Kuria and Olando
Greener Journal of Medical Sciences Vol. 3 (2), pp. 071-078, February 2013.
ISSN: 2276-7797 © 2011 Greener Journals
Manuscript Number: 110112197
Cost Effectiveness of Community Based and Residential Based treatment of Alcohol Use Disorders: Findings of a study in Kenya
1*Mary W. Kuria and 2Yvonne Olando
1MB. chB, M.Med. Psych, Ph.D. Psych., (University of Nairobi), Senior lecturer at the Department of Psychiatry, University of Nairobi, Kenya
2BA (Psychology), Dip Chemical Dependence/ Addictions Counseling, Dip Public Relations, Certificate in HIV/AIDS counseling, Msc. Clinical Psych. Continuing student University of Nairobi.
*Corresponding Author’s E-mail mkuria @ uonbi.ac.ke or wangari2 @ yahoo.com
Background: The gold standard in assessing asthma control is the Global Initiative for Asthma (GINA) criteria. It is difficult to follow GINA criteria in assessing asthma control in resource poor settings because of the lack of access to pulmonary functions tests. The Asthma Control Test (ACT) questionnaire is a simple, self-administered, accessible and validated tool that is used in assessing control among asthmatics. The ACT has the added advantage that it does not require lung function assessment. However, its relationship with GINA guideline-defined asthma control has not been clarified in our setting.
Aim: The aim of this study is to assess asthma control through ACT and GINA, and to determine if the ACT can be as useful as the GINA-guidelines criteria in assessing asthma control in our setting.
Methodology: It was a cross-sectional analytical study. Asthma control was assessed by the ACT and GINA criteria questionnaires. Pulmonary function tests were performed on the subjects according to American Thoracic Society (ATS) guidelines. The sensitivity, specificity, negative and positive predictive values of ACT were determined.
Results: A total of 65 asthmatics participated in this study. The level of asthma control among the subjects was poor, 37% and 23% by ACT and GINA criteria respectively. There was a significant and positive correlation between the ACT and GINA. The Kappa score for the entire subjects was 0.66 representing a substantial agreement between the ACT and GINA.
Conclusion: Asthma control was poor among the subjects. The fact that ACT can predict GINA guidelines-based level of control further gives credence to its usefulness in a resource-poor clinical setting.
Key words: Asthma Control Test (ACT), Global Initiative for Asthma (GINA), Asthma Control, Forced Expiratory Volume in one Second (FEV1).