On May 6, it is World Asthma Day, Guyana is not spared from this respiratory pathology. The Regional Health Observatory, and the Territorial Health Promotion Center are mobilizing on this occasion to better educate the population.
In Guyana, asthma represents an increasing issue for public health. The warm and humid climate promotes the proliferation of allergens, like the mite *blomia tropicalis *. The direct consequence is that part of the population is faced with this respiratory disease. However, diagnosis, management and awareness is insufficient, aggravating the impact of asthma on the population. The last survey dates from 2019, she was on The Guyanese aged 15 or over who declared to suffer from asthma.
The latest studies are not very recent, moreover given the climatic conditions of Guyana, the presence of specific allergens, we can say that the prevalence is underestimated in Guyana. There is a sub-detection that would be linked to the health system. Compared to France, ultimately we risk dying of asthma, if we are in Guyana
Doctor Manuella ImoungaResponsible for the Study Service at the Guyana Regional Health Observatory
The equatorial climate of Guyana promotes the presence of specific allergens such as tropical mites, pollens and even the Sahara sands, transported by the winds. These elements are particularly problematic for asthmatic people.
A study conducted between 2017 and 2020 at Cayenne hospital revealed that 65 % of asthmatic children were made aware of *blomia tropicalis *, a tropical mite.
Among them, 92 % showed a co-sensitization to other tropical mites and 55 % in the cockroaches.
Cockroaches (or cockroaches) are known to be particularly allergenic, which can cause respiratory allergies, rhinitis or asthma.
Although specific data on prevalence is limited, a 2019 survey reports that 7.2 % of Guyanese aged 15 years or more declared asthma. This figure, could be underestimated in relation to the actual magnitude of the problem due to a likely sub-detection.
In addition to allergens, other risk factors contribute to the prevalence of asthma in Guyana. Family history, smoking, air pollution, respiratory infections and precarious conditions are among the main triggers. Symptoms, although varied, include:
-- a whistling breathing,
- a persistent cough,
- thoracic oppression and
- a shortness of breath that can occur even at rest
Symptoms of asthma are sometimes unknown or trivialized, which leads to late diagnoses. This is particularly worrying for vulnerable populations, such as the elderly, in whom fatal cases have been identified. Asthma can still be fatal. In 2022, for example, four deaths related to asthma affected adults over 75 years of age.
The diagnosis and monitoring of asthma in Guyana are often hampered by limited access to specialized care and insufficient awareness. The available treatments, although effective, require good compliance and regular follow -up. However, the geographic and economic constraints of the territory make these conditions difficult to fulfill for a large part of the population.
Ideal management is based on a combination of background treatments, such as inhaled corticosteroids, and crisis treatments, such as rapid action bronchodilators. A targeted therapeutic education is also essential to allow patients to better manage their disease and avoid serious crises.
Prevention is a major axis to reduce the impact of asthma in Guyana. Primary prevention, which aims to limit exposure to allergens, is crucial, especially in children at risk. It would be necessary:
- Avoid tobacco smoke
- Promote health housing
- promote breastfeeding
In addition, secondary prevention based on early diagnosis, therapeutic education and rigorous monitoring can help improve the quality of life of patients. The integration of vulnerable populations into these programs is particularly important to limit inequalities in the face of management.
Beyond health consequences, asthma generates significant costs for health systems and families. The possible frequent hospitalizations, school and professional absenteeism as well as the decrease in the quality of life of patients and their entourage are all repercussions that illustrate the scope of this disease.
To meet these challenges, it is urgent to strengthen efforts in terms of prevention, awareness and management, while taking into account local specificities. Asthma constitutes a public health issue which, well taken care of, can allow each patient to lead a normal life, even in the heart of the Guyanese equatorial forest.
In France, asthma affects more than 4 million people and has up to 60,000 hospitalizations. About 5 % of patients suffer from severe asthma. In 2022, 770 deaths, mainly in adults over 55, were identified.
The World Health Organization has identified around 450,000 deaths related to asthma, worldwide in 2019, and estimated the number of people affected by this pathology at 262 million.
