Abstract
BackgroundAsthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide. Information on asthma prevalence in the Middle East is fragmented and relatively out-dated. The SNAPSHOT program was conducted to obtain updated information.MethodsSNAPSHOT is a cross-sectional epidemiological program carried out in five Middle Eastern countries (Egypt, Turkey, Kuwait, Saudi Arabia, and the United Arab Emirates, the latter three grouped into a Gulf cluster) to collect data on asthma, allergic rhinitis, benign prostatic hyperplasia and bipolar disorder. The survey was carried out by telephone in a random sample of the adult general population with quotas defined according to country demographics. The analysis presented in this paper focuses on asthma. Subjects were screened for asthma based on criteria from the global Asthma Insights and Reality studies. Current prevalence (last 12 months) was estimated. Multivariate logistic regression analyses were used to investigate risk factors related to asthma and the association with allergic rhinitis and other co-morbidities. Quality of life was assessed using the three-level EQ-5D questionnaire.Results2124 out of the 33,486 subjects enrolled in the SNAPSHOT program fulfilled the criteria for asthma. The adjusted prevalence of asthma ranged from 4.4% [95% CI: 4.0–4.8%] in Turkey, to 6.7% [95% CI: 6.2–7.2%] in Egypt and 7.6% [95% CI: 7.1–8.0%] in the Gulf cluster. Prevalence was higher (p < 0.0001) in women than men and increased with age (p < 0.0001). Co-morbidities occurred more frequently in asthma subjects compared to the non-asthma population (38% vs. 15% p < 0.0001). Subjects with asthma reported a lower (p < 0.0001) EQ-VAS score (68.2 ± 22.9) compared to the general population (78.1 ± 17.5). The risk factors associated with asthma were age, gender, country, and certain co-morbidities, namely respiratory, cardiovascular, gastrointestinal, nervous, and neurological diseases.ConclusionThe observed adjusted prevalence of asthma in the Middle East ranges from 4.4% to 7.6%, which is comparatively lower than the reported prevalence in Europe and North America. Asthma has a negative impact on quality of life, and is associated with high levels of co-morbid diseases, indicating a need for physicians to check for co-morbidities and ensure they are managed correctly in all asthma patients.
Highlights
Asthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide
This review focused on general population studies which investigated asthma prevalence in the Middle East and North Africa region
The reported prevalence estimates suggest that the Middle East is a low/medium prevalence area compared to other regions in the world
Summary
Asthma is a common chronic respiratory disease leading to morbidity, mortality and impaired quality of life worldwide. Prevalence has been shown to vary widely both between countries and within countries, and has been steadily increasing alongside that of allergy, as modern lifestyles are adopted and communities become more urbanised, a trend that is predicted to continue over the two decades [2] For those people affected by the disease, it can be a cause of major disability and impact greatly on quality of life [1, 2]. To improve the understanding of asthma prevalence worldwide, further international studies are needed and require use of a consistent case definition for asthma and identical study methodologies This would allow cross country comparison of data and provide a benchmark for future studies
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