Multi-Factor Analysis of Single-Center Asthma Control in Xiamen, China
Yu Zhu1, Taoling Zhong2, Dandan Ge1
1Department of Pediatrics, The First Affiliated Hospital of Xiamen University, Xiamen, China.
Insights
Air pollutants like PM10, NO2, and SO2 worsen childhood asthma control in Xiamen. Factors like age, season, treatment, and compliance also significantly impact asthma outcomes.
Area of Science:
- Environmental Health
- Pediatric Pulmonology
- Epidemiology
Background:
- Childhood asthma remains a significant public health concern globally.
- Understanding contributing factors is crucial for effective management and prevention strategies.
- Previous studies have explored various risk factors, but regional environmental impacts require further investigation.
Purpose of the Study:
- To investigate the influence of environmental factors, clinical characteristics, and treatment adherence on uncontrolled childhood asthma in Xiamen, China.
- To identify key predictors for asthma control rates in pediatric patients.
- To provide evidence for targeted interventions and public health policies.
Main Methods:
- Retrospective analysis of 7,211 asthma cases from 3,268 children treated at Xiamen University's First Affiliated Hospital (January 2016 - June 2018).
- Utilized Rank sum test and ordered multi-class logistic regression to analyze associations between variables and asthma control.
- Assessed outcomes based on well-controlled, partly-controlled, and uncontrolled asthma classifications.
Main Results:
- Particulate Matter (PM10), Nitrogen Dioxide (NO2), and Sulfur Dioxide (SO2) were significantly associated with higher rates of uncontrolled asthma.
- Older children exhibited lower uncontrolled asthma rates, while increased treatment steps correlated with higher rates.
- Better treatment compliance was strongly linked to lower uncontrolled asthma rates. Asthma control varied seasonally, with winter showing the highest uncontrolled rates.
Conclusions:
- Air pollution (PM10, NO2, SO2), older age, season (winter), treatment complexity, and compliance are significant predictors of childhood asthma control in Xiamen.
- Environmental monitoring and improved treatment adherence are vital for managing childhood asthma.
- Findings support the need for region-specific strategies to mitigate asthma exacerbations.
Abstract:
We evaluated the effects of air pollutants, age, allergic history, family allergic history, treatment, treatment steps, and compliance on uncontrolled childhood asthma in Xiamen, China. The clinical data of children with asthma in the pediatric outpatient department of the First Affiliated Hospital of Xiamen University from January 2016 to June 2018 were analyzed retrospectively. According to the assessment of the patients' outcome including well-controlled, partly-controlled and uncontrolled, 7,211 cases of 3,268 patients were selected. Rank sum test and ordered multi-class logistic regression analysis were used. In the rank sum test, age, allergic history, family allergic history, season, treatment, treatment steps and compliance were found associated with uncontrolled rate (all P < 0.001). Logistic regression analysis showed that PM10, NO2, and SO2 raised uncontrolled-asthma rate (aOR 1.311, aOR 1.281, aOR 1.252, respectively). Older children had lower uncontrolled rate (OR = 0.849, 95% CI: 0.758-0.950), children with higher treatment steps had higher uncontrolled rate (OR = 1.227, 95%CI: 1.040-1.448), and children with better treatment compliance have lower uncontrolled rate (OR = 0.374 95% CI: 0.331-0.424). The order of the uncontrolled rate of asthma from high to low was winter, spring, autumn, and summer. PM10, NO2, SO2, age, season, treatment steps, and treatment compliance have significance for predicting the control rate of childhood asthma in Xiamen, China.
