ASTHMA IN TOGO: STATE OF KNOWLEDGE, IMMUNOMETABOLIC AND NEUROENDOCRINE DETERMINANTS, THERAPEUTIC CHALLENGES, AND POTENTIAL OF TRADITIONAL PHARMACOPOEIA, A SCOPING REVIEW

Background: Asthma is a growing public health concern in sub-Saharan Africa. This scoping review critically maps current knowledge regarding epidemiology, immunometabolic and neuroendocrine determinants, therapeutic challenges, and the potential of traditional pharmacopoeia in Togo. Methods: Conducted in accordance with PRISMA-ScR guidelines, a systematic search was performed across PubMed, Scopus, Web of Science, ScienceDirect, Google Scholar, and grey literature sources for literature published between 2016 and 2026, alongside relevant historical data. Included studies underwent qualitative thematic synthesis. Results: Twenty-three documents met inclusion criteria. Asthma prevalence among school-going adolescents is estimated at 8.7% (95% CI [7.6–9.9]), with geographical disparities between Grand Lomé (10.5%) and the Kara region (5.9%). Overweight/obesity (aOR=1.81) and adverse childhood experiences (aOR=1.79) were significantly associated with asthma. In reference hospital settings, approximately 75% of adult patients presented with poorly controlled asthma, primarily driven by socioeconomic barriers, limited access to inhaled corticosteroids, and educational deficiencies. While traditional pharmacopoeia is frequently utilized, its formal integration remains constrained by standardization gaps, uncharacterized toxicity, and a lack of clinical trials. Conclusion: Findings emphasize the need to strengthen epidemiological surveillance, expand access to diagnostics and maintenance therapies, and leverage community pharmacists to decentralize care. For traditional pharmacopoeia, priorities include rigorous ethnobotanical documentation, phytochemical and toxicological characterization, and preclinical evaluations.