ABSTRACT
INTRODUCTION: Lack of recent data on asthma control in Algeria led to this study whose results were compared with those of the same study conducted in the Middle East and North Africa (MENA). METHOD: This cross-sectional epidemiological study was performed in adults who had been diagnosed with asthma for at least one year and without exacerbation within the last 4 weeks. Asthma control was assessed using the 2012 Global Initiative for Asthma (GINA) criteria and the Asthma control test (ACT) questionnaire. RESULTS: We studied 984 patients mainly managed by specialist physicians; 61% female, mean age 45 years, body mass index 27kg/m2, active smokers 2%. Medication was prescribed in 92% with 78% receiving inhaled corticosteroids alone or with add-on therapies. Good adherence was observed in 27%. Asthma control was observed in 34.6% vs. 28.6% in other countries (P < 0.001). Low level of education, absence of medical insurance, lack of physical exercise, and-long duration of the disease were significantly associated with uncontrolled asthma. CONCLUSION: Poor control of asthma is still observed in Algeria despite a high level of specialist involvement. Except for adherence, known predictive factors of poor asthma control have been observed. Quality improvement training of health care professionals and patient education are probably the main issues to be addressed.
Subject(s)
Asthma/epidemiology , Asthma/therapy , Medication Adherence/statistics & numerical data , Administration, Inhalation , Adolescent , Adrenal Cortex Hormones/administration & dosage , Adult , Africa, Northern/epidemiology , Aged , Algeria/epidemiology , Asthma/pathology , Cross-Sectional Studies , Disease Progression , Female , Humans , Male , Middle Aged , Middle East/epidemiology , Smoking/adverse effects , Smoking/epidemiology , Smoking Cessation/statistics & numerical data , Treatment Outcome , Young AdultSubject(s)
Asthma/etiology , Rhinitis, Allergic, Perennial , Rhinitis, Allergic, Seasonal , Adolescent , Asthma/epidemiology , Asthma/therapy , Child , Global Health , Humans , Prevalence , Rhinitis, Allergic, Perennial/complications , Rhinitis, Allergic, Perennial/diagnosis , Rhinitis, Allergic, Perennial/epidemiology , Rhinitis, Allergic, Perennial/therapy , Rhinitis, Allergic, Seasonal/complications , Rhinitis, Allergic, Seasonal/diagnosis , Rhinitis, Allergic, Seasonal/epidemiology , Rhinitis, Allergic, Seasonal/therapy , Risk Factors , World Health OrganizationABSTRACT
Human papillomaviruses (HPV) have been implicated in the pathogenesis of human squamous cell carcinoma, especially of cervical carcinomas. In two previous studies concerning squamous cell carcinomas of the lung, DNA of HPV subtypes 6/11/16/18 (and 31/33/35 for one study) was detected by in situ hybridization in 7% to 30% of the cases. A series of 31 frozen biopsies of lung carcinomas were examined for the presence of HPVDNA by nested polymerase chain reaction (PCR). Type-specific primers (6/11, 16 and 18; Amplicis HPV(R)) located in the E6 or E7 transforming region of HPV were used. HPV DNA was found in 2 of 18 cases (11%) of squamous cell carcinoma, in 1 of 4 cases of adenocarcinoma and in 2 of 7 cases of neuro-endocrine cancers. The two large cell undifferentiated carcinomas were HPV negative. There were three cases of HPV 6/11, one case of HPV 16, and one sample positive for HPV 6/11 and HPV 18. No any consistent morphologic change with HPV lesions could be observed whereas squamous metaplasia could be seen only in squamous cell carcinomas. The frequency of 11% among the squamous cell carcinomas is comparable to those previously reported in studies utilizing in situ hybridization. To our knowledge HPV DNA had never been detected previously in adenocarcinomas or neuro-endocrine tumors. This finding should be confirmed by the investigation of larger series, but suggests that HPV could play a role in carcinogenesis of different types of lung carcinoma, although at low frequency.
