Identification of the risk factors and management of asthma among children in naivasha, Kenya
Abstract
Background: In Kenya, asthma affects 10% of the population. Major factors contributing to
asthma morbidity and mortality are environmental exposures to risk factors, under diagnosis and
under treatment. Most asthma exacerbations can be prevented if management is comprehensive.
Poorly managed asthma leads to emergency treatment and hospitalization, which are much more
costly for patients than effectively managed treatment.
Study objective: The study’s objective was to evaluate the risk factors and management of
asthma among children aged 5-12 years in Naivasha District.
Study Design: The study was ahospital-based cross-sectional study.
Study Population: The study population was composed of 150 Children aged 5-12years
diagnosed with asthma in Naivasha District.
Methodology: Purposeful sampling of children diagnosed with asthma, aged 5-12yrs old
attending Naivasha District Hospital, Karagita Dispensary and Finlay Hospitals was done to
enroll 150 children into the study. Questionnaires were administered to caregivers of children
diagnosed with asthma. In addition, the prescriptions were examined to check for clinician’s
drug prescribing patterns. Data was analyzed using stata version 12 and the results summarized
in tables. Inferential and descriptive statistics was derived by using P values and confidence
intervals.
Results: Factors that were found to be significantly associated with asthma control were;
duration of stay in or near a flower farm, presence of a smoker in the family and presence of
household pet. Conditional logistic regression models were fitted to estimate odds ratio and 95%
confidence intervals (CI). Uncontrolled asthma was associated with presence of a smoker in the
household(OR= 0.46; 95% CI, 0.095-22.629), presence of household pets( OR= 4.36; 95% CI,
1.182-16.057) and duration of stay near a pesticide treated farm(OR=0.72; 95% CI, 0.05380.975).There
was no significant relationship between the child’s asthma control and age of child,
sex of child, distance of school from flower, guardian’s level of education, guardian’s income,
and guardian’s occupation as a flower farm worker, child’s age of diagnosis and use of indoor
pesticides. In addition, asthma management was not in line with the national guidelines resulting
in suboptimal therapy.
Conclusion: Inconclusion, environmental pollutants are risk factors to asthma control.The
factors that had a strong association to asthma control were environmental tobacco smoke
(p=0.008),duration of stay near a pesticide treated flower farm (p=0.022) and presence of
household pets (P=0.009).Under utilization of the national asthma guidelines also contributed to
poor asthma treatment outcomes.
Recommendations: This study was a cross sectional. We therefore recommend that a case
control study be carried out using these study findings as a baseline to determine the strength of
association between the risk factors and asthma control.
Citation
Master of Pharmacy in Clinical PharmacyPublisher
University of Nairobi