Top 8 Respiratory Diseases in Nepal

Diseases that affect the airways and lungs of the human respiratory system are commonly termed as respiratory diseases.

Respiratory illnesses are widespread and common across the globe. While genetic predisposition and environment, for example, the working environment, are the main source of respiratory illnesses.

Nevertheless, smoking is also attributed to the primary cause of respiratory diseases in this day and age.

Major organs that are affected with respiratory diseases include nasal cavities, throat, larynx, and trachea (windpipe), bronchi and bronchioles (tissues of the lungs), and respiratory muscles of the chest.

Figure: Depiction of different organs associated with the respiratory tract

As vital it is for us to breathe, the lungs are the organs that are exposed to varying environments containing dust and harmful gases which is the main reason for the predominance of respiratory illnesses across the globe.

In addition to that large and sophisticated network of capillaries that are embedded in our lungs processing the whole output of the heart in the form of blood has a varying degree of sensitivity across individuals.

This in turn dictates that diseases that affect small blood vessels and allergies are prone to initiate respiratory disease in an individual.

In this article, we discuss and elaborate on the top 8 respiratory diseases that are prevalent in the world and in Nepal.

1. Asthma

Asthma is a chronic respiratory condition that brings difficulty breathing due to the inflammation of the respiratory tract.

In other words, asthma is a condition were our airways narrow and swell producing extra mucus. 

It usually starts at a very early age and progresses into adulthood. The most common symptoms of asthma are difficulty breathing, tightness of chest, dry cough, wheezing, and shortness of breath.

Similarly, environmental allergies are also a noticeable cause of asthma since air pollution that induces respiratory infections can also trigger asthma in an individual.

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However, the quality of life of asthma patients can improve a lot, with good quality air (environment) and a better lifestyle.

Some anti-inflammatory medication and rescue inhalers can be life-saving at times for asthma patients and therefore very handy to keep.

2. Chronic Obstructive Pulmonary Disease (COPD)

COPD is a broad term that refers to respiratory illnesses that leads to breathlessness and difficulty exhaling. It encompasses many diseases such as chronic bronchitis and emphysema under its umbrella.

Major signs of (COPD) include shortness of breath and coughing up sputum especially in the morning. Since (COPD) can develop in several years, it is hard to identify as its symptoms are generally mistaken for the aging process and body deterioration.

The onset of (COPD) generally starts when people are in their 30’s and 40’s and has its peak when they are at their 50’s, 60’s and 70’s without any signs of shortness of breath.

Thus it is quite tricky to identify and hence get help at its earlier stage. Consequently, it goes far too long undetected, developing a varying degree of severity, while most of the cases being chronic and irreversible just to worsen with time.

Moreover, smoking is a prime cause associated with (COPD) with very few exceptions of cases with people with (COPD) without a case history of long term smoking.

Therefore, good healthy lifestyle habits with regards to cigarette smoking are crucial for avoiding this serious respiratory illness.

The gravity of the situation in terms of its severity can be explained by the fact that (COPD) being the third major cause of death in the U.S. according to the American Lung Association.

3. Pneumonia

Pneumonia is a disease of the lungs triggered by the infection due to bacteria, viruses, and fungi that cause inflammation of air sacs in the lungs.

Conditions worsen as the air sacs that are technically termed as alveoli are filled with fluid or puss resulting in difficulty breathing.

Major symptoms include coughing mucus, fever and chills, shortness of breath, and chest pain while the severity of the condition can vary from mild to life-threatening. 

Moreover, pneumonia can be contagious depending upon the agent of infection such as bacteria or viruses.

Generally, it spreads from person to person when they come in contact with the airborne droplets resulting from the cough and sneeze.

Similarly, susceptibility to pneumonia and the severity of its condition primarily depends upon the smoking history and immune status of an individual.

As very young and very old people are mostly at the risk of contracting the disease.

As a result, frail and sick people may develop serious complications while a young, healthy individual can just overcome it without any complication.

Some basic ways to avoid pneumonia is to adopt healthy sanitary habits such as washing hands frequently, getting flu shots and pneumonia vaccines occasionally. 

4. Tuberculosis

Tuberculosis is a bacterial disease that most commonly infects the lungs and causes a long drawn out distressing conditions such as severe hemorrhage from the lungs.

As statistics suggest, 2018 alone recorded 1.5 million deaths due to single infective causative agent Mycobacterium tuberculosis, which causes T.B. thereby speaking volumes on the gravity of the precarious situation that exists.

