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Determinants of Asthma Control in Jordanian Children: The Role of Comorbidities and FeNO Levels
Enas Al-Zayadneh1, Walid Al-Qerem2, Judith Eberhardt3
1Department of Pediatrics, School of Medicine, University of Jordan, Queen Rania St., Amman 11942, Jordan.
Insights
In Jordan, over 60% of children have uncontrolled asthma, with comorbidities like sleep apnea significantly worsening control. Fractional exhaled nitric oxide (FeNO) shows potential but requires further study for clinical use.
Area of Science:
- Pediatric Pulmonology
- Respiratory Medicine
- Clinical Biomarkers
Background:
- Pediatric asthma is common globally, with poor control posing significant challenges.
- Jordan faces a rising prevalence of childhood asthma, necessitating better understanding of control factors.
- Effective assessment tools are crucial for managing pediatric asthma effectively.
Purpose of the Study:
- To identify predictors of asthma control in Jordanian children.
- To evaluate the clinical utility of fractional exhaled nitric oxide (FeNO) as a supplementary biomarker.
- To assess the impact of comorbidities on pediatric asthma control.
Main Methods:
- Cross-sectional study of 329 children (7-17 years) with physician-diagnosed asthma.
- Data collection included clinical history, spirometry, FeNO measurements, and Asthma Control Test (ACT) scores.
- Logistic regression analysis was used to identify predictors of asthma control.
Main Results:
- 62.6% of pediatric participants exhibited uncontrolled asthma.
- Comorbidities including obstructive sleep apnea, GERD, allergic rhinitis, and bronchiolitis obliterans were linked to poorer asthma control.
- Antihistamine use and elevated FeNO levels correlated with reduced odds of asthma control.
Conclusions:
- FeNO shows potential as a non-invasive marker for airway inflammation in pediatric asthma.
- Clinical utility of FeNO is currently limited by variability and confounding factors.
- Comprehensive, individualized asthma management addressing comorbidities is essential; further longitudinal studies on FeNO are warranted.
Background/Objectives:
Asthma is a prevalent chronic respiratory disease in children, and poor asthma control remains a major clinical challenge worldwide. In Jordan, the rising prevalence of pediatric asthma highlights a need to better understand the factors influencing asthma control and to evaluate new assessment tools.
Methods:
This cross-sectional study aimed to identify predictors of asthma control and to assess the clinical utility of fractional exhaled nitric oxide (FeNO) as a supplementary biomarker. A total of 329 children with physician-diagnosed asthma, aged 7-17 years, were recruited from Jordan University Hospital. Clinical history, spirometry, FeNO measurements, and Asthma Control Test scores were collected.
Results:
Overall, 62.6% of participants had uncontrolled asthma. Logistic regression analysis revealed that comorbidities such as obstructive sleep apnea, gastroesophageal reflux disease, allergic rhinitis, and bronchiolitis obliterans were significantly associated with poorer asthma control. Antihistamine use and elevated FeNO levels were also linked to lower odds of asthma control.
Conclusions:
While FeNO showed promise as a non-invasive marker of airway inflammation, its clinical application remains limited due to variability and confounding factors. A comprehensive, individualized approach to asthma management, considering comorbidities and conventional assessments, is essential. Larger, longitudinal studies are needed to establish the role of FeNO in routine pediatric asthma care.
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