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Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa

BACKGROUND: Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk...

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Autores principales: Mphahlele, Reratilwe, Lesosky, Maia, Masekela, Refiloe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193066/
https://www.ncbi.nlm.nih.gov/pubmed/37192778
http://dx.doi.org/10.1136/bmjresp-2022-001498
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author Mphahlele, Reratilwe
Lesosky, Maia
Masekela, Refiloe
author_facet Mphahlele, Reratilwe
Lesosky, Maia
Masekela, Refiloe
author_sort Mphahlele, Reratilwe
collection PubMed
description BACKGROUND: Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC. METHODS: A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021. RESULTS: A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01. CONCLUSION: Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting.
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spelling pubmed-101930662023-05-19 Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa Mphahlele, Reratilwe Lesosky, Maia Masekela, Refiloe BMJ Open Respir Res Asthma BACKGROUND: Asthma remains highly prevalent, with more severe symptoms in low-income to middle-income countries (LMICs) compared with high-income countries. Identifying risk factors for severe asthma symptoms can assist with improving outcomes. We aimed to determine the prevalence, severity and risk factors for asthma in adolescents in an LMIC. METHODS: A cross-sectional survey using the Global Asthma Network written and video questionnaires was conducted in adolescents aged 13 and 14 from randomly selected schools in Durban, South Africa, between May 2019 and June 2021. RESULTS: A total of 3957 adolescents (51.9% female) were included. The prevalence of lifetime, current and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms; 38.9% (n=211/543) and 40.7% (n=147/361) had doctor-diagnosed asthma; of these, 72.0% (n=152/211) and 70.7% (n=104/147), respectively, reported using inhaled medication in the last 12 months. Short-acting beta agonists (80.4%) were more commonly used than inhaled corticosteroids (13.7%). Severe asthma was associated with: fee-paying school quintile (adjusted OR (CI)): 1.78 (1.27 to 2.48), overweight (1.60 (1.15 to 2.22)), exposure to traffic pollution (1.42 (1.11 to 1.82)), tobacco smoking (2.06 (1.15 to 3.68)), rhinoconjunctivitis (3.62 (2.80 to 4.67)) and eczema (2.24 (1.59 to 3.14)), all p<0.01. CONCLUSION: Asthma prevalence in this population (13.7%) is higher than the global average (10.4%). Although common, severe asthma symptoms are underdiagnosed and associated with atopy, environmental and lifestyle factors. Equitable access to affordable essential controller inhaled medicines addressing the disproportionate burden of asthma is needed in this setting. BMJ Publishing Group 2023-05-16 /pmc/articles/PMC10193066/ /pubmed/37192778 http://dx.doi.org/10.1136/bmjresp-2022-001498 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Asthma
Mphahlele, Reratilwe
Lesosky, Maia
Masekela, Refiloe
Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
title Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
title_full Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
title_fullStr Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
title_full_unstemmed Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
title_short Prevalence, severity and risk factors for asthma in school-going adolescents in KwaZulu Natal, South Africa
title_sort prevalence, severity and risk factors for asthma in school-going adolescents in kwazulu natal, south africa
topic Asthma
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193066/
https://www.ncbi.nlm.nih.gov/pubmed/37192778
http://dx.doi.org/10.1136/bmjresp-2022-001498
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