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ERHABOR: On How To Manage Increasing Cases Of Chest Diseases (1)

ERHABORGregory Erhabor is the founder and Project Coordinator, Asthma and Chest Care Foundation; Consultant Chest Physician and immediate past President of Nigerian Thoracic Society and professor of Medicine, Obafemi Awolowo University, Ile-Ife, Osun State. He spoke to PAUL ADUNWOKE on management of chest diseases and asthmatic patients. 

Why your interest in thoracic/chest medicine?
THERE is increasing pollution in the country and many have taken to smoking, thus manifesting chest diseases like chronic obstructive lung disease, occupational lung diseases and worsening cases of asthma.

Moreover, a disease like tuberculosis is one of the leading infectious diseases in the world and Nigeria is one of the high burden countries. It’s rather unfortunate that a number of politicians, men of God, commissioners and big men in this country have died of Asthma, lung cancer and other chest diseases, yet only a few is aware that these diseases can be prevented and properly managed.

That is why Asthma and Chest Care Foundation (ACCF) was established to provide patient care, education, pursue research, train health professionals and offer philanthropic programmes for patients with asthma – free distribution of asthma drugs and information materials – in order to ensure that no life is lost as a result of asthma or other chest conditions again in Nigeria.

We encourage all patients and individuals with cough of more than two to three weeks, sputum production, haemoptysis (coughing out of blood), chest wall pain, noisy breathing, breathlessness, frequent colds, loss of weight, loss of appetite, fever and night sweats to report to the nearest health facility for necessary tests.

Let’s take a look at the statistics: about 10 to 15 million Nigerians are suffering from asthma. In our study among University undergraduates between the ages of 15 – 35yrs in Southwestern Nigeria, we reported a prevalence of 18.7 per cent. Again, 14.1per cent of the respondents had probable asthma while another 4.3per cent had suspected asthma totaling 18.7 per cent.

A number of them, living with the condition have not been diagnosed and many remain untreated. In the past, asthma was seen as a disability but today, with proper treatment and preventive measures, asthma can be controlled. Hence, the awareness by the foundation aims at educating and ensuring that patients are free from asthma.

By doing this, the number of asthmatic patients presenting with life threatening symptoms will reduce and patients will be properly diagnosed.

I have other programmes on heart and lungs-related diseases but what inspired me for the asthma prevention and management initiative is the fact that people always talk about treatment and cure for diseases but nobody talks about prevention.

Again, there are few places around, where one can get proper treatment. I believe it’s much easier to prevent diseases than to cure them. So, my focus had been on possible ways of stopping the disease; finding better ways to help patients in this fight for breath. Topmost on my mind is a question like ‘how can I ensure they lived a better life?’

As a response to this, I resorted to educating asthmatic patients and those with other chest conditions, like Tuberculosis, lung cancer and pneumonia among others. And to achieve these, I embarked on advocacy and organising training for medical doctors so as to ensure that those with chest and lungs-related diseases have what it takes to live a healthy life.

We partner with other organisations, NGOs and other institutions to help achieve these goals. They include; American College of Chest Physicians, American Thoracic Society, Breathe Easy Foundation, UK
etc.

How severe can asthma attack be and how does chest medicine handle the challenges?
Severe attacks are common causes of death from Asthma and one of the major problems is that asthmatic patients are unable to recognise the seriousness of these attacks. However, a number of pointers could help in determining whether or not, an attack is severe.

If these pointers were well understood and monitored by asthmatic patients, a drastic decrease in mortality rates would be recorded. They need to watch out, for an increased frequency in night attacks, that is, waking up more than once at night because of wheeze, cough or difficulty in breathing.

Again, asthma attack presents increasing limitation in day-to-day activities such as, climbing stairs, cooking and other household chores is noticed. Another pointer is increased dependence on bronchodilators – drugs that opens the airways. For instance, using inhaler, between four and six times a day is a sign of a severe attack.

Other things to watch out for are fever, infections of the throat, sinuses and lungs; all of which may trigger a severe attack. Deterioration of peak flow reading and bluish appearance of the tongue, lips and fingertips are also to be observed.

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