Assessment of level of asthma control and related factors in children attending pediatric respiratory clinics in Addis Ababa, Ethiopia

Prevalence and associated factors of pediatric uncontrolled asthma in Vietnam

OBJECTIVE

Uncontrolled asthma profoundly affects quality of life and imposes a significant societal burden. However, reports on its prevalence and contributing factors in Vietnam remain limited. This study aimed to address this gap by investigating the prevalence and factors associated with uncontrolled asthma among children in Vietnam.

METHODS

An analytical cross-sectional study was conducted involving 344 pediatric asthma patients and their caregivers. The Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT) were used to assess asthma control in children aged 4-11 and 12-16 years, respectively. Data on patient, caregiver, and treatment characteristics were collected for analysis. Logistic regression analysis was employed to identify factors associated with uncontrolled asthma.

RESULTS

The prevalence of uncontrolled asthma was 40.1%. Factors significantly associated with uncontrolled asthma included previous admissions due to asthma (aOR = 2.80, 95% CI: 1.56-5.04, p < .001), inadequate caregiver knowledge (aOR = 2.86, 95% CI: 1.58-5.19, p < .001), and non-adherence to controller medication (aOR = 1.92, 95% CI: 1.07-3.48, p = .030).

CONCLUSIONS

The prevalence of uncontrolled asthma in Vietnamese children is quite high. Previous admissions due to asthma, inadequate caregiver knowledge, and controller medication non-adherence were identified as significant factors associated with uncontrolled asthma.

Asthma control, its related factors, and impact on quality of life among pediatric patients at a tertiary center in Jordan: a cross-sectional study

INTRODUCTION

Pediatric asthma is a common respiratory disease that burdens affected patients, their caregivers, and the entire healthcare system. Uncontrolled asthma ultimately impacts patients' quality of life. There are limited studies examining the factors associated with asthma control and quality of life. Thus, this study aimed to explore factors associated with asthma control and examine the relationship between asthma control and quality of life in children with asthma.

METHODS

A cross-sectional study was conducted from October 2023 to January 2024 at the Jordan University Hospital, including 136 children aged 7-17 diagnosed with asthma. Asthma control was assessed using the Asthma Control Test (ACT) or Childhood Asthma Control Test (C-ACT). Medication adherence was measured using the 8-item Morisky Medication Adherence Scale (MMAS), and quality of life was evaluated using the Pediatric Asthma Quality of Life Questionnaire (PAQLQ).

RESULTS

Only 43.4% of patients had proper asthma control. The average quality of life and MMAS scores were 4.9 ± 1.5 and 4.2 ± 1.9, respectively. Uncontrolled asthma was associated with increased hospital admissions (p = 0.008), sensitivity to cold (p = 0.002), spring weather (p = 0.031), and infections (p = 0.001). Patients with controlled asthma had significantly higher quality of life (p < 0.001), but no significant differences in MMAS scores (p = 0.743). On multivariate analysis, QoL score was a positive predictor of control (p < 0.001), while sensitivity to infections were a negative predictor (p < 0.05).

CONCLUSION

Most pediatric patients with asthma at the Jordan University Hospital had poor asthma control. Quality of life remained a positive predictor of control irrespective of adherence to asthma treatment. This highlights the need for caregivers and physicians to focus greater attention on these cases, given the substantial clinical and social challanages they poses for affected children.

Factors influencing health-related quality of life in children with asthma: insights from Addis Ababa public hospitals

Background

Bronchial asthma is a global health problem in particular a respiratory condition characterized by broncho spasms that negatively affect the quality of life (QOL) of children. However, there is a paucity of data regarding the health-related quality of life of asthma in children in Ethiopia, and the study area.

Objective

The objective of this study was to assess the health-related quality of life among asthmatic children aged 7-17 in selected hospitals in Addis Ababa, Ethiopia.

Methods

An institutional-based analytical cross-sectional study involving 136 asthmatic children aged 7-17 years was conducted in the selected hospital in Addis Ababa, from February to April 2024. Respondents were chosen using a systematic random sampling method. Structured, interviewer-administered, and pretested questionnaires, were used to collect data. The data were coded and entered into Epi-Data 3.1 before being exported to SPSS version 25 for analysis. Logistic regression was employed to identify factors influencing health-related quality of life Statistical significance was set at p < 0.05 with a 95% confidence interval.

Results

The study found that 46% [95% CI: 37.6-54.4%] of the study participants had a poor quality of life. Factors associated with an increased likelihood of poor quality of life included caregivers' lack of formal education (Adjusted Odds Ratio [AOR]: 1.39 [1.80-10.69]), a family history of asthma (AOR: 2.51 [1.46-4.299]), longer asthma duration (AOR: 3.47 [1.89-6.39]), uncontrolled asthma (AOR: 3.47 [1.89-6.39]), moderate persistent asthma (AOR: 2.4 [1.40-4.20]), and comorbidities (AOR: 2.4 [1.40-4.20]).

Conclusion

The study highlights almost half of asthmatic children had a poor quality of life in Addis Ababa. Factors such as caregivers' lack of formal education, a family history of asthma, longer duration and increased severity of asthma, uncontrolled asthma, and comorbidities were significantly associated with poor quality of life. Therefore, implementing targeted education programs, encouraging family history assessments, and strengthening comorbidity screening and management for children and their families in Addis Ababa are recommended.

