Prevalence of asthma in North Africa: the Asthma Insights and Reality in the Maghreb (AIRMAG) study

Abstract

Background: Bronchial asthma is the most frequent chronic respiratory disease in both adults and children. The prevalence and burden of asthma vary considerably between different regions of the world. Information on asthma in Africa is fragmentary and relatively old.

Objective: The objective of this cross-sectional epidemiological survey was to determine the prevalence and burden of asthma in the North African countries of Algeria, Morocco and Tunisia using the methodology developed in the Asthma Insights and Reality (AIR) programme.

Methods: A general population sample was generated using a stratified sampling method based on randomly-generated lists of telephone numbers. The target sample consisted of 10,000 households in each country, which were contacted by telephone. A structured interview was proposed. Two screening questions were asked to identify subjects with asthma. Subjects who met these criteria were then questioned in more detail about their asthma.

Results: Of 30 350 households contacted, 1090 subjects with asthma were identified of whom 872 provided complete data. The age- and gender-adjusted prevalence of asthma was 3.45% [95% CI: 3.09 3.80%] in Algeria, 3.89% [95% CI: 3.52 4.27%] in Morocco and 3.53% [95% CI: 3.18 3.89%] in Tunisia. Prevalence was highest in children and older adults, and in urban areas. Annual incidence rates ranged between 28/10,000 in Tunisia and 46/10,000 in Algeria. 74.3% of adults reported being handicapped by their asthma all or most of the time, 26.4% reported a visit to a hospital emergency department in the previous year and 23.9% absence from work or school due to asthma. 48.0% reported that their sleep was very or quite disturbed by asthma.

Conclusions: The prevalence of asthma in the Maghreb countries is moderate, but its impact is high.