Africa: Millions of teens have undiagnosed asthma

Millions of teenagers in Africa are living with undiagnosed asthma amid rapid urbanization, a new study reveals. Published in the media, the research surveyed 27,000 students from urban areas in Malawi, South Africa, Zimbabwe, Uganda, Ghana, and Nigeria. It found that over 3,000 reported asthma symptoms, yet only around 600 had been formally diagnosed.

Many affected children experienced school absences and sleep disruptions due to wheezing. “Our findings suggest millions of adolescents in sub-Saharan Africa may have undiagnosed asthma symptoms,” said Dr. Gioia Mosler, the research manager from Queen Mary University of London. The team, known for their influential work on air pollution that contributed to the introduction of the ultra-low emission zone (Ulez) in London, emphasized the urgent need for diagnostic tools and medication in the region.

Asthma rates have risen across sub-Saharan Africa in recent decades, driven by urbanization that exposes children to increased air pollution and other risk factors. Experts also pointed to the likely impact of the climate crisis.

The Achieving Control of Asthma in Children and Adolescents in Africa (Acacia) study recruited 12 to 14-year-olds, revealing that 12% reported asthma symptoms, but only 20% of these cases had been diagnosed. Lung function tests indicated that nearly half of those with severe symptoms but no diagnosis were “very likely” to have asthma.

Even among those formally diagnosed, about one-third were not using any medication to manage the condition.

Dr. Rebecca Nantanda, leading the research in Uganda from Makerere University, noted that undiagnosed and poorly controlled asthma significantly affects children’s physical and mental health, as well as the wellbeing of their caregivers. She called for immediate action to improve access to medicines and diagnostic services in light of the high rates of severe undiagnosed asthma highlighted by the Acacia study.

Professor Jonathan Grigg from Queen Mary University of London explained that asthma symptoms are exacerbated by exposure to fine particulate pollutants, with the effects of the climate crisis yet to fully unfold. In some sub-Saharan regions, climate change may increase children’s exposure to dust and natural fires, while mitigation efforts could reduce fossil fuel-derived pollution.

The pharmaceutical industry has shown reluctance to back asthma research in countries where they do not plan to market their products. However, innovations like handheld wheeze detectors and school-based asthma clinics could significantly alleviate the asthma burden.

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