ASTHMA remains a significant yet underdiagnosed health issue for adolescents in sub-Saharan Africa. Despite advancements in treatment and diagnosis globally, many young individuals in the region suffer from severe symptoms without formal diagnosis or adequate management, as highlighted by recent research.
From 1990–2010, the number of African children with asthma rose from 34 million to 50 million, driven partly by increased urbanisation. Asthma is now the second leading cause of chronic respiratory deaths in sub-Saharan Africa. However, systemic barriers such as poor awareness, limited access to healthcare, and insufficient diagnostic tools have resulted in a large proportion of undiagnosed cases, especially among adolescents.
A multi-country, school-based study of adolescents aged 12–14 across 6 urban areas revealed alarming statistics. A significant percentage of participants reported severe asthma symptoms, with nearly 30% missing school due to wheezing in the prior month. Among these symptomatic adolescents, most lacked a formal diagnosis, leaving their symptoms untreated. Objective tests confirmed probable asthma in nearly half of the undiagnosed cases.
Even among those diagnosed, many lacked access to proper treatment. For instance, only a minority used inhalers with spacers, a cost-effective measure shown to improve bronchodilator therapy. Furthermore, one-third of diagnosed adolescents with severe symptoms were not using any form of inhaler. These findings underscore a disconnect between clinical guidelines and real-world practices in asthma management.
Environmental triggers also exacerbate the issue. Adolescents reported exposure to pollution sources such as biomass fuel burning, heavy traffic, and poor indoor air quality, contributing to respiratory problems. Despite this, education about asthma triggers and therapies remains limited.
This study highlights the urgent need for community-based interventions, such as school health programmes that include asthma screening and care. Mobile asthma clinics, proven effective in the United States, could also play a critical role. Strengthening healthcare systems, improving education, and integrating asthma management into school health policies are vital steps to address the high burden of asthma in sub-Saharan Africa.
Reference
Oyenuga VO et al. Asthma symptoms, severity, and control with and without a clinical diagnosis of asthma in early adolescence in sub-Saharan Africa: a multi-country, school-based, cross-sectional study. Lancet Child Adolesc Health. 2024;DOI:10.1016/S2352-4642(24)00232-3.
