Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations]
Background: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among scho...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wellcome
2019-11-01
|
| Series: | Wellcome Open Research |
| Online Access: | https://wellcomeopenresearch.org/articles/4-168/v1 |
| _version_ | 1818301445875695616 |
|---|---|
| author | Harriet Mpairwe Pius Tumwesige Milly Namutebi Marble Nnaluwooza Tonny Katongole Josephine Tumusiime Barbara Apule Caroline Onen Mike Mukasa Joseph Kahwa Emily L. Webb Neil Pearce Alison M. Elliott |
| author_facet | Harriet Mpairwe Pius Tumwesige Milly Namutebi Marble Nnaluwooza Tonny Katongole Josephine Tumusiime Barbara Apule Caroline Onen Mike Mukasa Joseph Kahwa Emily L. Webb Neil Pearce Alison M. Elliott |
| author_sort | Harriet Mpairwe |
| collection | DOAJ |
| description | Background: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among schoolchildren with asthma in urban Uganda, to assess the level of asthma control and management. Methods: Schoolchildren aged 5-17 years were enrolled, asthma was diagnosed by the study medical team. Asthma control was assessed using the Asthma Control Test and the childhood Asthma Control Test. Data on previous asthma management was obtained using interviewer-led questionnaires. Data were analysed using multiple linear and multiple logistic regression. Results: We enrolled 561 children with asthma, of whom only 56% had ever had an asthma diagnosis. We categorised asthma as well-controlled (55.5%), partly-controlled (29.5%) and poorly-controlled (15.0%). Poor asthma control was associated with increasing age (adjusted regression coefficient [95% confidence interval], p-value: -1.07 [-1.20, -0.94], p<0.0001), concurrent allergic rhinitis (-1.33 [-2.28, -0.38], p=0.006), and city residence in early life (-1.99 [-3.69, -0.29], p=0.06). Regular use of inhaled asthma medication in the last 12 months was very low; 18.1% for salbutamol and 6.7% for inhaled corticosteroids. The main barriers to inhaled asthma medication use were lack of prescription (47.6%) and inaccurate diagnosis (38.8%). Increased inhaler use was associated with tertiary education of the fathers (adjusted odds ratio [95% confidence interval], p-value: 5.19 [2.39-11.28], p<0.0001), city residence in early life (4.66 [1.79-12.43], 0.002) and an asthma diagnosis prior to enrolment (11.39 [6.35-20.43], p<0.0001). Conclusions: This study confirms that children with asthma in Uganda generally have inadequate asthma control, which is attributable to poor asthma management. This could be improved through re-training of medical workers and patient education, and by increasing availability and affordability of essential asthma medications. |
| first_indexed | 2024-12-13T05:23:08Z |
| format | Article |
| id | doaj.art-4c53694be52144ee9b30972b0cbc116d |
| institution | Directory Open Access Journal |
| issn | 2398-502X |
| language | English |
| last_indexed | 2024-12-13T05:23:08Z |
| publishDate | 2019-11-01 |
| publisher | Wellcome |
| record_format | Article |
| series | Wellcome Open Research |
| spelling | doaj.art-4c53694be52144ee9b30972b0cbc116d2022-12-21T23:58:16ZengWellcomeWellcome Open Research2398-502X2019-11-01410.12688/wellcomeopenres.15460.116907Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations]Harriet Mpairwe0Pius Tumwesige1Milly Namutebi2Marble Nnaluwooza3Tonny Katongole4Josephine Tumusiime5Barbara Apule6Caroline Onen7Mike Mukasa8Joseph Kahwa9Emily L. Webb10Neil Pearce11Alison M. Elliott12MRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaLondon School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UKLondon School of Hygiene & Tropical Medicine, Keppel St, Bloomsbury, London, WC1E 7HT, UKMRC/UVRI and LSHTM Uganda Research Unit, Plot 51-59 Nakiwogo Road, Box 49, Entebbe, UgandaBackground: Children from low- and middle-income countries have poor asthma control, mainly because of poor management. The extent of this problem in Uganda is not well known, but such information would be useful to guide policy and practice. We therefore conducted a cross-sectional study among schoolchildren with asthma in urban Uganda, to assess the level of asthma control and management. Methods: Schoolchildren aged 5-17 years were enrolled, asthma was diagnosed by the study medical team. Asthma control was assessed using the Asthma Control Test and the childhood Asthma Control Test. Data on previous asthma management was obtained using interviewer-led questionnaires. Data were analysed using multiple linear and multiple logistic regression. Results: We enrolled 561 children with asthma, of whom only 56% had ever had an asthma diagnosis. We categorised asthma as well-controlled (55.5%), partly-controlled (29.5%) and poorly-controlled (15.0%). Poor asthma control was associated with increasing age (adjusted regression coefficient [95% confidence interval], p-value: -1.07 [-1.20, -0.94], p<0.0001), concurrent allergic rhinitis (-1.33 [-2.28, -0.38], p=0.006), and city residence in early life (-1.99 [-3.69, -0.29], p=0.06). Regular use of inhaled asthma medication in the last 12 months was very low; 18.1% for salbutamol and 6.7% for inhaled corticosteroids. The main barriers to inhaled asthma medication use were lack of prescription (47.6%) and inaccurate diagnosis (38.8%). Increased inhaler use was associated with tertiary education of the fathers (adjusted odds ratio [95% confidence interval], p-value: 5.19 [2.39-11.28], p<0.0001), city residence in early life (4.66 [1.79-12.43], 0.002) and an asthma diagnosis prior to enrolment (11.39 [6.35-20.43], p<0.0001). Conclusions: This study confirms that children with asthma in Uganda generally have inadequate asthma control, which is attributable to poor asthma management. This could be improved through re-training of medical workers and patient education, and by increasing availability and affordability of essential asthma medications.https://wellcomeopenresearch.org/articles/4-168/v1 |
| spellingShingle | Harriet Mpairwe Pius Tumwesige Milly Namutebi Marble Nnaluwooza Tonny Katongole Josephine Tumusiime Barbara Apule Caroline Onen Mike Mukasa Joseph Kahwa Emily L. Webb Neil Pearce Alison M. Elliott Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations] Wellcome Open Research |
| title | Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_full | Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_fullStr | Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_full_unstemmed | Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_short | Asthma control and management among schoolchildren in urban Uganda: results from a cross-sectional study [version 1; peer review: 1 approved, 2 approved with reservations] |
| title_sort | asthma control and management among schoolchildren in urban uganda results from a cross sectional study version 1 peer review 1 approved 2 approved with reservations |
| url | https://wellcomeopenresearch.org/articles/4-168/v1 |
| work_keys_str_mv | AT harrietmpairwe asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT piustumwesige asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT millynamutebi asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT marblennaluwooza asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT tonnykatongole asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT josephinetumusiime asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT barbaraapule asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT carolineonen asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT mikemukasa asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT josephkahwa asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT emilylwebb asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT neilpearce asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations AT alisonmelliott asthmacontrolandmanagementamongschoolchildreninurbanugandaresultsfromacrosssectionalstudyversion1peerreview1approved2approvedwithreservations |