Background: Asthma control, patients’ awareness level and adherence to treatment in Kazakhstan have never been
studied. The aim of this study was to verify the prevalence of controlled, poorly controlled and uncontrolled asthma in
a large sample of three largest cities of Kazakhstan.
Methods: We recruited 600 (median age 54 (interquartile range (IQR) 22) years, 64% females) patients with diagnosis
confirmed earlier in the outpatient facilities in Almaty, Astana and Shymkent in 2020–2021. We offered a structured
questionnaire on asthma control and risk factors as of GINA and performed spirometry. We report the prevalence of
asthma control, knowledge and skills and pharmacological treatment with 95% confidence interval (CI) and the association
of selected predictors with asthma control.
Results: With the median of 9 (IQR 13) years of diagnosis, 40% of patients had comorbid COPD and 42% had allergic
rhinitis, whereas 32% lived with pets. Asthma was well-controlled in only 12.3% (95% CI 9.7–15.0), partly controlled in
29.8% (95% CI 26.2–33.5) and uncontrolled in 57.8% (95% CI 53.9–61.8) patients. ACQ-5 score (range 0–5.8, median
2) equaled 0.2 (IQR 0.85) in well-controlled asthma patients, 1.4 (IQR 1) in partly controlled and 2.8 (IQR 1.4) in uncontrolled
asthma patients. Knowledge and skills levels were very low. Only 54% were on inhaled corticosteroids (52.2%
of them used budesonide/formoterol and 39.5% used fluticasone/salmeterol). 39% used steroids per os or parenterally
within a period of 12 months (51% of patients with uncontrolled asthma).
Conclusions: Asthma control, knowledge and skills levels of asthma patients in the largest cities of Kazakhstan remain
unacceptably low, whereas pharmacological treatment is far from optimal. Urgent action should be taken to support
doctors’ training, and we call to launch a national asthma program to coordinate asthma care in Kazakhstan.
KEYWORDS: Prevalence, Inhaled steroids, Peakflowmetry, GINA