Gaps in knowledge and clinical practice in Asthma care among health workers in Port Harcourt, Nigeria

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Uchenna Onubogu
Adaku Chukwuma
Ekop Eno
Chimuanya Dimkpa



Asthma is a leading chronic respiratory disease among adults and children.  Care gaps in asthma have been shown to worsen the outcome of patients. This study aimed to identify asthma care gaps in health facilities, basic knowledge, and clinical practice among healthcare providers.


This was a cross-sectional study among doctors, nurses, and pharmacists who participated in an asthma workshop in Port Harcourt using self-administered, questionnaires to assess care gaps.


Sixty-two healthcare workers from 25 healthcare facilities participated in the study, consisting of mainly Doctors  47(75.8%). Most facilities had nebulizers 21(84%) while 8(32%) had at least one supportive investigation for asthma. Half of the participants knew all four cardinal asthma symptoms. Report of management of acute asthma exacerbations among the doctors showed nebulized salbutamol 41(87.2%)  was the most common medication used, while intravenous aminophylline 31(66.0%), oral salbutamol 29(61.7%) and antibiotics 24(51.1%), was also reported to be used. Forty-one(87.2%) discharged patients on a treatment plan. Asthma control was assessed adequately by 17(36.2%), while inhaler technique was routinely taught to patients by 29(61.7%) and personalized action plan was given by 21(44.7%).


The study identified care gaps in monitoring and diagnostic equipment and tests for asthma in health facilities as well as gaps in participants’ asthma knowledge and medication use. Training and retraining of healthcare workers as well as the provision of equipment are recommended for improved asthma patient care.


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Onubogu, U., Chukwuma, A., Eno, E., & Dimkpa, C. (2024). Gaps in knowledge and clinical practice in Asthma care among health workers in Port Harcourt, Nigeria. African Journal of Research in Medical and Health Sciences, 2(1), 1-11.


García-Marcos L, Asher MI, Pearce N, Ellwood E, Bissell K, Chiang CY, et al. The burden of asthma, hay fever and eczema in children in 25 countries: GAN Phase I study. Eur Respir J. 2022 Sep 15;60(3):2102866. Doi: 10.1183/13993003.02866-2021. PMID: 35144987; PMCID: PMC9474895.

Mortimer K, Lesosky M, García-Marcos L, Asher MI, Pearce N, Ellwood E, et al. The burden of asthma, hay fever and eczema in adults in 17 countries: GAN Phase I study. Eur Respir J. 2022 Sep 15;60(3):2102865. doi: 10.1183/13993003.02865-2021. PMID: 35210319;

PMCID: PMC9474894.

Global Initiative for Asthma. GINA report, global strategy for asthma management and prevention. 2022; Global Initiative for Asthma:10th October 2022.

Price C, Agarwal G, Chan D, Goel S, Kaplan AG, Boulet LP, et al. Large care gaps in primary care management of asthma: a longitudinal practice audit. BMJ Open. 2019 Jan 29;9(1): e022506. doi: 10.1136/bmjopen-2018-022506. PMID: 30696669; PMCID: PMC6352804.

The Forum of International Respiratory Societies (FIRS). Closing-gaps-in-asthma-care. Updated 2022. Accessed October, 10th, 2022.

Adeniyi B, Ilesanmi O, Obaseki D, Desalu O, Betiku B, Erhabor G. Relationship between knowledge and quality of asthma care among physicians in south-west Nigeria. Niger J Clin Pract. 2017;20(5):566-572. doi: 10.4103/1119-3077.206363.

Ozoh OB, Ndukwu CI, Desalu OO, Adeyeye OO, Adeniyi B. Knowledge and practice assessment, and self-reported barriers to guideline-based asthma management among doctors in Nigeria. Niger J Clin Pract. 2019;22(5):692-700. doi: 10.4103/njcp.njcp_569_18.

