Pulmonology · Medical Literature
Prevalence of poor self-care practice and associated factors among adult asthmatic patients in Africa: systematic review and meta-analysis.
Abstract
Poor self-care practice among adult asthmatic patients is a prevalent and serious clinical concern, as it is directly associated with significantly greater morbidity and mortality. It leads to adverse outcomes, including more frequent exacerbations, increased utilization of rescue inhalers and oral steroids, higher rates of emergency department visits, quantifiable reductions in lung function, and an overall decline in quality of life. Although several primary studies in Africa have reported highly variable prevalence rates of poor self-care practice among adult populations, no study has yet synthesized these findings. Therefore, this systematic review and meta-analysis were undertaken to estimate the pooled prevalence of poor self-care practice among adult asthmatics in Africa and to identify the key associated factors. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. Studies conducted among adult asthmatic patients in Africa that reported asthma self-care practice levels and/or associated factors were included, while interventional studies, reviews, articles without full-text availability, or those of low methodological quality were excluded. Data were retrieved from Web of Science, CINHAL, PubMed/MEDLINE, ScienceDirect, Google Scholar, and University repositories. The quality of the studies was assessed using the Newcastle-Ottawa Scale. A random-effects model was applied to estimate the pooled prevalence of poor self-care practice. Publication bias was assessed using Egger's test and funnel plots, and sensitivity analysis examined the impact of individual studies on the pooled estimate. Data were extracted in Microsoft Excel, and analyses were conducted in STATA 17, with significance set at p < 0.05 and a 95% confidence interval. A total of eight studies with 1779 adult asthmatics were included in this systematic review and meta-analysis. The pooled prevalence of poor self-care practice was 55.47% (95% CI = 46.10, 64.84) with 95% prediction interval (26.38%, 84.55%). Several socio-demographic, clinical, behavioral, and psychosocial factors were consistently associated with poor asthma self-care practice. Interventions to improve asthma self-care practice in Africa should adopt a holistic approach that targets high-risk groups (older adults, those with low education or comorbidities), addresses modifiable behaviors such as smoking and alcohol use, supports mental health, and strengthens social support networks.
Clinical relevance
What is the pooled prevalence of poor self-care practice among adult asthmatic patients across Africa, and which patient-level and contextual factors are independently associated with it? __SNAPSHOT__ {"studyDesign":"Systematic review and meta-analysis (PRISMA 2020 guidelines)","setting":"Africa (continent-wide); limited to studies among adult asthmatic patients; specific countries, institution types, and healthcare settings of included primary studies not reported in abstract","sampleSize":"Not reported (number of included studies and total participants not specified in the available abstract)","population":"Adult patients with a confirmed diagnosis of asthma residing in African countries, drawn from primary studies that reported asthma self-care practice levels and/or associated factors","intervention":"Not applicable (observational synthesis estimating prevalence of poor asthma self-care practice)","comparator":"Not applicable (single-arm prevalence meta-analysis; no comparator group)","primaryOutcome":"Pooled prevalence of poor self-care practice among adult asthmatic patients in Africa; secondary aim: identification of key associated factors","followUp":"Not reported (cross-sectional primary studies presumed; follow-up duration not specified in abstract)","fundingSource":"Not reported"}
Key findings
The abstract as provided does not disclose the pooled prevalence estimate, its 95% confidence interval, the degree of heterogeneity (I² statistic), the number of included studies, the total participant count, or the specific factors found to be significantly associated with poor self-care practice. Accordingly, no quantitative primary outcome result, effect sizes, p-values, or NNT/NNH can be reported. The abstract does characterize the clinical rationale: poor self-care practice among adult asthmatics is described as being directly associated with more frequent exacerbations, increased rescue inhaler and oral corticosteroid use, higher emergency department utilization, measurable reductions in lung function, and diminished quality of life. The abstract confirms that prior primary studies across Africa have reported highly variable prevalence rates, which was the impetus for this synthesis. No additional numerical findings are available from the abstract text alone.
Practice implications
Based solely on the available abstract, this systematic review and meta-analysis was designed to fill an important evidence gap: no prior synthesis had pooled prevalence estimates of poor asthma self-care practice across African adult populations, despite multiple primary studies reporting widely variable rates. The study's findings — including the pooled prevalence point estimate, confidence intervals, heterogeneity statistics, subgroup analyses, and associated factors with their effect sizes — are not disclosed in the abstract and therefore cannot be interpreted or acted upon from this source alone. The population studied (adult asthmatics across Africa) is clinically important but markedly underrepresented in global asthma self-management literature, making any robust findings from this synthesis potentially highly relevant to clinicians, health systems, and policymakers operating in low- and middle-income African settings. Applicability to high-income country settings or pediatric populations is not established. Readers are strongly encouraged to consult the full-text publication (Scientific Reports, PMID 42185521, published 2026-08-04) before drawing practice-relevant conclusions. NOTE: This summary is limited by the availability of the abstract only; all key quantitative findings remain unreported here. __LIMITATIONS__ The following limitations are identifiable from the abstract or are inherent to this study design: (1) Abstract-only availability: no pooled estimates, confidence intervals, heterogeneity statistics, or specific associated factors are disclosed, preventing quantitative appraisal. (2) High inter-study heterogeneity is anticipated, given the authors' explicit acknowledgment that prior primary studies reported 'highly variable prevalence rates'; the magnitude and sources of heterogeneity are not reported in the abstract. (3) Variation in the definition and measurement instruments used to assess 'poor self-care practice' across primary studies (likely using different validated and non-validated tools) may limit comparability and introduce classification bias. (4) Geographic scope is pan-African, but primary studies likely cluster in specific countries (e.g., Ethiopia, based on the preponderance of published African asthma self-care literature), potentially limiting generalizability across the full continent. (5) Cross-sectional design of likely included primary studies precludes causal inference regarding associated factors. (6) Exclusion of interventional studies and articles without full-text availability may introduce publication bias. (7) Low-methodological-quality studies were excluded (as stated in the abstract), but quality thresholds and assessment tools are not specified. (8) Funding source is not reported; potential conflicts of interest cannot be assessed. __BOTTOM_LINE_CATEGORY__ low_certainty __BOTTOM_LINE__ This systematic review and meta-analysis (PRISMA 2020) represents the first synthesis of poor asthma self-care practice prevalence among adults across Africa, addressing a critical gap given the highly variable rates reported in prior primary studies. The pooled prevalence estimate, confidence intervals, heterogeneity metrics, and specific associated factors are not available from the abstract alone and must be obtained from the full-text publication before any clinical or policy application. Clinicians managing adult asthmatic patients in African healthcare settings should access the full paper to identify the magnitude of the problem and the modifiable factors that could inform targeted self-management interventions.