A new study by researchers at the Makerere University Lung Institute has found that 82% of adolescents aged 12 to 19 in Kampala are living with uncontrolled asthma, raising concerns about respiratory health in Uganda’s rapidly urbanizing capital.
Published in BMC Pediatrics in 2025, the study assessed 263 adolescents from 17 secondary schools, all with a documented history of asthma. Using the internationally recognized Asthma Control Test, researchers led by Dr. James Davis Katumba, Prof. Bruce Kirenga and Dr. Rebecca Nantanda found that 81.8% of participants had asthma that was not well controlled, despite the availability of effective treatments.
The adolescents reported frequent symptoms. Nearly all, 98.9% experienced wheezing in the past year, 95% reported wheezing after exercise, 86.1% reported speech disturbances and 44.4% had sleep disruptions caused by asthma. Many also reported recurrent attacks affecting daily life and academic performance.
Environmental exposures emerged as major contributors to poor asthma control. Adolescents who relied on public transport, such as taxis and buses, were almost six times more likely to have uncontrolled asthma compared with those using private transport — a risk linked to Kampala’s high levels of traffic-related air pollution. Household mould also posed a significant threat, with adolescents living in mould-affected homes four times more likely to report uncontrolled asthma.
Most participants lived in urban areas, with 91.2% residing in densely populated communities around Kampala. A majority attended boarding school, and the median age of asthma onset was nine years. The study also found that 67.2% of participants had other chronic conditions, mostly allergies. Access to healthcare varied, with the nearest facilities located one to three kilometers away and travel times of up to 32 minutes.
Researchers warn that uncontrolled asthma among adolescents has long-term consequences, including reduced physical activity, frequent absenteeism, emergency visits and potential lung damage. They note that the findings come at a time when Kampala faces rapid urbanization, rising industrial activity and worsening air quality — factors that, alongside indoor hazards like mould, are fueling a growing respiratory health crisis among young people.
The authors recommend strengthening school-based asthma management through regular assessments, better training for teachers and school nurses, and improved access to inhalers and preventive care. They also call for action to reduce household mould, improve ventilation and implement policies to curb traffic-related emissions near schools and residential areas.
The study is one of the most detailed assessments of adolescent asthma control in Uganda to date. “Targeted action today can prevent long-term health consequences tomorrow,” the authors wrote.
The findings come as Uganda moves to expand respiratory health services. Last month, Dr. Diana Atwine, permanent secretary at the Ministry of Health, launched a national fundraising drive to construct a specialized Lung Institute facility, budgeted at USD 14.9 million. The facility is expected to expand Uganda’s capacity to diagnose, treat and manage complex lung diseases while supporting advanced research and training in respiratory health.
