Pattern of Asthma Exacerbation in Children seen at Federal Medical Centre, Umuahia, Nigeria.

Francis Chukwuma Korie, Obinna Victory Obaji, Chikaodili Adaeze Ibeneme, Ndubuisi Kennedy Chukwudi, Maduka D. Ughasoro, Ihuoma K. Ukpabi


Background: The pattern of presentation of asthma is protean especially during childhood period when a lot of asthma mimics abound. The ability to identify asthma exacerbation in a busy Emergency Room aids appropriate triaging and cost-effective management especially in resource-poor countries.

Objectives: To determine the pattern of asthma exacerbation including peak season of presentation and the common precipitating factors in children at the Emergency Room of Federal Medical Centre, Umuahia, Nigeria.

Method: A retrospective descriptive study using data of children managed for bronchial asthma at the Emergency Room of Federal Medical Centre, Umuahia, Nigeria over a 5 year period.

Results: The proportion of children managed for bronchial asthma was 98/10004 (1%). Out of 98 subjects, 60 (61.2%) were males. Their ages ranged from 1 to 16 years with a median age of 6.5 years and a modal age of 4 years, and with 38/98 (38.8%) being 5 years and younger. The peak period of presentation was in rainy season (72/98 - 73.1%). Cold air was the highest 16/98 (16.3%) identifiable precipitating factor, followed by dust 13/98 (13.2%), while the commonest clinical features were cough 86/98 (87.8%), breathlessness 85/98 (86.7%) and rhonchi 69/98 (70.4%).

Conclusion: The commonest clinical features of asthma exacerbation in children in our environment are similar to those in other climes, and they include cough, breathlessness and

rhonchi. As in other studies around the world, there is a male preponderance. The peak

presentation is in the rainy season, with cold air as the commonest precipitating factor.




Childhood, Asthma, Exacerbation, Pattern, Nigeria.



Papadopoulos N G, Arakawa H, Carlsen KH, Custovic A, Gern J, Lemanske R et al.

International Consensus on (ICON) Paediatric Asthma. Allergy 2012; 67(8): 976-997.

WHO | Asthma. WHO. 2013. Available from: (Assessed on 30th March, 2017).

Kashif M, Singh T, Aslam A, Khaja M. Asthma mimic: Case report and literature review of vocal cord nodule associated with wheezing. SAGE Open Medical Case Reports 2017; 5: 1–5. DOI:11T7/2050313X17744980

Brozek G, Lawson J, Szumilas D, Zejda J. Increasing prevalence of asthma, respiratory symptoms, and allergic diseases: Four repeated surveys from 1993-2014. Respir Med 2015;109(8):982-90. doi: 10.1016/j.rmed.2015.05.010

Kwong GNM, Proctor A, Billings C, Duggan R, Das C, Whyte MKB et al. Increasing prevalence of asthma diagnosis and symptoms in children is confined to mild symptoms. Thorax 2001;56(4):312-314.

Oviawe O, Osarogiagbon W O. Asthma in children. In:Azubuike JC, Nkangineme KEO, editors. Paediatric and child health in a tropical region. 3rd ed. Educational Printing and Publishing; 2016. 1373-1397

Alaa-Eldin A. Hassan, Sabah AbdouHagrass, Prevalence of Bronchial Asthma in Primary School Children. American Journal of Medicine and Medical Sciences. 2017; 7(2):67-73. doi: 10.5923/j.ajmms.20170702.05.

Pal R, Dahal S, Pal S. Prevalence of Bronchial Asthma in Indian Children. Indian Community Med 2009; 34(4):310-316. doi:10.4103/0970-0218.58389.

Qureshi UA, Bilques S, ulHaq I, Khan MS, Qurieshi MA, Qureshi UA. Epidemiology of bronchial asthma in school children (10–16 years) in Srinagar. Lung India2016; 33(2):167-173. doi:10.4103/0970-2113.177442.

Akhiwu HO, Asani MO, Johnson ABR, Ibrahim M. Epidemiology of pediatric asthma in a Nigerian population. J Health Res Rev 2017;4:130-6

Edelu BO, Eze JN, Ayuk AC, Oguonu T. Prevalence and pattern of asthma exacerbation in children seen at the University of Nigeria Teaching Hospital, Enugu. Niger J Paediatr 2016; 43 (2):78-82

Oren E, Rothers J, Stern DA, Morgan WJ, Halonen M, Wright AL. Cough during infancy and subsequent childhood asthma ClinExp Allergy 2015; 45 (9): 1439-1446 DOI.10.1111/cea.12573 Cyanosis - A Serious Asthma Issue. Available from: (Assessed 29th June, 2018).

Fitzpatrick AM, Moore WC. Severe asthma phenotypes – how should they guide evaluation and treatment? J Allergy ClinImmunolPract. 2017;5(4):901–908.

Dharmage SC, Lowe AJ, Matheson MC, Burgess JA, Allen KJ, Abramson MJ. Atopic dermatitis and the atopic march revisited. Allergy 2014;69(1):17–27. DOI. 10.1111/all.12268

WebMD. Risk Factors for Asthma: Gender, Genetics, Allergies, and More. Available from: (Assessed on 20thApril, 2017).

Schatz M, Clark S, Camargo CA Jr. Sex differences in the presentation and course of asthma hospitalizations. Chest 2006; 129(1):50-5.

Aderele WI. Bronchial asthma in Nigerian children. Arch Dis Child 1979;54(6):448–53. DOI. 10.1136/adc.54.6.448

Vink NM, Postma DS, Schouten JP, Rosemalen JGM, Boezen M. Gender differences in asthma development and remission during transition through puberty: the TRacking Adolescents’ Individual Lives Survey (TRAILS) study. J Allergy ClinImmunol 2010;126(3):498-504.e6

Oguonu T, AyukCA, Edelu BO, Ndu IK. Pattern of respiratory diseases in children presenting to the paediatric emergency unit of the University of Nigeria Teaching Hospital, Enugu: a case series report. BMC Pulmonary Medicine 2014 14:101.doi: 10.1186/1471-2466-14-101

Pocket guide for asthma management and prevention a guide for health care professionals based on the global strategy for asthma management and prevention 2014 (For children 5 years and younger) Availablefrom: age=ar-YE (Accessed on 22nd April, 2017).

Van Aalderen Wim M. Childhood asthma: diagnosis and treatment. Scientifica (Cairo) 2012; 2012:674204. doi:10.6064/2012/674204

Pelaia G., Vatrella A., Gallelli L., Renda T., Cazzola M., Maselli R et al. Respiratory infections and asthma. Respir Med 2006; 100(5):775-784. DOI:10.1016/j.rmed.2005.06.025

Ahanchian H., Jones C. M., Chen Y. S. & Sly P. D. Respiratory viral infections in children with asthma: do they matter and can we prevent them?BMC Pediatrics 2012;12:147.doi:10.1186/1471-2431-12-147

Tan WC. Viruses in asthma exacerbation. CurrOpinPulm Med2005;11(1):21-26. doi:10.1097/01.mcp.0000146781.11092.0d

Full Text: PDF


  • There are currently no refbacks.

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

ISSN: 1597-4292