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Respir Med. 2014 Oct;108(10):1446-52. doi: 10.1016/j.rmed.2014.07.007. Epub 2014 Jul 22.

Respiratory tract infections and asthma control in children.

Author information

1
Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Lundlaan 6, 3508 AB Utrecht, The Netherlands. Electronic address: k.zomer-kooijker@umcutrecht.nl.
2
Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands.
3
Department of Paediatric Pulmonology and Allergology, University Medical Centre Utrecht, Lundlaan 6, 3508 AB Utrecht, The Netherlands.
4
Utrecht Institute for Pharmaceutical Sciences, Division of Pharmacoepidemiology & Clinical Pharmacology, David de Wied Building, Universiteitsweg 99, 3584 CG Utrecht, The Netherlands.
5
St. Antonius Hospital, Department of Paediatrics, Postbus 2500, 3430 EM Nieuwegein, The Netherlands.
6
Tergooi Hospital, Department of Paediatrics, Rijksstraatweg 1, 1261 AN Blaricum, The Netherlands.
7
Meander Medisch Centrum, Department of Paediatrics, Postbus 1502, 3800 BM Amersfoort, The Netherlands.

Abstract

INTRODUCTION:

Asthma control is considered the major goal of asthma management, while many determinants of control are difficult to modify. We studied the association between respiratory infection episodes (RTIs) of various types and asthma control.

METHODS:

Cross-sectional data were used from children aged 4-18 years with physician-diagnosed asthma who participated in a web-based electronic portal for children with asthma, allergies or infections. Asthma control was measured using the Childhood Asthma Control Test (C-ACT) or the Asthma Control Test (ACT). Linear regression was used to analyse the association between categories of numbers of various types of RTIs sustained in the preceding 12 months (categorized) and asthma control, adjusted for potential confounders.

RESULTS:

Asthma control was assessed in 654 children, and 68.5% were clinically well controlled (ACT ≥ 20). Higher total numbers of RTIs in the last 12 months were strongly associated with a lower level of asthma control (p(trend) < 0.001). Similarly strong statistically significant associations were found for subtypes of RTI: ≥4 vs. 0 otitis episodes: coefficient -1.7 (95% CI -3.3 to -0.2); ≥5 vs.0 colds: coefficient -2.3 (95% CI -3.0 to -1.6); ≥3 vs. 0 bronchitis episodes: coefficient -3.1 (95% CI -4.0 to -2.3), each with p(trend) < 0.05.

CONCLUSION:

Higher numbers of reported respiratory tract infections are associated with lower level of asthma control. The different type of respiratory tract infections contribute equally to less controlled asthma.

KEYWORDS:

Asthma; Bronchitis; Children; Control; Otitis; Respiratory tract infections

PMID:
25087902
DOI:
10.1016/j.rmed.2014.07.007
[Indexed for MEDLINE]
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