Asthma Control In Children Research Articles

An impact of activated Epstein–Barr Virus and HHV-6 on the course and control of bronchial asthma in children of the Amur Region

The role of viral infection in bronchial asthma (BA) is well-known being reflected particularly in GINA. An effect of pneumotropic intracellular persistent herpesviruses on the course of BA is of particular interest. The most common viruses of this group are cytomegalovirus (CMV), EpsteinBarr virus (EBV), and human herpesvirus 6 (HHV-6). The CMV role has been discussed in our previous publications allowing us to focus here on EBV and HHV-6. We examined 167 children with BA that was diagnosed and clinically assessed in accordance with the current national clinical guidelines. Patients with controlled asthma (70 patients), partially controlled and uncontrolled asthma (97 patients) were stratified into several groups. The detection of EBV and HHV-6 DNA was carried out in throat swabs by PCR; the level of total and virus-specific IgA, IgM, IgG, IgE as well as serum level of IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-8 and TNF was assessed by enzyme linked immunosorbent assay; lymphocyte subpopulations were analyzed by flow cytometry. The dose of topic GCS was taken into account with reference to the fluticosone equivalent; the function of external respiration was studied by spirometry. It was revealed that EBV DNA was found in 14.2% of cases, whereas HHV-6 in 19.0% of cases, but 14.4% and 52.4% of patients, respectively, shed no pathogen-linked DNA. At the same time, patients with uncontrolled BA are significantly more likely to shed the pathogen DNA, so that EBV is released in 17.1% vs 4.5% of patients with controlled BA, HHV-6 in 19.5% vs 13.6%. On the contrary, children with controlled BA were significantly more often (63.6% vs 51.2%) negative for viral DNA shedding. Moreover, virus shedding was paralleled with higher levels of IL-5: it was as high as 0.91 pg/ml and 0.29 pg/ml for EBV and HHV-6, respectively; those shedding DNA of both pathogens vs no shedding had IL-5 at level of 0.25 pg/ml vs 0.11 pg/ml. Similar pattern was observed for higher total IgE: 184.5 IU for EBV, 113.1 IU for HHV-6, and 371.7 IU shedding both viruses vs 95.2 IU in without DNA pathogen shedding; lower level of FEV1: EBV 96.6%, HHV-6 98.8%, and 106.2% in patients shedding both viruses vs 109.8% in patients not shedding the pathogen DNA. Patients shedding EBV DNA require higher doses of topic GCS to achieve disease control: EBV 325.0 mg, HHV-6 186.4 mg; shedding both viruses 328.1 mg of topic GCS vs 198.6 mg in patients without pathogen DNA shedding. Thus, activation of both EBV and HHV-6 worsens BA control and aggravates its course, but EBV persistence has a more pronounced effect on the course and control of the disease.

Caregiver Expressed Emotion and Pediatric Asthma: A Call for Culturally Specific Adaptations.

Background: Expressed emotion is the affective attitudes and behaviors of an individual toward another. In this preliminary study, we described expressed emotion among caregivers of children with asthma living in low-income urban area and evaluated its association with child asthma control. Methods: Forty-one children (90.2% African American/Black) and their caregivers participated. Measures included the Childhood Asthma Control Test and the Five-Minute Speech Sample coded for overall expressed emotion, emotional over-involvement, and criticism. Results: Most caregivers were rated borderline (31.7%) or high (48.8%) for expressed emotion, borderline (31.7%) or high (39.0%) for emotional overinvolvement, and low for criticism (73.2%). The association between criticism and asthma control neared statistical significance [U(Nlow = 30, NB/high = 11) = 100, z = -1.922, P = 0.055]. Conclusion: Findings suggest an examination into expressed emotion coding procedures for caregivers in low-income urban areas, and culturally specific adaptations may be necessary. Future research should confirm findings in a larger sample and consider how parental criticism affects children's asthma management.

