Asthma is one of the most common chronic diseases in the world, and in Nigeria, it is significantly underdiagnosed and undertreated. Millions of Nigerians live with asthma without ever receiving a proper diagnosis, managing recurring episodes of breathlessness, coughing, and chest tightness as “normal” or attributing them to malaria, chest infection, or spiritual causes.
The reality is that asthma is a manageable condition. With the right diagnosis, the right medication, and knowledge of your personal triggers, most people with asthma can live full, active, unrestricted lives. What makes asthma dangerous is not the disease itself; it is uncontrolled asthma. And in Nigeria, uncontrolled asthma is tragically common.
What Is Asthma?
Asthma is a chronic inflammatory disease of the airways — the tubes that carry air in and out of the lungs. In people with asthma, these airways are persistently inflamed and hypersensitive. When exposed to certain triggers, the airways:
- Swell and become more inflamed
- Produce excess mucus that partially blocks airflow
- Go into bronchospasm, the muscles around the airways tighten, narrowing the tubes further
The result is the classic asthma symptoms: wheezing, coughing, chest tightness, and shortness of breath. Between episodes, many people with asthma feel completely normal, which is why it is so easy to dismiss.
Asthma is not contagious and not curable, but it is highly controllable with proper management.
Types of Asthma
Allergic asthma: Triggered by allergens – dust mites, pollen, mould, animal dander, cockroaches. The most common type globally and in Nigeria. Often runs alongside other allergic conditions like eczema and allergic rhinitis (hay fever).
Non-allergic asthma: Triggered by factors unrelated to allergy – exercise, cold air, smoke, strong odours, stress, respiratory infections, or medications like aspirin and ibuprofen.
Occupational asthma: Triggered by substances in the workplace – wood dust, chemical fumes, flour dust, latex, or paint. Common in Nigerian factory workers, bakers, carpenters, and painters.
Exercise-induced asthma: Symptoms occur primarily during or after physical exertion. Common in children and young adults. Does not mean the person cannot exercise; it means exercise needs to be managed appropriately.
Childhood asthma: Asthma beginning in childhood is extremely common. Many children with asthma experience significant improvement or apparent remission in adulthood, though the underlying airway sensitivity often remains.
Symptoms of Asthma
Asthma symptoms vary in frequency and severity from person to person. Common symptoms include:
Wheezing
A high-pitched whistling sound when breathing, particularly when breathing out. Wheezing is the most recognisable asthma symptom. In mild asthma, it may only be audible with a stethoscope; in severe attacks, it is clearly audible without.
Shortness of Breath
A feeling of not being able to get enough air, chest tightness, or breathlessness, particularly with exertion or when triggered. In severe attacks, the person may be unable to speak in full sentences or lie flat.
Chronic Cough
A persistent cough, often worse at night and in the early morning, that does not respond to standard cough syrups. In some people, chronic cough is the only asthma symptom (called cough-variant asthma). This is frequently misdiagnosed as persistent bronchitis or tuberculosis in Nigeria.
Chest Tightness
A sensation of pressure, squeezing, or constriction in the chest as though something heavy is sitting on it.
Symptoms Worse at Night or Early Morning
Asthma characteristically worsens between midnight and 6 am, when airway inflammation is naturally highest. Waking at night with coughing, wheezing, or breathlessness is a classic asthma pattern.
Symptoms That Come and Go
Unlike most infections, asthma symptoms fluctuate, triggered by specific exposures and improving with removal of the trigger or with medication.
Common Asthma Triggers in Nigeria
Understanding your personal triggers is one of the most important steps in asthma management. The most relevant triggers in the Nigerian environment include:
Dust and Dust Mites
The Nigerian harmattan season (November-March) dramatically increases dust in the air, making it the most challenging period for asthmatic Nigerians. Dust mites, microscopic creatures living in mattresses, pillows, upholstered furniture, and carpets, are a major year-round trigger, particularly in humid coastal cities like Lagos.
Air Pollution and Vehicle Emissions
Urban Nigeria, particularly Lagos and Kano, has significant air pollution from vehicle exhaust, generator fumes, and industrial emissions. For people with asthma, this is a constant and difficult-to-avoid trigger.
Generator Fumes
The near-universal use of petrol and diesel generators in Nigerian homes and businesses exposes asthmatic individuals to carbon monoxide and particulate matter, potent airway irritants. Generator exhaust is a particularly significant and underappreciated asthma trigger in Nigeria.
Cooking Smoke
Wood fire and charcoal cooking, still common across Nigeria, particularly in lower-income areas releases smoke that directly irritates the airways. Even kerosene stove fumes are a significant trigger.
