Assessment of asthma management of adults in Africa

A cross sectional study of asthma management of adults in Africa based on an anonymous questionnaire was conducted among 149 general practitioners working in the principal 18 cities in the Ivory Coast located in 6 geographical regions drawn for the purpose of this study. Data collected included: complementary tests prescribed at first diagnosis, typical prescriptions for acute asthma and for long-term control, knowledge of metered-dose inhalation techniques. regular measurement of FEW and prescription of sports activities. Forty-one percent Of the physicians were unaware of the usefulness of expiration volume measurements and FEV1 measurements were prescribed by only 8%. The most widely prescribed tests were chest x-ray, blood cell counts, and ENT consultation. Lung Junction tests were requested by 12.75% of the physicians and skin allergy tests by 10.74%. Beta2 agonists were prescribed for acute asthma, basically by inhalation or subcutaneous administration and were generally combined with corticosteroid therapy. Nebulization was rarely prescribed. Aberrant prescriptions (delayed release tablets, corticosteroid sprays, delayed release corticoidsteriods) were also given. For long term management, delay release beta2-agonists were most widely used. Delayed release corticosteroid injecttions were prescribed by 18,5% of the physicians and metered dosers by 14%. Dry powders were rarely used. These findings emphasize the poor management of asthma in Africa. Directives taking into account the social and economic setting in the Ivory Coast should be initiated.