Asthma in Adults; Epidemiology, Risk Factor and Patterns of Presentation: A Cross Sectional, Questionnaire Based Study in Baghdad Teaching

Abstract

background :Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role, leading to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing. Although clinicians are satisfied with this definition, epidemiologists are still searching for their own. Studies on asthma used either questionnaire or histopathophysiologic way to define asthma each has its privileges and drawbacks. Asthma has become more common in both children and adults around the world in recent decades. Its prevalence has been dramatically increased during last few years, but still no definite asthma prevalence is specified in Iraq.Aim of the Study : To define the prevalence of some risk factors in Iraqi asthmatics, patterns of presentation, and to find the level of education about asthma among the patients, this study was conducted.Method :Two hundred twenty five asthmatic patients diagnosed by questionnaire, supported by clinical detection of wheeze, were included in a cross sectional study done in outpatients clinic, Baghdad Teaching hospital in Baghdad, collected from December 2007 to March 2008.Results : mean age for the study sample is 38 years, 50 are men and 175 are women. Normal body mass index reported in 86 patients, 78 patients (33.7 %) have positive family history of allergic diseases, 110 patients reported exposure to environment with house dust mite, and 49 patients (21.7%) were passive smoker. Persistent symptoms are commonest pattern of asthma reported in 157 patients. Eighty eight patients use their treatment regularly, and 31 patients used steroid inhalers. Proper usage of inhalers as assessed by demonstration found in only 39 patients. Spirometry or pulmonary function tests are performed only in 11 patients (4.9 %) for diagnosis or asthma follow-up.Conclusions : High body mass index, exposure to an environment in favored for house mite inhabitance, family history of atopy, history of allergic diseases, Gastro-intestinal symptoms suggestive of gastroesophageal reflux disease and Allergic rhinitis and sinusitis are the commonest risk factors reported by asthmatics.Irregular treatment with inhalers especially corticosteroid and their improper usage are still widely spread among our patients, also spirometry and other pulmonary function tests are still rarely used in diagnosis, and management of asthmatic patients.