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Published on: May 12, 2023
Uncontrolled asthma and its risk factors in Chinese children: A cross-sectional observational study
Li Xiang1, Jing Zhao2, Yuejie Zheng3
1a Department of Respiratory Disease , Beijing Children's Hospital, Capital Medical University , Beijing , China.
Insights
Nearly 20% of Chinese children have uncontrolled asthma, with treatment non-adherence and allergic rhinitis being key risk factors. Improving adherence and managing allergic rhinitis are crucial for better asthma control in pediatric patients.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Public Health
Background:
- Asthma is a significant health concern for children in China.
- Limited data exists on asthma management and control in this population.
- Understanding control levels and risk factors is essential for targeted interventions.
Purpose of the Study:
- To evaluate asthma control status in Chinese pediatric patients.
- To identify risk factors associated with uncontrolled asthma in this demographic.
Main Methods:
- A survey of 4223 persistent asthma patients aged 2-16 years across 42 tertiary hospitals in China.
- Utilized Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT), and Global Initiative for Asthma (GINA) criteria for assessment.
- Multivariate logistic regression models were employed to identify risk factors for uncontrolled asthma.
Main Results:
- 19.9% of pediatric asthma patients exhibited uncontrolled asthma.
- High rates of uncontrolled asthma were linked to treatment non-adherence (44.1%), allergic rhinitis (23.3%), disease duration (≥1.5 years, 22.8%), and family history of allergic rhinitis (21.5%).
- Treatment non-adherence significantly increased the risk of uncontrolled asthma (OR = 5.79, p < 0.001).
Conclusions:
- Approximately 20% of Chinese pediatric asthma patients experience uncontrolled asthma.
- Treatment adherence and allergic rhinitis are the most significant modifiable risk factors.
- Interventions should focus on enhancing treatment adherence and managing allergic rhinitis to improve pediatric asthma control in China.
Objective:
Asthma afflicts many children in China but information about asthma management among Chinese pediatric asthma patients is limited. This study aims to evaluate asthma control among Chinese pediatric patients and identify risk factors associated with uncontrolled asthma.
Methods:
A total of 4223 patients with persistent asthma aged 2-16 years from 42 tertiary hospitals across all regions of mainland China except Tibet were surveyed. Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT) and Global Initiative for Asthma (GINA) criteria were used to assess asthma control for children aged 12-16 years, 4-11 years and 2-3 years, respectively. Uncontrolled asthma was defined as ACT or C-ACT score ≤19 or GINA-defined uncontrolled asthma. Risk factors associated with uncontrolled asthma were identified using multivariate logistic regression models.
Results:
Asthma was uncontrolled in 19.9% of the subjects. High rates of uncontrolled asthma were found in subjects with treatment non-adherence (44.1%), concomitant allergic rhinitis (AR) (23.3%), disease duration ≥ 1.5 years (22.8%), and first-degree relatives with AR (21.5%). The risk of uncontrolled asthma was much higher in the treatment non-adherence group compared to the complete adherence group (OR = 5.79, p < 0.001). Concomitant AR, disease duration ≥ 1.5 years, and first-degree relatives with AR were also confirmed as risk factors associated with uncontrolled asthma.
Conclusions:
About 20% of Chinese pediatric asthma patients had uncontrolled asthma. Treatment adherence and AR were the most significant risk factors. Tailored measures aimed at improving treatment adherence and diagnosis and treatment of AR should be adopted to improve the level of asthma control in Chinese children.
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