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Wang Z, Li Y, Gao Y, Fu Y, Lin J, Lei X, Zheng J, Jiang M. Global, regional, and national burden of asthma and its attributable risk factors from 1990 to 2019: a systematic analysis for the Global Burden of Disease Study 2019. Respir Res 2023; 24:169. [PMID: 37353829 DOI: 10.1186/s12931-023-02475-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/10/2023] [Indexed: 06/25/2023] Open
Abstract
BACKGROUND The burden of asthma in terms of premature death or reduced quality of life remains a huge issue. It is of great importance to evaluate asthma burden geographically and time trends from 1990 to 2019 and to assess the contributions of age, period, and cohort effects at global level. METHODS Asthma prevalence, deaths, and disability adjusted life years (DALYs) as well as risk-attributable burden were collected from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 database and were compared by age and sex. The Smoothing Splines models were used to estimate the relationship between asthma DALYs and the sociodemographic index (SDI). The Age-Period-Cohort model was used to determine effects of ages, periods, and birth cohorts on disease rates. RESULTS Between 1990 and 2019, the declines were 24.05% (95% uncertainty interval [UI] - 27.24 to - 20.82) in age-standardized asthma prevalence, 51.3% (- 59.08 to - 43.71) in mortality, and 42.55% (- 48.48 to - 36.61) in DALYs rate. However, the burden of asthma continued to rise, with an estimated 262.41 million prevalent cases globally (95% UI 224.05 to 309.45). Asthma caused greater DALYs in females than in males among people aged 20 years and older. The lowest age-standardized DALYs rate was observed at a SDI of approximately 0.70. The Longitudinal age curves showed an approximate W-shaped pattern for asthma prevalence and a likely J-shaped pattern for asthma mortality. The period effect on prevalence and mortality of asthma decreased from 1990 to 2019. Compared with the 1955-1959 birth cohort, the prevalence relative risk (RR) of asthma was highest in the 1905-1909 birth cohort, whereas the mortality RR continued to decline. At the global level, the percentages of high body-mass index, occupational asthmagens, and smoking contributing to DALYs due to asthma were 16.94%, 8.82%, and 9.87%, respectively. CONCLUSIONS Although the age-standardized rates of asthma burden declined in the past 30 years, the overall burden of asthma remains severe. High body mass index becomes the most important risk factor for DALYs due to asthma at the global level.
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Affiliation(s)
- Zhufeng Wang
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China
| | - Yun Li
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China
| | - Yi Gao
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China
| | - Yu Fu
- Department of Allergy and Clinical Immunology, National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Junfeng Lin
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China
| | - Xuedong Lei
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China
| | - Jinping Zheng
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China.
| | - Mei Jiang
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Road, Guangzhou, 510120, Guangdong, China.
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Maabreh R, Alrabab'a MH, Morsy MA, Al-Akash HY, Rajeh Saifan A, Al-Yateem N. Guideline Implementation for Improved Asthma Management and Treatment Adherence in Children in Jordan. Healthcare (Basel) 2023; 11:1693. [PMID: 37372811 DOI: 10.3390/healthcare11121693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/25/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
Asthma imposes a significant social burden on children, their families, and society at large. As a chronic health condition, effective management could greatly benefit from consistent adherence to guidelines. Despite this, minimal effort has been exerted to examine the impact of asthma management guidelines and adherence to treatment on children with asthma and the mothers caring for them. This study was designed to evaluate the influence of asthma management guidelines on the knowledge and treatment adherence among children with asthma and their mothers. A quasi-experimental design was utilized, and the study was conducted at two large hospitals in Jordan: Princess Rahma Hospital and King Hussein Medical Center. A purposive sample of children aged 6-12 years (n = 100) who were accompanied by their mothers (n = 100) were recruited for this study. Data were collected using a structured questionnaire and an observation checklist before and after the implementation of guidelines. Statistical analyses were performed using SPSS. The results revealed a statistically significant improvement in knowledge related to asthma among children and their mothers (p < 0.001). Additionally, a statistically significant difference was observed in the children's adherence to their treatment regimen before and after the implementation of asthma management guidelines (p < 0.001). Moreover, the improvements in knowledge and practice related to asthma were sustained in the follow-up assessments. In conclusion, the guidelines had a beneficial effect on the children's adherence to their treatment regimen both before and after their implementation. Thus, asthma patients should adhere to conventional guidelines at various health services to manage their condition effectively.
