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Open Access Standard case management of asthma in Sudan: a pilot project

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SETTING: A pilot project for asthma management in selected hospitals in Khartoum and Gezira States, Sudan.

OBJECTIVE: To assess standard case management of asthma in 2007–2008.

DESIGN: Local adaptation of guidelines, followed by situational analysis, pre-intervention study, training and implementation. Treatment outcome was assessed 1 year after patient enrolment.

RESULTS: Situational analysis revealed that inhaled beclometasone was not available in the public sector. During the project, 2068 patients were enrolled: severity of asthma was intermittent in 185 (9.0%), mild persistent in 231 (11.2%), moderate persistent in 640 (31.0%), severe persistent in 812 (39.3%) and unclassified in 200 (9.7%). Of the 1654 patients with persistent asthma who were treated with inhaled corticosteroids, 1157 (70.0%) had treatment cards available for outcome assessment. Of these, 652 (56.4%) did not attend their annual evaluation, among whom 1 (0.1%) died and 651 (56.3%) were lost to follow-up. Of the 505 patients who attended their annual evaluation, 417 (82.6%) improved, 32 (6.3%) were stable and 56 (11.1%) were worse. The frequency of emergency visits and hospitalisation decreased substantially among those who presented for the 1 year follow-up assessment.

CONCLUSION: The results of standard case management of asthma were encouraging; however, a high proportion of patients did not return for long-term management.

Keywords: asthma; follow-up; management; treatment outcome

Document Type: Research Article

Affiliations: 1: Epi-Lab, Khartoum, Sudan 2: International Union Against Tuberculosis and Lung Disease, Paris, France; Division of Pulmonary Medicine, Department of Internal Medicine, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; and Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan 3: Ministry of Health, Madani, Gezira State, Sudan 4: Epi-Lab, Khartoum, Sudan; and Department of Family and Community Medicine, University of Dammam, Khobar, Saudi Arabia 5: World Health Organization, Eastern Mediterranean Regional Office, Cairo, Egypt 6: International Union Against Tuberculosis and Lung Disease, Paris, France

Publication date: September 21, 2013

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