Determinants of asthma disease control in Ambo University Referral Hospital: Observational cross-sectional study

Abstract

Over a decade, different stakeholders have engaged concerted efforts to reduce morbidity and mortality related to asthma. Despite all these efforts, substantial proportions of asthmatic patients do not achieve proper asthma control. The aim of this study was to evaluate the level of asthma control and to assess the factors that might influence control of the disease. The study was conducted at the Ambo University Referral Hospital which is allied with College of Medicine and Health Sciences, Ambo University and serve for a training center for postgraduates and undergraduate medical and health sciences students. The study was conducted from February to March 2019 on a sample of 82 asthmatic patients. The dependent variable was asthma disease control, according to the Global Initiative for Asthma criteria. Accordingly, patients were classified into three classes; controlled, partially controlled and uncontrolled asthma. Binary logistic regression analysis was used to determine factors associated with the poor asthma control. The results were represented as percentages in valid results. Continuous variables were represented as a mean and standard deviation (SD). The level of asthma disease control and analysis of factors associated with poor asthma control was the main outcome measure. Results revealed that a total of 82 asthmatic patients with a mean age (standard deviation [SD]) of 44.9 ± 8.9 of years were participating in the study. Only 23.2% of patients were controlled, 2.4% had partial control and 74.4% were poorly controlled. Large proportions of patients (89.02%) recruited were treated with short acting beta agonists (SABA) plus medium/high daily doses of corticosteroids.In multivariate analysis, patients having concomitant allergic rhinitis (Adjusted odds ratio= AOR: 7.87; 95% CI [1.13 - 11.75]) and chronic sinus (AOR: 13.31; 95% CI [1.57-17.40]), not used ICS (AOR: 4.45; 95% CI [1.17-9.94]) and female sex (AOR: 3.26; 95% CI [0.87-6.20]) had increased odds of uncontrolled asthma with p-value of <0.05. Thus, large proportions of patients had poorly controlled asthma. Female sex, unused inhalational corticosteroids, co-morbidities like allergic rhinitis and sinusitis significantly increased the odds of having uncontrolled asthma. Key words: Asthma, level of asthma control, determinants, Ambo University Referral Hospital.