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Affiliation(s)
- Roqia Maabreh
- Faculty of Nursing, Al-Balqa Applied University, Alsalt 19117, Jordan
| | | | - Madiha Amin Morsy
- Pediatric Nursing Department, Faculty of Nursing, Ain Shams University, Cairo 11517, Egypt
| | | | - Ahmad Rajeh Saifan
- Faculty of Nursing, Applied Science Private University, Amman 11937, Jordan
| | - Nabeel Al-Yateem
- College of Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates
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Ben Ameur S, Elasmar K, Jdidi J, Belhadj R, Aloulou H, Maaloul I, Damak J, Kammoun T. Prise en charge de l’asthme de l’enfant par le médecin de première ligne au Gouvernorat de Sfax, Tunisie. Rev Mal Respir 2022; 39:839-847. [DOI: 10.1016/j.rmr.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/26/2022] [Indexed: 12/05/2022]
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Said ASA, Hussain N, Kharaba Z, Al Haddad AHI, Abdelaty LN, Roshdy RRS. Knowledge, attitude, and practice of pharmacists regarding asthma management: a cross-sectional study in Egypt. J Pharm Policy Pract 2022; 15:35. [PMID: 35505447 PMCID: PMC9062855 DOI: 10.1186/s40545-022-00432-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background Asthma is a significant public health issue that poses a substantial health and economic burden. Despite the availability of effective asthma medications, its management remain suboptimal. Recent asthma guidelines have highlighted the importance of pharmacist unique position and its interventional strategies in positively impacting asthma treatment outcomes. Therefore, this study aimed to assess the degree of Egyptian pharmacists’ knowledge, attitudes, as well as their practices towards asthma management in line with the recent asthma guidelines. Methods This cross-sectional study was conducted among 800 pharmacists working in different private and governmental sectors. The data were collected using a 37-item pre-validated self-administered KAP questionnaire. The data were analyzed using Student’s t-test and analysis of variance to assess the association between each KAP level and the sociodemographic variables at the significance level of 0.05. Results Of the 800 distributed questionnaire, a total of 550 participants (316 Male, and 234 Female) responded, representing a 68.7% response rate. The mean ± SD score of knowledge, attitude, practice, and barrier was 5.49 ± 1.65 (min = 0; max = 8), 23.5 ± 2.84 (min = 15, max = 30), 43.12 ± 8.61 (min = 28, max = 62), and 27.76 ± 3.72 (min = 17, max = 39), respectively. The results showed that poor knowledge, attitude, and practice scores were achieved by 30.54, 0, and 38.72% of participants, respectively. Conclusion Our findings revealed the inconsistencies between poor pharmacists’ knowledge and practices with respect to their positive attitudes. The lack of pharmacists’ knowledge and compliance to recent GINA guidelines in this study highlight the crucial need for effective Educational strategies that should better equip pharmacists for their potential role in asthma care.
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Affiliation(s)
- Amira S A Said
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE. .,AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE. .,Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.
