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

Journal article

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.

Authors: Habineza, H; Mutumbira, C; Hedt-Gauthier, BL; Borg, R; Gupta, N

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: International Union Against Tuberculosis and Lung Disease
• Journal: International Journal of Tuberculosis and Lung Disease
• Volume: 21
• Issue: 10
• Pages: 1176-1182
• Publication date: 2017-10-01
• Acceptance date: 2017-06-05
• DOI: 10.5588/ijtld.17.0039
• EISSN: 1815-7920
• ISSN: 1027-3719
• Pmid: 28766486
• Language: English
• Keywords: hospitals, district; asthma; Rwanda; retrospective studies; FFR; middle aged; bronchodilator agents; rural health services; treatment outcome; follow-up studies; cohort studies; severity of illness index; sural population; anti-asthmatic agents; adolescent