Factors associated with uncontrolled asthma among Sudanese adult patients

Abstract

Objectives: Uncontrolled asthma is a major health problem resulting in increased morbidity, mortality, healthcare utilization, and costs. The aim of this study was to determine the level of asthma control and its associated factors in Sudan. Materials and Methods: We performed a cross-sectional study of 362 adult asthmatics consecutively recruited from the three main tertiary hospitals in Khartoum State-Sudan, between March and June 2018. Data were collected using standardized questionnaires and the asthma control test (ACT) was used to determine the level of control. Logistic regression analysis was used to determine factors associated with uncontrolled asthma. Results: The mean age of the subjects was 40.1 years (SD 15.7) and the sex distribution was almost equal, with 195 (53.9%) females. Among all asthmatics, the prevalence of uncontrolled asthma was 84.5%, according to ACT score. Factors associated with uncontrolled asthma included; health facility (odd ratios [OR] = 2.96 [1.27–6.86]), time to reach facility (OR = 4.51 [1.68–12.06]), non-adherence to follow-up visits (OR = 5.11 [1.12–23.36]), steroids tablets use without prescription (OR = 9.01 [1.01–79.88]), family history of asthma (OR = 0.45 [0.21– 0.95]), and inhaler technique training (OR = 0.37 [0.17–0.78]). Conclusion: This study showed a high rate of uncontrolled asthma in three tertiary hospitals in Khartoum. Factors associated with uncontrolled asthma may be considered as targets for future intervention strategies.

Prevalence of medication adherence among adult asthmatic patients in four African countries: A systematic review and meta-analysis

“…Previous primary studies and reviews reported a high prevalence of uncontrolled asthma in Africa region (45%–90%). 49 , 50 , 51 , 52 In Africa, mortality rates from asthma is disproportionately high. 53 Therefore, emphasis should be given to improve medication adherence among asthmatic patients in Africa through the improvement of the availability, affordability and accessibility of essential medicines used for the treatment of asthma.…”

Fungal infections in Sudan: An underestimated health problem

“…Compared to other neighboring countries, these estimates are relatively lower than in Egypt, but similar to the Democratic Republic of Congo [ 76 , 97 ]. In Sudan, asthma is among the top 10 cause of hospitalization, and the rate of uncontrolled disease is very high reaching up to 84.5% according to a recent study from Osman et al [ 98 ].…”

Gaps in asthma diagnosis and treatment in low- and middle-income countries

“…Poor adherence is a major factor causing poor control of the disease. Involuntary poor adherence occurs when patients do not use their inhalers correctly ( 18 , 19 ) or have not understood the dosage regimen. Dhadge et al from India found that despite appropriate training, patients made critical mistakes in use of inhalers within the first 24 h which sequentially increased at 7 days and 28 days respectively ( 20 ).…”