Cosmas Odoemena
The death of renowned Nigeria movie producer Amaka Igwe, following an asthma attack is shocking. Igwe was a first-rate movie producer, a Nigerian female version of James Cameron.
Reports said she had the attack in Enugu, her home state, where she was doing a preproduction of a new Igbo soap.
Because of people like Igwe the world is now taking more interest in Nigeria. It is official that Nollywood, the Nigerian movie industry has had a big impact on making Nigeria Africa's biggest economy. Igwe played a big role in taking Nollywood to this level. With movies like Violated, Rattlesnake and the beautiful soap, Checkmate, underlining her reputation as one of the best, if not the best movie producer in Nigeria.
How sad that asthma could take Igwe's life only a few days to the marking of World Asthma Day, held every first Tuesday in May, with this year's falling on the 6th. An annual event whose theme this year according to the organisers, Global Initiative for Asthma (GINA) is ironically "You Can Control Your Asthma."
Igwe is resting in peace. Nigeria will sorely miss her.
Igwe succumbed to a chronic condition that is characterised by airway narrowing, which makes it difficult for the victim to breathe, and this is worse on expiration.
According to WHO estimates, 235 million people suffer from asthma. It is believed that the prevalence rate in Nigeria exceeds 10% of the population.
Asthma is often underdiagnosed.
The standard treatment involves inhalation of corticosteroids, drugs that reduce inflammation and the use of bronchodilators, drugs that help open up the airway. Asthma requires lifelong treatment.
Though asthma can occur in those without risk factors, there are established risk factors that predispose to asthma.
Atopy is a long known risk factor for asthma. It refers to an allergic hypersensitivity reaction to allergens, substances that trigger the body to have an allergic reaction. Examples of atopy are eczema (atopic dermatitis), allergic conjuctivities, allergic rhinitis and asthma itself. Some studies have shown that children with atopic dermatitis may have a more severe and persistent asthma when they become adults. Allergens can be found in dust. A study showed levels of bacterial endotoxins in house dust were directly linked to asthma. You can also get indoor allergens from animal protein, especially in dogs and cats; also cockroaches, dust mites, fungi and mould.
Environmental factors also play a role in asthma. Automobile smoke, noxious fumes from household cleaners, and even paints can trigger asthma. Others are nitrogen oxide, and gas stoves are the main source of indoor nitrogen oxide. Studies have shown that people who use cooking gas are more likely to have asthmatic attacks, than those who cook with other methods. Others are sulfur dioxide, cold temperatures and high humidity.
Cigarette smoke is also a trigger factor. Women who smoke during pregnancy are likely to have infants with lower lung function compared to non smoking mothers. Furthermore, studies link secondhand smoke exposure with the development of asthma in early life. That is why the whole country should have smoke-free legislation.
Prematurity is also a risk factor for asthma.
For those who use airfreshners, even this and other scents can trigger off asthmatic attacks. This is because they can contain volatile organic compounds (VOCs) which include esthers, alcohols, and formaldehyde. Experts advocate opening the windows instead of using airfreshners.
Asthma is more common in children and adults who are overweight or obese, a good reason to lose weight.
It has also been established that acid reflux, and GERD (gastroeosophageal reflux disease) can trigger asthma. This is because acid backs up leading to a hyperreaction in the airways. These conditions have to be treated.
Researchers are looking into susceptibility genes for asthma and allergy. An example is one carried out by Donata Vercelli and published in Nature. Vercelli said, "Rapid progress in asthma genetics has led to the identification of several candidate genes that are associated with asthma-related traits."
Though asthma attack is a potential thing, it takes a trigger factor to occur. But knowing the trigger factor is often not that easy.
However, patients can be free of attacks for years. Though it is advised that patients be on drugs for life, many things can make patients to be uncompliant. Frequent drug consumption may be an inconvenience to the patient. Also, the cost of managing asthma is on the increase, especially with new drugs. This alone can make patients not get their drugs.
That is why there is a need for newer ways of managing asthma that are drug-free. In this regard, one of the treatments being tried is bronchial thermoplasty. It employs radio frequency currents to bring down the amount of smooth muscle in the airways, thereby stopping the narrowing that occurs.
What's more, a clinical trial is ongoing where doctors are testing if treatment with a CPAP (continuous positive pressure airway pressure) machine will improve symptoms in asthmatics by causing their airways to be less reactive.
"At night-time, their muscles that are around their windpipes are not being allowed to relax. In essence, they're working almost 24 hours a day," Mario Castro, Professor of Medicine and Pediatrics, Washington University School of Medicine said.
The CPAP pushes air down the windpipe, forcing the muscles to relax. It's often used for patients with sleep apnea.
In the 12-week study, patients used the device for at least four hours a day and had no serious side effects.
"The most exciting thing is that it's not a drug. This is a device," Dr. Castro said.
Researchers at 19 sites across the US are still recruiting patients for this clinical trial, which is sponsored by the American Lung Association.
“If CPAP is found to be effective, this will introduce an entirely new way to treat asthma without medication.” states Robert Wise, MD, director of the American Lung Association Asthma Clinical Research Centers Network “If we can reduce the number of inhalers and frequency of inhaled rescue medication with this new treatment, it will not only relieve the burden of asthma but improve their quality of life as well”.
If anyone were to produce a blockbuster movie to tell the world about asthma, it would have been Igwe. Asthma is not like HIV/AIDS, or malaria or any of those diseases that the world follows that make them attract huge funding, but if you have ever had a recurrent feeling of impending doom, because you cannot breathe then you will know how asthmatics feel, and how terribly asthma could do with a little more attention. And that is why I cannot but agree with GINA's sub-theme "It's Time to Control Asthma." The world must agree, too.
