Background
Methods
Study design
Study population
Guidelines
Ethics
Variables
-
Socio-demographic variables: age, sex, Body Mass Index (BMI), marital status, number of children, residence, educational level, occupation and health insurance.
-
Environmental and clinical variables: season of consultation, reasons of visit, duration of asthma, family history of asthma, active and passive smoking, presence or absence of concomitant diseases, co-morbidities (rhinitis, allergic conjunctivitis, gastroesophageal reflux (GERD), respiratory infections), nocturnal awakenings, number of crisis, symptoms during 3 previous months (expectoration, wheezing, dyspnea, nocturnal coughing), presence or absence of allergies, lung function, and adherence to treatment.
Statistical analysis
Results
Profile of patients with asthma
Socio-demographiccharacteristics
All | Controlled | Partly controlled | Uncontrolled |
p-value
| |
---|---|---|---|---|---|
n = 396 | n = 211(53%) | n = 72(18%) | n = 113(29%) | ||
Age, n(%) |
.005*
| ||||
[18–39] years | 162(42.0) | 69(42.6) | 39(24.1) | 54(33.3) | |
[40–64] years | 198(51.3) | 120(60.6) | 27(13.6) | 51(25.8) | |
> 64 years | 26(6.7) | 17(65.4) | 2(7.7) | 7(26.9) | |
Female gender, n(%) | 266(67.3) | 139(52.3) | 44(16.5) | 83(31.2) | .191 |
BMI, km/m2, n(%) | .304 | ||||
Normal weight or underweight (BMI < 25) | 99(45.8) | 60(60.6) | 15(15.2) | 24(24.2) | |
Overweight (BMI [25–30]) | 69(31.9) | 34(49.3) | 15(21.7) | 20(29.0) | |
Obesity (BMI > 30) | 48(22.2) | 33(68.8) | 6(12.5) | 9(18.8) | |
Married, n(%) |
.025*
| ||||
No | 90(23.3) | 37(41.1) | 22(24.4) | 31(34.4) | |
Yes | 296(76.7) | 168(56.8) | 46(15.5) | 82(27.7) | |
Number of children, n(%) |
.002*
| ||||
≤2 children | 147(45.2) | 67(45.6) | 30(20.4) | 50(34.0) | |
> 2 children | 178(54.8) | 116(65.2) | 25(14.0) | 37(20.8) | |
Place of residence, n(%) | .544 | ||||
Large town | 317(85.4) | 175(55.2) | 52(16.4) | 90(28.4) | |
Small town | 44(11.9) | 22(50.0) | 9(20.5) | 13(29.5) | |
Village | 10(2.7) | 3(30.0) | 3(20.0) | 4(40.0) | |
Educational level, n(%) | .113 | ||||
Secondary education or University | 94(30.3) | 42(44.7) | 18(19.1) | 34(36.2) | |
No scooling or primary school | 216(69.7) | 123(56.9) | 37(17.1) | 56(25.9) | |
Habitual activity, n(%) | .712 | ||||
Activelyemployed | 94(26.4) | 48(51.1) | 18(19.1) | 28(29.8) | |
Retired | 23(6.5) | 15(65.2) | 4(17.4) | 4(17.4) | |
Housework | 221(62.1) | 126(57.0) | 32(14.5) | 63(28.5) | |
Student | 18(5.1) | 8(44.4) | 4(22.2) | 6(33.3) | |
Social Health insurance, n(%) |
.000*
| ||||
No | 92(23.6) | 28(30.4) | 24(26.1) | 40(43.5) | |
Yes | 298(76.4) | 180(60.4) | 47(15.8) | 71(23.8) |
Environmental and clinical factors
All | Controlled | Partly controlled | Uncontrolled |
p-value
| |
---|---|---|---|---|---|
n = 396 | n = 211 | n = 72 | n = 113 | ||
Season of consultation, n(%) | .280 | ||||
Summer | 69(17.5) | 44(63.8) | 10(14.5) | 15(21.7) | |
Automn | 129(32.7) | 62(48.1) | 26(20.2) | 41(31.8) | |
Winter | 155(39.3) | 82(52.9) | 25(16.1) | 48(31.0) | |
