Assessment of asthma care, self-management and healthcare services access during the Sudanese war: a cross-sectional survey.

BACKGROUND: Asthma poses a great burden as one of the most common long-term non-communicable diseases. The April 2023 Sudanese war has severely disrupted the healthcare system, greatly affecting asthmatic patients by limiting access to medications and diagnostic services. Therefore, this research aims to investigate asthma control, self-management and healthcare access among asthma patients in Sudan during the ongoing war. METHODS: A cross-sectional study was conducted among Sudanese patients with asthma during the ongoing war using a convenience sampling. An online questionnaire was distributed from September 2024 to June 2025. It covered sociodemographic data, the validated Asthma Control Test (ACT), self-management and healthcare access. Data were analysed using SPSS software, employing descriptive statistics, χ2 tests and linear regression, with significance set at p<0.05. RESULTS: Among the 229 asthmatic patients surveyed, 60.3% had poorly controlled asthma. Since the onset of the conflict, 43.2% had not attended any follow-up visits, while 48.5% required at least one emergency room visit during the war. Despite these challenges, 86.0% reported having quick access to healthcare during active attacks. However, 17.9% were unable to obtain their medications regularly, forcing many to adopt alternative coping strategies: 6.1% sought medical advice through online consultations, 15.7% increased their prescribed doses on their own and 39.3% used whatever medications were available without prescriptions, which was significantly associated with poor asthma control (χ²=29.29, p<0.01). Regression analysis revealed dose reduction was linked to worse control (β=-3.68, p=0.004), while refugee status and better adherence to medications predicted higher ACT scores (β=2.88, p<0.001; β=0.54, p=0.028). CONCLUSIONS: This study highlights a considerable gap in asthma control during the ongoing war, despite the availability of healthcare services in times of urgent need. Many patients adopted coping strategies such as using whatever medications were available without prescriptions or independently increasing their prescribed doses. Enhancing patient education on proper asthma self-management and improving access to healthcare services, including telemedicine consultations, could play a crucial role in achieving better asthma control.