Severe Exacerbation of Asthma in the Emergency Department of the Albert Royer Children's Hospital in Dakar: A Retrospective Study

Abstract

Introduction: Asthma is a multifactorial disease of the lower respiratory tract. It is also the most common chronic disease in children. It is a chronic inflammatory disease of the airways. In Senegal, the overall prevalence of asthma remains unknown. To update data on asthma exacerbations in the emergency department, we conducted this study in the emergency department of the CHNEAR hospital in Dakar. Aim: The objective was to describe the epidemiological, clinical, therapeutic, and prognostic aspects. Methodology: This was a retrospective descriptive study conducted over a one-year period, from January 1st to December 31st, 2022, in the Emergency Department (ED) of the Albert Royer Children's Hospital in Dakar. All children presenting with a severe acute asthma exacerbation were included in the study. Incomplete records were excluded. Data were collected using a questionnaire from the hospitalization records. We used Microsoft Excel 10 for data collection and analysis. Results: During the study period, 1621 patients were hospitalized in the emergency department, including 60 for severe exacerbations (a prevalence of 3.7%), of whom 7 had incomplete and unusable medical records. A total of 53 patients were included and constituted our study population. The male-to-female ratio was 1.21. The mean age of the patients was 40 months. Among our patients, 34 or 64% came from the peripheral areas of Dakar. Among our patients, in 31 (58.5%) the onset of symptoms was nocturnal, and in 6 patients (11.3%) the symptoms began during the day. Of our patients, 17 (32%) had started treatment at home. Among our patients, 51 or 96% presented with polypnea and 49 or 92% with tachycardia, hypoxemia was present in 43 patients or 81%. In our study, respiratory distress was found in 100% of patients. A chest X-ray was performed in 44 patients, or 83%. Among our patients, 100% had received nebulized salbutamol treatment. Betamethasone was administered to 37 patients (70%), and magnesium sulfate to 8 patients (15%). The outcome was favorable in 100% of patients without hemodynamic or respiratory complications. The average length of hospital stay was 3 days. Conclusion: Asthma is the most common chronic condition in children; its diagnosis and immediate management of exacerbations should be within the reach of every practitioner.