Asthma control in children

Asthma control in children

The role of vitamin D in the severity and control of asthma in children and adolescents: A protocol for systematic review and meta-analysis

Vitamin D plays an important role in the immune system and consequently in the inflammatory process of asthma. It acts directly on the regulation of helper T lymphocytes 1 (Th1) and helper T lymphocytes 2 (Th2) cells, and regulatory T lymphocytes. Evidence shows that vitamin D acts on dendritic cells, raising inflammatory mediators and increasing the imbalance between Th1, Th2, and helper T lymphocytes 17 (Th17). Evidence shows a strong association between vitamin D levels and asthma incidence, especially in patients with severe and uncontrolled asthma. A systematic and comprehensive search will be performed using four main databases, PubMed, EMBASE, Cochrane Library, and Web of Science. Articles will be searched from the earliest available time to august 2022. The studied population will be composed of children and or adolescents with asthma. From the data obtained, all articles found will be transferred to the Rayyan platform. Study selection will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Checklist (PRISMA P-2020). In addition, if sufficient data are available, a meta-analysis will be conducted. Two independent reviewers will conduct the studies selection, data extraction, and risk of bias assessment. The outcome measures will be to analyze the serum levels of vitamin D in patients with asthma and to relate this hormone to the control and severity of the disease and its anti- inflammatory effect. A systematic review will provide better knowledge regarding vitamin D and its role in the severity and control of asthma. The findings of this study will be published in a peer-reviewed journal.

ROLE OF HIGH- SENSITIVITY C REACTIVE PROTEIN (hs-CRP) IN ASSESSMENT OF ASTHMA CONTROL IN CHILDREN

Introduction: Data are scarce on hs-CRP as a biomarker for airway inflammation in pediatric asthma. We aimed to examine correlation between hs-CRP and asthma control levels. Methods: Children with physician- diagnosed asthma, ages 6 to 15 years, were enrolled. GINA-2016 criteria were used to assess the level of asthma control. The relationships between serum hs-CRP and each of asthma control measures (Asthma control criteria, spirometry, impulse oscillometry, eosinophil counts and Fractional exhaled nitric oxide (FeNO) were assessed. Results: 150 asthmatic children were enrolled; 52 (35%) had well controlled asthma, 76 (51%), and 22 (14%) children had partly controlled and uncontrolled asthma, respectively. Median (IQR) values of hs-CRP were 0.47 (0.1, 1.67) mg/L in well controlled, 0.30 (0.1, 1.83) mg/L in partly controlled, and 2.74 (0.55, 3.74) mg/L in uncontrolled asthma (p = 0.029). Using Receiver Operator Characteristic (ROC) curve analysis, area under curve for hs-CRP mg/L to discriminate between uncontrolled and (controlled + partly controlled) asthma was 0.67 (95% CI 0.55, 0.80) and a cutoff 1.1 mg/L of serum hs-CRP level had a sensitivity of 68.1% with specificity of 67.97%. In two groups of hs-CRP (< 3 mg/L) and hs-CRP (≥ 3 mg/L), high hs-CRP group had higher proportion of uncontrolled asthmatic children (p = 0.03). Conclusion: We observed higher serum hs-CRP values in children with uncontrolled asthma suggesting its potential role as a biomarker of asthma control.

Caregiver Perceptions of Change in Pediatric Asthma Control During the COVID-19 Pandemic.