| | - Nadia Hussain
- AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE.,Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE
| | - Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE.,AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE
| | - Amal H I Al Haddad
- Chief Operations Office, Sheikh Shakbout Medical City (SSMC), Abu Dhabi, UAE
| | - Lamiaa N Abdelaty
- Department of Clinical Pharmacy, Faculty of Pharmacy, October 6 University, Cairo, Egypt
| | - Raghda R S Roshdy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.,Department of Clinical Pharmacy, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
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Said ASA, Hussain N, Abdelaty LN, Al Haddad AHI, Mellal AA. Inhaled Corticosteroid phobia among parents of Egyptian asthmatic children. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2021. [DOI: 10.1016/j.cegh.2021.100810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Barriers to and Facilitators of Adherence to Clinical Practice Guidelines in the Middle East and North Africa Region: A Systematic Review. Healthcare (Basel) 2020; 8:healthcare8040564. [PMID: 33333843 PMCID: PMC7765264 DOI: 10.3390/healthcare8040564] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/19/2020] [Accepted: 12/08/2020] [Indexed: 12/17/2022] Open
Abstract
The current review aims to investigate the barriers to and facilitators of the adherence to clinical practice guidelines (CPGs) in the Middle East and North Africa (MENA) region. English language studies published between January 2010 and May 2019 were searched on PubMed, Embase, and EBSCO. The barriers were categorized as clinician-related factors, such as lack of awareness of familiarity with the CPGs, and external factors, such as patients, guidelines, and environmental factors. The search identified 295 titles, out of which 15 were included. Environmental factors, specifically lack of time, resources, incentives, availability, and costs of treatment or diagnostic tests, training, and dissemination plans were the most commonly identified barriers. The familiarity with or awareness of healthcare professionals about the guideline, guideline characteristics, lack of agreement with the guidelines and preference in clinical judgment, physician self-efficacy, and motivation were reported to a lesser extent. Few studies reported on the compliance of facilitators with the guidelines including disseminating and advertising guideline materials, education and training on the guidelines, regulatory and financial incentives, and support from institutions. The review highlights that the studies on barriers to and facilitators of compliance with CPGs in the MENA region are limited in number and quality.
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Ingemansson M, Jonsson M, Henriksson P, Hedlin G, Kull I, Wikström Jonsson E, Krakau I, Kiessling A. Influence of contextual factors on quality of primary care in children with asthma. J Eval Clin Pract 2019; 25:521-530. [PMID: 30461139 DOI: 10.1111/jep.13078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 10/20/2018] [Accepted: 10/23/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Asthma is a common chronic disease among children, quality assurance is thus important. Adherence to pre-specified quality indicators of practice guidelines could be used to assess the quality of asthma care. The aim was to estimate which contextual factors that had an influence on the primary health care centres (PHCs) adherence to the quality indicators as stated in the practice guidelines. METHOD A pragmatic cross-sectional study was performed comprising 14 PHCs in Sweden. Included contextual factors were socio-demographic characteristics, organizational characteristics, and indicators regarding engagement in asthma care. Documentation on adherence to the quality indicators was retrieved from the medical health care records. Quality indicators included documentation of history of allergy and risk factors, diagnostics and patient support performed, and pharmacological treatment. To score adherence, a composite quality indicator (CQI) was computed for each PHC. A multivariable regression analysis was performed by orthogonal projection to latent structures (OPLS). By this analysis, the relationship between the result variable (CQI) and 26 pre-specified contextual factors was assessed. RESULTS There was a wide variation of CQI between the PHCs. The OPLS analysis identified that 10 of the contextual factors influenced CQI. The most pronounced influences were found in more time scheduled for asthma care, a lower age-limit for performing spirometry, a lower duty-grade for general practitioners, and a higher activity at asthma educational seminars. We found no influence of socio-demographic contextual factors. CONCLUSION We found that some of the contextual factors at the PHCs influenced the quality of performed care. Evidence-based care in paediatric asthma may thus be presumed to be facilitated by allocating time, by improving interprofessional collaboration, and by creating structures and opportunities for commitment to asthma care.
