Optimising Asthma Control in a Sub-Saharan African Population: Assessing Agreement among Five Standardized...

Area of Science:

• Pulmonary Medicine
• Clinical Epidemiology
• Health Outcomes Research

Background:

• Asthma management relies on symptom control assessment via questionnaires.
• Comparative data on questionnaire performance is limited in Sub-Saharan Africa.

Purpose of the Study:

• To evaluate the performance and agreement of five asthma control questionnaires in a Nigerian adult population.
• To compare diagnostic accuracy against Global Initiative for Asthma (GINA) criteria.

Main Methods:

• Cross-sectional study of 100 adults with asthma in Nigeria.
• Utilized Global Initiative for Asthma (GINA), Asthma Control Test (ACT), Asthma Control Questionnaire (ACQ-7), RCP-3Qs, and ATAQ.
• Assessed agreement using Cohen's kappa and diagnostic accuracy via ROC curves.

Main Results:

• Asthma control levels varied between 73%-83% across tools.
• Low agreement observed between most tools; moderate agreement between ACT and ACQ (κ=0.546).
• ACT, ACQ, and RCP-3Qs showed high diagnostic accuracy (AUC >0.75) for GINA-defined well-controlled asthma; ATAQ performed poorly (AUC=0.5).

Conclusions:

• ACT, ACQ, and RCP-3Q are effective for identifying GINA-defined well-controlled asthma in this population.
• ATAQ demonstrated poor diagnostic value.
• The low agreement highlights that these tools are not interchangeable for asthma control assessment.