Abstract
We evaluated the effects of air pollutants, age, allergic history, family allergic history, treatment, treatment steps, and compliance on uncontrolled childhood asthma in Xiamen, China. The clinical data of children with asthma in the pediatric outpatient department of the First Affiliated Hospital of Xiamen University from January 2016 to June 2018 were analyzed retrospectively. According to the assessment of the patients' outcome including well-controlled, partly-controlled and uncontrolled, 7,211 cases of 3,268 patients were selected. Rank sum test and ordered multi-class logistic regression analysis were used. In the rank sum test, age, allergic history, family allergic history, season, treatment, treatment steps and compliance were found associated with uncontrolled rate (all P < 0.001). Logistic regression analysis showed that PM10, NO2, and SO2 raised uncontrolled-asthma rate (aOR 1.311, aOR 1.281, aOR 1.252, respectively). Older children had lower uncontrolled rate (OR = 0.849, 95% CI: 0.758–0.950), children with higher treatment steps had higher uncontrolled rate (OR = 1.227, 95%CI: 1.040–1.448), and children with better treatment compliance have lower uncontrolled rate (OR = 0.374 95% CI: 0.331–0.424). The order of the uncontrolled rate of asthma from high to low was winter, spring, autumn, and summer. PM10, NO2, SO2, age, season, treatment steps, and treatment compliance have significance for predicting the control rate of childhood asthma in Xiamen, China.
Highlights
Asthma is a common chronic respiratory disease, especially in children
The associations between treatment steps and asthma control remained statistically significant.Treatment adherence was a risk factor in uncontrolled childhood asthma
The diagnosis and control assessment of childhood asthma in this study were from Chinese guidelines which was made based on Global Initiative for Asthma (GINA) [14]
Summary
Asthma is a common chronic respiratory disease, especially in children. The control of asthma is closely related to the quality of life of patients. Children’s asthma is related to various factors such as environmental factors, genetic factors, and immunological factors. Environmental pollution plays a part in asthma exacerbation, and there are a few investigations regarding to the relationship between air pollutants and childhood asthma in China. PM1, PM2.5, and PM10 exposure had a negative effect on adolescent respiratory system and was associated with asthma exacerbation [3, 4]. NO2, SO2, and CO were risk factors of severe childhood asthma [5,6,7]. The research on the air pollution and childhood asthma control is rare in China
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