[Asthma control in adult Algerian patients. Comparison with other North African and Middle-East countries]. / Contrôle de l'asthme chez l'adulte en Algérie. Comparaison avec les autres pays d'Afrique du Nord et du Moyen Orient.

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.

[The impact of acute exacerbations of COPD on mortality]. / Impact des exacerbations aiguës de BPCO sur la mortalité.

INTRODUCTION: The purpose of the study was to evaluate the impact of acute exacerbations of chronic obstructive pulmonary disease (COPD) on mortality and to identify the predictive factors in the Algerian population where COPD occurs as frequently as in the rest of the world. METHODS: An observational study of a cohort of 400 patients with an established diagnosis of COPD was performed in the pulmonology department of the University of Algiers. The patients were divided into two groups according to the number of exacerbations they experienced and were followed prospectively for 3 years. Mortality was analyzed comparatively in both groups. RESULTS: During the follow-up period 39 patients died, mainly frequent exacerbators (84.6%), with a high mortality occurring during and in the months following hospitalisation (69.2%). By multivariate analysis the phenotype "frequent exacerbator" (RR=6.20; 95% CI: 2.6 to 14.8), GOLD category C (RR=7; 95% CI: 1.28 to 14.7), GOLD category D (RR=7.11; 95% CI: 1.38 to 15.6), age≥80 years (RR=2.7, 95% CI: 2.23 to 3.76) and chronic core pulmonale (RR=2.35; 95% CI 1.05 to 5.25) were shown to be independent risk factors of death. CONCLUSION: The frequency and the severity of exacerbations impact negatively on the survival of patients with COPD.

[Epidemiology of chronic obstructive pulmonary disease in Algiers]. / Épidémiologie de la bronchopneumopathie chronique obstructive dans la wilaya d'Alger.

INTRODUCTION: Chronic obstructive pulmonary disease (COPD) and its consequences in terms of disability and mortality are, in current practice, a serious public health problem whose prevalence is unknown in Algeria. This study aims to evaluate this disease in order to plan a better system of management. METHODS: The study used a questionnaire and spirometry and involved a representative sample of the adult population aged over 21 years. It was carried out with the assistance of the National Office of the Statistics (ONS) near the homes of the subjects who were selected according to the random mode in three degrees. The study concerned 1800 adults (50.4% men and 49.6% women) regardless of their tobacco smoking status. They were asked to answer the questionnaire and to perform spirometry. RESULTS: The prevalence of COPD is 4.9% for the whole population. It is rare before forty years of age (0.1%) and reaches 9.2% in those over 40 years old. In this older group the difference according to sex is significant (16.1% for men, 2.5% for women). Tobacco smoking increases the prevalence which reaches 31.5% among smokers, 14.6% among the ex-smokers and 2.5% among non-smokers. It increases with age and affects one man on four over 65 years old and one smoker on two in this age bracket. The prevalence of the various stages of severity is 6%, 2.7%, 0.3% and 0.2% respectively. CONCLUSION: The prevalence of the COPD found approaches that described in the literature. It increases with age and tobacco smoking and 0.2% of the population aged more than 40 years suffer from respiratory handicap. The management of this disease requires better organization at both the medical and social level.

[Epidemiology of smoking in the Wilaya population of Algeria]. / Epidémiologie du tabagisme dans la population de la Wilaya d'Alger.

A questionnaire survey was done in 1985 to determine the smoking habits of a representative sample of men and women in the Wilaya of Algiers. Among the men 77.1% used tobacco: 48.7% smoked cigarettes, 15.0% chewed tobacco, and 13.4% used both. There was no relationship between socioeconomic category and tobaccos consumption. Tobacco use among women was much lower (13.6%) and limited to cigarette smoking. The authors also examined relationships between smoking habits and functioned respiratory signs, and the reasons why former smokers stopped smoking.