Prevalence of uncontrolled childhood asthma and its association with parental knowledge in Karachi, Pakistan

To evaluate the prevalence of uncontrolled asthma in children and its association with parental knowledge.

This cross-sectional study was conducted at the paediatric clinic of the Aga Khan University Hospital, Karachi, Pakistan, from July 2024 to December 2024. Asthmatic children aged 4-16 years and their accompanying parents (at least one) were enrolled in the study with consent. Uncontrolled asthma was determined using the Childhood Asthma Control Test, with a score of less than 19. Parental asthma knowledge was assessed using the Asthma Knowledge Questionnaire. Multivariable logistic regression analysis was used to adjust for potential confounding factors and identify markers of suboptimal control among children with asthma.

A total of 170 children were enrolled in the study, 99 (58.2%) were male, and the mean age was 8.00 ± 2.97 years. The mean age at the time of asthma diagnosis was 3.77 ± 2.59 years. There were 110 (64.7%) children who had controlled asthma, and 60 (35.3%) had uncontrolled asthma. Inhaler use was more frequent among children with uncontrolled asthma (76.7% vs 57.3%). Emergency department visits in the past year (75.0% vs 51.8%), intensive care unit (ICU) admissions (48.3% vs 27.2%) and pet exposure (28.3% vs 15.5%) were significantly higher in the uncontrolled group. The mean parental knowledge scores in both groups did not differ significantly (56.77±7.36 vs 55.00±7.43) and were inadequate in both groups. In multivariable analysis, children with good asthma control have fewer emergency department visits, while inhaler use (reliever or controller) is more common in poorer control.

This study concludes that parental asthma knowledge was inadequate and not associated with asthma control in children. Emergency department visits, ICU admissions and pet exposure were more common among children with poor asthma control.