Asthma results significant health problem on individuals and clinical facilities.
Hospital based retrospective cross sectional study was conducted. Data was collected from patient record, who visited adult emergency room from February 1, 2016 to February 1, 2017. Finally it was analyzed with SPSS Version 20 and presented in tables and graphs.
From total 120 patients studied 55 (45.8%) were males and 65(54.2%) being females and producing a 0.84 to 1.0 of male to female. Magnitude of Asthma produced as 1.5%. On average, respondents’ age was 46.73 with standard Deviation of 17.5. Among respondents, 61(50.8%) affected with allergen, 21(17.5%) because of asthma, 13(10.8%) because of drug adherence and 25(20.8%) because of activities done and depression.
There was a low prevalence of asthma with no sex difference. The dominantsymptoms found from the study subjects were wheezing, dyspnea and cough.
Keywords:
An explanation of asthma is a “chronic inflammatory disease of the airways" which results chest tightness, coughing, wheezing and difficulty of breathing.
This is considered as major public health problem globally. Asthma magnitude in developed states is 50%in the 20th century [1, 2].
Asthma is correlated with chronic rhinitis, in which most asthma patients nearly 75-80% had also rhinitis [2-4].
In Ethiopia state it becomes a double burden in addition with infectious diseases. Asthma is most common during childhood and affects at least 13% of Canadian children. It continues to become a big burden for those children that come at emergency department [5, 14].
Common factors for asthma occurrence were major asthma, drug compliance incorrect use of drugs and bad perception for asthma [7].
Asthma accounts for more than 15 million physician office and hospital outpatient department visits, and nearly 2 million emergency department visits each year. According to Statistics Canada, 8.5% of the populations (aged 12 and over) have been diagnosed as having asthma [10-12].
Burden of Asthma in Saudi patients is approximately 20-25%. Findings at Black Lion Referral Hospital 2015; asthma burden was 1.04 [13, 14].
Quantitative research approach was used for the present study
Hospital based retrospective cross sectional study was conducted from February 1, 2016 to February 1, 2017G.C.
Adult Emergency Room in Zewuditu Memorial Hospital, Addis Ababa, Ethiopia. The study was conducted from December 2016 to June 2017.
All adult patients (whose age is >13 years) with bronchial asthma and visited adult emergency room of Zewuditu Memorial Hospital from February 1, 2016 to February 1, 2017 were included in the study. Patients without diagnosis of asthma, incomplete cards, patients whose age <13 years were excluded from the study.
Asthma patients at Adult Emergency Room of Zewuditu Memorial Hospital from February 1, 2016 to February 1, 2017 was sampled.
A sampling technique of systematic random sampling conducted to run the paper.
The required data was obtained by preparing a structured checklist from medical records. Data gathered by four BSC Nurse.
Quality of data assured through giving training for data collectors on how to use the questionnaire. The principal investigator supervised for quality assurance of the data.
Data entry was done using epinfo version 7 and all analysis were performed using the SPSS version 20. Data was summarized using proportion, mean, standard deviation and median. Results were considered significant at
Among 145 patients retrieved, 120 patients fulfill the eligibility criteria. From these 55 (45.8%) were males and 65(54.2%) were female giving a male to female ratio of 0.84 to 1.0. most were in 34-43 years and 54-63 that accounts 31(25.8%) and 25(20.8%) respectively. Only 7 (5.8%) were in 14-23 years. The mean age of the patient was 46.73. 83(69.2%) were urban and 37(30.8%) were rural residents. Majority were employee 61(50.9%) in government agencies (Table 1).
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| AGE | ||
| 14-23 | 7 | 5.8 |
| 24-33 | 24 | 20 |
| 34-43 | 31 | 25.8 |
| 44-53 | 13 | 10.8 |
| 54-63 | 25 | 20.8 |
| 64-73 | 8 | 6.7 |
| 73-83 | 9 | 7.5 |
| 84-93 | 3 | 2.5 |
| Total | 120 | 100 |
| SEX | ||
| Male | 55 | 45.8 |
| Female | 65 | 54.2 |
| Total | 120 | 100 |
| RESIDENCY | ||
| Urban | 83 | 69.2 |
| Rural | 37 | 30.8 |
| Total | 120 | 100 |
| OCCUPATION | ||
| Farmer | 19 | 15.8 |
| Trader | 15 | 12.5 |
| Government | 61 | 50.9 |
| employee | ||
| Self-employee | 25 | 20.8 |
| Total | 100 |
8030 patients visited Zewuditu Memorial Hospital from February1, 2016 - Feb1, 2017.From these 120 patients (1.5%) were asthma victims.