Spring | 41(10.4) | 21(51.2) | 11(26.8) | 9(22.0) | |
Reasons of the current visit, n(%) |
.000*
| ||||
A follow-up visit | 348(87.9) | 208(59.8) | 60(17.2) | 80(23.0) | |
Aggravation of asthma | 48(12.1) | 3(6.2) | 12(25.0) | 33(68.8) | |
History of asthma, mean(±SD) | 11.4(±9.7) | 12(±9.9) | 10(±9.5) | 11(±9.5) | .331 |
Family history of asthma, n(%) | .514 | ||||
None | 226(58.2) | 115(50.9) | 42(18.6) | 69(30.5) | |
Yes (parents, grandparents, uncles and aunts) | 162(41.8) | 92(56.8) | 26(16.0) | 44(27.2) | |
Smoking habits, n(%) |
.031*
| ||||
Never smoker | 327(83.4) | 166(50.8) | 57(17.4) | 104(31.8) | |
Active smoker | 35(8.9) | 21(60.0) | 9(25.7) | 5(14.3) | |
Ex-smoker | 30(7.7) | 22(73.3) | 4(13.3) | 4(13.3) | |
Passive smoking, n(%) | .881 | ||||
No | 144(39.5) | 77(53.3) | 27(18.8) | 40(27.8) | |
Yes | 221(60.5) | 120(54.3) | 37(16.7) | 64(29.0) | |
Concomitant diseases, n(%) |
.001*
| ||||
No | 136(34.4) | 89(65.4) | 21(15.4) | 26(19.1) | |
Yes | 259(65.6) | 121(46.7) | 51(19.7) | 87(33.6) | |
Co-morbidities, n(%) | |||||
Rhinitis | 221(59.7) | 109(49.3) | 44(19.9) | 68(30.8) |
.045*
|
Allergic conjunctivitis | 165(44.6) | 78(47.3) | 34(20.6) | 53(32.1) |
.039*
|
Gastroesophageal Reflux Disease | 38(9.6) | 12(31.6) | 8(21.1) | 18(47.4) |
.011*
|
Respiratory Infections | 65(16.5) | 13(20.0) | 18(27.7) | 34(52.3) |
.000*
|
Waking during the night, n(%) |
.000*
| ||||
No | 254(65.3) | 205(80.7) | 18(7.1) | 31(12.2) | |
Yes | 135(34.7) | 0(0.0) | 53(39.3) | 82(60.7) | |
Number of crisis, n(%) |
.000*
| ||||
≤2/week | 276(70.6) | 208(75.4) | 55(19.9) | 13(4.7) | |
> 2/week | 115(29.4) | 0(0.0) | 16(13.9) | 99(86.1) | |
Symptoms during 3 previous months | |||||
Expectoration | 29(7.3) | 0(0.0) | 7(24.1) | 22(75.9) |
.000*
|
Wheezing | 92(72.4) | 0(0.0) | 36(39.1) | 56(60.9) |
.016*
|
Dyspnea | 109(27.5) | 0(0.0) | 38(34.9) | 71(65.1) |
.000*
|
Nocturnal coughing | 69(55.2) | 0(0.0) | 26(37.7) | 43(62.3) | .283 |
Allergy to, n(%) | |||||
Dust | 295(76.8) | 153(51.9) | 56(19.0) | 86(29.2) | .199 |
Animals | 76(19.8) | 29(38.2) | 18(23.7) | 29(38.2) |
.008*
|
Mold | 233(60.7) | 123(52.8) | 41(17.6) | 69(29.6) | .767 |
Pollen | 121(31.6) | 57(47.1) | 24(19.8) | 40(33.1) | .157 |
Smoke | 20(5.1) | 9(45.0) | 6(30.0) | 5(25.0) | .375 |
Medication | 40(10.1) | 25(62.5) | 3(7.5) | 12(30.0) | .168 |
Certain foods | 49(14.2) | 25(51.0) | 6(12.2) | 18(36.7) | .333 |
Season variation | 89(22.5) | 50(56.2) | 11(12.4) | 28(31.5) | .260 |
Other cause of crisis, n(%) | |||||
Stressful event | 8(2.0) | 4(50.0) | 2(25.0) | 2(25.0) | .879 |
Emotion | 2(0.5) | 0(0.0) | 0(0.0) | 2(100.0) | .081 |
Effort | 16(4.1) | 6(37.5) | 3(18.8) | 7(43.8) | .348 |
Pulmonary function testing (FEV), n(%) | .377 | ||||
FEV < 80% | 29(64.4) | 16(55.2) | 7(24.1) | 6(20.7) | |
FEV ≥80% | 16(35.6) | 6(37.5) | 7(43.8) | 3(18.8) | |
Adherence to treatment, n(%) | .488 | ||||
No | 12(3.0) | 6(50.0) | 1(8.3) | 5(41.7) | |
Yes | 384(97.0) | 205(53.4) | 71(18.5) | 108(28.1) |
Factors associated with asthma control
