Sudan Journal of Medical Sciences
ISSN: 1858-5051
High-impact research on the latest developments in medicine and healthcare across MENA and Africa
Factors Associated with Poor Asthma Control among Sudanese Patients Attending Atbara Teaching Hospital in Sudan
Published date: Dec 31 2024
Journal Title: Sudan Journal of Medical Sciences
Issue title: Sudan JMS: Volume 19 (2024), Issue No. 4
Pages: 432 – 440
Authors:
Abstract:
Objective: To identify factors associated with poor bronchial asthma control in patients attending Atbara Teaching Hospital, Sudan, in 2020.
Methods: This was an analytical, descriptive, cross-sectional hospital-based study conducted at the Atbara Teaching Hospital in River Nile State, Sudan, between February and June 2020. All patients diagnosed with bronchial asthma who were attending any hospital department were included.
Results: In total, 292 patients were enrolled, 51.4% were aged 18–45 years and 51.4% were female. The most frequent complaints were an audible wheeze and shortness of breath (approximately 93%), and 49% had been diagnosed with asthma >10 years previously. Of the patients, 42% were admitted 1 to 3 times and 47.3% were admitted to the intensive care unit (ICU). Hospital admission was associated with improper inhaler use (P = 0.003), the presence of triggers at home or work (P = 0.003), and passive smoking (P = 0.016). ICU admission was associated with female sex (P = 0.039) and the presence of triggers at home or work (P = 0.026).
Conclusion: Asthma is a major problem in Atbara City. Improper inhaler use, the presence of triggers at home or work, and passive smoking were significantly associated with hospital admission. Female sex and the presence of triggers at home or work were significantly associated with ICU admission.
Keywords: poor asthma control, bronchoconstriction, exacerbation of asthma, asthma risk factors, Sudan
References:
[1] Luyster, F. S., Teodorescu, M., Bleecker, E., Busse, W., Calhoun, W., Castro, M., Chung, K. F., Erzurum, S., Israel, E., Strollo, P. J., & Wenzel, S. E. (2012). Sleep quality and asthma control and quality of life in nonsevere and severe asthma. Sleep and Breathing, 16(4), 1129–1137. https://doi.org/10.1007/s11325-011- 0616-8
[2] To, T., Stanojevic, S., Moores, G., Gershon, A. S., Bateman, E. D., Cruz, A. A., & Boulet, L. P. (2012). Global asthma prevalence in adults: Findings from the cross-sectional world health survey. BMC Public Health, 12(1), 204. https://doi.org/10.1186/1471-2458- 12-204
[3] Song, P., Adeloye, D., Salim, H., Dos Santos, J. P., Campbell, H., Sheikh, A., & Rudan, I. (2022). Global, regional, and national prevalence of asthma in 2019: A systematic analysis and modelling study. Journal of Global Health, 12, 04052. https://doi.org/10.7189/jogh.12.04052
[4] WORLDHEALTHRANKINGS. (n.d.). Sudan: Asthma. https://www.worldlifeexpectancy.com/sudan-asthma
[5] Castro-Rodriguez, J. A., Forno, E., Rodriguez- Martinez, C. E., & Celedón, J. C. (2016). Risk and protective factors for childhood asthma: What is the evidence? The Journal of Allergy and Clinical Immunology. In Practice, 4(6), 1111–1122. https://doi.org/10.1016/j.jaip.2016.05.003
[6] Cazzoletti, L., Marcon, A., Corsico, A., Janson, C., Jarvis, D., Pin, I., Accordini, S., Bugiani, M., Cerveri, I., Gislason, D., Gulsvik, A., de Marco, R., & the Therapy and Health Economics Group of the European Community Respiratory Health Survey. (2010). Asthma severity according to Global Initiative for Asthma and its determinants: An international study. International Archives of Allergy and Immunology, 151(1), 70–79. https://doi.org/10.1159/000232572
[7] Wong, K., Rowe, B., Douwes, J., & Senthilselvan, A. (2010). International prevalence of asthma and wheeze in adults: Results from the world health survey. American Journal of Respiratory and Critical Care Medicine, 181, A3117.
