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[Asthma control status in children and related factors in 29 cities of China]
1Asthma Clinical and Education Center, Capital Institute of Pediatrics, Beijing, China. janezhao0607@yahoo.com
Insights
Many children have poorly controlled asthma, with over 66% experiencing attacks in the past year. Improving parental knowledge, medication adherence, and regular check-ups are key to better asthma control and reduced severity in children.
Area of Science:
- Pediatric Pulmonology
- Public Health
- Epidemiology
Context:
- Asthma is a prevalent chronic respiratory disease in children, significantly impacting their quality of life and healthcare systems.
- Understanding the current status of asthma control and its determinants is crucial for developing effective management strategies.
Purpose:
- To assess the level of asthma control and identify factors influencing asthma severity in a large cohort of children across China.
- To investigate the relationship between parental knowledge, attitudes, and practices (KAP) and children's asthma outcomes.
Summary:
- A cross-sectional study involving 2485 children (0-14 years) diagnosed with asthma revealed poor control in 66.0% experiencing attacks, 26.8% emergency visits, and 16.2% hospitalizations within 12 months.
- Multivariate analysis identified parental education, KAP scores, regular clinic visits, specific asthma knowledge, environmental factor avoidance (e.g., plush toys), and adherence to inhaled corticosteroids as protective factors.
- Conversely, food allergies, eczema, and a family history of asthma were identified as significant risk factors for poor asthma control and increased severity.
Impact:
- Findings highlight the urgent need for targeted interventions to improve asthma management in pediatric populations.
- Educational programs for parents and healthcare providers focusing on asthma triggers, medication adherence, and regular monitoring can significantly enhance disease control and reduce healthcare utilization.
- Addressing environmental and genetic risk factors alongside improving parental engagement is essential for mitigating the burden of childhood asthma.
Objective:
To investigate the status of asthma control in the city and severity of asthma in children and to identify related factors.
Method:
This study was conducted in one children's hospital or tertiary hospital in each of the 29 provinces except Xinjiang and Xizang Autonomous Regions. Totally, 2960 parents with asthmatic children ages 0 to 14 years, and all had been diagnosed with asthma at least 3 months ago and the course was more than 12 months, who visited those hospitals were selected for the knowledge, attitude, and practice (KAP) questionnaire survey, and separated into the controlled asthma group and uncontrolled asthma group according to children's asthma conditions in the past 12 months. Multivariate analysis was carried out based on the answers to 28 tested factors; 2485 of 2960 questionnaires from 29 provinces were valid.
Result:
Of the 2485 valid questionnaires, 66.0% asthmatic children had asthma attacks in the past 12 months, 26.8% asthmatic children had visited the emergency department, 16.2% asthmatic children had been hospitalized. The total cost was significantly higher in the uncontrolled group than in contro group (χ² = 23.14, P < 0.01). Parents' education level, parents' KAP scores, regular visits for asthma control, knowledge of "3 or more times recurrent wheezing suggesting asthma", knowledge of "cough lasting for more than 4 weeks suggesting asthma", knowledge of "cough improved with bronchodilators suggesting asthma", knowledge of "awareness of using short-acting β₂ agonist for acute attack", avoiding contact with plush toys, adhere to use nasal steroid, inhaled corticosteroids/composite preparation, age of children and course of asthma in children are protective factors that affect asthma control and severity of asthma in children. Food allergies, eczema and family history of asthma are risk factors.
Conclusion:
Asthma in many children was poorly controlled. Factors that affect asthma control and severity include parents' knowledge about asthma, exposure to adverse environment, the compliance with medication and regular visits for asthma control. Awareness and improvement the related factors about asthma control and severity can help leading asthma to a well-controlled status and reducing the severity of asthma.
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