University of Groningen Asthma prevalence and mortality in sub Saharan Africa: the case of Uganda Kirenga, Bruce DOI: 10.33612/diss.102038349 IMPORTANT NOTE: You are advised to consult the publisher's version (publisher's PDF) if you wish to cite from it. Please check the document version below. Document Version Publisher's PDF, also known as Version of record Publication date: 2019 Link to publication in University of Groningen/UMCG research database Citation for published version (APA): Kirenga, B. (2019). Asthma prevalence and mortality in sub Saharan Africa: the case of Uganda. University of Groningen. https://doi.org/10.33612/diss.102038349 Copyright Other than for strictly personal use, it is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), unless the work is under an open content license (like Creative Commons). Take-down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. Downloaded from the University of Groningen/UMCG research database (Pure): http://www.rug.nl/research/portal. For technical reasons the number of authors shown on this cover page is limited to 10 maximum. Download date: 28-09-2021 Asthma Prevalence and Mortality in Sub Saharan Africa: The Case of Uganda PhD thesis to obtain the degree of PhD at the University of Groningen on the authority of the Rector Magnificus Prof. C. Wijmenga and in accordance with the decision by the College of Deans. This thesis will be defended in public on Wednesday 27th November 2019 at 11.00 hrs by Bruce James Kirenga born on 12 January 1975 in Kiboga, Uganda 537136-L-sub01-bw-Kirenga Processed on: 30-10-2019 PDF page: 1 Promotores Prof. dr. T. van der Molen Prof. dr. H.M. Boezen Prof. dr. M.R. Kamya Co-promotor Dr. C. de Jong Assessment Committee Prof. dr. M.J. Postma Prof. dr. H.A.M. Kerstjens Prof. dr. P.J. Sterk 537136-L-sub01-bw-Kirenga Processed on: 30-10-2019 PDF page: 2 Paranymphs J ob van Boven Edgar Twine 537136-L-sub01-bw-Kirenga Processed on: 30-10-2019 PDF page: 3 Table of Contents CHAPTER 1: GENERAL INTRODUCTION 1 1.1 Definition of asthma . 1 1.2 The burden of asthma . 1 1.3 Factors associated with the development of asthma . 1 1.4 Pathogenesis of asthma . 2 1.5 Asthma case definition . 3 1.6 Uganda . 5 1.7 Objectives and rationale for this thesis . 6 References . 8 CHAPTER 2: Prevalence and factors associated with asthma among adolescents and adults in Uganda: a general population-based survey 12 ABSTRACT . 13 2.1 BACKGROUND . 14 2.2 METHODS . 14 2.3 RESULTS . 17 2.4 DISCUSSION . 22 2.5 CONCLUSION. 23 References . 25 2.6 ADDITIONAL FILES . 27 2.7 Supplementary tables . 27 CHAPTER 3: The proportion of asthma and patterns of asthma medications prescriptions among adult patients in the chest, accident and emergency units of a tertiary health care facility in Uganda 31 ABSTRACT . 32 3.1 INTRODUCTION . 33 3.2 METHODS . 33 3.3 RESULTS . 35 3.4 DISCUSSION . 36 References . 38 CHAPTER 4: Chronic respiratory diseases in a tertiary health care facility in a developing country in Africa: a hospital based descriptive study 40 ABSTRACT . 41 4.1 BACKGROUND . 42 4.2 METHODS . 42 4.3 RESULTS . 43 4.4 DISCUSSION . 44 References . 46 ii 537136-L-sub01-bw-Kirenga Processed on: 30-10-2019 PDF page: 4 CHAPTER 5: Rates of asthma exacerbations and mortality and associated factors in Uganda: a 2-year prospective cohort study 47 ABSTRACT . 48 5.1 BACKGROUND . 49 5.2 METHODS . 49 5.3 RESULTS . 50 5.4 DISCUSSION . 52 5.5 Online supplemental material for the manuscript “Rates of asthma exacerbations and mor- tality and associated factors in Uganda: a 2-year prospective cohort study.” 55 5.5.1 METHODS . 56 5.5.2 RESULTS . 58 References . 62 CHAPTER 6: The impact of HIV on the prevalence of asthma in Uganda: a general population survey 63 ABSTRACT . 64 6.1: BACKGROUND . 65 6.2 METHODS . 66 6.3 RESULTS . 67 6.4 DISCUSSION . 71 References . 74 CHAPTER 7: The State of Ambient Air Quality in Two Ugandan Cities: A Pilot Cross-Sectional Spatial Assessment 77 ABSTRACT . 78 7.1 INTRODUCTION . 79 7.2 METHODS . 80 7.2.1 Study Design . 80 7.2.2 Study Sites and Monitoring Approaches . ..