By Kudakwashe Pembere
With childhood asthma becoming increasingly prevalent in Africa’s major cities, a new study has found that Harare has a childhood asthma prevalence rate of 16%, the Achieving Control of Asthma in Children in Africa (ACACIA) study findings stated.
The study was an observational study aimed at gathering evidence on paediatric asthma in urban areas of Ghana, Malawi, Nigeria, South Africa, Uganda, and Zimbabwe.
These findings help close a significant research gap on childhood asthma in Africa. The study commenced in 2019 and concluded in 2021.
Speaking during the presentation of the study’s results on Thursday, one of the researchers, Dr. Ismail Ticklay, noted that Zimbabwe recorded the second-highest prevalence among SADC countries.
“In each of the six countries, the main city participated in the study. We selected schools based on convenience, and chose children aged between 12 and 14 because they are easier to engage with and more capable of completing lung function tests. In Harare, we found the asthma prevalence to be approximately 16%—15.9%, to be exact—compared to 23.8% in Durban, South Africa, and 4.2% in Malawi,” he said.
Dr. Ticklay added that the study highlighted significant gaps in asthma treatment among adolescents with a clinical diagnosis. “Three-quarters of these children continued to experience severe symptoms, and nearly one-third were not using any asthma medication,” he explained.
According to Dr. Ticklay, the findings reflect poor diagnosis and inadequate treatment of childhood asthma.
“These results point to a broader problem of underdiagnosis and undertreatment, which negatively affects schooling, sleep, and overall quality of life. Contributing factors include rapid urbanisation, air pollution, and climate change. Even among those clinically diagnosed by a doctor, treatment was often inconsistent. About one-third were not using any medication, and very few were using spacers. These findings indicate poor access, low adherence, or both. It’s an urgent public health concern,” he emphasized.
Dr. Ticklay further explained that the study focused on urban areas due to activities that contribute to rising childhood asthma rates.
“Yes, asthma is increasing due to urbanisation, but also because of other conditions like the burning of charcoal and wood, and general pollution, all of which raise asthma rates among children. The key is to address these underlying challenges,” he said.
The study proposed four key strategies to address the issue.
“First, expanding school-based screening to detect cases early. Screening should be conducted when children enter school to allow for early diagnosis. Second, implementing community and school education initiatives to raise awareness about asthma. Third, improving access to essential medications such as inhaled corticosteroids and bronchodilators. And fourth, enacting policies to reduce environmental risks through air pollution control and health-focused urban planning. By investing in diagnosis and treatment, we can significantly improve health outcomes for adolescents in Zimbabwe and across the region,” said Dr. Ticklay.
Health and Child Care Secretary Dr. Aspect Maunganidze, in a speech delivered on his behalf by Dr. Simukai Zizhou, Director of Health Informatics in the Ministry, commended the researchers, stating the study has immense value—not only in advancing academic knowledge but also in addressing “a real and urgent public health concern affecting thousands of Zimbabwean children—and that is asthma.”
Dr. Maunganidze noted that non-communicable diseases (NCDs) are steadily rising in Zimbabwe, with asthma being a significant contributor, especially among children.
“For too long, asthma has remained on the periphery of our health agenda. Other conditions such as HIV and AIDS, and sexual and reproductive health, often take precedence. Unfortunately, this means conditions like asthma, which affect children daily in our communities, are overlooked. This research shines a light on the hidden burden of asthma in our schools and communities, and most importantly, the lived experiences of children who often suffer in silence, their condition misunderstood or ignored,” he said.
He added that the Ministry of Health is committed to using evidence to build a more inclusive health system.
“This includes tackling the stigma these children face, which too often leads to delays in diagnosis, poor treatment adherence, and long-term health consequences. As the Ministry of Health and Child Care, we are committed to using this evidence to strengthen our health system—one that reaches children where they are, including in their schools.
“We view this as an opportunity to enhance training for nurses, doctors, and school health personnel and to ensure asthma receives the attention it deserves within our NCD programs.
“We must also work towards integrating school clinics with nearby health facilities and tertiary institutions so that children with asthma can access proper diagnosis, including skin testing and regular follow-ups.
“Strengthening these linkages will improve continuity of care and ultimately prevent avoidable complications that impair quality of life and reduce long-term productivity. I would like to commend the researchers, participating schools, community members, and all stakeholders involved in this vital work.
