Asthma control in Kazakhstan: need for urgent action
Vinnikov D. Raushanova A. Mukatova I. Nurpeissov T. Кushekbayeva A. Toxarina A. Yessimova B. Bespayeva F. Brimkulov N.
7 January 2023BioMed Central Ltd
BMC Pulmonary Medicine
2023#23Issue 1
Background: Asthma control, patients’ awareness level and adherence to treatment in Kazakhstan have never been studied. The aim of this study was to verify the prevalence of controlled, poorly controlled and uncontrolled asthma in a large sample of three largest cities of Kazakhstan. Methods: We recruited 600 (median age 54 (interquartile range (IQR) 22) years, 64% females) patients with diagnosis confirmed earlier in the outpatient facilities in Almaty, Astana and Shymkent in 2020–2021. We offered a structured questionnaire on asthma control and risk factors as of GINA and performed spirometry. We report the prevalence of asthma control, knowledge and skills and pharmacological treatment with 95% confidence interval (CI) and the association of selected predictors with asthma control. Results: With the median of 9 (IQR 13) years of diagnosis, 40% of patients had comorbid COPD and 42% had allergic rhinitis, whereas 32% lived with pets. Asthma was well-controlled in only 12.3% (95% CI 9.7–15.0), partly controlled in 29.8% (95% CI 26.2–33.5) and uncontrolled in 57.8% (95% CI 53.9–61.8) patients. ACQ-5 score (range 0–5.8, median 2) equaled 0.2 (IQR 0.85) in well-controlled asthma patients, 1.4 (IQR 1) in partly controlled and 2.8 (IQR 1.4) in uncontrolled asthma patients. Knowledge and skills levels were very low. Only 54% were on inhaled corticosteroids (52.2% of them used budesonide/formoterol and 39.5% used fluticasone/salmeterol). 39% used steroids per os or parenterally within a period of 12 months (51% of patients with uncontrolled asthma). Conclusion: Asthma control, knowledge and skills levels of asthma patients in the largest cities of Kazakhstan remain unacceptably low, whereas pharmacological treatment is far from optimal. Urgent action should be taken to support doctors’ training, and we call to launch a national asthma program to coordinate asthma care in Kazakhstan.
GINA , Inhaled steroids , Peakflowmetry , Prevalence
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Al-Farabi Kazakh National University, 71 Al-Farabi Avenue, Almaty, 050040, Kazakhstan
Peoples’ Friendship University of Russia (RUDN University), Moscow, Russian Federation
Medial University Astana, Astana, Kazakhstan
Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan
South-Kazakhstan Medical Academy, Shymkent, Kazakhstan
Regional Clinical Hospital, Shymkent, Kazakhstan
Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
Al-Farabi Kazakh National University
Peoples’ Friendship University of Russia (RUDN University)
Medial University Astana
Asfendiyarov Kazakh National Medical University
South-Kazakhstan Medical Academy
Regional Clinical Hospital
Kyrgyz State Medical Academy
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