Treating persistent asthma in rural Rwanda: characteristics, management and 24-month outcomes

Int J Tuberc Lung Dis. 2017 Oct 1;21(10):1176-1182. doi: 10.5588/ijtld.17.0039. Epub 2017 Aug 1.

Abstract

Setting: In 2007, the Rwandan Ministry of Health, with support from Partners In Health, introduced a district-level non-communicable disease programme that included asthma care.

Objective: To describe the demographics, management and 24-month outcomes of asthma patients treated at three rural district hospitals in Rwanda.

Design: We retrospectively reviewed electronic medical records of asthma patients enrolled from January 2007 to December 2012, and extracted information on demographics, clinical variables and 24-month outcomes.

Results: Of the 354 patients, 66.7% were female and 41.5% were aged between 41 and 60 years. Most patients (53.1%) were enrolled with moderate persistent asthma, 40.1% had mild persistent asthma and 6.8% had severe persistent asthma. Nearly all patients (95.7%) received some type of medication, most commonly a bronchodilator. After 24 months, 272 (76.8%) patients were still alive and in care, 21.1% were lost to follow-up, 1.7% had died and 0.3% had transferred out. Of the 121 patients with an updated asthma classification at 24 months, the severity of their asthma had decreased: 17.4% had moderate and 0.8% had severe persistent asthma.

Conclusion: Our findings show improvements in asthma severity after 24 months and reasonable rates of loss to follow-up, demonstrating that asthma can be managed effectively in rural, resource-limited settings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Bronchodilator Agents / therapeutic use*
  • Cohort Studies
  • Female
  • Follow-Up Studies
  • Hospitals, District
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Rural Health Services
  • Rural Population*
  • Rwanda
  • Severity of Illness Index
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Asthmatic Agents
  • Bronchodilator Agents