Although several indicators suggest that pediatric asthma control in the United States improved early in the pandemic, other indicators suggest not. Missing are reports from caregivers of the experiences of their children with asthma early in the pandemic. Using the PP-ACT and other measures that we specifically constructed for our research, we conducted a cross-sectional national survey of US caregivers of children with asthma (N=595) to examine perceived change in their child's asthma control and changes in reports of ED visits and use of emergency relief medicine and controller medicine pre-pandemic (January to March 2020) versus early-pandemic (June to September 2020). Caregivers fell into three groups: most caregivers perceived that their child's asthma control was improved (50.3%) or unchanged (41.2%), and few reported worse control (8.5%). Surprisingly, all three groups of caregivers reported similar frequencies of early-pandemic and pre-pandemic ED visits and use of emergency relief medicine. Also surprising, caregivers who perceived their child's asthma as more controlled (compared with the other two groups) reported more frequent ED visits and use of emergency relief medicine, yet also more use of controller medicine at both early-pandemic and pre-pandemic. The mismatch between caregivers' perceptions of their child's early-pandemic asthma control and their reports of ED visits and use of emergency relief medicine suggests that caregivers may rely on a gist (a global evaluation that can include nonbiomedical evidence) when estimating their child's asthma control. Caregivers and their families could benefit from help from clinicians in understanding the discrepancy between subjective asthma control and asthma control indicators and in understanding what well-controlled asthma looks and feels like.

CO87 Reductions in Exacerbations and Improvements in Lung Function and Asthma Control in Children With Moderate-to-Severe Type 2 Asthma Analyzed by High- or Medium-Dose of Inhaled Corticosteroids at Baseline

CO87 Reductions in Exacerbations and Improvements in Lung Function and Asthma Control in Children With Moderate-to-Severe Type 2 Asthma Analyzed by High- or Medium-Dose of Inhaled Corticosteroids at Baseline

Physical Activity and Childhood Asthma Control: Mediation and Moderation Role of Body Mass Index

Physical Activity and Childhood Asthma Control: Mediation and Moderation Role of Body Mass Index

Asthma control in normal weight and overweight/obese asthmatic children following adenotonsillectomy.

Childhood adenotonsillar hypertrophy (ATH) with sleep-disordered breathing (SDB) frequently occurs concomitant with asthma. Adenotonsillectomy and reduction in asthma severity association has been reported. We describe changes in asthma control in nonobese or normal weight and obese/overweight children undergoing adenotonsillectomy for SDB. This prospective, nonrandomized cohort trial with 6-month follow-up at a tertiary children's hospital enrolled 41 children with persistent asthma undergoing adenotonsillectomy for SDB. Children with significant chronic medical conditions, premature birth (< 28weeks), or recent respiratory infection were excluded. Patients were stratified by baseline BMI into nonobese or normal weight (BMI < 85 percentile) and obese/overweight (BMI > 85%). The primary outcome was change in Childhood Asthma Control Test (cACT) scores 3 and 6 months following adenotonsillectomy. Secondary outcome examined improvement in Pediatric Asthma Caregiver's Quality of Life Questionnaire (PACQLQ) 3 and 6months following adenotonsillectomy. Baseline characteristics were similar except for anthropometric measures and mean PACQLQ (P = .03). Children with nonobese or normal weight (n = 26) had statistically significant improvement in change in cACT at 3 (22.80 ± 2.33 vs. 17.86 ± 3.53, P < .001) and 6 (20.71±3.29 vs. 18.24 ± 4.16, P = .044) months compared with baseline. PACQLQ scores also improved at 3 (6.20 ± 0.87 vs. 4.56 ± 1.12, P < .001) and 6 (6.36 ± 0.72 vs. 4.93 ± 0.96, P < .001) months. Obese/overweight children (n = 10) had significant improvement in cACT scores at 6months (20.00 ± 3.90 vs. 15.00 ± 6.90, P = .048). Change of cACT scores at 3months (17.86 ± 3.53 vs. 14.86 ± 6.31, P = .272) was not significantly different. PACQLQ scores improved at 3 (5.47 ± 1.09 vs. 3.70 ± 0.85, P < .001) and 6 (5.75 ± 2.19 vs. 3.67 ± 1.04, P = .016) months. Nonobese or normal-weight children undergoing adenotonsillectomy demonstrated significant improvement in asthma control scores at 3 and 6 and obese/overweight children at 6 months. Using the PACQLQ, caregiver quality of life improved for all children at 3 and 6 months. Surgical management of ATH in children with comorbid SBD and asthma is a good treatment option.