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Affiliation(s)
- Maria Ingemansson
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Marina Jonsson
- Centre of Occupational and Environmental Medicine, Stockholm County Council, Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden
| | - Peter Henriksson
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
| | - Gunilla Hedlin
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.,Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Inger Kull
- Department of Clinical Science and Education, Sachs Children and Youth Hospital, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | - Eva Wikström Jonsson
- Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden.,Clinical Pharmacology, Karolinska University Hospital, Stockholm, Sweden.,Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden
| | - Ingvar Krakau
- Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden
| | - Anna Kiessling
- Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden
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Mjid M, Souissi Z, El gueddari Y, Ben Younes A, Raharisson O, Daghfous H, Toujani S, Beji M. Prise en charge thérapeutique des asthmatiques adultes et application des recommandations du GINA dans les pays du Maghreb et à Madagascar. REVUE FRANÇAISE D'ALLERGOLOGIE 2019. [DOI: 10.1016/j.reval.2019.02.213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Ahmed R, Robinson R, Mortimer K. The epidemiology of noncommunicable respiratory disease in sub-Saharan Africa, the Middle East, and North Africa. Malawi Med J 2017; 29:203-211. [PMID: 28955434 PMCID: PMC5610297 DOI: 10.4314/mmj.v29i2.24] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Noncommunicable diseases (NCDs) are a major and increasing global health issue. The World Health Organization (WHO) estimates that NCDs represent 63% of all global deaths of which 3.9 million are due to chronic respiratory diseases (CRDs) and Chronic Obstructive Pulmonary Disease (COPD) in particular. COPD is now the third most common cause of death globally; 90% of these deaths occur in Low and Middle Income Countries (LMICs). COPD affects 329 million people, almost 5% of the world's population. In addition, asthma affects 334 million people, again representing almost 5% of the world's population. There is limited literature published on the epidemiology of COPD and Asthma from Sub-Saharan Africa (SSA) and Middle East and North Africa (MENA). Both diseases are under-diagnosed and underestimated in both SSA and MENA regions. The burden of COPD in sub-Saharan Africa is disputed and reports offer variable prevalence estimates, ranging from 4.1% to almost 22.2%. SSA and MENA countries report similar mortality rates from COPD of 18 per 100,000 population (2001 data). Asthma is a less common cause of death than COPD but is a major cause of morbidity; WHO estimates that there are 250,000 deaths per year from asthma, mainly in LMICs and it remains in the top twenty causes of disability in children globally. Risk factors for CRD are genetic and environmental; the latter dominated by air pollution exposures including tobacco smoke, household air pollution, outdoor air pollution and occupational exposures.
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Affiliation(s)
- Rana Ahmed
- The Epidemiological Laboratory, Khartoum, Sudan
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Ryan Robinson
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Kevin Mortimer
- Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Nabih ES, Kamel HFM, Kamel TB. Association Between CD14 Polymorphism (-1145G/A) and Childhood Bronchial Asthma. Biochem Genet 2016; 54:50-60. [PMID: 26475135 DOI: 10.1007/s10528-015-9699-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Accepted: 09/26/2015] [Indexed: 02/05/2023]
Abstract
Polymorphisms in the promoter region of CD14 gene have been associated with asthma and atopy although the findings between cohorts have not been uniform. We aimed at investigating the association between CD14 gene (-1145G/A) polymorphism and bronchial asthma in Egyptian children. Genotyping of CD14 gene (-1145G/A) polymorphism was done by real-time PCR in 192 asthmatic children (atopic, n = 100 and non-atopic, n = 92) and 181 age- and gender-matched healthy children. Serum levels of total IgE were measured by ELISA. Skin prick test was performed on all patients. We found that the frequency of AA genotype was significantly higher in asthmatic children compared to healthy controls. Asthmatic children carrying GG genotype had a significantly lower prevalence of atopic asthma. Meanwhile, the "A" allele was significantly higher in atopic asthmatic children compared to healthy and non-atopic children. Moreover, atopic children carrying the "G" allele showed better asthma control. In conclusion, our findings represent an evidence for the role of CD14 gene (-1145G/A) polymorphism in childhood asthma and asthma control.
