Study design, setting and population
This hospital based cross-sectional quantitative study design was carried out from March 01 to April 30, 2018 among adult patients in an adult emergency outpatient department of Debre Berhan Referral Hospital, which is located in Debre Berhan town 130 km north of Addis Ababa. This hospital is the only governmental referral hospital in the North Shoa Zone of Amhara region that provides both curative and preventive services for 3 million people in its catchment area including inhabitants from neighboring regions of Afar and Oromia. All adult patients who visited adult emergency OPD department were our source population.
Sample size and sampling strategies
A total of 257 adult patients have participated in the study. Each study participant was selected through systematic sampling techniques with an interval of every fourth adult patient who visited the adult emergency outpatient department.
Operational definition
Bronchial asthma: A study subject was labeled as bronchial asthmatic if he/she has the symptoms of shortness of breath with wheezing and having normal breathing in between episodes of shortness of breath that lasts for three month in the past 12 months. Those asthmatic patients whose age < 13 years and critically ill who can’t able to respond were excluded from the study.
Chronic disease: Course of the disease that lasts for more than three months.
Drug discontinuation: a study participant withdraws drugs in an attempt to improve outcomes for any disease.
Exercise habit: a study participant who has an experience of physical exercise once per a day for more than 30 minutes for relaxation or health.
Frequent utilization of perfume: a study participant utilizes perfume at their home more than twice per a day.
Data collection tool and methods
The structured questionnaire adapted from reviewing different kinds of the literature of similar studies was used for the collection of quantitative data [2, 12]. Data on bronchial asthma, demographic characteristics, environmental and housing condition, individual behavior and health-related factors were collected via interview. Data was collected immediately after stabilizing from emergency department. A team of three experienced data collectors were trained in conducting an interview. Interviewer were available to collect data at the daytime only. English version questionnaire was translated into Amharic language and again translated back to English by experts who were fluent in both languages to check consistency.This study was carried out after getting ethical clearance from Debre Berhan University research ethics review committee. Verbal informed consent was taken from the study participant after briefed about the study. Omitting names of the study subjects from the questionnaire help to assure confidentiality of the information.
Statistical analysis
Data were entered by using Epi-Info 7.0.9.7 version computer software package for editing, cleaning, coding, and checking completeness and consistency. Finally, data were exported to SPSS window version 20 for data management and analysis. Descriptive analysis was done to describe the characteristics of our study population. Both bivariate and multivariate logistic regression analysis were used to identify the predictors of asthma. Variables with a 95% confidence interval and a P value < 0.05 during the bivariate analysis were included in the multivariate logistic regression analysis to see the relative effect of confounding variables. Adjusted odds ratios with 95% confidence interval were calculated and P-value less than 0.05 were considered as statistically significant. Finally, data was displayed by tables, graphs and statements.