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7/28/2019 Isaac Report
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Matthew Masoli
Denise Fabian
Shaun Holt
Richard Beasley
Medical Research Institute of New Zealand
Wellington, New Zealand
University of SouthamptonSouthampton, United Kingdom
Developed for the Global Initiative for Asthma
TM
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Actions Required toReduce the Burden of Asthma
1. Recognise asthma as an important cause of morbidity,
economic cost, and mortality worldwide.
2. Measure and monitor the prevalence of asthma, and themorbidity and mortality due to asthma throughout the world.
3. Identify and address the economic and political factorswhich limit the availability of health care.
4. Improve accessibility to essential drugs for the management
of asthma in low- and middle-income countries.
5. Identify and address the environmental factors includingindoor and outdoor pollution which affect respiratorymorbidity including that due to asthma.
6. Promote and implement anti-tobacco public healthpolicies to reduce tobacco consumption.
7. Adapt international asthma guidelines for developingcountries to ensure they are practical and realistic in termsof different health care systems. This includesdissemination strategies for their implementation.
8. Integrate the GINA guidelines with other global respiratoryguidelines for children and adults. In this respect, there isa requirement to merge the key elements of the differentrespiratory guidelines into an algorithm for use at the first
point of entry of a respiratory patient's contact with healthservices.
9. Promote cost-effective management approaches whichhave been proven to reduce morbidity and mortality,thereby ensuring optimal treatment is available to as manypersons as possible with asthma worldwide.
10. Research the causation of asthma, primary and secondaryintervention strategies, and management programmesincluding those for use in developing countries.
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Barriers to Reducing the Burden of Asthma (continued)
8. Patient barriers includinga. cultural factors
b. lack of informationc. underuse of self-managementd. over-reliance on acute caree. use of alternative unproven therapies.
9. Inadequate government resources provided for health careincluding asthma.
10. The requirement of respiratory specialists and relatedorganisations required to care for a wide variety ofdiseases, which has in some regions resulted in a failure toadequately promote awareness of asthma.
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Scotland Jersey
Guernsey Wales
Isle of Man England
New Zealand Australia
Republic of Ireland Canada
Peru Trinidad & Tobago
Costa Rica
Brazil United States of America Fiji
Paraguay Uruguay
Israel Barbados
Panama Kuwait
Ukraine Ecuador
South Africa Finland
Malta Czech Republic
Ivory Coast Colombia
Turkey Lebanon
Kenya Germany
France Japan
Norway Thailand Sweden
Hong Kong United Arab Emirates
Philippines Belgium Austria
Saudi Arabia Argentina
Iran Estonia Nigeria
Spain Chile
Singapore Malaysia Portugal
Uzbekistan FYR Macedonia
Italy Oman
Pakistan Tunisia Latvia
Cape Verde Poland
Algeria South Korea Bangladesh
Morocco Occupied Territory of Palestine
Mexico Ethiopia
Denmark India
Taiwan Cyprus
Switzerland Russia China
Greece Georgia
Romania Nepal
Albania Indonesia
Macau
Figure 1:Ranking of the Prevalence
of Current Asthma Symptomsin Childhood by Country (I)
(Written Questionnaire:Self-reported wheezing in the
previous 12 month period,in 13- to 14-year-old children.
See section on Methodological Issues.)
C
ountry
C
ountry
Prevalence of asthma symptoms (%)Prevalence of asthma symptoms (%)
0 5 10 15 20 25 30 35 40
Peru
New Zealand
Australia
Uruguay
Kuwait
United States of America
Canada
Kenya
Chile
Japan
Hong Kong
Paraguay
Singapore
Philippines
Malta
Argentina
France
Pakistan
Spain
Morocco
Thailand
South Africa
Portugal
Malaysia
Austria
Germany
Italy
Sweden
Finland
Lebanon
Taiwan
Bangladesh
Poland
South Korea
Iran
India
Ivory Coast
Estonia
China
Indonesia
Latvia
Russia
Uzbekistan
Albania
Figure 2:Ranking of the Prevalence
of Current Asthma Symptomsin Childhood by Country (II)
(Video Questionnaire:Positive response to clinical asthma scene,
in 13- to 14-year-old children.See section on Methodological Issues.)