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Akram W, Hussein MS, Ahmad S, Mamat MN, Ismail NE. Validation of the knowledge, attitude and perceived practice of asthma instrument among community pharmacists using Rasch analysis. Saudi Pharm J 2015; 23:499-503. [PMID: 26594115 PMCID: PMC4605899 DOI: 10.1016/j.jsps.2015.01.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 01/01/2015] [Indexed: 12/03/2022] Open
Abstract
There is no instrument which collectively assesses the knowledge, attitude and perceived practice of asthma among community pharmacists. Therefore, this study aimed to validate the instrument which measured the knowledge, attitude and perceived practice of asthma among community pharmacists by producing empirical evidence of validity and reliability of the items using Rasch model (Bond & Fox software®) for dichotomous and polytomous data. This baseline study recruited 33 community pharmacists from Penang, Malaysia. The results showed that all PTMEA Corr were in positive values, where an item was able to distinguish between the ability of respondents. Based on the MNSQ infit and outfit range (0.60-1.40), out of 55 items, 2 items from the instrument were suggested to be removed. The findings indicated that the instrument fitted with Rasch measurement model and showed the acceptable reliability values of 0.88 and 0.83 and 0.79 for knowledge, attitude and perceived practice respectively.
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Affiliation(s)
- Waqas Akram
- Clinical BioPharmaceutics Research Group (CBRG), Inhalational Delivery Research Unit (IDRU) and Biomedical Analysis Lab (BAL), Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
| | - Maryam S.E. Hussein
- Clinical BioPharmaceutics Research Group (CBRG), Inhalational Delivery Research Unit (IDRU) and Biomedical Analysis Lab (BAL), Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
| | - Sohail Ahmad
- Clinical BioPharmaceutics Research Group (CBRG), Inhalational Delivery Research Unit (IDRU) and Biomedical Analysis Lab (BAL), Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
| | - Mohd N. Mamat
- i-Learn Centre, Academic Affairs Division, Universiti Teknologi MARA, 40000 Shah Alam, Selangor, Malaysia
| | - Nahlah E. Ismail
- Clinical BioPharmaceutics Research Group (CBRG), Inhalational Delivery Research Unit (IDRU) and Biomedical Analysis Lab (BAL), Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam Campus, 42300 Bandar Puncak Alam, Selangor, Malaysia
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Al-khateeb AJ, Al khateeb JM. Research on psychosocial aspects of asthma in the Arab world: a literature review. Multidiscip Respir Med 2015; 10:15. [PMID: 25905019 PMCID: PMC4405861 DOI: 10.1186/s40248-015-0011-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Accepted: 03/17/2015] [Indexed: 12/23/2022] Open
Abstract
The importance of psychosocial factors in the management of bronchial asthma has long been recognized. This paper offers a review of research published in the English language related to psychosocial aspects of bronchial asthma in Arab countries. Several databases (PubMed, Science Direct, Springer Link, ERIC, and PsychInfo) were searched using the following keywords: bronchial asthma, Arab countries, Algiers, Bahrain, Comoros, Djibouti, Egypt, Iraq, Jordan, Kuwait, Lebanon, Libya, Mauritania, Morocco, Oman, Palestine (West Bank, Gaza), Qatar, Saudi Arabia, Syria, Tunisia, Sudan, Somalia; United Arab Emirates, and Yemen. Thirty-two studies were conducted in 9 Arab countries. Almost all studies found were published in the last fourteen years with an apparent increasing rate in the last five years. In descending order, these studies addressed: knowledge of and attitudes toward asthma, quality of life, behavioral and emotional problems and factors related to academic achievement. The main results of the studies reviewed were: (a) physicians', school staff's, and parents' knowledge of and attitudes toward asthma were generally unsatisfactory, (b) in-service asthma education programs significantly impacted parent and staff knowledge and attitudes, and asthma management practices, (c) quality of life in children and adolescents was significantly adversely affected by asthma, (d) asthma was a common cause of school absenteeism, and had a significant negative impact on academic achievement of students, and (e) students with asthma had significantly higher rates of behavioral and emotional difficulties compared to students without asthma. The paper concludes with a discussion about the implications of these results and a call for further research in this area.
