Department of Biostatistics, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
Department of Community Health, School of Public Health, College of Health Sciences, University of Ghana, Accra, Ghana.
PLoS One. 2020 Dec 9;15(12):e0243642. doi: 10.1371/journal.pone.0243642. eCollection 2020.
A previous multi-site study involving lower- and middle-income countries demonstrated that asthma in older adults is associated with long-term exposure to particulate matter, male gender and smoking. However, variations may occur within individual countries, which are relevant to inform health promoting policies as populations live longer. The present study estimates asthma prevalence and examines the sociodemographic characteristics and environmental determinants associated with asthma in older adults in Ghana.
This study utilised data from the nationally representative World Health Organization Study on global AGEing and adult health (SAGE) Ghana Wave 2. A final sample of 4621 individuals residing in 3970 households was used in analytical modelling. Factors associated with asthma were investigated using single level and multilevel binary logistic regression models.
Asthma was reported by 102 (2.2%) respondents. Factors associated with asthma in the univariate model were: those aged 60-69 (OR = 5.22, 95% CI: 1.24, 21.95) and 70 or more (OR = 5.56, 95% CI: 1.33, 23.26) years, Ga-Adangbe dialect group (OR = 1.65, 95% CI: 1.01, 2.71), no religion (OR = 3.59, 95% CI: 1.77, 7.28), having moderate (OR = 1.76, 95% CI: 1.13, 2.75) and bad/very bad (OR = 2.75, 95% CI: 1.58, 4.80) health state, and severe/extreme difficulty with self-care (OR = 3.49, 95% CI: 1.23, 9.88) and non-flush toilet facility (OR = 0.62, 95% CI: 0.39, 0.99). Factors independently associated with asthma in the adjusted models were: those aged 60-69 (OR = 4.49, 95% CI: 1.03, 19.55) years, father with primary education or less (OR = 0.40, 95% CI: 0.17, 0.94), no religion (OR = 2.52, 95% CI: 1.18, 5.41), and households with non-flush toilet facility (OR = 0.58, 95% CI: 0.35, 0.96). Significant residual household-level variation in asthma was observed. Over 40% of variance in asthma episodes could be attributable to residual household-level variations.
Individual as well as household factors were seen to influence the prevalence of asthma in this national survey. Clinical management of these patients in health facilities should consider household factors in addition to individual level factors.
先前一项涉及中低收入国家的多地点研究表明，老年人哮喘与长期暴露于颗粒物、男性性别和吸烟有关。然而，在个体国家内可能存在差异，这些差异与人口寿命延长有关，为制定促进健康的政策提供了依据。本研究旨在评估加纳老年人哮喘的患病率，并探讨与哮喘相关的社会人口学特征和环境决定因素。
本研究利用了来自具有代表性的世界卫生组织全球老龄化和成人健康研究（SAGE）加纳第二波的数据。最终分析模型使用了居住在 3970 户家庭中的 4621 名个体。使用单水平和多水平二元逻辑回归模型调查与哮喘相关的因素。
有 102 名（2.2%）受访者报告患有哮喘。单变量模型中与哮喘相关的因素包括：60-69 岁（OR=5.22，95%CI：1.24，21.95）和 70 岁或以上（OR=5.56，95%CI：1.33，23.26），Ga-Adangbe 方言群体（OR=1.65，95%CI：1.01，2.71），无宗教信仰（OR=3.59，95%CI：1.77，7.28），中度（OR=1.76，95%CI：1.13，2.75）和差/非常差（OR=2.75，95%CI：1.58，4.80）健康状况，以及严重/极度自理困难（OR=3.49，95%CI：1.23，9.88）和非冲水厕所设施（OR=0.62，95%CI：0.39，0.99）。在调整后的模型中，与哮喘相关的因素包括：60-69 岁（OR=4.49，95%CI：1.03，19.55）岁，父亲接受过小学或以下教育（OR=0.40，95%CI：0.17，0.94），无宗教信仰（OR=2.52，95%CI：1.18，5.41），以及非冲水厕所设施家庭（OR=0.58，95%CI：0.35，0.96）。观察到哮喘在家庭层面存在显著的残余变异。哮喘发作的 40%以上的变异可以归因于家庭层面的残余变异。
个人和家庭因素都被认为会影响该国家调查中哮喘的患病率。在医疗机构对这些患者进行临床管理时，除了个体因素外，还应考虑家庭因素。