The Effects of Second-hand Smoke Exposure on Asthma Symptoms in Children

Objective − The aim of study was to evaluate the effects of parental smoking and tobacco smoke exposure (TSE) on asthma symptoms in children, and to raise awareness of the detrimental effects of TSE for asthmatic children.Methods − A modified and validated questionnaire on TSE was completed by 76 parents and their children who were being treated at Srebrnjak Children’s Hospital for asthma. Patients filled in a standardized ACT questionnaire about their asthma symptoms, whereas parental smoking data were derived from a questionnaire filled in by the parents. The answers were structured as ordinal and categorical variables. The non-parametric Mann-Whitney U test and Kruskal-Wallis test were performed.Results −There are statistically significant differences in the frequency of asthma symptoms in children depending on whether household members smoked cigarettes, with statistically significant differences in the frequency of asthma symptoms in children depending on whether their parents smoked cigarettes outside the house, only in one/certain room or everywhere in the house. 34.1% of smoking parents vs 9.4% of nonsmoking parents allow smoking in a car while the child is riding in it. 40.9% of parents who smoke vs 21.9% of non-smoking parents believe that their child is exposed to tobacco smoke somewhere other than in their household or car.Conclusion − TSE is associated with more symptoms and worse asthma control in asthmatic children.

The Impact of Caregiver Depression on Child Asthma Outcomes: Pathways and Mechanisms

Depression is common in caregivers of children with asthma and is associated with poor outcomes in their child. No prior studies have longitudinally examined caregiver depression remission as a predictor of improvement in child asthma control. This 2-site study examined whether the proportion of time a caregiver was in depression remission predicted subsequent child asthma control at exit. Caregivers (n= 205) with current major depressive disorder and their children, ages 7 to 17, with persistent asthma were observed every 4 weeks for 52 weeks. Caregiver depressive symptoms were measured using the 17-item Hamilton Rating Scale for Depression (HRSD). Child asthma was assessed with the (Childhood) Asthma Control Test (cACT/ACT) and spirometry, and depression with the Children's Depression Inventory (CDI). Linear regression analyses were conducted with change in cACT/ACT, CDI, and forced expiratory volume in 1 second (FEV1)% predicted as outcomes and proportion of time the caregiver was in remission (HRSD score ≤ 7) as the predictor. Multilevel mediation analyses examined the role of child depressive symptoms and asthma controller medication adherence. Children were, on average, 54.1% female and 11 years old. Caregiver proportion of time in HRSD-assessed remission of depression was a significant predictor of improvement in cACT/ACT, CDI, and FEV1% predicted. Child CDI score, but not medication adherence, mediated the relationship between caregiver HRSD scores and child asthma control scores. Improvement in caregiver depression positively influences child asthma outcomes partially through improvement in child depressive symptom severity. Caregiver depression screening and treatment might lead to improvement in child asthma outcomes.

Effect of Haemophilus influenzae, Streptococcus pneumoniae and influenza vaccinations on infections, immune response and asthma control in preschool children with asthma.

