Inflammatory Infiltrate in the Respiratory Tract and Their Relationship to Respiratory Function Among Asthmatics in Accra, Ghana

Although many studies have been conducted into the cause, pathogenesis and lung changes in asthmatic patients, not much has been done in Ghana. This study sought to find out the inflammatory infiltrate in the airways tract and their relationship with respiratory function among asthmatics in Korle-Bu Teaching Hospital, Accra, Ghana. One hundred and sixty-five subjects (77 controls, 88 asthmatics age range: 12-75 years, median age 43.5) participated in the study. Subjects completed a risk factor questionaire and provided sputum for cell count and spirometer was used for the lung function test. However, in patients with acute attack, the spirometry was done 4 weeks after the attack. Of the 88 asthmatics, thirty-three (40.74 %) had FEV1 predicted values less than 50 % compared with only 15 (9.48 %) of controls. Forty-one (51.25 %) and 59 (76.62 %) of asthmatics and controls had FVC predicted value greater than or equal to 70 % while 11 (13.75 %) and 3 (8.90 %) of asthmatics and controls respectively had FVC predicted value less than 50 %. Twenty-six percent of the sputum smears from asthmatics and 1.2 % of controls contained eosinophils (p-value- 0.014). Macrophages were present in 86 % of smears from control and 46 % smears from asthmatics, while neutrophils were found in 94 % of smears from both asthmatics and controls (p-value-0.002). This study added to the fact that sputum cytology can be used to assess airway inflammation in asthmatics and concluded that, the effect of asthma on lung function is influenced by the predominant inflammatory cell type in the airways.