Risk factors associated with uncontrolled asthma in children - a systematic review and meta-analysis

OBJECTIVE

We aim to assess the risk factors of uncontrolled asthma in children and adolescents.

METHODS

A systemic search was conducted from electronic databases (PubMed/Medline, Cochrane Library, and Google Scholar) from inception to July 17, 2023. All statistical analyses were conducted in Review Manager 5.4.1. Studies meeting inclusion criteria were selected. A random-effects model was used when heterogeneity was seen to pool the studies, and the result was reported in the odds ratio and the corresponding 95% confidence interval. We also used a narrative approach where it was not feasible to quantitatively assess the outcome.

RESULTS

Ten observational studies were used to conduct this systematic review and meta-analysis. A quantitative analysis of five factors was done. Pooled analysis showed a statistically significant risk of uncontrolled asthma in association with past hypersensitivity reactions (standardized mean difference [SMD] = 1.51 (1.16, 1.98); p = .002; I2 = 84%) and incomplete controller adherence (SMD = 3.15 (1.83, 5.41); p < .0001; I2 = 94%). While non-significant relation was seen in parental asthma (SMD = 1.23 (0.98, 1.55); p = .07; I2 = 15%), oral corticosteroid use (SMD = 0.99 (0.72, 1.36); p = .96; I2 = 81%) and education of caregivers (SMD = 0.99 (0.72, 1.36); p = .96; I2 = 81%). Some other factors were also discussed qualitatively.

CONCLUSION

Our study shows that some significant risk factors might cause uncontrolled asthma in children and adolescents like past hypersensitivity reactions and incomplete controller adherence.

Navigating the asthma network on Twitter: Insights from social network and sentiment analysis

Background

Asthma is a condition in which the airways become inflamed and constricted, causing breathing difficulties, wheezing, coughing, and chest tightness. Social networks can have a substantial effect on asthma management and results. However, no studies of social networks addressing asthma have been undertaken.

Objective

The aim of this research was to identify the significant social network structures, key influencers, top topics, and sentiments of asthma-related Twitter conversations.

Methods

All the tweets collected for this study included the keyword "asthma" or were mentioned in or in replies to tweets that were performed. For this study, a random sample of Twitter data was collected using NodeXL Pro software between December 1, 2022, and January 29, 2023. The data collected includes the user's display name, Twitter handle, tweet text, and the tweet's publishing date and time. After being imported into the Gephi application, the NodeXL data were then shown using the Fruchterman-Reingold layout method. In our study, SNA (Social Network Analysis) metrics were utilized to identify the most popular subject using hashtags, sentiment-related phrases (positive, negative, or neutral), and top influencer by centrality measures (degree, betweenness).

Results

The study collected 48,122 tweets containing the keyword "asthma" or mentioned in replies. News reporters and journalists emerged as top influencers based on centrality measures in Twitter conversations about asthma, followed by government and healthcare institutions. Education, trigger factors (e.g., cat exposure, diet), and associated conditions were highly discussed topics on asthma-related social media posts (e.g., sarscov2, copd). Our study's sentiment analysis revealed that there were 8427 phrases associated neutral comments (18%), 12,582 words reflecting positive viewpoints (26%), and 27,111 words reflecting negative opinions (56%).

Conclusion

This study investigates the relevance of social media influencers, news reporters, health experts, health organizations, and the government in the dissemination and promotion of asthma-related education and awareness during public health information.

The emerging role of digital health in the management of asthma

The most common reasons seen for lack of asthma control include misconceptions about disease control, low controller treatment adherence, poor inhaler technique, and the resulting underuse of controllers and overuse of short-acting beta2 agonists (SABAs). Narrowing these care gaps may be achieved through well-designed patient education that considers the patient's motivation, beliefs, and capabilities regarding their asthma and its management and empowers the patient to become an active participant in treatment decisions. Digital health technologies (DHTs) and digital therapeutic (DT) devices provide new opportunities to monitor treatment behaviors, improve communication between healthcare providers and patients, and generate data that inform educational interactions. DHT and DT have been proven effective in enhancing patient self-management in other chronic conditions, particularly diabetes. Accelerated integration of DHT and DT into the management of asthma patients is facilitated by the use of digital inhalers that employ sensor technology ("smart" inhalers). These devices efficiently provide real-time feedback on controller adherence, SABA use, and inhaler technique that have the strong potential to optimize asthma control.

Maintenance Therapy for Children and Adolescents with Asthma: Guidelines and Recommendations from the Emilia-Romagna Asthma (ERA) Study Group

Asthma is the most frequent chronic disease of childhood, affecting up to 20% of children worldwide. The main guidelines on asthma maintenance therapy in pediatrics suggest different approaches and describe different stages of asthma to determine the most appropriate treatment. This project aims to summarize the most recent evidence regarding maintenance therapy for asthma in children and adolescents. A multidisciplinary panel of experts was asked clinical questions regarding the treatment of children and adolescents with asthma. Overall, 10 clinical questions were addressed, and the search strategy included accessing electronic databases and a manual search of gray literature published in the last 25 years. After data extraction and narrative synthesis of results, recommendations were developed using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) methodology. Results showed that the choice of medication depends on the severity of the child's asthma, phenotype, age, preference, and individual factors. In addition to medications, the identification of comorbidities and modifiable factors is crucial to obtaining good control. Asthma in children is heterogeneous, and its evolution varies over time. Since most recommendations for asthma management in childhood are extrapolated from clinical studies performed in adults, more clinical trials specifically designed for young children should be conducted.