Haemophilus influenzae (H. influenzae), Streptococcus pneumoniae (pneumococcus) and influenza vaccines are administered in children to prevent infections caused by these pathogens. The benefits of vaccination for asthma control in children and the elicited immune response are not fully understood. This study aimed to investigate the impact of these vaccinations on respiratory infections, asthma symptoms, asthma severity and control status, pathogen colonization and in vitro immune responses to different stimulants mimicking infections in asthmatic children. Children aged 4-6 years were recruited into the multicentre prospective PreDicta study conducted across five European countries. Information about vaccination history, infections, antibiotic use, inhaled corticosteroid (ICS) use and asthma symptoms in the last 12 months were obtained from questionnaires of the study. Nasopharyngeal samples were collected at the first visit to assess bacterial and viral colonization, and venous blood for isolation of peripheral blood mononuclear cells (PBMCs). The PBMCs were stimulated with phytohemagglutinin, R848, Poly I:C and zymosan. The levels of 22 cytokines and chemokines were measured in cell culture supernatants using a luminometric multiplex assay. One-hundred and forty asthmatic preschool children (5.3 ± 0.7 years) and 53 healthy children (5.0 ± 0.8 years) from the PreDicta cohort were included in the current study. Asthmatic children were associated with more frequent upper and lower respiratory infections, and more frequent and longer duration of antibiotic use compared with healthy children. In asthmatic children, sufficient H. influenzae vaccination was associated with a shorter duration of upper respiratory infection (URI) and overall use and average dose of ICS. The airway colonization was characterized by less pneumococcus and more rhinovirus. Pneumococcal vaccination was associated with a reduction in the use rate and average dose of ICS, improved asthma control, and less human enterovirus and more H. influenzae and rhinovirus (RV) airway colonization. Influenza vaccination in the last 12 months was associated with a longer duration of URI, but with a decrease in the occurrence of lower respiratory infection (LRI) and the duration of gastrointestinal (GI) infection and antibiotic use. Asthmatic preschoolers vaccinated with H. influenzae, pneumococcus or influenza presented higher levels of Th1-, Th2-, Th17- and regulatory T cells (Treg)-related cytokines in unstimulated PBMCs. Under stimulation, PBMCs from asthmatic preschoolers with pneumococcal vaccination displayed a predominant anti-inflammatory immune response, whereas PBMCs from asthmatic children with sufficient H. influenzae or influenza vaccination were associated with both pro- and anti-inflammatory immune responses. In asthmatic preschoolers, the standard childhood vaccinations to common respiratory pathogens have beneficial effects on asthma control and may modulate immune responses relevant to asthma pathogenesis.

Inverse association between Helicobacter pylori infection and childhood asthma in a physical examination population: a cross-sectional study in Chongqing, China

BackgroundChildhood asthma has substantial effects on children's health. It is important to identify factors in early life that influence childhood asthma. Accumulating evidence indicates that Helicobacter pylori may protect against allergic diseases. This study aimed to evaluate the relationship between H. pylori infection and pediatric asthma in Chongqing, China.Materials and methodsThis cross-sectional study included healthy children aged 4–18 years who underwent a 13C urea breath test during medical checkups in 2021. All medical information was extracted from electronic medical records and a big data system. Logistic regression was used to evaluate the association between H. pylori infection and pediatric asthma, and multivariate regression models were adjusted for covariates.ResultsIn our study, 2241 participants, including 1240 boys (55.33%) and 1001 girls (44.67%), underwent urea breath testing (average age: 8.67 ± 2.70 years). Among them, 292 (13.03%) were positive for H. pylori and 152 (6.78%) had asthma. The rates of asthma diagnosis in H. pylori-negative and -positive children were 7.23% and 3.77%, respectively (odds ratio = 1.995; 95% confidence interval: 1.003–3.968; P < .05). Furthermore, family history of asthma and the percentage of eosinophils in routine blood examination were associated with childhood asthma; however, the body mass index, platelet count, and serum vitamin D level were not.ConclusionsWe demonstrated a significant inverse association between H. pylori infection and pediatric asthma in Chongqing, China. Further studies are required to determine the causal association and underlying mechanisms to prevent and control childhood asthma.

