Study of the Major Risk Factors Associated with Bronchial Asthma in Children in Georgia

Abstract

Bronchial asthma is an important health problem worldwide. Identification of asthma risk factors is important in asthma management. A better study of risk factors provides an opportunity for primary prevention of asthma. Assessment of the symptoms, severity, and control of bronchial asthma in children living in different regions of Georgia, identification of the risk factors and their relationship to asthma severity, and asthma control.

Observational, cross-sectional study. Data were collected in 2017 - 2020 from M. Iashvili Children's Central Hospital, as well as from Batumi and Zugdidi Referral Hospitals. In the research participated 507 children aged 2 to 18 diagnosed with asthma. The research tool was a set of questionnaires consisting of the following questionnaires: 1) General questionnaire - a basic, general questionnaire that included information about the asthma of the participants; 2) The Pediatric Quality of Life Inventory TM (Peds QL), Asthma Module (Version 3.0, Short Form (SF 22)). Pediatric Quality of Life Inventory (Peds QL), Asthma Module (Version 3.0, Short Form (SF 22)); 3) The Peds QL Multidimensional Fatigue Scale; 4) The Peds QLTM Family Impact Module; 5) Asthma control test (ACT) or the childhood Asthma-Control Test (C-ACT);

Asthma severity and control are significantly associated with a genetic factor. Children whose mothers had bronchial asthma (31.6%) had a severe form of asthma, and children whose fathers had bronchial asthma made up 57.1%.

Being overweight is associated with both, asthma severity and asthma control. 1/3 of the overweight children had severe (18%) and moderate (12.6%) asthma. As for asthma control, 13.2% of the overweight patients had uncontrolled and 4.4% had partially controlled asthma.

In children with a smoking mother the incidence of a severe form of asthma is 6.25 times higher than in the case of a non-smoking mother. In smoking father, the incidence of severe asthma was 9.9 times higher than in the case of a non-smoking father. 33.7% of children of smoking mothers and 19% of smoking fathers were diagnosed with severe forms of asthma. As for asthma control, 17.3% of the children of smoking mothers had uncontrolled asthma, while the children of smoking fathers made up 16, 15%.

41.3 % had severe asthma with concomitant allergic diseases (4.9% of children with concomitant allergic rhinitis, 14.7% with food allergies, and 21.7% with mixed allergies). Uncontrolled forms were most often detected in children with concomitant mixed allergies (30.4%).

Home humidity, type of flooring, and type of fuel used were also associated with asthma severity and its control; the presence of dampness was strongly correlated with both severe forms of asthma as well as poor control. The presence of carpet was associated with more severity than control, and the presence of linoleum was associated with both severity and control. Severe asthma was correlated with firewood use.

Severe and uncontrolled forms of asthma were correlated with family income as well as parental education. Child asthma is a family burden; 100% of the parents of the participants said that they had difficulties in the family due to the child's asthma, such as anxiety and depressive mood (63%), financial (12%), and other difficulties (25%).

Finally; Identification of risk factors plays an important role in controlling asthma. Correctly managed bronchial asthma ensures a reduction in the impact of asthma on the quality of life of both the child and the entire family.