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The implementation of global initiative for asthma (GINA) guidelines and Its Impact on asthma control in Ethiopia: A Longitudinal Study
Abstract
Background: Asthma is one of the common chronic respiratory illnesses that affect approximately 339 million people in the world. This study aimed to assess asthmatic patients’ usage of short-acting beta-2 agonist (SABA) medication and Asthma control with GINA recommended asthma management guidelines.
Methods: A longitudinal study of data set from the Ethiopian African Severe Asthma Project (ASAP) at Tikur Anbessa Specialized Hospital was used as a data source. The ASAP project was a prospective, multi-centered, cohort study designed to investigate the prevalence and clinic characteristics of severe asthma in three African countries. Socio-demographic, comorbid conditions, and medication usage were extracted from the database. Descriptive statistics and binary logistic regression were used in data analyses.
Results: A total of 203 asthmatics were included in this analysis; 124 (61.1%) were females and 55 (27.1%) were age group 50-59 years. At baseline, 190 (93.6%) had uncontrolled asthma. Most 110(54.2%) were using only SABA medication. Of those patients using SABA alone, 108 (98.18%) had uncontrolled asthma. After enrolment in ASAP, GINA management guidelines were followed, inhaled corticosteroids (ICS) and long-acting beta-agonist (LABA) medications were the most frequently prescribed medications 182(89.7%), and usage of SABA medication decreased from 54.2% to 29.6%. Asthma control level significantly improved (P<0.0001) at six and twelve months of therapy as compared to baseline. Combination therapies were frequently prescribed at six months 172(84.2%). The frequency of controlled asthma at baseline, six, and twelve months was 6.40%, 65.02%, and 71.92%, respectively.
Conclusion: Implementation of GINA guidelines significantly improved asthma control. For a better outcome of asthma treatment, we are highly recommended the adoption of the GINA guideline in the national treatment guideline of Ethiopia.
