Case-control study of severe life threatening asthma (SLTA) in a developing community

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dc.contributor.authorVan Der Merwe L.
dc.contributor.authorDe Klerk A.
dc.contributor.authorKidd M.
dc.contributor.authorBardin P.G.
dc.contributor.authorVan Schalkwyk E.M.
dc.date.accessioned2011-05-15T16:18:13Z
dc.date.available2011-05-15T16:18:13Z
dc.date.issued2006
dc.description.abstractBackground: Distinct risk factors for asthma death have not been identified in developing communities. This study was conducted to distinguish risk factors for severe life threatening asthma (SLTA), a proxy for asthma death, in a developing country. Methods: A case-control study was performed at a University Hospital serving developing communities in the Western Cape Province, South Africa, over the period October 1997 to April 2000. Thirty consecutive patients with SLTA admitted to the intensive care unit (ICU) were compared with 60 chronic asthmatic patients, without a history of SLTA, who had attended the hospital outpatient respiratory clinic over the same period. Results: The risk of SLTA in comparison with controls increased with female sex (odds ratio (OR) 3.3, 95% CI 1.2 to 9.6, p = 0.02), rural residence (OR 8.1, 95% CI 2.6 to 25.3, p = 0.0005), and absence of a formal income (OR 5.7, 95% CI 2 to 16.6, p = 0.002). Cases were more likely to have had more than one hospital admission in the previous year (OR 8, 95% CI 2.5 to 25.2, p = 0.0009) and more than one emergency room visit in the previous year (OR 4.4, 95% CI 1.19 to 16.4, p = 0.04). Patients with SLTA were less likely to use inhaled corticosteroids (OR 5.6, 95% CI 1.9 to 16.5, p = 0.003) and more likely to use inhaled fenoterol (OR 6, 95% CI 2.2 to 16.2, p = 0.0004). Patients with SLTA also had lower mean (SE) forced expiratory volume in 1 second (FEV1) measurements (66.9 (9.5)% predicted v 82.5 (4.0)% predicted; p = 0.03) and lower FEV 1/FVC ratios (60.7 (4.1)% predicted v69.6 (1.9)% predicted; p = 0.05) documented before the episode of SLTA. Conclusions: Risk factors for SLTA that are mainly analogous to those distinguished in other environments have been identified in a geographical area characterised by a third world socioeconomic context. Rural residence and poverty may increase the risk of SLTA.
dc.description.versionArticle
dc.identifier.citationThorax
dc.identifier.citation61
dc.identifier.citation9
dc.identifier.issn00406376
dc.identifier.other10.1136/thx.2005.052308
dc.identifier.urihttp://hdl.handle.net/10019.1/14563
dc.subjectbeta adrenergic receptor stimulating agent
dc.subjectcholinergic receptor blocking agent
dc.subjectcorticosteroid derivative
dc.subjectfenoterol
dc.subjecttheophylline
dc.subjectadolescent
dc.subjectadult
dc.subjectanamnesis
dc.subjectarticle
dc.subjectasthma
dc.subjectclinical article
dc.subjectcommunity care
dc.subjectcontrolled study
dc.subjectdeath
dc.subjectdemography
dc.subjectdose response
dc.subjectemergency ward
dc.subjectfemale
dc.subjectforced expiratory volume
dc.subjecthospital admission
dc.subjecthuman
dc.subjectincome
dc.subjectintensive care unit
dc.subjectlung function
dc.subjectmale
dc.subjectoutpatient department
dc.subjectpriority journal
dc.subjectrisk factor
dc.subjectrural area
dc.subjectsex difference
dc.subjectuniversity hospital
dc.subjectAdult
dc.subjectAnti-Asthmatic Agents
dc.subjectAsthma
dc.subjectCase-Control Studies
dc.subjectDeveloping Countries
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectRespiratory Function Tests
dc.subjectRisk Factors
dc.subjectSouth Africa
dc.titleCase-control study of severe life threatening asthma (SLTA) in a developing community
dc.typeArticle
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