Mosquito Coils and Insecticide Sprays
Burning mosquito coils and aerosol insecticide sprays (Raid, Baygon) release chemicals that are powerful airway irritants and common asthma triggers. Many Nigerians with asthma are unaware that their nightly mosquito coil is worsening their symptoms.
Harmattan Dust
The dry, dusty winds of the harmattan season are one of the biggest asthma triggers in Nigeria. The combination of dry air, reduced humidity, and heavy dust particles creates optimal conditions for asthma flare-ups.
Perfumes, Incense, and Strong Odours
Strong fragrances, including perfumes, air fresheners, incense, and scented candles, trigger airway spasm in sensitive individuals.
Respiratory Infections
Viral respiratory infections, including the common cold, influenza, and COVID-19 are a major asthma trigger. They inflame already-sensitive airways and can precipitate severe attacks.
Exercise
Vigorous exercise, particularly in cold or dusty air, can trigger bronchoconstriction. This does not mean avoiding exercise; with proper pre-treatment and warm-up, most people with exercise-induced asthma can exercise normally.
Stress and Strong Emotions
Emotional stress, anxiety, and even laughing or crying hard can trigger or worsen asthma symptoms through their effect on breathing patterns and airway tone.
Aspirin and NSAIDs
Ibuprofen, aspirin, diclofenac, and related medications trigger asthma in approximately 10–20% of adults with asthma, a condition called aspirin-exacerbated respiratory disease. If your asthma worsens after taking these common pain relievers, tell your doctor. Paracetamol is generally safe.
Diagnosing Asthma
Asthma is frequently underdiagnosed in Nigeria, either because symptoms are attributed to other causes or because proper diagnostic testing is not performed. A proper asthma diagnosis involves:
Clinical History
A detailed account of symptoms when they occur, what triggers them, whether they improve with bronchodilator medication (reliever inhaler), family history of asthma or allergies, and associated conditions (eczema, allergic rhinitis).
Spirometry
The gold standard diagnostic test for asthma. The patient breathes into a device that measures airflow and lung capacity. In asthma, airflow is reduced and improves significantly after a bronchodilator is given; this reversibility is the hallmark of asthma. Spirometry is available at well-equipped clinics and hospitals in Nigeria.
Peak Flow Measurement
A simpler test using a peak flow meter, a small hand-held device that measures how fast air can be blown out. In asthma, peak flow is reduced during symptoms and shows significant variability. Peak flow meters are inexpensive and can be used at home to monitor asthma control.
Allergy Testing
Skin prick tests or blood tests (specific IgE) identify which allergens are triggering asthma useful for targeted avoidance and for considering allergen immunotherapy.
Chest X-Ray
Usually normal in asthma but useful to exclude other conditions like tuberculosis, pneumonia, or heart failure that can cause similar symptoms.
At Pretty Healthcare, respiratory assessments and diagnostic services are available. If you or your child have a chronic cough, recurrent wheezing, or breathlessness that comes and goes, a proper assessment can change everything.
Treatment and Management
Asthma treatment follows a stepwise approach based on the severity and frequency of symptoms. The goal is complete control, no symptoms, no limitations, no emergency visits.
Reliever Medications (Short-Acting Bronchodilators)
Salbutamol (Ventolin) inhaler, the blue reliever inhaler used during an asthma attack. It relaxes the muscles around the airways, opening them within minutes. Every person with asthma should have a reliever inhaler and know how to use it correctly.
Reliever inhalers treat symptoms but do not treat the underlying inflammation. Using a reliever inhaler more than twice a week (outside of exercise) signals that asthma is not adequately controlled and a preventer medication is needed.
Preventer Medications (Inhaled Corticosteroids)
Beclomethasone, budesonide, or fluticasone inhalers, the most important asthma medications for people with persistent symptoms. They reduce airway inflammation over time, preventing attacks from occurring. They must be taken every day, not just during attacks and may take 1-2 weeks to show full benefit.
Many Nigerians resist preventer inhalers due to fear of steroids, but inhaled steroids are delivered directly to the lungs in very small doses and have minimal systemic effects at standard doses. They are safe for long-term use and are the cornerstone of asthma prevention.
Combination Inhalers
Inhalers containing both a preventer (inhaled steroid) and a long-acting bronchodilator such as Seretide (fluticasone + salmeterol) or Symbicort (budesonide + formoterol) are used for moderate to severe asthma. They provide both daily control and symptom relief.
Oral Medications
Leukotriene receptor antagonists (montelukast) tablet taken daily, particularly useful for allergic asthma and exercise-induced asthma. Often combined with inhaled treatment.
Oral steroids (prednisolone) short courses for severe attacks or exacerbations. Not for long-term daily use.
