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Asthma control in children is associated with nasal symptoms, obesity, and health insurance: a nationwide survey
Author(s) -
FerreiraMagalhães Manuel,
Pereira Ana Margarida,
SaSousa Ana,
MoraisAlmeida Mário,
Azevedo Inês,
Azevedo Luís Filipe,
Fonseca João Almeida
Publication year - 2015
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12395
Subject(s) - medicine , asthma , overweight , obesity , pediatrics , population , logistic regression , environmental health
Background This study aimed to estimate the prevalence of asthma control and determinants of poor control in the Portuguese pediatric population (<18 years); secondarily, we described asthma‐related healthcare services and medication use. Methods Data of 98 children with current asthma, from the second phase of a nationwide population‐based telephone survey ( INA sma study), were analyzed. Asthma control definition was based on GINA criteria, grouping partially controlled and uncontrolled asthma as ‘not‐controlled asthma’ ( NCA ). We used multivariate logistic regression to study factors associated with NCA and with unscheduled medical visits for asthma. Results About half of the children had NCA (49%, 95% CI 39–59%). In the multivariate model, risk factors for NCA were as follows: substantial nasal symptoms ( a OR 6.80), overweight/obesity ( a OR 3.44), and not having health insurance ( a OR 3.78). All the children with NCA had nasal symptoms, and the lack of asthma control was also associated with the increasing number of nasal symptoms (p < 0.001). In the previous year, 90% (95% CI 84–96%) of children with current asthma had healthcare visits and 67% (95% CI 58–77%) used medication for asthma. The risk of unscheduled medical visits was higher in children with nasal symptoms ( a OR 3.63) and in those without health insurance ( a OR 2.79), and lower in adolescents ( a OR 0.19). Conclusions Half of the children with asthma were poorly controlled. Nasal symptoms and obesity are important determinants of asthma control. Children without health insurance are at greater risk of poor asthma outcomes; this association is reported for the first time in a European country.