Asthma Symptoms, Knowledge, and Perception in Sub-Saharan African Adolescents - Preliminary Results of the Achieving Control of Asthma in Children in Africa (ACACIA) Study

RATIONALE: Childhood asthma has been rising in urban areas of sub-Saharan Africa and asthma symptoms areprevalent in 10% to 20% of children aged 13 to 14 years [Adeloye D, Chan KY, Rudan I, et al. 2013]. A reportfrom the Global Asthma Network (GAN) in 2018 speculates that asthma symptom control in African children ispoor. The ACACIA (Achieving Control of Asthma in Children in Africa) study aims to provide evidence on barriersto control of asthma symptoms, which contributes to poor health outcomes in urban African children.METHODS: After informed consent, data were collected between September 2019 and March 2020 from childrenaged 12 to 14 years, with asthma symptoms and/or doctor diagnosis of asthma at schools in urban areas ofsub-Saharan Africa in Ghana, Malawi, Nigeria, South Africa, Uganda, and Zimbabwe. Children answeredquestions on: symptom severity, medication, access to healthcare, knowledge, and the Brief-Illness PerceptionQuestionnaire (B-IPQ). RESULTS: Data were obtained from 442 children, 61.5% had severe asthma symptoms,48.2% needed emergency healthcare for asthma symptoms in the previous year, and 50% would have liked toget medical help for these symptoms, but were not able to get it at least once in the last year. 72.4% ofparticipants had no previous diagnosis of asthma by a doctor. Participants with asthma diagnosis answered onaverage 5.3 (SD=2.1) out of 14 knowledge questions correctly (full dataset: mean=4.7, SD=2.2), 39.7% ofthese participants incorrectly thought that you can get addicted to asthma inhalers (full dataset: 30.5%). Of 55children with a salbutamol reliever inhaler, 43.6% incorrectly thought that asthma was well controlled if a relieverinhaler is taken daily. Mean B-IPQ Personal Control Score was 3.7 (range: 0=absolutely no control, 10=extremeamount), with 21.3% choosing absolutely no control. Mean B-IPQ Illness Concern Score was 5.1 (range: 0=notat all, 10=extremely concerned), with 25.7% choosing extremely concerned. CONCLUSIONS: In this preliminaryACACIA data analysis, we identified a significant proportion of adolescents with asthma symptoms withoutprevious asthma diagnosis. Of those with an asthma diagnosis, there was a lack of knowledge about asthma.Many participants were concerned about the condition, yet few felt they were in control of it

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