigeon because of air congestion, the child is breathing air but cannot breathe it out.

Diagnosis

Most people who are said to be asthmatic are not. A diagnosis, which includes the lung function test, as well as spirometry, where the child is asked to take in a big breath and then blow as hard and long as he or she can into a machine, is used in making definitive diagnosis. It is especially in use for young children.

There is also the peak flow metre, used to measure how well air moves out.

There is also the six-minute walk test.

• To be continued