Effective treatment of a child with adenoidal hypertrophy and severe asthma by omalizumab: a case report

BackgroundChildhood adenoid hypertrophy (AH) is common and is often associated with allergic asthma, resulting in complications like obstructive sleep apnea syndrome (OSAS). Management of the disease and its complications is often challenging.Case presentationWe report here a case of a 10-year-old boy who suffered from severe allergic asthma and rhinitis and was treated with omalizumab. Before the treatment, the childhood asthma control test (C-ACT, 14), visal analog scale (VAS, 7) and lung function (mild obstructive ventilation dysfunction and moderate to severe dysfunction in ventilation in small airway) were seriously affected. Polysomnography showed OSAS (apnea hypopnea index, AHI, 6.4), low hypooxia saturation (lowest pulse oxygen saturation, LoSpO2, 70%), and adenoid hypertrophy (at grade III). After treating with omalizumab for 4 weeks (once treatment), the ventilation function, symptoms of asthma and allergic rhinitis (C-ACT, 24; VAS, 2), and OSAS (AHI: 1.8 and LoSpO2: 92.6%) were all improved, and the adenoids size was also significantly reduced to grade II. And during the following 3 times of treatment, the allergic symptoms continued improving, and the size of adenoid was reduced to grade I. Even 6.5 months after cessation of omalizumab, the size of adenoid remained at grade I.ConclusionThis is the first documented case that childhood adenoid hypertrophy can be significantly improved by omalizumab.

Inferior endothelial function improved following optimisation of asthma control in children

Association between asthma control and cardiovascular disease (CVD) remains highly plausible as the two are related to chronic systemic inflammation. Children with physician-diagnosed asthma and matched healthy controls underwent endothelial function assessment. Repeat measurements were performed in uncontrolled asthmatics after initiation or up-titration of inhaled corticosteroids (ICS), compared to those with well-controlled asthma without ICS therapy. We found that children with uncontrolled asthma had inferior endothelial function compared to matched healthy controls. Enhancement in endothelial function, lung function and symptom control was observed in uncontrolled asthmatics after initiation or up-titration of inhaled corticosteroids (ICS). These results provided further evidence of a likely relationship between asthma control and cardiovascular health.

Development of Core Outcome Measures sets for paediatric and adult Severe Asthma (COMSA).

Effectiveness studies with biological therapies for asthma lack standardised outcome measures. The COMSA (Core Outcome Measures sets for paediatric and adult Severe Asthma) working group sought to develop Core Outcome Measures (COM) sets to facilitate better synthesis of data and appraisal of biologics in paediatric and adult asthma clinical studies. COMSA utilised a multi-stakeholder consensus process among patients with severe asthma, adult, and paediatric clinicians, pharmaceutical representatives and health regulators from across Europe. Evidence included a systematic review of development, validity, and reliability of selected outcome measures plus a narrative review and a pan-European survey to better understand patients' and carers' views about outcome measures. It was discussed using a modified GRADE Evidence to Decision framework. Anonymous voting was conducted using predefined consensus criteria. Both adult and paediatric COM sets include forced expiratory volume in 1 s (FEV1) as z scores, annual frequency of severe exacerbations and maintenance oral corticosteroid use. Additionally, the paediatric COM set includes the Paediatric Asthma Quality of Life Questionnaire, and Asthma Control Test (ACT) or Childhood-ACT while the adult COM includes the Severe Asthma Questionnaire and the Asthma Control Questionnaire-6 (symptoms and rescue medication use reported separately). This patient-centred collaboration has produced two COM sets for paediatric and adult severe asthma. It is expected that they will inform the methodology of future clinical trials, enhance comparability of efficacy and effectiveness of biological therapies, and help assess their socioeconomic value. COMSA will inform definitions of non-response and response to biological therapy for severe asthma.

