与刚果民主共和国金沙萨成年哮喘患者哮喘控制不佳相关的因素。
Factors associated with uncontrolled asthma in adult asthmatics in Kinshasa, Democratic Republic of Congo.
机构信息
Unit of Pneumology, Department of Internal Medicine, University Clinics of Kinshasa, Medical School, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
Department of Epidemiology and Biostatistics, School of Public Health, University of Kinshasa, Kinshasa, Democratic Republic of Congo.
出版信息
PLoS One. 2019 Apr 18;14(4):e0215530. doi: 10.1371/journal.pone.0215530. eCollection 2019.
BACKGROUND
The ultimate goal of asthma treatment is long-term control. Uncontrolled asthma is a major public health problem worldwide, but there is a lack of data on asthma control and its causes in the Democratic Republic of Congo (DRC).
OBJECTIVE
To determine the socio-demographic, environmental, clinical, and biological factors and comorbidities associated with uncontrolled adult asthma in Kinshasa, DRC.
METHODS
We performed a cross-sectional study of 216 male and female asthmatics aged 18 and over consecutively recruited from tertiary clinics and the community in Kinshasa between June 2017 and February 2018. For each subject, socio-demographic, clinical, para clinical and environmental data were recorded. Forced Expiratory Volume in one second (FEV1) values were obtained by Spirometry, allergen testing performed using the skin prick test, serum vitamin D levels measured by radioimmunoassay, and asthma control assessed using the asthma control test (ACT) score. Multiple logistic regression identified factors associated with uncontrolled asthma.
RESULTS
The average age of participants was 45.2 (SD 17.6) years, 74% were female, and 42% had a low educational level. Among all asthmatics, the prevalence of uncontrolled asthma was 56%, abnormal serum vitamin D level 95%, abnormal FEV1 65%, sensitization to two allergens (cat dander and dust mites) 18%, sleep disorders 37%, and heartburn 60%. Male (aOR 2.24; 95% CIs 1.04-4.79), low educational level (aOR 3.26; 95% CIs 1.54-6.67), sensitization to both cat dander and dust mites (aOR 2.67; 95% CIs 1.16-6.14), FEV1 ≤80% (aOR 2.07; 95% CIs 1.08-3.96), abnormal serum vitamin D level (aOR 5.11; 95% CIs 1.17-22.33), sleep disorders (aOR 1.96; 95% CIs 1.04-3.71), and heartburn (aOR 2.02; 95% CIs 1.04-3.92) were significantly associated with uncontrolled asthma.
CONCLUSION
Uncontrolled asthma is common in Kinshasa, and these factors associated with uncontrolled asthma may be considered as targets for future intervention strategies.
背景
哮喘治疗的最终目标是长期控制。未控制的哮喘是全球范围内的一个主要公共卫生问题，但在刚果民主共和国（DRC）缺乏关于哮喘控制及其原因的相关数据。
目的
确定与金沙萨成年未控制哮喘相关的社会人口学、环境、临床和生物学因素及合并症。
方法
我们对 2017 年 6 月至 2018 年 2 月期间在金沙萨的三级诊所和社区中连续招募的 216 名年龄在 18 岁及以上的男性和女性哮喘患者进行了横断面研究。记录了每位患者的社会人口学、临床、临床前和环境数据。使用肺量计测量了一秒用力呼气量（FEV1）值，通过皮肤点刺试验进行了过敏原检测，使用放射免疫测定法测量了血清维生素 D 水平，并使用哮喘控制测试（ACT）评分评估了哮喘控制情况。多变量逻辑回归确定了与未控制哮喘相关的因素。
结果
参与者的平均年龄为 45.2（SD 17.6）岁，74%为女性，42%的受教育程度较低。在所有哮喘患者中，未控制哮喘的患病率为 56%，异常血清维生素 D 水平为 95%，异常 FEV1 为 65%，对两种过敏原（猫皮屑和尘螨）过敏的为 18%，睡眠障碍为 37%，胃灼热为 60%。男性（比值比 2.24；95%置信区间 1.04-4.79）、受教育程度低（比值比 3.26；95%置信区间 1.54-6.67）、对猫皮屑和尘螨均过敏（比值比 2.67；95%置信区间 1.16-6.14）、FEV1≤80%（比值比 2.07；95%置信区间 1.08-3.96）、异常血清维生素 D 水平（比值比 5.11；95%置信区间 1.17-22.33）、睡眠障碍（比值比 1.96；95%置信区间 1.04-3.71）和胃灼热（比值比 2.02；95%置信区间 1.04-3.92）与未控制哮喘显著相关。
结论
未控制的哮喘在金沙萨很常见，与未控制的哮喘相关的这些因素可能被视为未来干预策略的目标。
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