Asthma control in Kazakhstan: need for urgent action

Asthma control in Kazakhstan: need for urgent action

Vinnikov et al. BMC Pulmonary Medicine (2023) 23:7

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

Occupation and chronic obstructive pulmonary disease in Minsk tractor plant workers

Occupation and chronic obstructive pulmonary disease in Minsk tractor plant workers

American journal of industrial medicine. 2017;60:1049–1055.

Background: The aim of this study was to measure the association of exposure to dust at workplace with COPD using objective methods of exposure and outcome classification.

Methods: Forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) <70%; FVC below LLN, and FEV 1 below LLN from the annual screening of Minsk Tractor Plant workers (N = 458) were tested for predictors in an adjusted logistic regression model.

Results: In a regression model, adjusted for pack-years of smoking, age, sex, and work duration, work in highly exposed workplaces was associated with FEV 1/FVC<70% (odds ratio (OR) 2.10 (95% confidence interval (CI) 1.16;3.83); and FEV1.

Conclusions: Workers in highly exposed to dust workplaces had double odds of
developing COPD.

KEYWORDS: COPD, dust, occupational, smoking, spirometry, TSP