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Affiliation(s)
- Anas J Al-khateeb
- />Internal Medicine Department, Saint Michael’s Medical Center, 111 Central Avenue, Newark, New Jersey 07102 USA
| | - Jamal M Al khateeb
- />Department of Counseling & Special Education, College of Education, University of Jordan, Queen Rania Street, Amman, 119942 Jordan
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Does guideline knowledge affect treatment compliance among emergency doctors? Am J Med Sci 2015; 348:357-61. [PMID: 25118657 DOI: 10.1097/maj.0000000000000269] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The insufficient adoption of internationally accepted clinical guidelines may lead to less than adequate patient care of patients with asthma. OBJECTIVE To evaluate the knowledge and treatment compliance with Global Initiative of Asthma (GINA, 2011) asthma treatment guidelines among emergency physicians (EPs) at a referral hospital in northern Malaysia. METHODS A cross-sectional study was designed in the territory-level referral hospital in northern Malaysia. Twenty-seven EPs were asked to complete an asthma guideline questionnaire to assess their knowledge regarding GINA 2011 asthma treatment guidelines. A total of 810 patients were enrolled, and 30 patients were selected per physician. The authors evaluated the physicians' compliance with GINA 2011 asthma treatment guidelines. RESULTS Of 27 EPs, 20 (74.1%) had adequate knowledge of GINA 2011 asthma treatment guidelines. A total of 615 (75.9%) patients received guideline-recommended emergency treatment. Shortness of breath (n = 436, 53.8%) was the most frequently reported chief complaint. Furthermore, there was a significant but weak association between knowledge of the guideline and treatment compliance among emergency doctors (P = 0.003, φ = 0.110). Moreover, there was no significant change in therapy for patients with comorbid conditions. The mean age of respondents was 27.3 years. CONCLUSIONS Overall, a fair level of guideline knowledge and treatment compliance was noted among EPs. Doctors with adequate guideline knowledge were more likely to comply with GINA 2011 asthma treatment guidelines.
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The improvement in asthma severity and pulmonary functions after laser acupuncture application in asthmatic children. ACTA ACUST UNITED AC 2014. [DOI: 10.1097/01.mjx.0000457178.59145.b5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Adeloye D, Chan KY, Rudan I, Campbell H. An estimate of asthma prevalence in Africa: a systematic analysis. Croat Med J 2014; 54:519-31. [PMID: 24382846 PMCID: PMC3893990 DOI: 10.3325/cmj.2013.54.519] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Aim To estimate and compare asthma prevalence in Africa in 1990, 2000, and 2010 in order to provide information that will help inform the planning of the public health response to the disease. Methods We conducted a systematic search of Medline, EMBASE, and Global Health for studies on asthma published between 1990 and 2012. We included cross-sectional population based studies providing numerical estimates on the prevalence of asthma. We calculated weighted mean prevalence and applied an epidemiological model linking age with the prevalence of asthma. The UN population figures for Africa for 1990, 2000, and 2010 were used to estimate the cases of asthma, each for the respective year. Results Our search returned 790 studies. We retained 45 studies that met our selection criteria. In Africa in 1990, we estimated 34.1 million asthma cases (12.1%; 95% confidence interval [CI] 7.2-16.9) among children <15 years, 64.9 million (11.8%; 95% CI 7.9-15.8) among people aged <45 years, and 74.4 million (11.7%; 95% CI 8.2-15.3) in the total population. In 2000, we estimated 41.3 million cases (12.9%; 95% CI 8.7-17.0) among children <15 years, 82.4 million (12.5%; 95% CI 5.9-19.1) among people aged <45 years, and 94.8 million (12.0%; 95% CI 5.0-18.8) in the total population. This increased to 49.7 million (13.9%; 95% CI 9.6-18.3) among children <15 years, 102.9 million (13.8%; 95% CI 6.2-21.4) among people aged <45 years, and 119.3 million (12.8%; 95% CI 8.2-17.1) in the total population in 2010. There were no significant differences between asthma prevalence in studies which ascertained cases by written and video questionnaires. Crude prevalences of asthma were, however, consistently higher among urban than rural dwellers. Conclusion Our findings suggest an increasing prevalence of asthma in Africa over the past two decades. Due to the paucity of data, we believe that the true prevalence of asthma may still be under-estimated. There is a need for national governments in Africa to consider the implications of this increasing disease burden and to investigate the relative importance of underlying risk factors such as rising urbanization and population aging in their policy and health planning responses to this challenge.
