Adeyeye O O, Onadeko B O
Department of Medicine, Lagos State University, College of Medicine, 1/5, Oba Akinjobi GRA. P.M.B 21266, Ikeja, Lagos.
West Afr J Med. 2008 Jul;27(3):155-9.
There are several internationally accepted guidelines for the management of asthma.
To examine the utilization of these guidelines in the management of asthmatics as well as the use of inhaler devices among the asthmatics presenting for specialist assessment and treatment in Lagos, Nigeria.
One hundred and six consecutive patients with physician-diagnosed asthma referred on account of poor control for specialist review participated in the study between April 2006 and March 2007. The setting was the Chest Clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos. The patients aged between 13 and 64 years were interviewed about asthma control using previous hospitalization, frequency of night-time symptoms, and frequency of attendance at The Emergency Unit. Their knowledge of medications was assessed. Inhaler techniques were directly observed.
Fifty two (49.1%) had previous hospitalization for asthma. Fifty (47.2%) had weekly nighttime symptoms. Forty-eight (45.3%) had exacerbations requiring treatment at the emergency room in the week preceeding the interview. The metered dose inhaler was the commonest drug delivery device, in use by 72 (67.9%) of the patients. Thirty-two (30.2%) used diskus. Only 10 (10.6%) used nebulisers at any point. The inhaler technique was rated as good by thirty-four (47.2%) out of the seventy-two respondents and poor by thirty-eight (52.8%). Only thirty-four satisfactorily performed all steps. One hundred respondents (943%) skipped their medications. Majority of the asthmatics did not receive any health education about their condition. Possession of peak flow meter and use were low among the patients with only 22 (20.8%) having one.
Asthma control is poor among the patients in Lagos, Nigeria. Poor knowledge of disease, medication use and inhaler techniques contribute significantly to this problem.
有几种国际公认的哮喘管理指南。
研究这些指南在尼日利亚拉各斯哮喘患者管理中的应用情况，以及前来接受专科评估和治疗的哮喘患者吸入装置的使用情况。
2006年4月至2007年3月期间，连续106例因控制不佳而被转诊至专科进行复查的医生诊断为哮喘的患者参与了该研究。研究地点为拉各斯拉各斯州立大学教学医院伊凯贾分院的胸部诊所。对年龄在13至64岁之间的患者进行了访谈，询问其哮喘控制情况，包括既往住院情况、夜间症状出现频率以及急诊就诊频率。评估了他们对药物的了解情况。直接观察吸入技术。
52例（49.1%）患者曾因哮喘住院。50例（47.2%）患者每周有夜间症状。48例（45.3%）患者在访谈前一周内有需要在急诊室治疗的病情加重情况。定量气雾剂是最常用的给药装置，72例（67.9%）患者使用。32例（30.2%）患者使用都保。只有10例（10.6%）患者在任何时候使用雾化器。72名受访者中，34例（47.2%）的吸入技术被评为良好，38例（52.8%）被评为差。只有34例患者能令人满意地完成所有步骤。100例受访者（94.3%）漏服药物。大多数哮喘患者未接受过关于其病情的任何健康教育。患者中峰值流量计的拥有率和使用率较低，只有22例（20.8%）患者拥有一台。
尼日利亚拉各斯的哮喘患者病情控制不佳。对疾病、药物使用和吸入技术的了解不足是导致这一问题的重要因素。
