H Habineza1, C Mutumbira2, B L Hedt-Gauthier3, R Borg1, N Gupta3, N Tapela4, S Dusabeyezu1, G Ngoga1, E Harerimana2, E Mpanumusingo1, E Ngabireyimana2, E Rusingiza5, G Bukhman6. 1. Partners In Health/Inshuti Mu Buzima, Kigali. 2. Ministry of Health, Kigali. 3. Partners In Health/Inshuti Mu Buzima, Kigali, Rwanda, Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts. 4. Brigham and Women's Hospital, Division of Global Health Equity, Boston, Massachusetts, USA. 5. Ministry of Health, Kigali, University of Rwanda, Kigali, Rwanda. 6. Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, Brigham and Women's Hospital, Division of Global Health Equity, Boston, Massachusetts, USA, Partners in Health, Boston, Massachusetts, USA.
Abstract
SETTING: In 2007, the Rwandan Ministry of Health, with support from Partners In Health, introduced a district-level non-communicable disease programme that included asthma care. OBJECTIVE: To describe the demographics, management and 24-month outcomes of asthma patients treated at three rural district hospitals in Rwanda. DESIGN: We retrospectively reviewed electronic medical records of asthma patients enrolled from January 2007 to December 2012, and extracted information on demographics, clinical variables and 24-month outcomes. RESULTS: Of the 354 patients, 66.7% were female and 41.5% were aged between 41 and 60 years. Most patients (53.1%) were enrolled with moderate persistent asthma, 40.1% had mild persistent asthma and 6.8% had severe persistent asthma. Nearly all patients (95.7%) received some type of medication, most commonly a bronchodilator. After 24 months, 272 (76.8%) patients were still alive and in care, 21.1% were lost to follow-up, 1.7% had died and 0.3% had transferred out. Of the 121 patients with an updated asthma classification at 24 months, the severity of their asthma had decreased: 17.4% had moderate and 0.8% had severe persistent asthma. CONCLUSION: Our findings show improvements in asthma severity after 24 months and reasonable rates of loss to follow-up, demonstrating that asthma can be managed effectively in rural, resource-limited settings.
SETTING: In 2007, the Rwandan Ministry of Health, with support from Partners In Health, introduced a district-level non-communicable disease programme that included asthma care. OBJECTIVE: To describe the demographics, management and 24-month outcomes of asthmapatients treated at three rural district hospitals in Rwanda. DESIGN: We retrospectively reviewed electronic medical records of asthmapatients enrolled from January 2007 to December 2012, and extracted information on demographics, clinical variables and 24-month outcomes. RESULTS: Of the 354 patients, 66.7% were female and 41.5% were aged between 41 and 60 years. Most patients (53.1%) were enrolled with moderate persistent asthma, 40.1% had mild persistent asthma and 6.8% had severe persistent asthma. Nearly all patients (95.7%) received some type of medication, most commonly a bronchodilator. After 24 months, 272 (76.8%) patients were still alive and in care, 21.1% were lost to follow-up, 1.7% had died and 0.3% had transferred out. Of the 121 patients with an updated asthma classification at 24 months, the severity of their asthma had decreased: 17.4% had moderate and 0.8% had severe persistent asthma. CONCLUSION: Our findings show improvements in asthma severity after 24 months and reasonable rates of loss to follow-up, demonstrating that asthma can be managed effectively in rural, resource-limited settings.
Authors: Loise Ng'ang'a; Gedeon Ngoga; Symaque Dusabeyezu; Bethany L Hedt-Gauthier; Patient Ngamije; Michel Habiyaremye; Emmanuel Harerimana; Gilles Ndayisaba; Christian Rusangwa; Simon Pierre Niyonsenga; Charlotte M Bavuma; Gene Bukhman; Alma J Adler; Fredrick Kateera; Paul H Park Journal: BMJ Open Date: 2020-07-27 Impact factor: 2.692
Authors: Lauren Anne Eberly; Christian Rusangwa; Loise Ng'ang'a; Claire C Neal; Jean Paul Mukundiyukuri; Egide Mpanusingo; Jean Claude Mungunga; Hamissy Habineza; Todd Anderson; Gedeon Ngoga; Symaque Dusabeyezu; Gene Kwan; Charlotte Bavuma; Emmanual Rusingiza; Francis Mutabazi; Joseph Mucumbitsi; Cyprien Gahamanyi; Cadet Mutumbira; Paul H Park; Tharcisse Mpunga; Gene Bukhman Journal: BMJ Glob Health Date: 2019-06-17
Authors: Robert Rutayisire; Francis Mutabazi; Alice Bayingana; Ann C Miller; Neil Gupta; Gedeon Ngoga; Eric Ngabireyimana; Ryan Borg; Emmanuel Rusingiza; Charlotte Bavuma; Bosco Bigirimana; Fulgence Nkikabahizi; Marie Aimee Muhimpundu; Gene Bukhman; Paul H Park Journal: Ann Glob Health Date: 2020-03-23 Impact factor: 2.462
Authors: Emily B Wroe; Noel Kalanga; Elizabeth L Dunbar; Lawrence Nazimera; Natalie F Price; Adarsh Shah; Luckson Dullie; Bright Mailosi; Grant Gonani; Enoch P L Ndarama; George C Talama; Gene Bukhman; Lila Kerr; Emilia Connolly; Chiyembekezo Kachimanga Journal: BMJ Open Date: 2020-10-21 Impact factor: 2.692