[8] Price, D., Fletcher, M., & van der Molen, T. (2014). Asthma control and management in 8,000 European patients: The REcognise Asthma and LInk to Symptoms and Experience (REALISE) survey. NPJ Primary Care Respiratory Medicine, 24, 14009. https://doi.org/10.1038/npjpcrm.2014.9
[9] Braido, F., Brusselle, G., Guastalla, D., Ingrassia, E., Nicolini, G., Price, D., Roche, N., Soriano, J. B., Worth, H.; LIAISON Study Group. (2016). Determinants and impact of suboptimal asthma control in Europe: International cross-sectional and longitudinal assessment of asthma control (LIAISON) study. Respiratory Research, 17(1), 51.
[10] Global Initiative for Asthma (GINA). (2022). Global strategy for asthma management and prevention. https://ginasthma.org/gina-reports/
[11] Zeiger, R. S., Schatz, M., Dalal, A. A., Qian, L., Chen, W., Ngor, E. W., Suruki, R. Y., & Kawatkar, A. A. (2016). Utilization and costs of severe uncontrolled asthma in a managed-care setting. The Journal of Allergy and Clinical Immunology. In Practice, 4(1), 120–9.e3. https://doi.org/10.1016/j.jaip.2015.08.003
[12] Burr, M. L., Limb, E. S., Andrae, S., Barry, D. M., & Nagel, F. (1994). Childhood asthma in four countries: A comparative survey. International Journal of Epidemiology, 23(2), 341–347. https://doi.org/10.1093/ije/23.2.341
[13] Almqvist, C., Worm, M., Leynaert, B., & the Working Group of GA2LEN WP 2.5 Gender. (2008). Impact of gender on asthma in childhood and adolescence: A GA2LEN review. Allergy, 63(1), 47–57. https://doi.org/10.1111/j.1398-9995.2007.01524.x
[14] Postma, D. S. (2007). Gender differences in asthma development and progression. Gender Medicine, 4(2), S133–S146. https://doi.org/10.1016/S1550- 8579(07)80054-4
[15] Hussein, S. E., & Ahmed, M. A. (2005). Prevalence and risk factors of asthma among Wad Medani basic school children, Gezira state, Sudan. Journal of Family & Community Medicine, 12(3), 145–148. https://doi.org/10.4103/2230-8229.97580
[16] Bjornson, C. L., & Mitchell, I. (2000). Gender differences in asthma in childhood and adolescence. The Journal of Gender-Specific Medicine, 3(8), 57– 61.
[17] Horn, C. R., Clark, T. J. H., & Cochrane, G. M. (1990). Compliance with inhaled therapy and morbidity from asthma. Respiratory Medicine, 84, 67–70. https://doi.org/10.1016/S0954-6111(08)80097-2
[18] Apter, A. J., Boston, R. C., George, M., Norfleet, A. L., Tenhave, T., Coyne, J. C., Birck, K., Reisine, S. T., Cucchiara, A. J., & Feldman, H. I. (2003). Modifiable barriers to adherence to inhaled steroids among adults with asthma: It’s not just black and white. The Journal of Allergy and Clinical Immunology, 111, 1219–1226. https://doi.org/10.1067/mai.2003.1479
[19] Milgrom, H., Bender, B., Ackerson, L., Bowry, P., Smith, B., & Rand, C. (1996). Noncompliance and treatment failure in children with asthma. The Journal of Allergy and Clinical Immunology, 98, 1051– 1057. https://doi.org/10.1016/S0091-6749(96)80190-4
[20] Bender, B., Wamboldt, F. S., O’Connor, S. L., Rand, C., Szefler, S., Milgrom, H., & Wamboldt, M. Z. (2000). Measurement of children’s asthma medication adherence by self report, mother report, canister weight, and Doser CT. Annals of Allergy, Asthma & Immunology, 85, 416–421. https://doi.org/10.1016/S1081-1206(10)62557-4
[21] Lasmar, L., Camargos, P., Champs, N. S., Fonseca, M. T., Fontes, M. J., Ibiapina, C., Alvim, C., & Moura, J. A. (2009). Adherence rate to inhaled corticosteroids and their impact on asthma control. Allergy, 64(5), 784–789. https://doi.org/10.1111/j.1398- 9995.2008.01877.x
[22] Cassino, C., Berger, K. I., Goldring, R. M., Norman, R. G., Kammerman, S., Ciotoli, C., & Reibman, J. (2000). Duration of asthma in the elderly. American Journal of Respiratory and Critical Care Medicine, 162(4), 1423–1428. https://doi.org/10.1164/ajrccm.162.4.9912140
