Efficiency of bronchial asthma control in children of school age depending on the features of the disease debut

Abstract

Objective. To assess the effectiveness of achieving and maintaining control of bronchial asthma in children during dynamic observation, depending on the characteristics of the onset of the disease.
 Material and methods. In order to study the peculiarities of the course and controllability of bronchial asthma in children, depending on the alternative onset of the disease, 319 children were comprehensively examined by the "experience-control" method in parallel groups using a simple random sample on the basis of the Regional Children's Clinical Hospital in Chernivtsi. In 257 patients (I clinical group), bronchial asthma developed on the background of chronic obstructive bronchitis, the II clinical group included 43 children in whom BA debuted after suffering community-acquired pneumonia, and the third (III) clinical group was formed by 19 children in whom BA was verified after inpatient treatment for status asthmaticus.
 Research results. It was shown that the representatives of the III clinical group, compared with other patients, probably more often had the phenotype of early asthma and severe disease, and the ratio of the chances of severe asthma in the future for these children compared with the cohort of group I was 6.8. According to the results of self-assessment of asthma control on standardized questionnaires GINA and AST, as well as using a clinical-instrumental assessment scale, it was found that the level of disease control in all groups was insufficient, and the distribution of children in clinical groups in group III relative to other patients with partially controlled and uncontrolled asthma predominated. The conducted standard anti-inflammatory basic treatment allowed to achieve certain positive changes in patients of clinical observation groups, and the representatives of the III clinical group required more active basic anti-inflammatory therapy, in particular, the volume of the 1st step in GINA compared to patients of the I group was prescribed twice less often, and the 4th - 6.9 times more often.
 Conclusion. Patients with the onset of bronchial asthma in the form of status asthmaticus further retain a worse level of control over the disease as compared to patients with chronic obstructive bronchitis or pneumonia in history. This cohort of patients requires a larger volume of basic treatment, as well as a personalized approach to prescribing therapy with the obligatory consideration of the characteristics of asthma onset.