Browsing by Author "Haile, Tewodros"

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    The burden of severe asthma in sub-Saharan Africa: Findings from the African Severe Asthma Project
    (Elsevier Inc, 2024-01-09) Kirenga, Bruce J; Chakaya, Jeremiah; Yimer, Getnet; Nyale, George; Haile, Tewodros; Muttamba, Winters; Mugenyi, Levicatus; Katagira, Winceslaus; Worodria, William; Aanyu-Tukamuhebwa, Hellen; Lugogo, Njira; Joloba, Moses; Mersha, Tesfaye B.; Bekele, Amsalu; Makumbi, Fred; Mekasha, Amha; Green, Cynthia L.; de Jong, Corina; Kamya, Moses; van der Molen, Thys
    Background: Severe asthma is associated with high morbidity, mortality, and health care utilization, but its burden in Africa is unknown. Objective: We sought to determine the burden (prevalence, mortality, and activity and work impairment) of severe asthma in 3 countries in East Africa: Uganda, Kenya, and Ethiopia. Methods: Using the American Thoracic Society/European Respiratory Society case definition of severe asthma, we analyzed for the prevalence of severe asthma (requiring Global Initiative for Asthma [GINA] steps 4-5 asthma medications for the previous year to achieve control) and severe refractory asthma (remains uncontrolled despite treatment with GINA steps 4-5 asthma medications) in a cohort of 1086 asthma patients who had been in care for 12 months and had received all GINA-recommended medications. Asthma control was assessed by the asthma control questionnaire (ACQ). Results: Overall, the prevalence of severe asthma and severe refractory asthma was 25.6% (95% confidence interval [CI], 23.1-28.3) and 4.6% (95% CI, 3.5-6.0), respectively. Patients with severe asthma were (nonsevere vs severe vs severe refractory) older (39, 42, 45 years, P = .011), had high skin prick test reactivity (67.1%, 76.0%, 76.0%, P = .004), had lower forced expiratory volume in 1 second percentage (81%, 61%, 55.5%, P < .001), had lower quality of life score (129, 127 vs 121, P < .001), and had higher activity impairment (10%, 30%, 50%, P < .001). Factors independently associated with severe asthma were hypertension comorbidity; adjusted odds ratio 2.21 (1.10-4.47), P = .027, high bronchial hyperresponsiveness questionnaire score; adjusted odds ratio 2.16 (1.01-4.61), P = .047 and higher ACQ score at baseline 2.80 (1.55-5.08), P = .001. Conclusion: The prevalence of severe asthma in Africa is high and is associated with high morbidity and poor quality of life.
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    Characterization of Asthma and Its Determinants in Ethiopia: Part of the African Severe Asthma Project (ASAP)
    (Ethiopian Medical Journal, 2021) Bekel, Amsalu; Haile, Tewodros; Mekekasha, Amha; Fuad, Oumer; Muttamba, Winters; Mugenyi, Levi; Katagira, Wincey; Nyale, George; Lugogo, Njira; Worodria, William; Aanyu, Hellen T.; Joloba, Moses; Jong, Corina de; Makumbi, Fred; Molen, Thys van der; Chakaya, Jeremiah; Kirenga, Bruce J; Yimer, Getenet
    Asthma is a major public health problem globally affecting 339 million people with 300,000 annual death. African Severe Asthma Program was a multi-country prospective cohort study designed to characterize severe asthma in three African countries, Ethiopia, Uganda and Kenya. In this study, we describe the baseline characteristics and disease severity among asthmatics enrolled in the Ethiopia site of African Severe Asthma Program. Asthmatics seen at Tikur Anbessa Specialized Hospital from August 2016 to May 2018 were studied. Asthma was diagnosed based on symptoms and spirometry. Baseline demographic and clinical data were collected using a structured questionnaire. Standardized research tools were used to assess asthma severity, asthma control and asthma quality of life. A total of 419 asthmatic patients were enrolled in the study; the mean age for the group was 52 ± 8 years and 58.2 % were female. The majority of the participants, 365 (87.2%), had a prior diagnosis of asthma with a median (IQR) age at first diagnosis of 29 (IQR: 22 - 36) years. A family history of asthma was present in 149 (35.6%) subjects. Current or previous cigarette smoking was reported in 8.6% of the participants. Overall, 93.8% of the participants reported uncontrolled asthma symptoms (ACQ >1.5). More than half of the patients, had severe persistent asthma and 35% presented with one or more comorbidities. Conclusions: In Ethiopia, asthmatics presenting to a tertiary care hospital were characterized as predominantly female with late onset disease, poor control, and associated comorbidities. Key Words: Asthma, Characteristics, determinants and Severe