A descriptive study of children admitted with acute severe asthma to a tertiary hospital in Johannesburg, South Africa

The prevalence of asthma is high and the incidence is increasing significantly in Africa. Cases of severe exacerbations of asthma are managed as inpatients and are often used as indicators of asthma care. There is a paucity of data regarding hospitalised paediatric asthma cases in low- and middle-income countries (LMICs). This retrospective study describes the clinical presentation of children admitted to Charlotte Maxeke Johannesburg Academic Hospital in Johannesburg, South Africa, with asthma, and the association, if any, with intensive care unit (ICU) admission. Medical records between the years 2015 and 2020 were reviewed, revealing 134 admissions, with eight children being admitted to the ICU. The median age was four years (IQR 3,7) and the median duration of stay was four days (IQR 4,6). 66% of the children admitted were aged 1-5 years; 52.5% of the admissions were male. Allergic rhinitis was the most common associated comorbidity, at 42.4%. Most children presented with subcostal retractions (88.8%) and hypoxia (74.2%). Two children died from asthma complications. Children who had a known asthma diagnosis at the time of admission were more likely to have been readmitted than those who did not have a prior asthma diagnosis (p = < 0.001). Previous asthma hospitalisation was associated with ICU admission (p = 0.041). Most admissions occurred during the summer months. The trend in hospitalised asthma cases declined over the study period and paediatric asthma mortalities were rare. Further studies are needed to assess risk factors for paediatric asthma hospitalisation, especially in LMICs.