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Published on: August 7, 2017
Predictors of asthma control in children from different ethnic origins living in Amsterdam
Q M van Dellen1, K Stronks, P J E Bindels
1Department of Paediatric Pulmonology, Emma Children's Hospital, Academic Medical Center, University of Amsterdam, The Netherlands. q.vandellen@amc.uva.nl
Insights
Asthma control is poorer in children from certain ethnic backgrounds and those with limited Dutch language comprehension. These factors, along with wool blanket use, increase uncontrolled asthma risk in pediatric populations.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Sociology of Health
Background:
- Asthma control remains a challenge in diverse pediatric populations.
- Understanding socio-demographic and environmental factors is crucial for effective asthma management.
- Language barriers can impede healthcare access and adherence to treatment.
Purpose of the Study:
- To identify factors associated with uncontrolled asthma in a multi-ethnic pediatric cohort.
- To investigate the role of ethnicity, language comprehension, and environmental exposures on asthma control.
- To inform targeted interventions for improving asthma outcomes in vulnerable groups.
Main Methods:
- A cross-sectional study involving 278 children (aged 7-17) diagnosed with asthma and their parents.
- Asthma control assessed using the Asthma Control Questionnaire (ACQ).
- Data collected on sociodemographics, medication use, asthma knowledge, inhalation technique, and environmental factors; logistic regression used for analysis.
Main Results:
- Nearly 60% of children achieved well-controlled asthma.
- Independent risk factors for uncontrolled asthma included Surinamese ethnicity (OR 2.3), insufficient Dutch language comprehension (OR 2.3), and use of woollen blankets (OR 9.8).
- Male gender (OR 0.5) and non-daily inhaled corticosteroid use (OR 0.6) were associated with better asthma control.
Conclusions:
- Ethnicity and poor Dutch language comprehension are significant independent risk factors for uncontrolled asthma in children.
- Healthcare providers should consider using interpreters for patients with limited language proficiency.
- Targeted support for immigrant children is essential to improve asthma control and reduce health disparities.
Abstract:
To identify factors associated with asthma control in a multi-ethnic paediatric population. We interviewed 278 children with paediatrician diagnosed asthma (aged 7-17 years) and one of their parents. Asthma control was assessed with the Asthma Control Questionnaire (ACQ). Detailed information about sociodemographic variables, asthma medication, knowledge of asthma, inhalation technique and environmental factors were collected. Turkish and Moroccan parents were interviewed in their language of choice. Logistic regression analyses were used to identify correlates of asthma control. Of the 278 children, 85 (30.6%) were Dutch, 84 (30.2%) were Moroccan, 58 (20.9%) were Turkish and 51 (18.3%) were Surinamese. Overall, almost 60% had a status of well-controlled asthma, as indicated by the ACQ. Only 51 of the 142 (35.9%) Moroccan and Turkish parents had a good comprehension of the Dutch language. In logistic regression analyses the risk of having uncontrolled asthma was significantly higher among Surinamese children (OR 2.3; 95% CI 1.06-4.83), respondents with insufficient comprehension of the Dutch language (OR 2.3; 95% CI 1.08-4.78), children using woollen blankets (OR 9.8; 95% CI 1.52-63.42), and significantly lower among male (OR 0.5; 95% CI 0.31-0.91) and non-daily users of inhaled corticosteroids (OR 0.6; 95% CI 0.38-1.07). In conclusion, ethnicity as well as insufficient comprehension of the Dutch language appeared to be independent risk factors for uncontrolled asthma. Special attention should be given to children from immigrants groups for example by calling in an interpreter by physicians when comprehension is insufficient.
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