This institution-based cross-sectional study attempted to assess the magnitude and associated risk factors of asthma among adult patients in an adult emergency outpatient department of Debre Berhan Referral Hospital.
In the present study, the prevalence of bronchial asthma among adult patients in the referral hospital was 29.6%. This prevalence was higher compared to the study done in India, Uganda, Nigeria, Egypt and Ethiopia [2, 13-16]. A possible explanation for this difference could be due to the effect of climatic conditions. This study had been conducted on participants living in highland area which is elevated 2,810 meters (9,320 ft) above sea level and having very cold climate in almost all months of the year. Furthermore, growing population size and radical urbanization contributes to the increment of the prevalence of asthma by changing the pattern of environmental condition and lifestyles of the community. However, variables that hadn’t been included in the above studies, such as the level of air pollution, level of exposure to allergens, and climatic conditions, may have contributions for the difference of prevalence in different areas. This can be the concern of future researches.
This study revealed that urban residents (AOR: 1.5; 95%CI: 1.3 - 3.90) were more likely to develop bronchial asthma than rural residents. This was consistent with the report in Brazil, India and Uganda [2, 17, 18]. This might be explained outdoor air of urban area is highly polluted due to high levels of traffic and industry related emissions that could increase the risk of asthma. In contrast study done in India [19] showed that being a rural resident was significantly higher the odds of having asthma. Research conducted in Ethiopia [20] revealed that no association between asthma and residence of the patients. These variations might be due to the difference in the characteristics of the study population, geographical distribution and case definitions used to ascertain asthma.
As of this study, adult patient who come from low income status were more likely to develop bronchial asthma than counterpart. It was congruent with the study conducted in developed and developing country like Sweden, Australia and india [2, 21, 22]. This could be due to the fact that, low income levels of the households limited to apply appropriate prevention and control mechanisms of bronchial asthma.
This study indicated that patients who come from the family history of asthma (AOR: 2.7: 95%CI: 1.3 - 5.8) were more likely to develop bronchial asthma than from non-asthmatic family. Similar findings have been reported by other studies in developed and developing countries that showed a significant association between family history of asthma and asthma occurrence among adult patients [12, 15, 23, 24]. This association could be either due to genetic factors or a shared environment by the family members.
In this study, present of vermin at household level increased the probability of developing asthma among adult patients. The world health organization report in 2008 report also showed that evidence for a relationship between asthma and domestic exposure to cockroaches, mice and dust mites is strong [25]. This could be explained by house which have vermin’s concerns with the use of insecticides prays at home, with more frequent use being associated with bronchial asthma. Similar results can be found in the literature regarding the link between the use of home aerosolized cleaning products and asthma [26, 27].