Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/28623
Title: Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study
Authors: Kirenga, Bruce J.
de Jong, Corina
MUGENYI, Levicatus 
Katagira, Winceslaus
Muhofa, Abdallah
Kamya, Moses R.
Boezen, H. Marlke
van der Molen, Thys
Issue Date: 2018
Publisher: BMJ PUBLISHING GROUP
Source: THORAX, 73(10), p. 983-985
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% Cl: 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% Cl: 1.04 to 1.57, P=0.018). Better asthma control (OR 0.93, 95% Cl: 0.88 to 0.99, P=0.021) and number of baseline exacerbations (OR 1.35,95% Cl: 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 he associated with all-cause mortality was FEV1, with higher recent FEV, associated with lower all-cause mortality (OR 0.30, 95% Cl: 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.
Notes: [Kirenga, Bruce J.; Mugenyi, Levicatus; Kamya, Moses R.] Makerere Univ, Coll Hlth Sci, Lung Inst, Kampala, Uganda. [Kirenga, Bruce J.; Katagira, Winceslaus; Muhofa, Abdallah] Makerere Univ, Coll Hlth Sci, Dept Med, Kampala, Uganda. [de Jong, Corina; van der Molen, Thys] Univ Groningen, UMCG, Dept Gen Practice & Elderly Care, GRIAC Primary Care, Groningen, Netherlands. [de Jong, Corina; van der Molen, Thys] Univ Groningen, UMCG, GRIAC, Groningen, Netherlands. [Mugenyi, Levicatus] Univ Hasselt, Ctr Stat, Interuniv Inst Biostat & Stat Bioinformat, Hasselt, Belgium. [Boezen, H. Marlke] Univ Groningen, Dept Epidemiol, Groningen, Netherlands.
Document URI: http://hdl.handle.net/1942/28623
ISSN: 0040-6376
e-ISSN: 1468-3296
DOI: 10.1136/thoraxjnl-2017-211157
ISI #: 000446090900016
Category: A1
Type: Journal Contribution
Validations: ecoom 2019
Appears in Collections:Research publications

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