Onyebuchi Ezigbo. 70% of Nigeria’s population rely on primary healthcare facilities. This Day. Thursday, 16th February 2023. Available from:

Uzochukwu BSC. Primary health care systems (PRIMASYS): Case study from Nigeria. Geneva: World Health Organization press; 2017.Chapter 1, Overview of health care system1; p. 3-6.

Schull MJ, Ferris LE, Tu JV, Hux JE, Redelmeier DA. Problems for clinical judgement: 3. thinking clearly in an emergency. CMAJ. 2001;164(8):1170-1175.

Desalu OO, Busari OA, Onyedum CC, Salawu FK, Obateru OO, Nwogu KC, et al. Evaluation of current knowledge, awareness and practice of spirometry among hospital -based NJ igerian doctors. BMC Pulmonary Medicine. 2009;9(1):50. doi: 10.1186/1471-2466-9-50.

Chinese College of Emergency Physicians (CCEP); Emergency Committee of PLA; Beijing Society for Emergency Medicine; Chinese Emergency Medicine. Expert consensus on nebulization therapy in prehospital and in-hospital emergency care. Ann Transl Med. 2019 Sep;7(18):487. doi: 10.21037/atm.2019.09.44. PMID: 31700923; PMCID: PMC6803223.

Fawibe AE, Onyedum CC, Sogaolu OM, Ajayi AO, Fasae AJ. Drug prescription pattern for asthma among Nigerian doctors in general practice: A cross-sectional survey. Ann Thorac Med. 2012;7(2):78-83. doi: 10.4103/1817-1737.94524.

Desalu O, Adeoti A, Ogunmola O, Fadare J, Kolawole T. Quality of acute asthma care in two tertiary hospitals in a state in south western nigeria: A report of clinical audit. - Niger Med J. 2016; - 57(- 6): - 339-- 346. doi: 10.4103/0300-1652.193860.

Amin S, Soliman M, McIvor A, Cave A, Cabrera C. Understanding Patient Perspectives on Medication Adherence in Asthma: A Targeted Review of Qualitative Studies. Patient Prefer Adherence. 2020 Mar 10; 14:541-551. doi: 10.2147/PPA.S234651. PMID: 32210541; PMCID: PMC7071882.

Adeniyi BO, Adebayo AM, Ilesanmi OS, Obaseki DO, Akinwalere OO, Erhabor GE. Knowledge of spacer device, peak flow meter and inhaler technique (MDIs) among health care providers: An evaluation of doctors and nurses. Ghana Med J. 2018;52(1):15-21. doi: 10.4314/gmj.v52i1.4.

Panicker J, Sethi GR, Sehgal V. Comparative efficiency of commercial and improvised spacer device in acute bronchial asthma. Indian Pediatric. 2001;38(4):340-348.

Mphahlele RE, Kitchin O, Masekela R. Barriers and determinants of asthma control in children and adolescents in Africa: A systematic review. BMJ Open. 2021;11(10): e053100-2021-053100. doi: 10.1136/bmjopen-2021-053100 [doi].

Wu TD, Brigham EP, McCormack MC. Asthma in the primary care setting. Med Clin North Am. 2019;103(3):435-452. doi: S0025-7125(18)30169-X [pii].

Sanchis J, Gich I, Pedersen S, Aerosol Drug Management Improvement Team (ADMIT). Systematic review of errors in inhaler use: Has patient technique improved over time? Chest. 2016;150(2):394-406.

Gibson PG, Powell H, Coughlan J, Wilson AJ, Abramson M, Haywood P, et al. Self-management education and regular practitioner review for adults with asthma. Cochrane Database Syst Rev. 2003;(1):CD001117. doi: 10.1002/14651858.CD001117. PMID: 12535399.

Kim M, Arsenault C, Atuyambe LM, Macwan’gi M, Kruk ME. Determinants of healthcare providers’ confidence in their clinical skills to deliver quality obstetric and newborn care in Uganda and Zambia. BMC Health Serv Res 20, 539 (2020).

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