[23] Al-Zahrani, J. M., Ahmad, A., Al-Harbi, A., Khan, A. M., Al-Bader, B., Baharoon, S., Shememeri, A. A., & Al-Jahdali, H. (2015). Factors associated with poor asthma control in the outpatient clinic setting. Annals of Thoracic Medicine, 10, 100–104. https://doi.org/10.4103/1817-1737.152450
[24] Gebremariam, T. H., Binegdie, A. B., Mitiku, A. S., Ashagrie, A. W., Gebrehiwot, K. G., Huluka, D. K., Sherman, C. B., & Schluger, N. W. (2017). Level of asthma control and risk factors for poor asthma control among clinic patients seen at a Referral Hospital in Addis Ababa, Ethiopia. BMC Research Notes, 10, 558. https://doi.org/10.1186/s13104-017- 2887-z
[25] Umoh, V. A., Ekott, J. U., Ekwere, M., & Ekpo, O. (2013). Asthma control among patients in Uyo South-Eastern Nigeria. Indian Journal of Allergy Asthma and Immunology, 27, 27. https://doi.org/10.4103/0972-6691.116611
[26] Braman, S. S. (2006). The global burden of asthma. Chest, 130(1), 4S–12S. https://doi.org/10.1378/chest.130.1_suppl.4S
[27] Demoly, P., Annunziata, K., Gubba, E., & Adamek, L. (2012). Repeated cross-sectional survey of patientreported asthma control in Europe in the past 5 years. European Respiratory Review, 21, 66–74. https://doi.org/10.1183/09059180.00008111
[28] Göksel, Ö., Çelik, G. E., Öner Erkekol, F., Güllü, E., Mungan, D., & Misirligil, Z. (2009). Triggers in adult asthma: Are patients aware of triggers and doing right? Allergologia et Immunopathologia, 37, 122– 128. https://doi.org/10.1016/S0301-0546(09)71723-9
[29] Lemière, C., Bai, T., Balter, M., Bayliff, C., Becker, A., Boulet, L. P., Bowie, D., Cartier, A., Cave, A., Chapman, K., Cowie, R., Coyle, S., Cockcroft, D., Ducharme, F. M., Ernst, P., Finlayson, S., FitzGerald, J. M., Hargreave, F. E., Hogg, D.,... Markham, A. W., & the Canadian Adult Consensus Group of the Canadian Thoracic Society. (2004). Adult Asthma Consensus Guidelines update 2003. Canadian Respiratory Journal, 11(Suppl A), 9A–18A. https://doi.org/10.1155/2004/271362
[30] Teach, S. J., Crain, E. F., Quint, D. M., Hylan, M. L., & Joseph, J. G. (2006). Improved asthma outcomes in a high-morbidity pediatric population: Results of an emergency departmentbased randomized clinical trial. Archives of Pediatrics & Adolescent Medicine, 160, 535–541. https://doi.org/10.1001/archpedi.160.5.535
[31] Kiljander, T., Poussa, T., Helin, T., Jaakkola, A., Venho, K., & Lehtimäki, L. (2020). Symptom control among asthmatics with a clinically significant smoking history: A cross-sectional study in Finland. BMC Pulmonary Medicine, 20, 88. https://doi.org/10.1186/s12890-020-1127-9
[32] Boulet, L.-P., FitzGerald, J. M., McIvor, R. A., Zimmerman, S., & Chapman, K. R. (2008). Influence of current or former smoking on asthma management and control. Canadian Respiratory Journal, 15, 275– 279. https://doi.org/10.1155/2008/725074
[33] Braido, F., Brusselle, G., Guastalla, D., Ingrassia, E., Nicolini, G., Price, D., Roche, N., Soriano, J. B., & Worth, H. on behalf of the LIAISON Study Group. (2016). Determinants and impact of suboptimal asthma control in Europe: The international crosssectional and longitudinal assessment on asthma control (LIAISON) study. Respiratory Research, 17, 51. https://doi.org/10.1186/s12931-016-0374-z
[34] Çolak, Y., Afzal, S., Nordestgaard, B. G., & Lange, P. (2015). Characteristics and prognosis of never-smokers and smokers with asthma in the Copenhagen General Population Study. A prospective cohort study. American Journal of Respiratory and Critical Care Medicine, 192, 172– 181. https://doi.org/10.1164/rccm.201502-0302OC
