Asthma is a chronic, inflammatory airway disease involving airway hyper-responsiveness and intermittent airflow obstruction. Although potentially under-reported, asthma affects 20% of people in sub-Saharan Africa. [1] There is a wide range in prevalence among different geographic locations, owing in part to poverty, climate, and allergen exposure. [1] There appears to be a racial discrepancy in prevalence of asthma, with Asians being less affected than Native Americans, and a gender discrepancy, with a female preponderance among adult asthmatics. [2] Patients with asthma over the age of 65 years tend to fare worse than younger patients. [3] Identification of the level of severity of asthma and determination of the factors affecting asthma control are crucial to the design and implementation of strategies to reduce the number of exacerbations and hospital admissions, thus improving outcomes. Of vital importance is the documentation of important parameters in the management of asthma, particularly in a public hospital where patients often see different doctors at each visit. These include inhaler technique, frequency of exacerbations and number of admissions to hospital.Our impression is that the control of asthma in patients attending the Respiratory Outpatient Department (ROPD) at Chris Hani Baragwanath Academic Hospital (CHBAH), Johannesburg, is suboptimal. However, no study has been performed at our hospital to interrogate this hypothesis, or to quantify the proportion of our patients with severe disease and/or poor control. We are of the opinion that these data will provide important information on asthma management relevant to the South African (SA) healthcare system. MethodsWe undertook a retrospective analysis of scheduled visits by patients with asthma attending the ROPD at CHBAH. Data collected included demographics, symptoms, disease severity, medication prescription and usage, control of asthma, inhaler technique competency and spirometry. This information was captured by the investigator using a data collection sheet that is routinely completed as part of our patients' clinic records. The sources of information were the patients' files, held at ROPD.Definitions of asthma control and indicators of asthma severity were based on those advocated by local SA Thoracic Society guidelines. [4] Acute exacerbations and severity were determined by the need for oral steroid use, days off work, antibiotic use, number of Emergency Department visits (exacerbations), intensive care unit admissions and general ward ORIGINAL RESEARCHBackground. There is a sense among respiratory physicians that asthma is poorly controlled in public sector hospitals, possibly due to poor adherence and lack of knowledge regarding inhaler technique. Objective. To describe the status of asthma control in patients attending the Respiratory Outpatient Department at Chris Hani Baragwanath Academic Hospital. Methods. A retrospective record review was conducted on outpatient files of asthmatics known to the Respiratory Department. Data obtained...

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Objectives: The survey was to determine Knowledge, attitude, and practices around bronchiectasis, as a starting point for the development of guidelines for care in African Countries. Materials and Methods: This survey was administered to non-specialist physicians in urban health centers in Burkina Faso, Uganda, South Africa, and Ethiopia. Data were anonymized and analyzed at an individual level by country and health-care setting. Results: A total of 388 participants were recruited from Ouagadougou (75/388, 19.3%), Kampala (85/388, 21.9%), Johannesburg (74/388, 19.3%), and Addis Ababa (154/388, 39.6%). Median age was 30 years, and 66% were male, with a median of 3-year medical experience. Knowledge about the definition, clinical presentation, and diagnosis of disease was good. However, guidelines for local practice were largely absent. Wide variation was reported in diagnostic and management practices. Physicians recognized the need for guidelines and further training. Conclusion: This study highlighted the lack of local guidelines for bronchiectasis care in these settings and marked variation in approaches to investigation, diagnosis, and management within and between sites. Context-appropriate guidelines for bronchiectasis care in Sub-Saharan Africa are needed. These must be informed by local epidemiology, should reflect locally available resources and comorbidities including tuberculosis-disease, and should be codeveloped with local practitioners.