From 120 patients included in the study, 109 (90.8%) had wheezing, 97(80.8%) had cough, 102 (85%) dyspnea, 39(32.5%) rhinitis, 53(44.2%) sinusitis. 8(6.7%) atopic dermatitis (Table 2).
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| Wheezing | ||
| Yes | 109 | 90.8 |
| No | 11 | 9.2 |
| Cough | ||
| Yes | 97 | 80.8 |
| No | 23 | 19.2 |
| Dyspnea | 102 | 85 |
| Yes | ||
| No | 18 | 15 |
| Limits daily activities | ||
| Yes | 95 | 79.1 |
| No | 25 | 20.9 |
| Rhinitis | ||
| Yes | 39 | 32.5 |
| No | 81 | 67.5 |
| Sinusitis | ||
| Yes | 53 | 44.2 |
| No | 67 | 55.8 |
| Atopic Dermatitis | ||
| Yes | 8 | 6.7 |
| No | 112 | 93.3 |
| Cyanosis | ||
| Yes | 35 | 29.2 |
| No | 85 | 70.8 |
From patients included in the study (n=120), 63(52.5%) were moderate, 27 (22.5%) were mild and 30(25%) were severe asthma (fig.1).
From the sample n=120, most patients 70(58.3%) asthma their smoking issue is not clear, 34(28.3%) are not smoked and 16(13.3%) were smoker (Fig.2).
61(50.8%) were due to allergens, 21(17.5%) due to severity of asthma, 13(10.8%) due to drug compliance, and 25(20.8%) due to activities done and depression (Table 3).
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| Allergens | 61 | 50.8 |
| Severity of asthma | 21 | 17.5 |
| With unknown cause | ||
| Drug compliance | 13 | 10.8 |
| Others (stress, exercise…) | 25 | 20.8 |
41(34.17%) patents have other diseases like diabetes, high blood pressure and chronic obstructive pulmonary disease.
From chi-square test, gender and residency were related to asthma in P value of 0.029 and 0.049 respectively. In AOR of 0.966 [0.114-8.195] P-Value=0.975, AOR=1.344 [0.134-13.483] respectively. On the contrary, age not related with asthma in logistic and chi square test with p value of 0.610 and 0.276 respectively (Table 4).
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| Age | <54 | 73 | 2 | (2.7%) | 0.589 | 0.573(0.067- | 0.610 | ||
| (97.3%) | [0.080- | 4.876) | |||||||
| 4.334] | |||||||||
| >=54* | 43 | 2 | (4.4%) | 1.00 | |||||
| (95.6%) | |||||||||
| Sex | Male | 53 | 2 | (3.6%) | 1.189 | 0.966 (0.114- | 0.975 | ||
| (96.4%) | [0.162- | 8.195) | |||||||
| 8.728] | |||||||||
| Female* | 63 | 2 | (3.1%) | 1.00 | |||||
| Residency | (96.9%) | ||||||||
| Urban | 80 | 3 | (3.6%) | 1.1296 | 1.344(0.134- | 0.802 | |||
| (96.4%) | [0.130- | 13.483) | |||||||
| 12.899] | |||||||||
| Rural* | 36 | 1 | (2.7%) | 1.00 | |||||
| (97.3 %) | |||||||||
* reference, COR=crude odd ratio, AOR=adjusted odd ratio, IC= confidence interval
From 120 patients 55(45.8%) were male and 65(54.2%) were female giving a male to female ratio of 0.84 to 1.0. Which shows the prevalence with regard to sex is almost the same. There is a research done in Portugal which support this finding where females (57.3%) and male (42.7%) [8]. There was also a study done in Malaysia form 2007-2009 which shows it was slightly higher in females (9).
Most of the age group are found in the age interval of 24-63 account 66.6 % [8]. There was also a study conducted in black lion specialized hospital which was 79.7 % in this age group [14]. Because this age group is actively participating in different tasks and highly exposed to different allergens.
Magnitude of our finding was 1.5%. That is similar with global magnitude of asthma (1-18%) [6]. which is low than indian finding which was 2.38. Also from (Chandigarh=2.28, Delhi =1.9, Kamur=2.05 and Bangalore =3.47 [3]. This may be due to this country may highly industrialized than Addis Ababa.90.8 % had wheezing, 85% had dyspnea and 80.8 % had cough [14].
Health facilities should have up-to-date training for asthma. Emergency department patients should be considered an important target for asthma education (ED staffs should teach about asthma triggering factors).
The government should focus on the sanitation of urban environment to minimize asthma prevalence urban setting.
We acknowledge Addis Ababa University for creating an opportunity to run this study
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