Level of asthma control and risk factors for poor asthma control among clinic patients seen at a Referral Hospital in Addis Ababa, Ethiopia

Gebremariam, Tewodros Haile; Binegdie, A.B.; Mitiku, Abebe S.; Ashagrie, Aschalew W.; Gebrehiwot, Kibrom Gebresilasie; Huluka, Dawit Kebede; Sherman, Charles B.; Schluger, Neil W.

doi:10.1186/s13104-017-2887-z

Cited by 33 publications

(70 citation statements)

References 44 publications

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“…The proportion of patients who had daytime symptoms more than twice per week, nighttime awakening, and activity limitations were higher in our study as compared to the study revealed in Addis Ababa which showed that 62 (34.6%) patients demonstrated improper inhaler technique [16]. In our study, the proportion of inefficient patient was higher as compared to this finding.…”

Section: Discussioncontrasting

confidence: 61%

Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study

Kebede

Mamo

Molla

2019

Canadian Respiratory Journal

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Asthma is a heterogeneous disease which is characterized by chronic airway inflammation. It is a common chronic respiratory disease affecting 1–18% of population in different countries. It can be treated mainly with inhaled medications in several forms, including pressurized metered-dose inhaler (MDI). Patients encountered difficulty in using inhaler devices even after repeated demonstration and/re-evaluation. This could highly compromise patient treatment outcome/asthma control. To evaluate relationship between MDI use technique and asthma control among adult asthmatic patients who attend respiratory clinic in Jimma University Medical Center (JUMC), Southwest Ethiopia. A prospective observational study was conducted from March to August 22, 2018. All adult asthmatic patients who met the inclusion criteria were included in the study. Patient baseline assessment was conducted (patient demography, inhalation technique, adherence, and asthma control status). Inhalation technique was obtained using a standard checklist of steps recommended in National Institute of Health (NIH) guidelines. Patient adherence using asthma inhalation test and asthma control status was assessed by 2017 GINA guideline. Independent predictors of outcome were identified, strength of association between dependent and independent variables was determined by using ordinal logistic regression analysis, and statistical significance was considered at P<0.05. One hundred forty patients were included in the analysis. Among these, 26 (18.4%) patients were controlled, 65 (46.1%) partially controlled, and 35% uncontrolled. Proportion of patients with uncontrolled asthma were higher among inefficient as compared to efficient, whereas patients with controlled asthma were higher among efficient as compared to inefficient. Asthma control status is significantly associated with inhalation technique (P=0.006). Since most of the patients were inefficient and it is significantly associated with asthma control status, the hospital tried to adopt video MDI teaching program, and the patient should ask healthcare professionals how to take medication and they should bring their device to receive demonstration during visit. Health professionals should re-evaluate the patient during their hospital visit and encourage bringing their device to give demonstration.

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Section: Discussioncontrasting

confidence: 61%

Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study

Kebede

Mamo

Molla

2019

Canadian Respiratory Journal

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“…The result of a study conducted in Addis Ababa; Ethiopia, was in line with this nding. The study showed that asthmatic patients who had exacerbation were more than two times more likely to develop uncontrolled asthma (22). The possible explanation could be due to the fact that past exacerbation predicts future exacerbation that might increase asthma symptoms (38).…”

Section: Discussionmentioning

confidence: 96%

“…Similarly, a signi cant proportion of asthmatic patients suffer from uncontrolled asthma in Africa (17)(18)(19)(20). Studies conducted in Ethiopia showed different prevalence of uncontrolled asthma ranging from 64.5-85.2%, implying high prevalence of uncontrolled asthma in Ethiopia (21)(22)(23).…”

Section: Introductionmentioning

confidence: 99%

Determinants of Uncontrolled Asthma Among Adult Asthmatic Patients on Follow-Up at Chest Clinic of Jimma Medical Center: Unmatched Case-Control Study

