Wheeze, asthma diagnosis and medication use : a national adult survey in a developing country
Ehrlich, R.I., White, N., Norman, R.E., Laubscher, R., Steyn, K., Lombard, C., & Bradshaw, D. (2005) Wheeze, asthma diagnosis and medication use : a national adult survey in a developing country. Thorax, 60(11), pp. 895-901.
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As relatively little is known about adult wheeze and asthma in developing countries, this study aimed to determine the predictors of wheeze, asthma diagnosis, and current treatment in a national survey of South African adults.
A stratified national probability sample of households was drawn and all adults (>14 years) in the selected households were interviewed. Outcomes of interest were recent wheeze, asthma diagnosis, and current use of asthma medication. Predictors of interest were sex, age, household asset index, education, racial group, urban residence, medical insurance, domestic exposure to smoky fuels, occupational exposure, smoking, body mass index, and past tuberculosis.
A total of 5671 men and 8155 women were studied. Although recent wheeze was reported by 14.4% of men and 17.6% of women and asthma diagnosis by 3.7% of men and 3.8% of women, women were less likely than men to be on current treatment (OR 0.6; 95% confidence interval (CI) 0.5 to 0.8). A history of tuberculosis was an independent predictor of both recent wheeze (OR 3.4; 95% CI 2.5 to 4.7) and asthma diagnosis (OR 2.2; 95% CI 1.5 to 3.2), as was occupational exposure (wheeze: OR 1.8; 95% CI 1.5 to 2.0; asthma diagnosis: OR 1.9; 95% CI 1.4 to 2.4). Smoking was associated with wheeze but not asthma diagnosis. Obesity showed an association with wheeze only in younger women. Both wheeze and asthma diagnosis were more prevalent in those with less education but had no association with the asset index. Independently, having medical insurance was associated with a higher prevalence of diagnosis.
Some of the findings may be to due to reporting bias and heterogeneity of the categories wheeze and asthma diagnosis, which may overlap with post tuberculous airways obstruction and chronic obstructive pulmonary disease due to smoking and occupational exposures. The results underline the importance of controlling tuberculosis and occupational exposures as well as smoking in reducing chronic respiratory morbidity. Validation of the asthma questionnaire in this setting and research into the pathophysiology of post tuberculous airways obstruction are also needed.
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|Item Type:||Journal Article|
|Keywords:||antiasthmatic agent, academic achievement, adolescent, adult, age distribution, airway obstruction, allergic asthma, article, body mass, chronic obstructive lung disease, confidence interval, controlled study, developing country, disease association, environmental exposure, female, health insurance, health survey, human, infection control, interview, lung tuberculosis, major clinical study, male, obesity, occupational exposure, prediction, priority journal, probability, sample size, sex ratio, smoking, statistical analysis, urban area, wheezing, Asthma, Health Surveys, Humans, Medical Audit, Middle Aged, Peak Expiratory Flow Rate, Respiratory Sounds, South Africa|
|Subjects:||Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Epidemiology (111706)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > PUBLIC HEALTH AND HEALTH SERVICES (111700) > Public Health and Health Services not elsewhere classified (111799)
Australian and New Zealand Standard Research Classification
|Divisions:||Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Current > Schools > School of Public Health & Social Work
|Copyright Owner:||Copyright 2005 B M J Group|
|Deposited On:||14 Jan 2015 04:35|
|Last Modified:||03 Feb 2015 02:57|
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