Triggers of Acute Asthma in Patients Attending Emergency Centre in a Peri-urban District Hospital, Johannesburg, South Africa

Abstract

Introduction: Many avoidable triggers lead to acute asthma attack and subsequent visit to the emergency centre. The aim of the study was to determine triggers of acute asthma in order to target prevention efforts in patients attending emergency centre in a district hospital, Johannesburg, South Africa. Objectives were to describe acute asthma patients, identify triggers and severity at presentation. Methods involved a prospective descriptive cross-sectional study conducted from April to August 2015, in consenting adult participants. A researcher or trained assistant completed the semi-structured questionnaire in English. Results: Overall, 239 patients enrolled (139 males, 100 females with the median age 31 years). Majority presented with moderate acute asthma (52.72%). Active cigarette smoking (p-value<0.001) and/or passive cigarette smoking (p-value=0.004) were identified potential triggers for acute asthma attack. Chi-square or Fisher Exact test analysis were used for associations between variables and severity. Bivariate logistic regression was used to ascertain triggers associated with acute asthma attack. P-value < 0.05 was statistically significant. Confidence interval was 95%. There were no significant associations between the severity of acute asthma attack and acute respiratory infection (p-value=0.818), use of medication-related asthma triggers (p-value=0.942) and knowledge of asthma allergens (p-value =0.086). Conclusion: The majority patients presented in moderate acute asthma attack which was most probably triggered by active and/ or passive cigarette smoking. Hence, frequent visits to hospital in acute asthma attack could be minimized by removing avoidable triggers from households.