Moreover, it is considered one of the top 10 leading causes of deaths due to a single causative agent.

This pulmonary disease is communicable, through airborne transmission when an individual comes in contact with the bacteria when infected person propels them in the air when they cough, sneeze, or spit.

Although, one-quarter of the world’s population is thought to have latent T.B which means they are not ill and cannot spread the disease.

Moreover, people who contract the bacteria have a (5-15) % lifetime risk of falling ill with this disease, especially those that have compromised immune systems, fighting with HIV, suffering from malnutrition, or chain smokers.

Similarly, people who contract active T.B have symptoms such as cough, fever, night sweat, and weight loss. Commonly chest X-rays are sufficient to reveal this condition to the physician if you are experiencing such conditions.

While antibiotics are readily available for its treatment and cure which may comprise of doses that may extend to some elongated time intervals.

5. Lung Cancer

A condition when DNA mutation or change in normal cells of the lungs that form the air sacks, makes them abnormal in a way that it loses control on normal functions such as growth and development.

Therefore, these normal cells multiply abnormally and can metastasize (infect) other parts of the body. Although it can develop in any part of the lungs, air sacs are the primary site of cancerous development. 

One most vital risk factor for the development of lung cancer is considered to be cigarette smoking. Similarly, radiation exposer in the workplace, for example, radon exposer, asbestos exposer, diesel fumes, or second-hand smoke exposer are also considered to be the risk factors for lung cancer.

Symptoms for the identification of this disease include chronic coughing, coughing up blood, changes in voice, and harsh breathing sounds.

Since it takes years to develop and is hard to diagnose, it is the leading cause of cancer death in the U.S.A as reported by the American Cancer Society.

6. Cystic Fibrosis/Bronchiectasis

Cystic fibrosis is a kind of pulmonary disease that solely stems from the genetics of the parents.

It is characterized by the condition where the epithelial cells of the lungs over-produces thick and sticky mucus that consequently blocks the normal airways for the lungs.

It is implicated in numerous dangerous lung infections, and sometimes even blocking the pancreas that secretes enzymes to digest the food that we eat.

Cystic fibrosis develops as early as the age of two as it is genetically inherited from the parents.

Common signs of this disease are salty-tasting skin, chronic coughing, frequent lung infections and poor growth rate in the children.

While most patients that have this disease are also prone to develop bronchiectasis.

Similarly, bronchiectasis is the disease characterized by dilated bronchial tubes in the patient. It is hence this characteristic of this disease that makes the accumulation of the mucus easy thereby causing shortness of breath, wheezing, and frequent respiratory tract infection in those that develop this condition.

Nonetheless, cystic fibrosis is not the only pathway leading to bronchiectasis, for example, other respiratory tract infections can also lead to cystic fibrosis.

Nevertheless, it develops later in life and is seen more in the case of women than in men.

7. Pleural Effusion

This is a condition where there is a collection fluid in pleural space, which is a space between the lungs and chest wall.

This accumulation of the fluid can be the result of various conditions such as cancer, congestive heart failure, or pneumonia. Similarly, progressive chest discomfort and shortness of breath are the main symptoms of pleural effusion.

Usually, fluid from the pleural cavity is taken out with some medical procedures as a remedy, which allows the lungs to re-expand, and hence patients can breathe with ease.

Moreover, the fluid is tested further to examine the cause of the accumulation.

8. Allergic Rhinitis

This is a respiratory illness associated with the reaction of our body after it comes in contact with the allergen.

Allergens are substances that produce an allergic reaction in our body, for example, pollen grains.

The most common symptoms of allergic rhinitis include sneezing, coughing, itchy, and running nose.

This condition is universally predominant in the Indian sub-continent or outside with the statistics suggesting 8.4% of the people in India attending their doctors for all the pulmonary disorders.

Similarly, pollens are by far the most common cause of allergic rhinitis across the globe, while this condition predominantly exists during seasonal variation.

References:
Alana Biggers (M.D) (2019), Health line, everything you need to know about Pneumonia
David V. Bates, Britannica, Science, Respiratory Disease
Judith Marcin (M.D) (2019) Health line, Allergic Rhinitis?
Madhuragauri Shevade, et.at (2015) What are the most common respiratory diseases encountered in clinical practice? Results of a pilot study in 737 Indian patients, European Respiratory Journal, Volume 46
World Health Organization (2020), Tuberculosis, newsroom, factsheets
Unity Point Health (2020), The top 8 respiratory illnesses and diseases