High Prevalence of Undiagnosed Asthma Found Among Secondary School Students

Two in every 10 children aged between 12 and 15 have been found with symptoms of asthma, a respiratory condition that often presents with breathing difficulties, cough and wheezing among others.

Researchers at Makerere University Lung Institute screened 895 students attending secondary schools in Kampala, Wakiso and Mukono districts since 2018, and found that 177 of them had symptoms associated with asthma.

According to Dr Rebecca Nantanda, a consultant paediatrician and lung expert who led the study team, only 33.9 per cent of those that screened positive knew they were living with asthma and the majority were unaware despite having symptoms.

Worse still, 64 of the students had severe symptoms but had never been accurately diagnosed, and some were being treated for something different.

Previously, the institute had conducted studies among children and adults to determine the prevalence of the condition but data among adolescents had been missing. Now, new data finds that among this age group, only less than half of those who knew they had the condition had controlled disease with limited attacks and less need for medication.

Nantanda says that managing asthma is not all about treatment but that a number of lifestyle changes that can help a sufferer to live a normal life are recommended when someone is diagnosed. She says it’s worrying that health workers have been treating without actually knowing that they are treating asthma.

These findings were put to the Ministry of Health (MOH) where officials acknowledged that health workers haven’t received enough training on the diagnosis of asthma.

Dr Frank Mugabe, the Principal Medical Officer in charge of Non-Communicable Diseases (NCDs) at the Ministry told  URN that training is only piecemeal as health workers rely on what they studied while still in medical school to diagnose asthma. This is despite changing approaches to diagnosis and care.

For instance, he says, the standard of care is changing from treating the asthmatic with the popular oral drug salbutamol to inhalers but many are still prescribing this medicine.

Agreeing with the findings in the survey, he says the prevalence of asthma is on the increase as their data shows in the last three years, they have been recording over 100,000 new cases each year.

In 2020, he says they recorded 133,000 cases and these slightly reduced in 2021 to 124,000 because of restrictions related to COVID-19. This year, he says, they had recorded 106,000 cases by end of October and predicts that they might surpass the figures recorded in 2020.

Kampala, West Nile and South Western Uganda have the highest rates of asthma across all age groups. Mugabe attributes this to high rates of air pollution.

The same study;  Achieving Control of Asthma in Children in Africa (ACACIA) was conducted in five other countries including Malawi, South Africa, Ghana and Zimbabwe. Nantanda says results from Uganda do not vary so much from what researchers in those other countries have found.   

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