The African Severe Asthma Program (ASAP) is a three year multi country and multi-site research project. This GSK funded project is aimed at characterising severe asthma among African patients. The project brings together expertise from four collaborating institutions in Uganda, Kenya, Ethiopia and Netherlands. The four institutions include Makerere University Lung Institute (MLI), Addis Ababa University, Kenya Association for the Prevention of Tuberculosis and Lung Diseases (KAPTLD) and Groningen Research Institute for Asthma and COPD (GRIAC). Patient enrollment and follow is currently happening at Mulago Hospital/Kiruddu hospital in Uganda, Kenyatta National Hospital in Kenya and Black Lion hospital in Ethiopia.
The primary aim of this project is to identify and characterize severe asthma in Eastern Africa in order to understand its demographic, clinical, physiologic, pathologic, genomic and immunologic determinants.
The ASAP strategic objectives are:
- To compare the annual healthcare utilisation (HCU) (emergency room visits, hospitalization including admission to critical care units and unscheduled outpatient clinic or office visits), exacerbation, quality of life and mortality rates of severe and not- severe asthma patients
- To determine the factors associated with the asthma HCU events, quality of life, exacerbations and mortality
Primary Endpoint: The primary end point in this study is severe asthma. The proportion of the enrolled patients that have severe asthma will be ascertained and a factor analysis to identify factors independently associated with severe asthma will be performed.
Secondary Endpoints: The study has the following secondary end points: treatment resistant severe asthma, Health Care Utilization rates (emergency room visits, hospitalisation, office visits due to asthma symptoms, exacerbation rates, bronchodilator response, asthma control, BHR, quality of life, adherence (measured by the Morisky adherence scale and carnister weighing), depression, skin allergy, raised IgE and mortality. In addition frequency of severe asthma related genes in the cases and controls and their association with treatment resistant severe asthma will be an end point for the genetic component. Again we shall perform an exploratory factor analysis for these endpoints.
Under ASAP; a series of tests are being done. These include;
- Skin Prick tests for Allergy
- Total IgE assays
- Complete Blood Count
- FeNO test for airway inflammation
- Stool Microscopy
- Replicative SNP genotyping
- HIV testing
The ASAP network brings together top researchers from the 4 research institutions and scientists from GSK as well. The Investigators include;
Uganda: Dr Bruce Kirenga, Prof Moses Joloba, Dr William Worodria, Dr Hellen Aanyu Tukamuhebwa, Prof Moses Kamya, Dr Fredrick Makumbi
Kenya: Dr Chakaya Jeremiah, Dr George Nyale
Ethiopia: Dr Getnet Yimer, Dr Amsalu Bekele Binegdie, Dr Tewodros Haile
Netherlands: Prof Thys van der Molen, Dr Corina de Jong