Risk factors of severe asthma exacerbation among Egyptian children: a case- control study

Abstract

Background: Asthma is a prevalent major non-communicable disease that significantly affects the quality of life for many individuals. As measured by disability-adjusted life years, asthma is the 16th most common cause of years lived with disability and the 28th most common cause of burden of disease on a global scale.
Objective: This study aimed to determine the risk factors for asthma exacerbations among asthmatic children attending Mansura University Children Hospital and to assess the outcome of exacerbation.
Methods: The study included 110 participants, who were divided into two groups: Cases of asthma exacerbation and age- and sex-matched control group.
Results: This study showed no significant difference among patients and controls in terms of age, sex, residence and parent education. A significantly higher socioeconomic status was detected among control group than in cases. A significant higher mean body mass index, frequency of preterm, positive family history of atopy, asthma, allergic rhinitis, cough, wheezes, bad housing, smoking- related symptoms, viral-related symptoms, cold air-related symptoms, dust-related symptoms among cases than in control group. There was a significant association among severe asthma exacerbation and presence of strong emotions as aggravating factors. There was no significant association between exacerbation severity and past and family history of the studied cases. Younger age at diagnosis, low socioeconomic status were significant predictors of severe asthma. They predicted severity by 74.2%. Decreasing age at diagnosis by one year increased risk of severe asthma by 0.960(0.935 -0.987). Low socioeconomic status increased risk of severe asthma by 11.25 more times than cases with high socioeconomic status.
Conclusion: Obesity, prematurity, low socioeconomic status, younger age of diagnosis, family history of atopy, asthma or allergic rhinitis, bad housing, smoking, dust, viral infections, cold air and strong emotions are the most detected predictors and risk factors for asthma exacerbations among asthmatic children. Severe exacerbations were more associated with low socioeconomic status and presence of strong emotions as aggravating factors. It is imperative to possess an understanding of the specific risk factors in order to develop effective treatment and control protocols. Reduced exposure to these risk factors enhanced management of asthma.