Front Med (Lausanne). 2026 May 15;13:1823549. doi: 10.3389/fmed.2026.1823549. eCollection 2026.
ABSTRACT
OBJECTIVE: This study aims to determine the prevalence of uncontrolled asthma and its associated factors among adult asthmatic patients attending hospitals in Burao, Somaliland, in 2025.
METHOD: A cross-sectional study was conducted at four hospitals from May 1 to June 15, 2025, among 363 adult asthma patients selected using systematic random sampling. Data were collected using a structured, interviewer-administered questionnaire. Asthma diagnosis was confirmed by spirometry performed within 3 months before enrollment, demonstrating reversible airflow obstruction. Descriptive statistics summarized the sample characteristics. Variables with p < 0.25 in bivariable analysis were entered into multivariable logistic regression. Model fit was assessed using the Hosmer-Lemeshow test (p = 0.423), and multicollinearity was checked using the variance inflation factor (VIF < 2 for all variables). A p-value < 0.05 was considered statistically significant.
RESULT: Out of 382 adult asthma patients approached, 363 were included in the study, yielding a response rate of 98.4%. The mean age of participants was 47.6 ± 9.98 years, with 56.8% being male. Uncontrolled asthma was identified in 57.9% of the participants. Multivariable analysis revealed significant associations with poor medication adherence (AOR = 27.89; 95% CI: 7.75-100.30; p < 0.001), persistent asthma severity (AOR = 3.42; 95% CI: 1.27-9.23; p = 0.015), a family history of asthma (AOR = 27.51; 95% CI: 2.51-301.60; p < 0.001), biomass fuel use (AOR = 8.56; 95% CI: 3.08-23.78; p < 0.001), and occupational dust exposure (AOR = 68.65; 95% CI: 3.80-1239.19; p = 0.004). Due to small cell counts for dust exposure (n = 40 exposed) and family history (n = 113 with family history, including only 1 well-controlled case), these estimates have wide confidence intervals and should be interpreted cautiously. Exact logistic regression was performed as a sensitivity analysis, which confirmed the direction and statistical significance of these associations. The presence of air conditioning was also associated with increased odds (AOR = 6.26; 95% CI: 1.44-27.21; p = 0.014). Good asthma knowledge approached significance as a protective factor (AOR = 0.45; 95% CI: 0.20-1.04; p = 0.060).
CONCLUSION: The burden of uncontrolled asthma in Burao City is high, with modifiable factors such as medication adherence and follow-up care playing a vital role. Targeted interventions addressing these factors are crucial to improving asthma control in this setting.
PMID:42221096 | PMC:PMC13219360 | DOI:10.3389/fmed.2026.1823549
