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. 2018 Jul 5;18(1):110.
doi: 10.1186/s12890-018-0676-7.

The prevalence, burden and risk factors associated with bronchial asthma in commonwealth of independent states countries (Ukraine, Kazakhstan and Azerbaijan): results of the CORE study

Damilya Nugmanova  1 , Lyudmila Sokolova  1 , Yuriy Feshchenko  2 , Liudmila Iashyna  2 , Olga Gyrina  3 , Katerina Malynovska  4 , Ilgar Mustafayev  5 , Gulzar Aliyeva  5 , Janina Makarova  6 , Averyan Vasylyev  4 , Luqman Tariq  7
Affiliations

The prevalence, burden and risk factors associated with bronchial asthma in commonwealth of independent states countries (Ukraine, Kazakhstan and Azerbaijan): results of the CORE study

Damilya Nugmanova et al. BMC Pulm Med. .

Abstract

Background: In the Commonwealth of Independent States (CIS) countries epidemiology of Bronchial Asthma (BA) is poorly characterized. The objective of this analysis is to present the prevalence, burden and risk factors associated with BA in the CIS countries as part of the CORE study (Chronic Obstructive REspiratory diseases).

Methods: A total of 2842 adults (≥18 years) were recruited (964 in Kiev, Ukraine, 945 in Almaty, Kazakhstan, and 933 in Baku, Azerbaijan) in 2013-2015 during household visits. A two-step cluster random sampling strategy was used. All respondents were interviewed about respiratory symptoms, smoking, medical history. Two definitions were used: (i) "doctor diagnosed asthma" when the respondent reported that he/she had ever been diagnosed with BA by a doctor, (ii) "wheezing symptoms" (when the respondent reported wheezing at the ATS Respiratory Symptoms Questionnaire during the study) using GINA (2012) recommendations. Chi-square tests were used to assess differences in proportions. Binary logistic regression was used to estimate odds ratios (OR) and 95% CI for association between risk factors and BA.

Results: Prevalence of "doctor diagnosed asthma" was 12.5, 19.0 and 26.8 per 1000 persons, and prevalence of "wheezing symptoms" was 74.4, 254.8 and 123.4 per 1000 in Ukraine, Kazakhstan, and Azerbaijan, respectively. Statistically significant relationship with "wheezing symptoms" was shown for smoking (OR 1.99 (CI 1.22-3.27) in Ukraine, 2.08 (CI 1.54-2.81) in Kazakhstan, 8.01 (CI 5.24-12.24) in Azerbaijan); overweight/obesity (OR: 1.66 (CI 1.02-2.72); 1.94 (CI 1.44-2.62); 1.77 (CI 1.18-2.68), respectively) and dusty work (OR: 3.29 (CI 1.57-6.89); 1.68 (CI 1.18-2.39); 2.36 (CI 1.56-3.59), respectively), and for tuberculosis in Azerbaijan (OR: 10.11 (CI 3.44-29.69)). Co-morbidities like hypertension, cardiovascular diseases, abnormal blood lipids and a history of pneumonia occurred significantly (p < 0.05) more frequently in respondents with BA compared to those without BA across all participating countries.

Conclusion: In CIS countries (Ukraine, Kazakhstan and Azerbaijan) the prevalence of doctor diagnosed asthma was significantly lower compared to prevalence of wheezing symptoms underlining that BA is likely to be underreported in these countries. The information provided in this paper will be helpful for healthcare policy makers in CIS countries to instruct BA management strategies and to allocate healthcare resources accordingly.

Keywords: Azerbaijan; Bronchial asthma; Kazakhstan; Prevalence; Risk factors; Ukraine.

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Conflict of interest statement

Ethics approval and consent to participate

The study was reviewed and approved by Independent Ethic Committee in Kazakhstan (Central Commission for Ethics at the Ministry of Health of the Republic of Kazakhstan) and by Local Ethic Committees in Kazakhstan, Azerbaijan and Ukraine (Ethic Committee at Semey State Medical University, Almaty, Kazakhstan; Ethic Committee at Scientific Research Institute of Lung Diseases in Baku, Azerbaijan; Commission for Ethics at National Institute of Phthisiology and Pulmonology F.G. Yanovsky of NAMS, Kiev, Ukraine; Commission for Ethics at Center for Primary Health Care #2 of Shevchenko District, Kiev, Ukraine), according to the local legal requirements. Written informed consent was obtained from each participant before any procedures or data collection related to the study.

Consent for publication

Not applicable.

Competing interests

The study was sponsored by GlaxoSmithKline (GSK) marketing a number of treatments for COPD, Allergic Rhinitis, and Asthma.

D. Nugmanova, L. Sokolova, Y. Feshchenko, L. Iashyna, O. Gyrina, I. Mustafayev and G. Aliyeva report grants from GlaxoSmithKline, during the conduct of the study; personal fees from GSK, outside the submitted work; .

J. Makarova, K. Malynovska are employees of GlaxoSmithKline. A. Vasylyev and L. Tariq are GSK employees and shareholder.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Prevalence of doctor diagnosed asthma and wheezing symptoms (prevalence per 1000 and 95% confidence intervals). The prevalence was calculated per 1000 persons and expressed with 95% confidence intervals, for two definitions: doctor diagnosed asthma: when self-reported by the respondent (the respondent reported that he/she had ever been diagnosed with BA by a doctor while completing the study questionnaire), and wheezing symptoms: when the respondent reported wheezing at the ATS Respiratory Symptoms Questionnaire (answered positive to the question: “Does your chest ever sound wheezy or whistling?”)
Fig. 2
Fig. 2
Prevalence of doctor diagnosed asthma and wheezing symptoms stratified by age (prevalence per 1000 and 95% confidence intervals). The prevalence of BA was calculated per 1000 persons and expressed with 95% confidence intervals in three age groups: 18–39, 40–64, and ≥ 65 years old, for doctor diagnosed asthma: when self-reported by the respondent (the respondent reported that he/she had ever been diagnosed with BA by a doctor while completing the study questionnaire), and wheezing symptoms: when the respondent reported wheezing at the ATS Respiratory Symptoms Questionnaire (answered positive to the question: “Does your chest ever sound wheezy or whistling?”)
Fig. 3
Fig. 3
Prevalence of doctor diagnosed asthma and wheezing symptoms stratified by sex (prevalence per 1000 and 95% confidence intervals). The prevalence of BA was calculated per 1000 persons and expressed with 95% confidence intervals, among males and females, for doctor diagnosed asthma: when self-reported by the respondent (the respondent reported that he/she had ever been diagnosed with BA by a doctor while completing the study questionnaire), and wheezing symptoms: when the respondent reported wheezing at the ATS Respiratory Symptoms Questionnaire (answered positive to the question: “Does your chest ever sound wheezy or whistling?”)
Fig. 4
Fig. 4
Association between risk factors and wheezing symptoms (odds ratios [OR] and 95% confidence intervals for OR). Odds ratios [OR] and 95% confidence intervals for OR are presented for each potential risk factor. Asterisk (*) means statistically significant association between risk factor and wheezing symptoms (p < 0.05)
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