Effective asthma drugs not available in government hospitals

Tuesday April 30 2019
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Learning. Doctors show an Asthma exacerbation bottle that reduces severe risk of exacerbation during the International Lung Science Symposium at the college of Health Science on Monday. PHOTO BY RACHEL MABALA

Kampala. Key drugs in asthmatic treatment are not available in public health facilities, according to a study released on Monday.
Dr Davis Kibirige of Makerere University Lung Institute, said their research in 22 public hospitals indicated that patients were found to use dexamethasone, oral salbutamol tablets and syrups, which have proved to be ineffective in treatment of asthma.

He said Chronic Obstructive Pulmonary Disease (COPD) drugs such as inhaled LAMA monotherapies, inhaled LABA and LAMA combinations are not stocked in all the sampled hospitals yet they are key in treating the disease.

The study, which was done in 2017, looked at data on availability, cost and affordability of 17 medicines. It also covered two diagnostic tests essential in asthma and COPD management collected from 22 public hospitals, 23 private hospitals and 85 private pharmacies.
COPD is used to describe progressive lung diseases including emphysema, chronic bronchitis, and refractory (non-reversible) asthma. This disease is characterised by increasing breathlessness.
“Majority of public hospitals don’t have essential medicines generally to treat asthma. It is a worrying situation. The drugs patients are using have shown not to work. Long acting anti-muscaranic agents either alone or in combination with long acting beta agonists are absent,” Dr Kibirige said while addressing participants at an international lung science symposium at Mulago hospital on Monday.

He advised that the Uganda national essential medicines be listed and the clinical care guidelines be revised to accommodate the WHO-recommended drugs in the asthma management.
“Medicines and diagnostic tests essential in asthma and COPD care are not widely available in Uganda and remain largely unaffordable. There is glaring knowledge gaps among clinicians regarding management of asthma. Strategies to improve access should be implemented,” Dr Kibirige added.

Dr Gerald Mutungi, the Ministry of Health commissioner for non- Communicable diseases, prevention and control, said: “We didn’t know about the drugs by the time we made the guidelines. Now that we know, we are going to revise the list and include them soon. Medicine is evolving. At the time the list was made, asthma wasn’t our biggest problem. But now it is. We need to refocus and do in-service training to update our doctors on some of these developments,” Dr Mutungi said.

Asthma rates. Dr Bruce Kirenga, the director of Makerere University Lung Institute, said Uganda’s asthma prevalence is at 11 per cent, according to the 2016 study, compared to the continent’s 7.75 per cent. About 4.6 million Ugandans suffer from asthma with 175, 241 dying from the disease each year.
“We are seeing an increase in asthmatic patients. Uganda’s asthmatic problem is four percentage points above Africa’s. If your lung is not working nothing else works,” he said.


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