Prevalence and pattern of asthma exacerbation in children seen at the University of Nigeria Teaching Hospital, Enugu

Abstract

Abstract:Background: Acute exacerbation is a major cause of morbidity in asthmatic children. It can occur even in well controlled asthma. Aim: To determine the prevalence and pattern of acute exacerbation of asthma in children seen at the emergency room of the University of Nigeria Teaching Hospital (UNTH), Enugu. Materials and methods:This was a descriptive, cross sectional study in which consecutive children with acute exacerbation of asthma presenting to the Children Emergency Room (CHER) of UNTH, Enugu were recruited. Information from the history and examination were documented with a structured questionnaire completed by the attending doctor. Severity of their exacerbation was determined using the Global Initiative for Asthma (GINA) guidelines. The children were treated using the written management protocol used in CHER, UNTH, Enugu which was adapted from GINA guidelines.Results: There were a total of 114 presentations (episodes) of acute exacerbation asthma by 104 children within the study period with eight children having multiple episodes. This represented 6.5% of the overall number of emergency cases seen during the period. Nearly an equal number (ratio; 1: 1.04) of males and females were enrolled with the mean age of 7.9 ± 4.7 years. More children with asthma exacerbations were admitted during the rainy season months of May and June, while the dry season months of December and January recorded lower number of episodes.Most (86.0%) cases were mild to moderate exacerbations and 16 (15.3%) were severe. Three of the 22 (13.6%) children on controller medications were among the 16 that had severe exacerbation. No death was recorded during the period. Conclusion:The prevalence of asthma exacerbation is relatively high in our tropical environment and the pattern is similar to those of the developed countries in terms of age and sex distribution, however, the peak period of presentation differ in our environment.Key words: Asthma, exacerbation, children, prevalence, pattern tized asthmatics.2 These exacerbations are characteristically worse at night and can progress to severe airflow obstruction, shortness of breath, and respiratory distress and insufficiency.2 Rarely, severe sequelae such as hypoxic seizures, respiratory failure, and death can occur. It has also been noted that severe asthma exacerbation can occur in children with mild or controlled asthma. 3Exacerbations of asthma symptoms produce significant cost to health care systems and seriously diminish the quality of life of patients and their families. 4,5 It also accounts for disproportionate health care costs when compared to the management of stable state asthma.5 It is the most common cause of childhood emergency room visits, hospitalization and school absenteeism in

A Retrospective Audit of Pharmacologic and Non-Pharmacologic Management of Childhood Acute Asthma Exacerbation at Usmanu Danfodiyo University Teaching Hospital, Sokoto: Adherence to Global Treatment Guidelines

“…Nearly a three-quarter of our patients were admitted for ≤12 h probably due to most cases being mild asthma exacerbation. This is similar to the 74.6% of mild to moderate cases admitted for such short duration in another study from Nigeria ( Edelu et al, 2016 ). The short duration of admission by most of the patients may be a pointer to the efficiency of appropriate management plan instituted in all cases.…”

“…None of the patients presented with severe asthma exacerbations. This finding is surprising given the high rates reported in local and international studies ( Edelu et al, 2016 ; Dondi et al, 2017 ). A plausible explanation for this finding is that nearly all the patients were registered old patients of UDUTH; the only tertiary public hospital in the entire Sokoto State that runs a pediatric Pulmonology clinic.…”

Childhood Asthma in Nigeria: A Review of the Burden and Challenges of Management

“…Reported studies on exacerbations of childhood bronchial asthma in Nigeria showed that it may be responsible for about 2.9% to 6.5% of admissions into Children Emergency Units. [42,43] There were also reported peaks of exacerbations during the rainy seasons. [42,43] Unfortunately, the levels of knowledge of health care providers in the management of asthma exacerbation appears grossly suboptimal.…”

“…[42,43] There were also reported peaks of exacerbations during the rainy seasons. [42,43] Unfortunately, the levels of knowledge of health care providers in the management of asthma exacerbation appears grossly suboptimal. [44] Fawibe, et al, [44] in a survey of the mode of management of asthma exacerbation among Nigerian doctors in private practice, observed that majority (83.6%) were not aware of any guideline, both local and global, hence there was the frequent use of "aberrant drugs" such as antibiotics, mucolytic agents and antihistamines in their treatment schedules.…”

Comparison of Caries Experience of Asthmatic and Non-Asthmatic Children in Enugu, Nigeria

“…Asthma itself is a public health concern, being a major cause of infirmity, depletes scarce health resources and reduces quality of life of affected individuals. With its predisposition to dental caries formation in the affected individuals, the burden becomes more profound especially in developing countries like Nigeria, where health costs are largely borne by the individual patient [4,5].…”