Home/Social Environment and Asthma Profiles in a Vulnerable Community from Caracas: Lessons for Urban Venezuela?

Abstract

Background. Asthma is a significant public health problem in Venezuela affecting the predominantly urban and poor majority of the population. Information regarding home and the social environment, key elements in asthma, is found to be deficient in these deprived socioeconomic sectors. This study was carried out to depict a life with asthma in this context which has been served over the years by a National Asthma Control Program. Methods. A survey of families residing in a socioeconomically deprived community of Caracas was carried out with the assumption that this community reflects the image of a life with asthma emanating from our deprived urban areas. Home physical settings were inspected for the following items: moldy walls, floors, ceilings, windows, sewage, garbage disposal, running water, plumbing, electricity, telephone, construction debris, furniture, bathrooms, food storage, and home appliances. In addition, we also gathered information regarding smoking habits, fumes exposure, pets and/or animals, and sighting of roaches and/or rodents. The presence of people with asthma was observed and their status of control was assessed through the asthma control test (ACT). Comparisons were made between families with asthmatics and those without asthmatics. Results. Randomly, 242 of 750 families (32.26%) were surveyed, with “head of family” providing information (75.6%) on most occasions. No significant association was found with respect to the previously explored items in those families with or without the presence of asthmatics. Medically diagnosed asthma was found in 14.91%, with ACT scores of <19 points in two-thirds of these adults and asthmatic children. Asthmatics reported symptoms occurring mostly during the night and an almost exclusive use of rescue medications. Families provided most treatments and children preferred to use the oral route for control medications. Significant work and school absenteeism were detected in more than 50% of these asthmatics. Conclusions. No physical home environmental/risk factors turned out to be significantly associated with families reporting the presence of asthmatics. The high impact of asthma found in this Caracas slum underscores the realities of Venezuela’s impoverished urban majority. To properly address this important challenge, our National Asthma Control Program needs to be reassessed.

• ACT
• asthma
• asthma control
• asthma impact
• home environment
• slum

Acknowledgments

Our thanks to the community and leaders of “Los Erasos” for their enthusiastic cooperation during the survey process. Our special thanks to Limeyi Machado for liaison endeavors with the community; to MoH authorities, Distrito 1, Zona Metropolitana, Caracas: Jhon Jimenez and Dr. Gustavo Latorraca for allowing the survey to be carried out; to LETI Laboratories for financial support and strong encouragement; to Dr. Maria Gabriela Ponce, Sociologist, UCAB, for her helpful insight in relation to poverty estimations in Caracas; to the Medical Society at Centro Médico de Caracas; to the Board of Directors of Private Hospital Centro Médico de Caracas for their ongoing presence and support; and to Edito Bonalde for his careful grammatical review of the article.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of this article.

Sources of support: 1. Self; 2. LETI Laboratories, Caracas, Venezuela. LETI laboratories contributed approximately $USD 1,000.00/00 (one thousand) for purposes of personnel training, ad hoc printed material, as well as analysis of data obtained.