Asthma spreading and primary diagnostics problems in rural regions of Kazakhstan

Nurpeissov, Temyrzhan; Nurpeissov, Tair; Abdushukurova, Gulzada; Gazaliyeva, Meruert; Avdugalieva, Aizhan; Shagiyeva, Alima

doi:10.1186/2045-7022-5-s2-p22

Cited by 2 publications

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“…Economies in transition, high smoking prevalence, very high levels of ambient air pollution, most pronounced in the cold season due to solid fuel combustion for heating [ 2 ], occupational exposure to vapors, gas, dust and fumes [ 3 ] and the failure of healthcare systems to respond to the growing burden of CRD may explain high prevalence of CRD in the region. Official prevalence data are believed to remain biased, because they are calculated from self-admitted patients and those listed as medication recipients from the state insurance [ 4 ]. Few published studies indicate dramatic discrepancy between such data and the findings of the population-based surveys [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Official prevalence data are believed to remain biased, because they are calculated from self-admitted patients and those listed as medication recipients from the state insurance [ 4 ]. Few published studies indicate dramatic discrepancy between such data and the findings of the population-based surveys [ 4 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Chronic asthma is adults and chronic obstructive pulmonary disease (COPD) are the two leading causes of CRD in Kazakhstan, because the detection of other less prevalent diseases, including interstitial, is hampered by poor infrastructure and insufficient vigilance of primary healthcare doctors. Data on COPD prevalence in the epidemiological studies differ dramatically from the official data [ 4 , 5 ]. Thus, in a study based on forced expiratory flow in one second (FEV 1 )/forced vital capacity (FVC) below lower limit of normality (LLN), COPD prevalence was 8.7% in men and 3.4% in women in the age group 40 years and older [ 6 ], which was 10–15 times greater than the official data of the Ministry of Health.…”

Section: Introductionmentioning

confidence: 99%

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Asthma control in Kazakhstan: need for urgent action

et al. 2023

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Background Asthma control, patients’ awareness level and adherence to treatment in Kazakhstan have never been studied. The aim of this study was to verify the prevalence of controlled, poorly controlled and uncontrolled asthma in a large sample of three largest cities of Kazakhstan. Methods We recruited 600 (median age 54 (interquartile range (IQR) 22) years, 64% females) patients with diagnosis confirmed earlier in the outpatient facilities in Almaty, Astana and Shymkent in 2020–2021. We offered a structured questionnaire on asthma control and risk factors as of GINA and performed spirometry. We report the prevalence of asthma control, knowledge and skills and pharmacological treatment with 95% confidence interval (CI) and the association of selected predictors with asthma control. Results With the median of 9 (IQR 13) years of diagnosis, 40% of patients had comorbid COPD and 42% had allergic rhinitis, whereas 32% lived with pets. Asthma was well-controlled in only 12.3% (95% CI 9.7–15.0), partly controlled in 29.8% (95% CI 26.2–33.5) and uncontrolled in 57.8% (95% CI 53.9–61.8) patients. ACQ-5 score (range 0–5.8, median 2) equaled 0.2 (IQR 0.85) in well-controlled asthma patients, 1.4 (IQR 1) in partly controlled and 2.8 (IQR 1.4) in uncontrolled asthma patients. Knowledge and skills levels were very low. Only 54% were on inhaled corticosteroids (52.2% of them used budesonide/formoterol and 39.5% used fluticasone/salmeterol). 39% used steroids per os or parenterally within a period of 12 months (51% of patients with uncontrolled asthma). Conclusion Asthma control, knowledge and skills levels of asthma patients in the largest cities of Kazakhstan remain unacceptably low, whereas pharmacological treatment is far from optimal. Urgent action should be taken to support doctors’ training, and we call to launch a national asthma program to coordinate asthma care in Kazakhstan.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Asthma control in Kazakhstan: need for urgent action

et al. 2023

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The diagnostic accuracy of spirometry versus peak expiratory flow test for follow-up of adult asthma patients at primary care level

Mamyrbekova

Iskakova

Faizullina

et al. 2022

allergy asthma proc

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Background: The asthma burden is growing worldwide, and this is predisposed by environmental and occupational exposures as well as individual risk factors. This study was aimed at a comparison of diagnostic accuracy of spirometry and peak expiratory flow rate (PEFR) in asthma screening of adult patients with lung function abnormalities that present at the level of primary care. Methods: This study was conducted in Shymkent city, South Kazakhstan, the third most populous city of the country with developed industries and high rates of pulmonary diseases. Four hundred and ninety-five adult patients with lung function abnormalities were enrolled in the study and underwent two screening tests (spirometry and PEFR). The diagnosis of asthma was verified by a qualified pulmonologist after performance of screening tests and was based on symptoms, medical history, and laboratory and lung function tests. Results: The sensitivity of spirometry was 0.97 and that of PEFR was 0.95 (p = 0.721), whereas the specificity of spirometry was 0.37 and that of PEFR was 0.28 (p = 0.227). Both tests yielded the same results for the positive predictive value (0.98). The negative predictive value was significantly higher for spirometry versus PEFR (0.23 versus 0.08; p = 0.006). The positive and negative likelihood ratios of the two tests also differed significantly (p = 0.001 and p = 0.006, respectively), whereas the overall accuracy was comparable between the two tests (0.96 for spirometry and 0.94 for PEFR; p = 0.748). Conclusion: Ambulatory PEFR monitoring is non-inferior to the monitoring of the forced expiratory volume in 1 second and could be used for screening purposes on equal grounds with spirometry.

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Asthma spreading and primary diagnostics problems in rural regions of Kazakhstan

Cited by 2 publications

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Asthma control in Kazakhstan: need for urgent action

Asthma control in Kazakhstan: need for urgent action

The diagnostic accuracy of spirometry versus peak expiratory flow test for follow-up of adult asthma patients at primary care level

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