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. 2018 Sep 21;19(1):184.
doi: 10.1186/s12931-018-0898-5.

The impact of HIV on the prevalence of asthma in Uganda: a general population survey

Bruce J Kirenga  1 , Levicatus Mugenyi  2 , Corina de Jong  3   4 , J Lucian Davis  5 , Winceslaus Katagira  2 , Thys van der Molen  3   4 , Moses R Kamya  6 , Marike Boezen  7
Affiliations

The impact of HIV on the prevalence of asthma in Uganda: a general population survey

Bruce J Kirenga et al. Respir Res. .

Abstract

Background: HIV and asthma are highly prevalent diseases in Africa but few studies have assessed the impact of HIV on asthma prevalence in high HIV burden settings. The objective of this analysis was to compare the prevalence of asthma among persons living with HIV (PLHIV) and those without HIV participating in the Uganda National Asthma Survey (UNAS).

Methods: UNAS was a population-based survey of persons aged ≥12 years. Asthma was diagnosed based on either self-reported current wheeze concurrently or within the prior 12 months; physician diagnosis; or use of asthma medication. HIV was defined based on confidential self-report. We used Poisson regression with robust standard errors to estimate asthma prevalence and the prevalence ratio (PR) for HIV and asthma.

Results: Of 3416 participants, 2067 (60.5%) knew their HIV status and 103 (5.0%) were PLHIV. Asthma prevalence was 15.5% among PLHIV and 9.1% among those without HIV, PR 1.72, (95%CI 1.07-2.75, p = 0.025). HIV modified the association of asthma with the following factors, PLHIV vs. not PLHIV: tobacco smoking (12% vs. 8%, p = < 0.001), biomass use (11% vs. 7%, p = < 0.001), allergy (17% vs. 11%, p = < 0.001), family history of asthma (17% vs. 11%, p = < 0.001), and prior TB treatment (15% vs. 10%, p = < 0.001).

Conclusion: In Uganda the prevalence of asthma is higher in PLHIV than in those without HIV, and HIV interacts synergistically with other known asthma risk factors. Additional studies should explore the mechanisms underlying these associations. Clinicians should consider asthma as a possible diagnosis in PLHIV presenting with respiratory symptoms.

Keywords: Asthma; HIV; Prevalence; Uganda.

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Conflict of interest statement

Ethics approval and consent to participate

Ethics approval was obtained from the Mulago Hospital Research and Ethics committee and the Uganda National Council for Science and Technology. Participants provided written informed consent and were free to terminate study participation at any time during the study. For children between the ages of 12–18 years, we obtained their assent and parental/legal guardian consent.

Consent for publication

Not applicable, this manuscript does not contain any personal data.

Competing interests

The authors declare that they have no competing interests.

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 asthma by age stratified by HIV status and other asthma risk factors: a Prevalence of asthma by age and HIV status keeping all other factors at zero. b Prevalence of asthma by age and HIV status among participants exposed to biomass smoke (c) Prevalence of asthma by age and HIV status among smokers. d Prevalence of asthma by age and HIV status among participants with history of allergy. e Prevalence of asthma by age and HIV status among participants with family history of asthma f) Prevalence of asthma by age and HIV status among participants with history of TB treatment
Fig. 2
Fig. 2
Asthma prevalence ratios (HIV+ vs HIV-) considering different ages of participants
Fig. 3
Fig. 3
Asthma prevalence considering different known asthma risk factors (all p-values < 0.001)
See this image and copyright information in PMC

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