The effect of Adenotonsillectomy on asthma control in preschool children with obstructive sleep apnea

The effect of Adenotonsillectomy on asthma control in preschool children with obstructive sleep apnea

Evaluation of fractional exhaled nitric oxide in school-age children with asthma and sensitization to cat allergens

bronchial asthma is a chronic condition that is considerably prevalent among children. According to scientific evidence, cat allergens are most frequently responsible for the onset of asthma manifestations in children. Children are more likely to develop atopic asthma with eosinophilic inflammation. Under these circumstances, specific biomarkers are used as indicators of this inflammation. Fractional exhaled nitric oxide has been identified as a marker of eosinophilic airway inflammation in asthma. The aim of the research was to determine the fractional exhaled nitric oxide concentrations in school-age children with bronchial asthma and sensitization to cat allergens in order to predict asthma control status and assess therapeutic response. A total of 430 children aged between 6 and 17 years with asthma and sensitization to cat allergens participated in the study. The sensitization profile was investigated using a multicomponent molecular allergy diagnostic test (ALEX², Austria). The fractional exhaled nitric oxide levels were evaluated (NIOX VERO, Sweden). A total of 302 patients were enrolled in a retrospective study to find out how likely they were to gain bronchial asthma control over the course of therapy. As a result, a one-factor logistic regression analysis was conducted. A total of 128 children were included in the 12-month prospective research. All patients had a rise in fractional exhaled nitric oxide of &gt; 20 ppb, with children with severe asthma having levels of 35 ppb or higher. The study discovered that changes in the fractional exhaled nitric oxide concentrations at the end of a three-month therapy could be linked to the maintenance of bronchial asthma control after a 12-month treatment period (r = 0.619; p &lt;0.001). After a year of therapy, increasing baseline fractional exhaled nitric oxide levels reduced the probability of establishing bronchial asthma control in children (OR &lt;1; p &lt;0.001). The dynamics of fractional exhaled nitric oxide reduction increased the probability of achieving bronchial asthma control after completion of a three-month therapy (OR&gt; 1; p &lt;0.001). The effect of allergen-specific immunotherapy on the specified indicator of eosinophilic inflammation was demonstrated by a statistically significant difference in the mean values of fractional exhaled nitric oxide after a 12-month treatment period in the group of patients who received allergen-specific immunotherapy in combination with controller therapy versus the group of patients who received only controller therapy (p = 0.012). Thus, among school-age children with asthma and sensitization to cat allergens, the levels of fractional exhaled nitric oxide increased, especially in severe asthma. Not only the baseline fractional exhaled nitric oxide levels but also their dynamics after a three-month therapy should be considered when predicting the probability of establishing asthma control in these children. The inclusion of allergen-specific immunotherapy in the complex treatment of bronchial asthma in school-age children with sensitization to cat allergens has been shown to have a favourable therapeutic effect on the fractional exhaled nitric oxide levels.

Effectiveness of eAsthmaCare on Symptoms, Childhood Asthma Control Test, and Lung Function among Asthmatic Children.

A web-based self-health management system-eAsthmaCare, was developed as an intervention for asthmatic children. A randomized controlled trial was performed. Consent was obtained for 98 children with asthma to participate in the study and the pre- and post-test data collection process. The experimental group was given access to eAsthmaCare online management, the control group was subjected to general asthma management. The experimental and control groups' asthma symptoms, Childhood Asthma Control Test (C-ACT) scores, and lung function were evaluated, and their pre- and 3-month post-test results were compared. The following records were maintained: (1) medication record (2) daily asthma symptoms log (3) monthly C-ACT and lung function records. The C-ACT results indicated a p-value of < .01 for: overall improvements to childhood asthma symptoms, time effect, group and time interaction effects, and group and time interaction effects in relation to sleeping condition on the previous day; cough symptom time effect, and group and time interaction effects; the two groups' time effect in relation to cough symptoms; the two groups' time effect in relation to monthly activity restrictions (number of days); and the two groups' time effect in relation to nasal symptoms; the two groups' time effect; and group and time interaction effects (p < .01). In terms of the predictive values for lung function (FVC, FEV1, PEFR), the improvements in both groups were not statistically significant. The implementation of the eAsthmaCare intervention might have a positive impact on pediatric patients, making it an effective management tool for monitoring asthmatic children's physical function and discomfort.

Childhood asthma control: Implications of current strategies in sub-Saharan Africa

Childhood asthma control: Implications of current strategies in sub-Saharan Africa