Despite increased access to medicines, asthma prevalence remains high.
Asthma has been a common disease in Thailand, especially among younger children. However, over the past two decades, severe asthma attacks presenting to emergency rooms and/ or requiring hospital admission have decreased. This may be due to an increase in the availability of asthma preventers and controllers throughout the country, especially inhaled corticosteroids and montelukast. For those eligible for medical support (government employees, and those receiving social security and Universal Health Coverage), the Government subsidised cheaper generic versions of asthma medicines in the Essential Medicines List.
Global Asthma Network survey
Despite gains, the 2017-2018 Global Asthma Network (GAN) survey in Thailand found that asthma prevalence in children remains over 10%, with prevalence of severe wheeze at 2%. Therefore, we need further research into utilisation of acute and in-hospital care for asthma.
Air pollution measures
Over the last decade, Thailand has enforced stricter regulations to reduce outdoor air pollution, such as cleaner air emissions and vehicle fuels. Despite this, air quality in major cities in Thailand (Bangkok and Chiang Mai) continues to be at a critical level, especially in cooler months. Thankfully, due to effective advocacy by non-governmental organisations (NGOs), smoking in homes and public places is now a rare event.
The Chest and Allergy Societies in Thailand have regularly updated asthma guidelines for adults and children, and social media has made it easier for parents/patients to find appropriate professional care. Although death due to asthma is becoming more unusual, the recent asthmarelated death of a prominent politician led to calls for the provision of asthma action plans by physicians and improved asthma knowledge and procedures in emergency care settings.
In recent years, Thailand has noted an increase in the number of patients with food allergy and atopic dermatitis, suggesting that the allergic march may be at play. If this is the case, we would expect to see an increase in the number of asthma patients, rather than a continuing decrease, in the next decade.