Sex-based disparities in asthma prevalence in Sierra Leone.

Background: Asthma is a major public health concern globally, with notable disparities in prevalence across regions and demographic groups. In Sierra Leone, a country with limited healthcare infrastructure, asthma is a challenge. Sex-based disparities in asthma prevalence have been documented globally, yet their impact in Sierra Leone remains poorly understood. This study aims to provide age-standardized estimates of asthma prevalence in 2000, 2005, 2010, 2015, and 2019, focusing on trends and inequalities by sex.

Methods: The study utilized data from the World Health Organization equity data repository to estimate age-standardized asthma prevalence in Sierra Leone. Sex-disaggregated analyses was conducted to assess disparities in prevalence rates. Inequality measures, including absolute difference (D), prevalence ratio (R), population attributable fraction (PAF), and population attributable risk (PAR), were calculated to quantify sex-related disparities in asthma prevalence.

Results: In 2000, the age-standardized asthma prevalence in Sierra Leone was 2,807.2 per 100,000, increasing slightly to 2,855.5 per 100,000 in 2005, followed by a decline to 2,682.7 per 100,000 in 2010. Prevalence rose again to 2,709.8 per 100,000 in 2015 and reached 2,768.1 per 100,000 in 2019. Across all years, females consistently had higher asthma prevalence rates than males. In 2019, female asthma prevalence was 3,104.7 per 100,000 compared to 2,427.8 per 100,000 for males, with an absolute difference of 677.0 per 100,000 and a prevalence ratio of 1.3. Inequality measures revealed a gap over time, with negative PAF values (-5.9% in 2000 to -12.3% in 2019) and negative PAR values (-164.7 per 100,000 in 2000 to -340.3 per 100,000 in 2019).

Conclusion: The study points out the burden of asthma in Sierra Leone and the sex-based disparities in prevalence. The disproportionate burden among females underscores the need for interventions to address biological, behavioural, and environmental factors contributing to these inequalities. Policymakers should prioritize sex-disaggregated surveillance and implement sex-sensitive strategies to reduce asthma prevalence. Future research should investigate the underlying causes of sex-based disparities, including the role of environmental exposures and healthcare access, to inform more effective and equitable asthma control measures in Sierra Leone.