Prevalence of asthma indicators among adolescents in the Global Asthma Network Phase I (GAN Phase I) in Syria (2019–2020) - 09/03/22

According to the Global Asthma Report 2018 available from (www.globanasthmanetwoork.org/): 339 millions have asthma, causing one thousand death per day. While Inhaled Corticosteroids and LABA are in the list of Essential Medicines of WHO, they are not available in half of developing countries, where asthma is not included in health programs, non-referral and fragmented health systems. Global Asthma network launched a worldwide survey at country level, on the prevalence of asthma symptoms, severity, risk factors, and management. This comes 15 year after the International Study of Asthma and Allergies in childhood survey (ISAAC). In Syria, we participate with two centers in Lattakia and Damascus.

The standar questionnaire of ISAAC was repeated, the question (Do you havewheezing in the chest the last 12 months), was considered as equivalent of current asthma. With new focus on availability of essential medications, on severity and emergency visits to be matched with under treatment. And new focus on indoor air pollution, in Syria we added questions about exposure to chemicals of weapons and psychiatric disorders linked to the war, we wanted to explore their role on asthma prevalence and severity, Adolescents 13–14 years old in schools are asked by an expert to fill in the GAN questionnaire.

While current wheeze prevalence in ISAAC III in Syria was 5.1% for 13–14, it is 19% in GAN ten years later, 12% have criteria of severity. Indeed the war brought new pollutants accused by patients to provoke wheezing and breathlessness p=0,005 (8% have their asthma appearing after the war), and higher exposure to passive smoking p=0.001. It is of concern to see that doctor diagnosed asthma was only in 7.8%, wich allude to underdiagnosis. Medications: ICS, LABA, thanks to international help are offered for free in hospitals and shelters.

Asthma symptoms and severity should be considered for health program in Syria.