Dr Cosmas Odoemena
Cosmas Odoemena
The death of renowned Nigeria movie producer Amaka Igwe, following an asthma attack is shocking. Igwe was a first-rate movie producer, a Nigerian female version of James Cameron.
Reports said she had the attack in Enugu, her home state, where she was doing a preproduction of a new Igbo soap.
Because of people like Igwe the world is now taking more interest in Nigeria. It is official that Nollywood, the Nigerian movie industry has had a big impact on making Nigeria Africa's biggest economy. Igwe played a big role in taking Nollywood to this level. With movies like Violated, Rattlesnake and the beautiful soap, Checkmate, underlining her reputation as one of the best, if not the best movie producer in Nigeria.
How sad that asthma could take Igwe's life only a few days to the marking of World Asthma Day, held every first Tuesday in May, with this year's falling on the 6th. An annual event whose theme this year according to the organisers, Global Initiative for Asthma (GINA) is ironically "You Can Control Your Asthma."
Igwe is resting in peace. Nigeria will sorely miss her.
Igwe succumbed to a chronic condition that is characterised by airway narrowing, which makes it difficult for the victim to breathe, and this is worse on expiration.
According to WHO estimates, 235 million people suffer from asthma. It is believed that the prevalence rate in Nigeria exceeds 10% of the population.
Asthma is often underdiagnosed.
The standard treatment involves inhalation of corticosteroids, drugs that reduce inflammation and the use of bronchodilators, drugs that help open up the airway. Asthma requires lifelong treatment.
Though asthma can occur in those without risk factors, there are established risk factors that predispose to asthma.
Atopy is a long known risk factor for asthma. It refers to an allergic hypersensitivity reaction to allergens, substances that trigger the body to have an allergic reaction. Examples of atopy are eczema (atopic dermatitis), allergic conjuctivities, allergic rhinitis and asthma itself. Some studies have shown that children with atopic dermatitis may have a more severe and persistent asthma when they become adults. Allergens can be found in dust. A study showed levels of bacterial endotoxins in house dust were directly linked to asthma. You can also get indoor allergens from animal protein, especially in dogs and cats; also cockroaches, dust mites, fungi and mould.
Environmental factors also play a role in asthma. Automobile smoke, noxious fumes from household cleaners, and even paints can trigger asthma. Others are nitrogen oxide, and gas stoves are the main source of indoor nitrogen oxide. Studies have shown that people who use cooking gas are more likely to have asthmatic attacks, than those who cook with other methods. Others are sulfur dioxide, cold temperatures and high humidity.
Cigarette smoke is also a trigger factor. Women who smoke during pregnancy are likely to have infants with lower lung function compared to non smoking mothers. Furthermore, studies link secondhand smoke exposure with the development of asthma in early life. That is why the whole country should have smoke-free legislation.
Prematurity is also a risk factor for asthma.
For those who use airfreshners, even this and other scents can trigger off asthmatic attacks. This is because they can contain volatile organic compounds (VOCs) which include esthers, alcohols, and formaldehyde. Experts advocate opening the windows instead of using airfreshners.
Asthma is more common in children and adults who are overweight or obese, a good reason to lose weight.
It has also been established that acid reflux, and GERD (gastroeosophageal reflux disease) can trigger asthma. This is because acid backs up leading to a hyperreaction in the airways. These conditions have to be treated.
Researchers are looking into susceptibility genes for asthma and allergy. An example is one carried out by Donata Vercelli and published in Nature. Vercelli said, "Rapid progress in asthma genetics has led to the identification of several candidate genes that are associated with asthma-related traits."
Though asthma attack is a potential thing, it takes a trigger factor to occur. But knowing the trigger factor is often not that easy.
However, patients can be free of attacks for years. Though it is advised that patients be on drugs for life, many things can make patients to be uncompliant. Frequent drug consumption may be an inconvenience to the patient. Also, the cost of managing asthma is on the increase, especially with new drugs. This alone can make patients not get their drugs.
That is why there is a need for newer ways of managing asthma that are drug-free. In this regard, one of the treatments being tried is bronchial thermoplasty. It employs radio frequency currents to bring down the amount of smooth muscle in the airways, thereby stopping the narrowing that occurs.
What's more, a clinical trial is ongoing where doctors are testing if treatment with a CPAP (continuous positive pressure airway pressure) machine will improve symptoms in asthmatics by causing their airways to be less reactive.
"At night-time, their muscles that are around their windpipes are not being allowed to relax. In essence, they're working almost 24 hours a day," Mario Castro, Professor of Medicine and Pediatrics, Washington University School of Medicine said.
The CPAP pushes air down the windpipe, forcing the muscles to relax. It's often used for patients with sleep apnea.
In the 12-week study, patients used the device for at least four hours a day and had no serious side effects.
"The most exciting thing is that it's not a drug. This is a device," Dr. Castro said.
Researchers at 19 sites across the US are still recruiting patients for this clinical trial, which is sponsored by the American Lung Association.
“If CPAP is found to be effective, this will introduce an entirely new way to treat asthma without medication.” states Robert Wise, MD, director of the American Lung Association Asthma Clinical Research Centers Network “If we can reduce the number of inhalers and frequency of inhaled rescue medication with this new treatment, it will not only relieve the burden of asthma but improve their quality of life as well”.
If anyone were to produce a blockbuster movie to tell the world about asthma, it would have been Igwe. Asthma is not like HIV/AIDS, or malaria or any of those diseases that the world follows that make them attract huge funding, but if you have ever had a recurrent feeling of impending doom, because you cannot breathe then you will know how asthmatics feel, and how terribly asthma could do with a little more attention. And that is why I cannot but agree with GINA's sub-theme "It's Time to Control Asthma." The world must agree, too.
Dr Cosmas Odoemena
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