Physical Signs and Disease Control Among Asthma Patients Attending a Respiratory Diseases Clinic in Nigeria

The clinical manifestation of asthma results from variable abnormalities of airway function. The control of asthma is usually assessed subjectively by the presenting symptoms and objectively by the assessment of lung function. In the absence of objective assessment of lung function, the presence of physical signs of air flow limitation may be useful in evaluating disease severity. Asthma patients referred to a respiratory diseases clinic were recruited for this study. The asthma control test (ACT) was administered on the patients and physical examination was carried out by senior respiratory physicians. Seventy patients were recruited for this study. The average age of the patients was 46 ± 18 years. The average ACT score was 14.4 ± 4.8. Fifty eight (82.9%) of patients had poorly controlled asthma. Fourteen of the patients had tachypnoea, 6 had barrel shaped chest wall, 20 patients had expiratory wheeze on auscultation of the chest, 18 had fine crepitations on chest auscultation while two patients had hyper-resonant percussion notes. Twelve patients presented with one physical sign while six patients presented with two physical signs. Three physical signs were found in another 12 patients. In all 30 patients presented with any physical sign consistent with asthma. Multiple physical signs had a significant relationship with low ACT score after controlling for other variables. The presence of abnormal physical signs of asthma may be an indicator of severe asthma and the presence of multiple physical signs has a good correlation with ACT score.