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Affiliation(s)
- Davies Adeloye
- Davies Adeloye, WHO Collaborative Centre for Population Health Research and Training, Centre for Population Health Sciences, University of Edinburgh Medical School, Edinburgh, EH8 9AG, UK,
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Lababidi H, Abu-Shaheen AK, Bou Mehdi IA, Al-Tannir MA. Asthma care practicing among general practitioners in Lebanon: a cross-sectional study. J Asthma 2013; 51:51-7. [PMID: 24024792 PMCID: PMC3913077 DOI: 10.3109/02770903.2013.843096] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives The aim of this study was to characterize the current practice of asthma among general practitioners (GPs) in Lebanon. Methods Out of 2450 Lebanese registered GPs, a representative sample of 330 were stratified by region to fill out the questionnaire constructed on the basis of surveys developed mainly by the Chicago Asthma Surveillance Initiative Report Team in newly moderate persistent asthma patients aged 5 years and above. The questionnaire included information about ascertaining diagnostic techniques, pharmacotherapeutic approaches, formal patient education program; asthma related continuing medical education and asthma practice guidelines. Results Totally, 302 completed the questionnaire achieving a response rate of 91.5%. Chest radiography was the most commonly used diagnostic test (98%), while stain for eosinophilia was the less commonly used (7.9%). For clinical monitoring, cough and wheezing (98.7%) were mostly assessed. Short acting inhaled β2-agonists were often the most prescribed (94.3%) followed by inhaled corticosteroids (87.4%) then by long acting β-agonist (LABA) and theophylline (27.5% and 20.9%, respectively). Moreover, 10% of GPs provided formal asthma education program, 72.2% attended professional education and 65% adopted guidelines. Conclusion Based on current international guidelines, the overall Lebanese GPs practice of asthma management is not at an acceptable standard. Therefore, it is recommended to improve monitoring parameters, implement the asthma guidelines nationally and improve patient education.
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Affiliation(s)
- Hani Lababidi
- Pulmonary & Critical Care Department, King Fahad Medical City Hospital , Riyadh , Saudi Arabia
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Genetic association between common beta-2 adrenoreceptor polymorphism and asthma severity in school-age children. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2011. [DOI: 10.1016/j.ejmhg.2011.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Grover C, Armour C, Asperen PPV, Moles R, Saini B. Medication use in children with asthma: not a child size problem. J Asthma 2011; 48:1085-103. [PMID: 22013989 DOI: 10.3109/02770903.2011.624234] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The global burden of pediatric asthma is high. Governments and health-care systems are affected by the increasing costs of childhood asthma--in terms of direct health-care costs and indirect costs due to loss of parental productivity, missed school days, and hospitalizations. Despite the availability of effective treatment, the current use of medications in children with asthma is suboptimal. The purpose of this review is to scope the empirical literature to identify the problems associated with the use of pediatric asthma medications. The findings will help to design interventions aiming to improve the use of asthma medications among children. METHODS A literature search using electronic search engines (i.e., Medline, International Pharmaceutical Abstracts (IPA), PubMed, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL)) and the search terms "asthma," "children," and "medicines" (and derivatives of these keywords) was conducted. RESULTS The search terms were expanded to include emergent themes arising out of search findings. Content themes relating to parents, children themselves, health-care professionals, organizational systems, and specific medications and devices were found. Within these themes, key issues included a lack of parental knowledge about asthma and asthma medications, lack of information provided to parents, parental beliefs and fears, parental behavioral problems, the high costs of medications and devices, the child's self-image, the need for more child responsibility, physician nonadherence to prescribing guidelines, "off-label" prescribing, poor understanding of teachers, lack of access to educational resources, and specific medications. CONCLUSION These key issues should be taken into account when modifying the development of educational tools. These tools should focus on targeting the children themselves, the parent/carers, the health-care professionals, and various organizational systems.
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Affiliation(s)
- Charu Grover
- Faculty of Pharmacy, University of Sydney, Camperdown Campus, Sydney, New South Wales, Australia
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