The burden of severe asthma in sub-Saharan Africa : findings from the African Severe Asthma Project
Abstract
Background Severe asthma is associated with high morbidity, mortality and health care utilization but its burden in Africa is unknown. Objective To determine the burden (prevalence, mortality and activity and work impairment) of severe asthma in three Easter Africa countries (Uganda, Kenya and Ethiopia). Methods Using the American Thoracic Society/European Respiratory Society (ATS/ERS) case definition of severe asthma we analyzed for the prevalence of severe asthma (requiring GINA steps 4–5 asthma medications for the previous year to achieve control) and severe refractory asthma (remains uncontrolled despite treatment with GINA steps 4–5 asthma medications) in a cohort of 1086 asthma patients who had been in care for 12 months and had received all GINA recommended medications. Asthma control was assessed using the asthma control questionnaire (ACQ). Results Overall, the prevalence of severe asthma and severe refractory asthma was 25.6% (95% CI 23.1–28.3) and 4.6% (95% CI 3.5–6.0) respectively. Patients with severe asthma were (non- severe vs. severe vs. severe refractory) older (39, 42, 45 years, p=0.011), had high skin prick test reactivity (67.1%, 76.0%, 76.0%, p=0.004), had lower FEV1% (81%, 61%, 55.5%, p=<0.001), lower quality of life score (129, 127 vs 121, p=<0.001) and higher activity impairment (10%, 30%, 50%, p=<0.001). Conclusion The prevalence of severe asthma in Africa is high and is associated with high morbidity and poor quality of life.
Citation
Kirenga , B J , Chakaya , J , Yimer , G , Nyale , G , Haile , T , Muttamba , W , Mugenyi , L , Katagira , W , Worodria , W , Aanyu-Tukamuhebwa , H , Lugogo , N , Joloba , M , Mersha , T , Bekele , A , Makumbi , F , Mekasha , A , Green , C L , de Jong , C , Kamya , M & van der Molen , T 2024 , ' The burden of severe asthma in sub-Saharan Africa : findings from the African Severe Asthma Project ' , Journal of Allergy and Clinical Immunology: Global , vol. 3 , no. 2 , 100209 . https://doi.org/10.1016/j.jacig.2024.100209
Publication
Journal of Allergy and Clinical Immunology: Global
Status
Peer reviewed
ISSN
2772-8293Type
Journal article
Description
Funding: Funded by a project grant from the GSK Africa Non-communicable Disease Open Lab (project 8019).Collections
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