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      Factors associated with poor asthma symptom control in adult Angolan regularly seen at an outpatient respiratory clinic

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          Abstract

          Background

          Asthma is one of the most common chronic respiratory diseases and one of the most frequent causes of hospital care.

          Objectives

          To describe the clinical characteristics of asthma and factors associated with its control.

          Methods

          A cross-sectional study was conducted at the Military Hospital in Luanda, from April 2018 to March 2019. Data collection was performed using questionnaires on asthma symptoms and treatment, socio-demographic and environmental questions, and a Global Initiative for Asthma (GINA) questionnaire to assess the level of asthma control. Ordinal logistic regression analyses were performed. We estimated odds ratios, for higher categories of asthma control. P<0.05 was considered significant.

          Results

          The sample consisted of 305 asthmatics ≥18-years-old, 56% women, with a mean age of 41.3 years. About 28% of patients had controlled asthma, 36% partially controlled and 35% uncontrolled. Poor asthma control was associated with frequent use of short-acting beta-2 agonists [OR 5.70 (95%CI 2.37;13.7)], oral corticosteroids [OR 3.68 (95%CI 2.24;6.04)], and incorrect inhaler technique [OR 4.08 (95%CI 1.25;13.3)].

          Conclusions

          A significant number of adults living in Luanda have uncontrolled asthma due to the under-use of inhaled corticosteroid therapy. It is necessary to develop strategic management and prevention plans to improve Angolan asthmatics' medical care.

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          Most cited references23

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          Applied Logistic Regression

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            Standardization of Spirometry 2019 Update. An Official American Thoracic Society and European Respiratory Society Technical Statement

            Background: Spirometry is the most common pulmonary function test. It is widely used in the assessment of lung function to provide objective information used in the diagnosis of lung diseases and monitoring lung health. In 2005, the American Thoracic Society and the European Respiratory Society jointly adopted technical standards for conducting spirometry. Improvements in instrumentation and computational capabilities, together with new research studies and enhanced quality assurance approaches, have led to the need to update the 2005 technical standards for spirometry to take full advantage of current technical capabilities. Methods: This spirometry technical standards document was developed by an international joint task force, appointed by the American Thoracic Society and the European Respiratory Society, with expertise in conducting and analyzing pulmonary function tests, laboratory quality assurance, and developing international standards. A comprehensive review of published evidence was performed. A patient survey was developed to capture patients’ experiences. Results: Revisions to the 2005 technical standards for spirometry were made, including the addition of factors that were not previously considered. Evidence to support the revisions was cited when applicable. The experience and expertise of task force members were used to develop recommended best practices. Conclusions: Standards and consensus recommendations are presented for manufacturers, clinicians, operators, and researchers with the aims of increasing the accuracy, precision, and quality of spirometric measurements and improving the patient experience. A comprehensive guide to aid in the implementation of these standards was developed as an online supplement.
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              A simulation study of the number of events per variable in logistic regression analysis

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                Author and article information

                Journal
                Afr Health Sci
                Afr Health Sci
                African Health Sciences
                Makerere Medical School (Kampala, Uganda )
                1680-6905
                1729-0503
                September 2023
                : 23
                : 3
                : 672-682
                Affiliations
                [1 ] Department of Pulmonology, Military Hospital Luanda, Angola
                [2 ] Centro de Investigação em Saúde de Angola - CISA, Caxito, Bengo, Angola
                [3 ] Aveiro Healthcare Centre, Aradas Family Health Unit, Aveiro, Portugal
                [4 ] Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal
                [5 ] UBIAir - Clinical & Experimental Lung Centre, UBIMedical, University of Beira Interior, Covilhã, Portugal
                [6 ] Centre of Mathematics and Applications, Faculty of Sciences, University of Beira Interior, Covilhã, Portugal
                [7 ] Health and Technology Research Centre - H&TRC, Escola Superior de Tecnologia da Saúde de Lisboa, Instituto Politécnico de Lisboa, Portugal
                [8 ] Department of Allergy & Clinical Immunology, Cova da Beira University Hospital Centre, Covilhã, Portugal
                Author notes
                Corresponding author: Margarete L T Arrais, Department of Pulmonology, Military Hospital Luanda, Angola Tel: +244 912504157 mararrais@ 123456hotmail.com
                Article
                jAFHS.v23.i3.pg672
                10.4314/ahs.v23i3.78
                10862642
                38357136
                a4dbae12-3d18-40b8-a0e7-bc3f7b9d333f
                © 2023 Arrais MLT et al.

                Licensee African Health Sciences. This is an Open Access article distributed under the terms of the Creative commons Attribution License ( https://creativecommons.org/licenses/BY/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                asthma,angola,symptom control,inhalers
                asthma, angola, symptom control, inhalers

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