Abstract
IntroductionPrompt recognition and management of co-morbidities is an important step in ensuring optimal childhood asthma symptoms control. This study sets out to determine the prevalence, predictive factors and association of co-morbidities with asthma severity, lung functions and symptoms control in Nigerian children.MethodsChildren (aged 2 to 15 years) with physician-diagnosed asthma at the Wesley Guild Hospital, Nigeria were consecutively recruited. Asthma co-morbidities, severity and levels of symptoms control were assessed using standard definitions. Lung functions of children ≥ 6 years were also measured. Factors predictive of asthma co-morbidities and association of co-morbid conditions with asthma severity, lung functions and symptoms control were determined using univariate and multivariate analyses.ResultsA total of 186 children (male: female 1.4:1) were recruited and the majority (81.0%) had mild intermittent asthma. Forty (21.5%) had suboptimal symptoms control and 112 (60.2%) had associated co-morbidities. Allergic rhinitis and/or conjunctivitis (41.4%) were the most common co-morbidities. Predictors of concomitant presence of allergic rhinitis among the children were older age group ≥ 6 years (OR = 2.488; 95%CI 1.250-4.954; p = 0.036) and lack of exclusive breastfeeding (OR = 2.688; 95%CI 1.199 -5.872; p = 0.020) while obesity/overweight (OR = 6.300; 95%CI 2.040-8.520; p = 0.003) and Allergic rhinitis (OR = 2.414; 95%CI 1.188-6.996; p = 0.049) were determinants of persistent asthma. Suboptimal symptoms control was associated with having concomitant allergic rhinitis (p = 0.018), however no comorbid condition predicted lung function impairment.ConclusionAbout two-thirds of children with asthma had co-morbidities and allergic rhino-conjunctivitis was the most common. School age group and early introduction to breast milk substitutes predict the presence of these co-morbidities which also affect asthma severity and control.
Highlights
Childhood asthma is a leading cause of chronic respiratory disease in children [1]
Non-respiratory diseases like gastroesophageal reflux diseases (GERD), childhood obesity, hyperlipidaemia, diabetes mellitus, chronic obstructive pulmonary diseases (COPD) and psychological/emotional disturbances have been reported to be higher in children with asthma than their peers without asthma [6,7,8]
The Wesley Guild Hospital (WGH) is a tertiary arm of the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) which provides general and specialised care for children in the south west part of Nigeria
Summary
Childhood asthma is a leading cause of chronic respiratory disease in children [1]. It is a major cause of ill health, hospitalisation and emergency room visits as well as school absenteeism in children [1, 2]. The major goal of childhood asthma management is to achieve optimal symptoms control which will enable children with asthma to live a normal life and achieve their potentials [1]. As desirable as this management goal is, it is often not achievable. One of the reasons for poor or suboptimal symptoms control in childhood asthma is poor recognition and or management of asthma co-morbidities [1, 4, 5]. Non-respiratory diseases like gastroesophageal reflux diseases (GERD), childhood obesity, hyperlipidaemia, diabetes mellitus, chronic obstructive pulmonary diseases (COPD) and psychological/emotional disturbances have been reported to be higher in children with asthma than their peers without asthma [6,7,8]
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