Gasping for air: How asthma is suffocating Kenya's most vulnerable

How asthma is suffocating Kenya's most vulnerable. [Courtesy/GettyImages] Mathews Kizito from Busia County has lived with asthma since childhood. He believes the condition is hereditary, as his late father, Jacob Wafula, also suffered from it. Asthma, a chronic respiratory disease, causes the airways to become inflamed, narrowed, and filled with mucus, making it difficult to breathe. Common symptoms include chest tightness, wheezing, persistent coughing, and shortness of breath. Experts warn that asthma triggers vary widely and include allergens like pollen, cold weather, strong smells, smoke, exercise, and stress. Without proper treatment, asthma attacks can be life-threatening. According to the 2022 Kenya Demographic and Health Survey (KDHS), children aged six months to five years are particularly vulnerable, making asthma one of the most common chronic conditions of childhood. Globally, the World Health Organization (WHO) estimates that asthma affects 300 to 400 million people, causing around 250,000 deaths annually. A significant majority of these deaths occur in low- and middle-income countries such as Kenya. In Kenya, the WHO reported in 2023 that asthma affects roughly 10 per cent of the population-about four million people. Alarmingly, the disease is more prevalent in women than men, with 11 per cent of adult women affected compared to six per cent of adult men. Although asthma affects individuals of all ages, ethnicities, and socioeconomic backgrounds, its prevalence and severity differ widely across and within countries. Over the past three decades, asthma cases have risen in both developed and developing nations. The Global Asthma Report 2022 identifies it as the most common chronic illness in children. WHO classifies asthma among the major non-communicable diseases (NCDs) globally. Accessibility challenges Dr Joseph Aluoch, President of the Pan African Thoracic Society and a consultant chest specialist at Nairobi Hospital, describes asthma as a disease marked by recurrent episodes of breathlessness, wheezing, and coughing. These symptoms often worsen at night, disrupt sleep, reduce activity levels, and contribute to school and work absenteeism. Fortunately, asthma can be controlled with proper medical care. Dr Aluoch recommends a combination of long-term and quick-relief medications, tailored to the severity of the patient's condition. Inhaled corticosteroids are the most effective long-term treatment, reducing inflammation in the airways. Other options include daily oral medications such as theophylline, which helps relax the airways. He also highlights the use of antibiotics, particularly azithromycin, in managing chronic asthma. Macrolide antibiotics have shown promise in reducing asthma exacerbations due to their anti-inflammatory properties. These treatments are available in Kenya, but accessing and affording them remains a challenge for many patients. Although the Kenya National Asthma Guidelines have adopted standard treatment practices, the country's healthcare system still faces significant barriers. In low- and middle-income settings, health systems often lack the capacity to implement guidelines fully, and many patients cannot access or afford high-quality asthma inhalers. As a result, many asthma sufferers experience unnecessary, severe attacks that could have been prevented with appropriate treatment. The unavailability of fast-acting bronchodilators-used during acute attacks-exacerbates the problem, leading to more hospitalisations and higher healthcare costs. Uncontrolled asthma imposes a substantial economic burden on both households and the health system. Treatment costs for chronic conditions like asthma, diabetes, and hypertension range between USD 30 to 250 annually in public hospitals and up to USD 1,000 in private facilities. While this may be affordable for some, many low-income households still struggle. The WHO recognises asthma as one of the five major respiratory conditions globally. Alongside tuberculosis, respiratory infections, and certain cancers, asthma contributes significantly to global disease burden. In Kenya, the asthma burden is particularly acute in urban slums and poorly ventilated homes. Children in these environments-where charcoal is commonly used for cooking and heating-are especially vulnerable during cold seasons. WHO estimates that around 1.5 million Kenyan children live with asthma, though no recent national study has confirmed the exact number. According to a senior Ministry of Health official, who requested anonymity, comprehensive data on children aged 1-12 affected by asthma is lacking due to outdated or limited research. This knowledge gap hinders effective public health planning. Dr Aluoch stresses the urgency of prioritising asthma and other NCDs within Kenya's health agenda. "We must adopt aggressive strategies to reduce the burden of asthma and other non-communicable diseases," he says, adding, "This should be a high priority within the framework of the United Nations Sustainable Development Goals (SDGs)." Environmental factors such as exposure to smoke, chemicals like paint, tobacco use, and poor air circulation significantly contribute to asthma rates. Cold weather and genetic predisposition also play key roles. Without urgent interventions, asthma cases and related deaths in Kenya will continue to rise. To reduce the impact of asthma, Kenya needs stronger investment in public health education, improved access to affordable medication, better ventilation in homes, and consistent implementation of asthma care guidelines.

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