Correct Inhaler Technique
Up to 80% of asthma patients use their inhalers incorrectly a significant cause of poor asthma control. Inhaler technique should be demonstrated and checked by a healthcare provider at every visit. A spacer device (a chamber attached to the inhaler) significantly improves drug delivery and is especially important for children.
Managing Asthma in the Nigerian Environment
During Harmattan Season
- Wear a face mask or cover your nose and mouth when outdoors in dusty conditions
- Keep windows and doors closed during peak harmattan dust hours
- Dust surfaces with a damp cloth rather than dry dusting which disperses particles into the air
- Use nasal saline rinses to clear dust from nasal passages
- Keep reliever inhaler accessible at all times
At Home
- Replace mosquito coils with plug-in electric mosquito repellents or insecticide-treated nets
- Use insecticide sprays only when the asthmatic person is out of the room and ventilate thoroughly before they return
- Wash bedding in hot water weekly to reduce dust mites
- Avoid carpets and heavy curtains in bedrooms, they harbour dust mites
- Ensure good ventilation when cooking; where possible, use gas rather than wood or charcoal
Generators
- Never run a generator indoors or in an enclosed space
- Ensure generator exhaust is directed away from windows and air intake points of the home
- If generator fumes enter your home regularly, consider an anti-pollution face mask during generator hours
Asthma Action Plan
Every person with asthma should have a written Asthma Action Plan developed with their clinician. This plan specifies:
- Daily medications to take
- What to do when symptoms worsen (increase reliever use, start oral steroids)
- When to seek emergency care (symptoms not improving after reliever use, severe breathlessness, inability to speak)
An asthma attack that does not respond to reliever inhaler use after 10-15 minutes is a medical emergency, go to a hospital immediately.
Asthma in Children
Asthma is the most common chronic disease of childhood globally. In Nigerian children, it is frequently misdiagnosed as “frequent malaria,” “chest infection,” or “bronchitis.” Key signs in children:
- Recurrent cough especially at night and with exercise
- Recurrent wheezing episodes
- Frequent chest infections that take longer than usual to resolve
- Child avoids running because it makes them cough or wheeze
- History of eczema or allergic rhinitis in the child or family
Children with asthma can live fully active lives. With correct diagnosis and treatment, they should be able to run, play sports, and keep up with peers without restriction.
Nigeria-Specific Facts
- Asthma prevalence in Nigerian urban areas is rising driven by increasing air pollution, indoor allergens, and changing environmental conditions
- Harmattan season (November-March) is peak asthma season in Nigeria; emergency room visits for asthma attacks spike during this period
- Many Nigerians rely on reliever inhalers alone without preventer treatment, a pattern that leads to poor control and preventable attacks
- Misconceptions about inhaler “addiction” and steroid fear lead many patients to stop treatment,education is critical
- Herbal and traditional treatments for asthma have no evidence of efficacy and can delay access to life-saving medication during an acute attack
When to Seek Emergency Care
Go to a hospital immediately if:
- A reliever inhaler gives no relief or improvement lasts less than 4 hours
- Breathing is so difficult the person cannot speak in full sentences
- The skin between the ribs or at the base of the throat is sucking inward with each breath (respiratory distress)
- Lips or fingernails are turning blue (cyanosis)
- The person is confused, drowsy, or losing consciousness
A severe asthma attack is life-threatening. Do not wait to see if it improves.
Quick Summary
| What is asthma? | Chronic airway inflammation causing recurrent breathing difficulties |
| Is it curable? | No, but highly controllable |
| Key Nigeria triggers | Harmattan dust, generator fumes, mosquito coils, cooking smoke, pollution |
| Most common symptom | Wheezing, cough, chest tightness, breathlessness |
| Best diagnostic test | Spirometry |
| Reliever medication | Salbutamol (blue) inhaler for attacks |
| Preventer medication | Inhaled steroid taken daily to prevent attacks |
| Emergency sign | Reliever inhaler not working, go to hospital immediately |
Bottom Line
Asthma is not a weakness, not a spiritual problem, and not something to simply endure. It is a chronic but entirely manageable disease. With a correct diagnosis, the right medications used correctly, knowledge of your triggers, and an action plan for bad days, asthma should not limit your life. In Nigeria, where environmental triggers are significant and awareness is low, getting a proper diagnosis and proper treatment makes an enormous difference. If you or your child have recurring cough, wheezing, or breathlessness, do not keep guessing. Get assessed.
Book a respiratory assessment at Pretty Healthcare, Ikeja Lagos. Contact: prettyhealthcare.com.ng/diagnostics or chat with our health advisor on WhatsApp. Monday – Friday: 8am – 5pm | Saturday: 9am – 4pm.
