Increased prevalence of chest diseases in the Middle East place significant burdens on healthcare systems

At its 4thRegional Thoracic Medicine Forum, which was held recently in the United Arab Emirates (UAE), Boehringer Ingelheim, one of the world’s leading pharmaceutical companies brought together over 150 of the region’s top pulmonologists to shed light on continued innovation in respiratory care. 

At the event, experts have mentioned that the region as a whole has witnessed an increase in pulmonary diseases due to risk factors which include smoking, extreme weather variations, as well as genetic conditions. The prevalence of smoking and obesity has also reached alarming heights and the associated lung diseases present a major health burden to medical systems.  

The forum served as a platform to highlight the diagnosis and misdiagnosis as well as challenges towards controlling the prevalence of pulmonary diseases across the region that include asthma, chronic obstructive pulmonary disease (COPD) as well as Idiopathic pulmonary fibrosis (IPF). In addition, healthcare professionals from the UAE, Saudi Arabia, Egypt, Bahrain and Kuwait also stressed the importance of early detection of the symptoms and proper adherence to treatment protocols.

Dr. Siraj Omar Wali, Consultant pulmonologist and critical care at King Abdulaziz University Hospital, Jeddah said, “COPD is a chronic disease that causes limitations in lung airflow andthe fourth leading cause of death worldwide, and is expected to become the third leading cause by 2030. [1]The current rate of COPD prevalence is 2.4 per cent in Saudi Arabia, with many cases being missed due to it being often under-diagnosed. The most common symptoms are breathlessness and a chronic cough.  Although COPD is not curable, it is preventable; where treatment can help slow down the progression of the disease.  Moreover, data from the recent landmark 52-week DYNAGITO® trial, involving more than 7,800 people with COPD revealed a lowered rate of moderate-to-severe exacerbations know as flare-ups after the trial. This important trial shed light on the central role treatments play in the management of COPD which can help reduce symptoms and minimizing the future risk of exacerbations.’’

People who have a family history of COPD are also more likely to develop the disease if they smoke. [2]In addition, long-term exposure to other lung irritants also is a risk factor for COPD such as air pollution, chemical fumes and dusts from the environment or workplace. [3]

With more and more exposure to environmental and occupational factors, the risk of contracting pulmonary diseases such as COPD among the general population is high. Smokers, usually visit the doctor complaining from heart problems and are unaware of what COPD is. It is important to take into account that not only is early detection important, but also the form of treatment, as well as the training required for doctors and hospitals to deliver the best care possible for those who are affected by COPD.

In addition, experts at the forum shed light on the impact of asthma in the region. They said that the disease is not properly controlled and requires immediate action especially to increase awareness and overall understanding of chronic respiratory diseases amongst patients, healthcare providers and governments. Thenumber of people suffering from asthma across the world estimated to be as high as 334 million[4]. Asthma is not just a public health problem for high income countries: it occurs in all countries regardless of level of development. Over 80% of asthma deaths occurs in low and lower-middle income countries. [5]

Dr. Siraj Wali also noted, “The burden of asthma in Saudi Arabia and the extent to which guidelines are being followed for optimum asthma control are largely unknown. There are no reliable data on the prevalence of asthma in the Kingdom to date, but according to studies, the overall prevalence of asthma in children from Saudi Arabia has been reported to range from 8% to 25% based on studies conducted over the past three decades[6]. Asthma diagnosis requires the presence of one or more of the respiratory symptoms, worsening of the symptoms at night and exacerbation of the symptoms by viral infection, exercise, allergens, changing weather or smoke.[7]

“The disease can cause a considerable burden on the physical, social, and professional lives of affected individuals and family. According to the International Study of Asthma and Allergies in Childhood (ISAAC) and the European Community Respiratory Health Survey (ECRHS), there has been an increase in the general prevalence of asthma. Although the prevalence of the disease is more in developed countries, evidence in recent years has shown a sharp increase in developing countries due to the impact of urbanization’’ added Dr. Siraj Omar Wali.[8]

Doctors also highlighted the region’s increased prevalence of Idiopathic pulmonary fibrosis (IPF), a chronic and rare disease which is characterized by a progressive decline in lung function. 

“The lungs of a patient with IPF, over time builds up with scar tissue which is called fibrosis. This causes the lungs to become stiffer and lost their elasticity and so the lungs lose the ability to inflate and take in oxygen. IPFis a debilitating disease with no cure and so most patients diagnosed with this disease are likely to die as a result of complications such as heart failure.[9] The prognosis of IPF is worse than many forms of cancer- the 5-year survival rate with IPF is 20–40% (10) Symptoms of IPF are similar to other pulmonary diseases such as COPD and asthma which includes shortness of breath and chronic cough and so most patients are often misdiagnosed[10]. Diagnosis requires a set of diagnostic tests and it can take between one and two years from symptoms being presented to be diagnosed. In Saudi Arabia, the prevalence of IPF stands at 0.002% of the total populations.Early diagnosis and treatment of IPF remains a critical unmet need that needs an action, because acting quickly can make a difference[11]. Currently there are available medications that can prevent the IPF disease from progressing,” concluded Dr. Siraj Omar Wali.

Dr. Dalia Mahmoud Amr, Medical Lead, Middle East, Turkey and Africa (META) at Boehringer Ingelheim, said,“This year saw another successful edition of the Boehringer Ingelheim Regional Thoracic Medicine Forum, which aims to address ongoing issues pertaining to pulmonary conditions and provides a platform for expertsfrom around the region to exchange knowledge and explore a holistic approach to the treatment of COPD, asthma and IPF. Research and development has been the cornerstone of Boehringer Ingelheim's success and continues to be the major driver of innovative new approaches that help improve patient’s lives and address unmet therapeutic needs; in line with both national healthcare initiatives and systems.’’ 

The two day event comprised of interactive sessions with the overall goal for experts coming together to discuss the latest medical and scientific insights on treatment and management of pulmonary diseases across the META region.  Doctors agreed that there is still an urgent need to raise awareness among patients and inform doctors about respiratory illnesses, ensuring optimal diagnosis and recommendations around the right method of managing the burden of such diseases.