Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study

Bruce J Kirenga, Corina de Jong, Levicatus Mugenyi, Winceslaus Katagira, Abdallah Muhofa, Moses R Kamya, H Marike Boezen, Thys van der Molen

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6 Citations (Scopus)

Abstract

Data on asthma treatment outcomes in Africa are limited. 449 patients with asthma (age 5-93 years) in Uganda were followed up for 2 years to determine rates of exacerbations and mortality and associated factors. During follow-up the median number of exacerbations per patient was 1 (IQR 0-5) and 17 patients died (3.7%, 27.3 deaths per 1000 person years). Considering only the first year of follow-up, 59.6% of the patients experienced at least one exacerbation, 32.4% experienced three or more exacerbations. A multivariable model showed that the likelihood of experiencing at least one exacerbation in the first year of follow-up was lower with better baseline asthma control (higher asthma control test (ACT) score), with OR 0.87 (95% CI: 0.82 to 0.93, P=0.000), and was higher with more exacerbations in the year prior to enrolment (OR for log number of exacerbations 1.28, 95% CI: 1.04 to 1.57, P=0.018). Better asthma control (OR 0.93, 95% CI: 0.88 to 0.99, P=0.021) and number of baseline exacerbations (OR 1.35,95% CI: 1.11 to 1.66, P=0.005) were also the only factors that were independently associated with experiencing three or more exacerbations during the first year of follow-up. The only factor found to be associated with all-cause mortality was FEV1, with higher recent FEV1 associated with lower all-cause mortality (OR 0.30, 95% CI: 0.14 to 0.65; P=0.002). Rates of asthma exacerbations and mortality are high in Uganda and are associated with poor asthma control. Health systems should be strengthened to care for asthma patients.

Original languageEnglish
Pages (from-to)983-985
Number of pages3
JournalThorax
Volume73
Issue number10
DOIs
Publication statusPublished - Oct-2018

Keywords

  • ADULTS

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