Prevalence of poor self-care practice and associated factors among adult asthmatic patients in Africa: systematic review and meta-analysis.

Poor self-care practice among adult asthmatic patients is a prevalent and serious clinical concern, as it is directly associated with significantly greater morbidity and mortality. It leads to adverse outcomes, including more frequent exacerbations, increased utilization of rescue inhalers and oral steroids, higher rates of emergency department visits, quantifiable reductions in lung function, and an overall decline in quality of life. Although several primary studies in Africa have reported highly variable prevalence rates of poor self-care practice among adult populations, no study has yet synthesized these findings. Therefore, this systematic review and meta-analysis were undertaken to estimate the pooled prevalence of poor self-care practice among adult asthmatics in Africa and to identify the key associated factors. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 guidelines. Studies conducted among adult asthmatic patients in Africa that reported asthma self-care practice levels and/or associated factors were included, while interventional studies, reviews, articles without full-text availability, or those of low methodological quality were excluded. Data were retrieved from Web of Science, CINHAL, PubMed/MEDLINE, ScienceDirect, Google Scholar, and University repositories. The quality of the studies was assessed using the Newcastle-Ottawa Scale. A random-effects model was applied to estimate the pooled prevalence of poor self-care practice. Publication bias was assessed using Egger's test and funnel plots, and sensitivity analysis examined the impact of individual studies on the pooled estimate. Data were extracted in Microsoft Excel, and analyses were conducted in STATA 17, with significance set at p < 0.05 and a 95% confidence interval. A total of eight studies with 1779 adult asthmatics were included in this systematic review and meta-analysis. The pooled prevalence of poor self-care practice was 55.47% (95% CI = 46.10, 64.84) with 95% prediction interval (26.38%, 84.55%). Several socio-demographic, clinical, behavioral, and psychosocial factors were consistently associated with poor asthma self-care practice. Interventions to improve asthma self-care practice in Africa should adopt a holistic approach that targets high-risk groups (older adults, those with low education or comorbidities), addresses modifiable behaviors such as smoking and alcohol use, supports mental health, and strengthens social support networks.