Univariate analysis
Unadjusted OR | 95% CI |
p-value
| |
---|---|---|---|
1. Socio-demographic factors | |||
Age (Referenta: [18–39]) | .008 | ||
[40–64] years | 0.55 | [0.37–0.83] |
.004*
|
> 64 years | 0.48 | [0.20–1.11] | .085 |
Sex (Referenta: male) | 1.23 | [0.82–5.00] | .312 |
BMI (Referenta: normal weight or underweight) | .131 | ||
Overweight | 1.47 | [0.81–2.63] | .204 |
Obesity | 0.70 | [0.34–1.43] | .327 |
Married | 0.61 | [0.39–0.95] |
.029*
|
Number of children (Referenta: ≤2) | 0.47 | [0.30–0.71] |
.000*
|
Place of residence (Referenta: large town) | .384 | ||
Small town | 1.17 | [0.64–2.13] | .618 |
Village | 2.14 | [0.66–7.14] | .207 |
Educational level (Referenta:secondaryor university) | 0.61 | [0.39–0.97] |
.037*
|
Occupation (Referenta: actively employed) | .483 | ||
Retired | 0.55 | [0.22–1.39] | .209 |
Housework | 0.84 | [0.53–1.33] | .453 |
Student | 1.24 | [0.48–3.23] | .656 |
Health insurance | 0.34 | [0.22–0.53] |
.000*
|
2. Environmental and clinical factors | |||
Season of consultation(Referenta: summer) | .218 | ||
Automn | 1.83 | [1.03–3.23] |
.040*
|
Winter | 1.60 | [0.91–2, 78] | .103 |
Spring | 1.44 | [0.67–3.03] | .349 |
History of asthma | 0.99 | [0.97–1.01] | .267 |
Family history of asthma | 0.81 | [0.55–1.19] | .283 |
Smoking habits(Referenta: never smoker) |
.015*
| ||
Active smoker | 0.59 | [0.29–1.19] | .140 |
Ex-smoker | 0.36 | [0.16–0.83] |
.017*
|
Passive smoking | 1.00 | [0.67–1.5] | .993 |
Concomitant diseases | 2.15 | [1.43–3.23] |
.000*
|
Co-morbidities | |||
Rhinitis | 1.66 | [1.11–2.5] |
.014*
|
Allergic conjunctivitis | 1.65 | [1.11–2.44] |
.013*
|
Gastroesophageal reflux | 2.56 | [1.37–4.76] |
.003*
|
Respiratory Infections | 4.21 | [2.50–7.14] |
.000*
|
Allergy to: | |||
Dust | 1.40 | [0.88–2.22] | .161 |
Animals | 2.01 | [1.25–3.23] |
.004*
|
Mold | 1.16 | [0.78–1.72] | .469 |
Pollen | 1.47 | [0.97–2.22] | .066 |
Season variation | 0.96 | [0.61–1.52] | .862 |
Adherence to treatment | 0.71 | [0.24–2.08] |
.042*
|
Multivariate analysis
Adjusted OR | 95% CI |
p-value
| |
---|---|---|---|
1. Socio-demographic factors | |||
Age (Referenta: [18–39]) | |||
[40–64] years | 0.75 | [0.38–1.49] | .414 |
> 64 years | 0.77 | [0.21–2.76] | .683 |
Married | 2.37 | [0.63–8.85] | .201 |
Number of children (Referenta: ≤2) | 0.47 | [0.24–0.93] |
.030*
|
Educational level (Referenta: secondary or university) | 0.50 | [0.24–1.04] | .064 |
Health insurance | 0.41 | [0.18–0.93] |
.033*
|
2. Environmental and clinical factors | |||
Smoking (Referenta: never smoker) | |||
Active smoker | 0.51 | [0.19–1.39] | .191 |
Ex smoker | 0.50 | [0.16–1.60] | .242 |
Concomitant diseases | 3.36 | [0.99–11.34] |
.050*
|
Co-morbidities | |||
Rhinitis | 0.84 | [0.29–2.45] | .756 |
Allergic conjunctivitis | 1.00 | [0.49–2.03] | 1.00 |
Gastroesophageal Reflux Disease | 1.83 | [0.70–4.82] | .219 |
Respiratory Infections | 5.71 | [2.39–13.63] |
.000*
|
Allergy to animals | 2.76 | [1.36–5.59] |
.005*
|
Adherence to treatment | 0.07 | [0.01–0.98] |
.049*
|