Geleta

Dadi

Sona

2020

Preprint

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BackgroundUncontrolled asthma is a notorious public health problem throughout the world despite the presence of effective treatments. Characterizing phenotypes of patients with uncontrolled asthma and searching for risk factors of uncontrolled asthma have been suggested as priority research agenda in the prevention of chronic respiratory diseases. This study aimed to identify the determinants of uncontrolled asthma.MethodsInstitution-based case-control study was conducted on asthmatic patients who were on follow-up at chest clinic of Jimma University Medical (JMC) from March to May, 2020. A total of 59 cases and 118 controls were included in the study. Logistic regression was employed to identify determinants of uncontrolled asthma. Adjusted odds ratios (AORs) with their corresponding confidence intervals (CI) were used to assess the strengths of association between uncontrolled asthma and its determinants at p values ≤ 0.05.ResultsAge of the patients [AOR: 2.78; 95% CI: 1.14, 6.81], age of the cases’ residential houses [AOR: 3.65; 95% CI: 1.30, 10.28], presence of pets within the houses [AOR: 2.78; 95% CI: 1.29, 5.96], having rhinitis [AOR: 3.34; 95% CI: 1.17, 9.52], past asthma exacerbation [AOR: 2.38, 95% CI: 1.05, 5.40], non-adherence to treatment [AOR: 2.81; 95% CI: 1.30, 6.08] and smoking [AOR: 7.09; 95% CI: 1.84, 27.33] were found to be determinants of uncontrolled asthma.ConclusionsUncontrolled asthma is resulted from multiple sociodemographic, environmental, clinical, and behavioral factors. Therefore, interventions targeting to improve asthma control should consider those factors comprehensively.

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“…In summary, this study shared similar methodology including study setting, design, participants and data collection from a previously published work [14]. The institutional review board approved the study protocol and all subjects signed informed consent.…”

Section: Methodsmentioning

confidence: 97%

Perception of asthma control among asthmatics seen inChest Clinic at Tertiary Hospital, Addis Ababa, Ethiopia

2019

Self Cite

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BackgroundPatient awareness of asthma severity is important for optimal asthma management. However, there is often a discrepancy between physician assessment of asthma control based on guidelines and patient discernment of control. We compared physician and patient perception of asthma control in a clinic population seen at a tertiary hospital in Addis Ababa, Ethiopia.MethodsIn this cross-sectional study, 182 consecutive patients with a physician diagnosis of asthma seen in Chest Clinic at Tikur Anbessa Specialized Hospital (TASH) between July and December 2015 were studied. Demographics, asthma symptoms, medication use in the past month, and self-perception of asthma control in the past 7 days were obtained from the clinic records. Physician assessed asthma control was based on the GINA asthma symptom control assessment tool. Lung function was measured using a Diagnostic EasyOne Plus model 2001 SN spirometer. The institutional review board approved the study protocol.ResultsOf the 182 subjects, 68.1% were female. The mean age was 52 ± 12 years, and the mean (SD) duration of asthma was 19.4 ± 12.7 years. Forty-four (24.2%) patients had physician determined well-controlled asthma and 138 (75.8%) patients had physician determined partly controlled/uncontrolled asthma. One hundred and fifty-one (83%) patients thought their asthma control was good. However, the degree of concordance between physician evaluation and patient perception of asthma control was low (kappa index = 0.09). On multivariate analysis, self-perceived poor asthma control was associated with any activity limitation due to asthma and inconsistent inhaled corticosteroid use.ConclusionIn our study, the first of its kind in Ethiopia, a high percent of patients with physician determined well-controlled asthma has appropriate perception of their disease state. However, those patients with partly controlled/uncontrolled asthma had poor self-perception of their disease, emphasizing the need for further patient education. These conclusions may be especially useful in the care of asthmatics from other low-income countries.

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Level of asthma control and risk factors for poor asthma control among clinic patients seen at a Referral Hospital in Addis Ababa, Ethiopia

Cited by 33 publications

References 44 publications

Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study

Association of Asthma Control and Metered-Dose Inhaler Use Technique among Adult Asthmatic Patients Attending Outpatient Clinic, in Resource-Limited Country: A Prospective Study

Determinants of Uncontrolled Asthma Among Adult Asthmatic Patients on Follow-Up at Chest Clinic of Jimma Medical Center: Unmatched Case-Control Study

Perception of asthma control among asthmatics seen inChest Clinic at Tertiary Hospital, Addis Ababa, Ethiopia

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