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. 2019 Feb 22;19(1):227.
doi: 10.1186/s12889-019-6562-2.

Prevalence and factors associated with asthma among adolescents and adults in Uganda: a general population based survey

Bruce J Kirenga  1 , Corina de Jong  2   3 , Winceslaus Katagira  4 , Samuel Kasozi  4 , Levicatus Mugenyi  4   5 , Marike Boezen  6 , Thys van der Molen  2   7 , Moses R Kamya  8
Affiliations

Prevalence and factors associated with asthma among adolescents and adults in Uganda: a general population based survey

Bruce J Kirenga et al. BMC Public Health. .

Abstract

Background: Recent large-scale population data on the prevalence of asthma and its risk factors are lacking in Uganda. This survey was conducted to address this data gap.

Methods: A general population based survey was conducted among people ≥12 years. A questionnaire was used to collect participants socio-demographics, respiratory symptoms, medical history, and known asthma risk factors. Participants who reported wheeze in the past 12 months, a physician diagnosis of asthma or current use of asthma medications were classified as having asthma. Asthmatics who were ≥ 35 years underwent spirometry to determine how many had fixed airflow obstruction (i.e. post bronchodilator forced expiratory volume in one second/forced vital capacity (FEV1/FVC) ratio < lower limit of normal (LLN). Descriptive statistics were used to summarize participants' characteristics. Prevalence of asthma was calculated as a proportion of asthmatics over total survey population. To obtain factors independently associated with asthma, a random-effects model was fitted to the data.

Results: Of the 3416 participants surveyed, 61.2% (2088) were female, median age was 30 years (IQR, 20-45) and 323 were found to have asthma. Sixteen people with asthma ≥35 years had fixed airflow obstruction. The prevalence of asthma was 11.0% (95% CI:8.9-13.2; males 10.3%, females 11.4%, urban 13.0% and rural 8.9%. Significantly more people with asthma smoked than non-asthmatics: 14.2% vs. 6.3%, p < 0.001, were exposed to biomass smoke: 28.0% vs. 20.0%, p < 0.001, had family history of asthma: 26.9% vs. 9.4%, p, < 0.001, had history of TB: 3.1% vs. 1.30%, p = 0.01, and had hypertension: 17.9% vs. 12.0%, p = 0. 003. In multivariate analysis smoking, (adjusted odds ratio (AOR), 3.26 (1.96-5.41, p < 0.001) family history of asthma, AOR 2.90 (98-4.22 p- < 0.001), nasal congestion, AOR 3.56 (2.51-5.06, p < 0.001), biomass smoke exposure, AOR 2.04 (1.29-3.21, p = 0.002) and urban residence, AOR 2.01(1.23-3.27, p = 0.005) were independently associated with asthma.

Conclusion: Asthma is common in Uganda and is associated with smoking, biomass smoke exposure, urbanization, and allergic diseases. Health care systems should be strengthened to provide asthma care. Measures to reduce exposure to the identified associated factors are needed.

Keywords: Asthma; Prevalence; Uganda.

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Conflict of interest statement

Authors’ information

Not applicable. No relevant author details available

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
Survey districts (highlighted in blue), based on UN map of Uganda- including new districts by region
Fig. 2
Fig. 2
A Venn-diagram showing asthma prevalence by three diagnostic criteria and overlap between them
Fig. 3
Fig. 3
Prevalence of asthma by age group and gender
See this image and copyright information in PMC

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