The rising danger of asthma

Published online 29 May 2013

Rapidly changing lifestyles are increasing the prevalence of asthma across all the Middle East, but especially the Gulf region.

Ola Al-Ghazawy

© PhotoDisc/ Getty Images

A worldwide rapid increase in the number of asthma sufferers is particularly acute in the Gulf states, researchers have found.

After World Asthma Day this month promoted awareness of the condition, health professionals in the Middle East and North Africa (MENA) region have drawn attention to the scale of the problem. Research led by Mohammed Al Ghobain, a pulmonologist at the King Saud bin Abdulaziz University for Health Sciences, Riyadh revealed alarming figures.

Saudi Arabia took the lead, with a rate of 24% of the population suffering. In previous research, Qatar and Kuwait came next, with a rate of 19.8% and 16.8% respectively, followed by 13% in the United Arab Emirates. Oman had the lowest prevalence among the Gulf Cooperation Council 2345with a rate of just more than 10%.

Some 235-300 million people worldwide suffer from asthma which, if uncontrolled, can be fatal. It continues to increase – especially among children – and by 2025, this number is expected to increase by 100 million.

Underdiagnosis and poor treatment are increasing the incidence of death. Fatalities due to the inflammatory condition are on the rise in both middle and low-income countries across the world.

"The prevalence of asthma in Lebanon varies from study to study but is considered to be around 10%," says Pierre Bou Khalil, head of the Pulmonary and Critical Care Medicine Program at the American University of Beirut (AUB) Medical Center.

According to Mona El Falaki, head of the Pediatric Allergy and Pulmonology Unit at Cairo University, a 1994 study reported asthma prevalence among children and teenagers of 8.4% in Egypt6. But since then, several small scale surveillance studies in different parts of Egypt since then have shown a prevalence of around 16-18%, El Falaki warns.

A 2009 study published in Respiratory Medicine found that asthma in the Maghreb region – which covers all Arab states in North Africa west of Egypt – had asthma prevalence rates ranging between 3.4 and 3.9%7.

Rapid urbanization

The high rate in Saudi Arabia might be attributable to a rapid change in lifestyle.

The World Health Organization has not defined exact causes for asthma. However, many substances can trigger the inflammation of the airways, such as smoke, pollen, incense burning or perfume.

Bou Khalil, and El Falaki agree that one of the main reasons for the rise of asthma prevalence is the rapid spread of urbanization, especially in the Gulf states. Studies suggest crowded environments expose children to a high number of asthma triggers and may affect immune system development.

In his study, Al Ghobian suggests the high rate in Saudi Arabia might be attributable to a rapid change in lifestyle, dietary habits and higher exposure to indoor allergens, tobacco smoke, dust and sandstorms.

Bou Khalil, however, contends another reason for the increased prevalence of asthma in the region may be related to better diagnosis, adding that many cases in the past "used to be mislabelled as an allergy."

He suggests while it is untreatable, good management of asthma can reduce the episodes of wheezing, breathlessness, chest tightness and coughing suffered by patients. The Global Initiative for Asthma (GINA) suggests decreasing exposure to risk factors to decrease the irritation of the airways of the body that lead to these episodes.


  1. Al Ghobain, M.O. et al. Asthma prevalence among 16- to 18-year-old adolescents in Saudi Arabia using the ISAAC questionnaire. BMC Public Health 12:239 (2012). | Article | PubMed |
  2. Behbehani N.A. et al. Prevalence of asthma, allergic rhinitis, and eczema in 13- to 14-year-old children in Kuwait: an ISAAC study. International Study of Asthma and Allergies in Childhood. Ann Allergy Asthma Immunol 85: 58-63 (2000). | Article | PubMed |
  3. Al-Maskari F. et al. Asthma and respiratory symptoms among school children in United Arab Emirates. Allerg Immunol (Paris) 32(4):159-63 (2000).
  4. Janahi I.A. et al. Prevalence of asthma among Qatari schoolchildren: international study of asthma and allergies in childhood, Qatar. Pediatr Pulmonol 41: 80-86 (2006). | Article | PubMed |
  5. Al-Rawas O.A. et al. Trends in asthma prevalence and severity in Omani schoolchildren: comparison between ISAAC phases I and III. Respirology 13: 670-3 (2008). | Article | PubMed |
  6. El-Hefny A.M. et al. Epidemiology of Asthma in Cairo. Med. J. Cairo Univ. 62: 505-18, (1994).
  7. Benkheder A. et al.Control of asthma in the Maghreb: results of the AIRMAG study. Respir Med. (2009) doi:10.1016/S0954-6111(09)70023-X)70023-X