0 5 10 15 20 25 30
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Scotland 18.4Jersey 17.6Guernsey 17.5Wales 16.8Isle of Man 16.7England 15.3New Zealand 15.1Australia 14.7
Republic of Ireland 14.6Canada 14.1Peru 13.0Trinidad & Tobago 12.6Costa Rica 11.9Brazil 11.4United States of America 10.9Fiji 10.5Paraguay 9.7Uruguay 9.5Israel 9.0Barbados 8.9Panama 8.8Kuwait 8.5Ukraine 8.3Ecuador 8.2South Africa 8.1Czech Republic 8.0Finland 8.0Malta 8.0
Ivory Coast 7.8Colombia 7.4Turkey 7.4Lebanon 7.2Kenya 7.0Germany 6.9France 6.8Norway 6.8
Japan 6.7Sweden 6.5Thailand 6.5Hong Kong 6.2Philippines 6.2United Arab Emirates 6.2Belgium 6.0Austria 5.8Spain 5.7Saudi Arabia 5.6Argentina 5.5Iran 5.5Estonia 5.4Nigeria 5.4Chile 5.1Singapore 4.9Malaysia 4.8Portugal 4.8Uzbekistan 4.6FYR Macedonia 4.5
Italy 4.5Oman 4.5Pakistan 4.3Tunisia 4.3Cape Verde 4.2Latvia 4.2Poland 4.1Algeria 3.9
South Korea 3.9Bangladesh 3.8Morocco 3.8Occupied Territory of Palestine 3.6Mexico 3.3Ethiopia 3.1Denmark 3.0India 3.0Taiwan 2.6Cyprus 2.4Switzerland 2.3Russia 2.2China 2.1Greece 1.9Georgia 1.8Nepal 1.5Romania 1.5Albania 1.3Indonesia 1.1Macau 0.7
C
ountry
Prevalence of asthma symptoms (%)
Figure 4:
World Map of the Prevalence of Clinical Asthma
10.1
7.6-10.0
5.1-7.5
2.5-5.0
0-2.5
No standardised data available
Proportion of population (%)*
0 5 10 15 20 25 30
Wales
Australia
Scotland
Republic of Ireland
Canada
Estonia New Zealand
United States of America
England
Malta
Norway
Denmark
Spain
Poland
Sweden
Finland
Netherlands
Portugal
Iceland
Germany
Switzerland
Turkey
Belgium
Greece
France
Austria
Argentina
Costa Rica
Thailand
Romania
Italy Hong Kong
Colombia
Albania
Bangladesh
Algeria
India
Ethiopia
Taiwan
Gambia
Tunisia
Figure 3:Ranking of the Prevalence ofCurrent Asthma Symptoms in
Adults by Country(Written Questionnaire:
Self-reported wheezing in the previous12 month period, in 20- to 44-year-old adults.
See section on Methodological Issues.)
See section on Methodological Issues.
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of years of life lost to that of years of healthy life lost, representing ahealth gap measure which incorporates both loss of life and the lossof quality of life. This allows a composite measure of the burden ofboth fatal and non-fatal disease. As a result, the years lost to
disability (YLD) is added to the years of life lost to prematuremortality (YLL) to yield an integrated unit of health - the "disability-adjusted life-year" (DALY), with one DALY representing the loss ofone year of healthy life. The DALYs lost due to asthma worldwide in2001 are presented, together with the 30 leading causes of DALYs.These data were obtained from the recently published WHO WorldHealth Report 2002.
E. Populations with Regular Access to Essential Drugs
The world map documenting the percentage of the population ineach country with regular access to essential drugs was reproducedfrom the WHO World Health Report 1998.
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