title: Risk factors for asthma exacerbation in patients presenting to an emergency unit of a national referral hospital in Kampala, Uganda.
abstract: BACKGROUND
  Asthma exacerbations are caused by a variety of risk factors. Reducing exposure to these risk factors improves the control of asthma and reduces medication needs. Knowledge of the particular risk factors is essential in formulating controlling and treatment protocols. This study set out to determine the risk factors for asthma exacerbations in patients presenting to the emergency unit of Mulago Hospital.
  
  
  METHODS
  An unmatched case-control study involving 43 cases and 43 controls was conducted from November 2011 through February 2012. Asthma patients with exacerbations presenting to Mulago hospital's emergency unit were chosen as cases. The controls were asthma patients recruited from the hospital's outpatient department who had not had an exacerbation in the past 7 days. The study variables were age, sex, level of education, adherence to treatment, exercise, upper respiratory tract infections, household pets, smoking, strong emotions, exposure to in house wood or charcoal burning, weather, use of corticosteroids, beta-blockers and non-steroidal anti-inflammatory drugs. Univariate and multivariate statistical analysis was done using SPSS version 16 to identify independent risk factors for exacerbations.
  
  
  RESULTS
  Lack of corticosteroid use (OR = 22.109; 95% Confidence interval 6.952 to 70.315; p < 0.001) and presence of upper respiratory tract infections (OR 4.516; CI 1.258-16.213; p = 0.018) were significantly associated with exacerbations.
  
  
  CONCLUSIONS
  Lack of corticosteroid use and upper respiratory tract infections are associated with exacerbations in asthma patients presenting to the Emergency unit of Mulago Hospital.
authors.affiliation: Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital.
authors.forename: Richard E
authors.initials: RE
authors.lastname: Sanya
authors.affiliation: Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Kirenga
authors.affiliation: Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital.
authors.forename: William
authors.initials: W
authors.lastname: Worodria
authors.affiliation: Pulmonology unit, Department of Medicine, Makerere College of Health sciences/ Mulago Hospital.
authors.forename: Martin
authors.initials: M
authors.lastname: Okot-Nwang
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D001249:Asthma / Q000150:complications / Q000188:drug therapy*; D016022:Case-Control Studies; D004630:Emergencies; D004636:Emergency Service, Hospital; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D012141:Respiratory Tract Infections / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors; D014454:Uganda
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids
keywords: Asthma; asthma exacerbations; corticosteroids; risk factors