Children with bronchial asthma assessed for psychosocial problems in a teaching hospital in Nigeria

Prevalence and determinants of psychosocial disorders in children and adolescents with asthma in Enugu, Nigeria: a comparative cross-sectional study

Objective: Like most chronic illnesses, childhood asthma has a significant impact on the child's overall psychosocial well-being. Psychosocial disorders occur in children with uncontrolled asthma making their asthma control more difficult. We aimed to determine the prevalence and determinants of psychosocial disorders in children and adolescents with asthma.Methods: A comparative cross-sectional study of children and adolescents (aged 6 to 17 years with and without asthma) was conducted in a Nigerian tertiary health facility. The Revised Children Manifest Anxiety Scale (RCMAS) and Centre for Epidemiological Studies-Depression Scale for Children (CES-DC) were used to screen for anxiety and depression respectively.Results: A total of 190 (95 asthma and 95 non-asthma) children were studied. Anxiety occurred in 15 (15.8%) of asthma and four (4.2%) of non-asthma children, OR 95% CI =4.3 (1.4-13.4). Forty-five (47.4%) of asthma and 32 (33.7%) of non-asthma children had depression (OR 95% CI =1.8 (0.9-3.2). Asthma was significantly associated with social problems, difficulty in making friends (OR 95% CI =58.5 (3.5-979.9); restriction from daily activities (OR 95% CI =34.0 (2.0-578.5); stigma from peers (OR 95% CI =18.6 (1.1-326.2); and strengthened and overprotective relationship with parents, (OR 95% CI =26.0 (1.5-447.8). Poor asthma control was significantly associated with restriction from play, OR (95%CI) = 0.12 (0.04-0.32); anxiety, OR 95%CI =18.26 (3.80-87.76) and depression, OR 95%CI =4.57 (1.85-11.33).Conclusion: Children with asthma are more prone to psychosocial disorders than their non-asthma counterparts. Poor asthma control influenced the psychosocial well-being of children with asthma negatively.

Relation of Asthma Control with Quality of Life among a Sample of Egyptian Asthmatic School Children

BACKGROUND:

Asthma is considered a chronic health illness that not only resulted in physical symptoms but also emotional effects. It is; therefore, so important to assess the quality of life of asthmatic patients besides their level of disease control.

AIM:

To determine the correlation of asthma control with the health-related quality of life (HRQOL) of asthmatic children in Egypt.

METHODS:

One hundred and twenty-eight asthmatic Egyptian children were enrolled in the study. They were subjected to asthma severity grading, asthma control questionnaire (ACQ) and pediatric asthma quality of life questionnaire (PAQLQ). Studied cases were taken from 6 primary and preparatory schools, Giza governorate.

RESULTS:

The mean child control score was significantly higher in not well-controlled asthmatics compared to well-controlled asthmatics (p < 0.005). The not well controlled asthmatic children showed significantly lower activity limitation score, symptoms score, and overall asthmatic score compared to controlled asthmatic children (p < 0.05). The severity of asthma shows significant positive correlation with symptoms score, emotional function score and overall asthmatic score (p < 0.05).

CONCLUSION:

The quality of life for the asthmatic children is strongly correlated with the level of asthma control and severity.

Correlation Between Fractional Exhaled Nitric Oxide Levels and Efficacy of Inhaled Corticosteroids in Children With Bronchial Asthma

To investigate correlation between fractional exhaled nitric oxide (FeNO) levels and efficacy of inhaled corticosteroids in children with bronchial asthma. Between October 2013 and December 2014, 133 cases of children with bronchial asthma were randomly divided into the glucocorticoid group (n = 67; inhaled with Seretide/Pulmicort) and the nonglucocorticoid group (n = 66; inhaled with short-acting β2 receptor agonist if needed); and alternatively 72 cases of healthy children were regarded as the control group. FeNO, forced expiratory volume in 1 second to predicted value, forced expiratory volume in 1 second/forced vital capacity, induced sputum eosinophils (EOS)%, and total serum immunoglobulin (Ig) E and serum EOS% were detected and childhood asthma control test (C-ACT) scale was investigated pretreatment and 3 and 6 months posttreatment, respectively. FeNO levels, induced sputum EOS%, total serum IgE, and serum EOS% were significantly lower, whereas forced expiratory volume in 1 second to predicted value, forced expiratory volume in 1 second/forced vital capacity, and C-ACT scores were obviously improved in the glucocorticoid group 6 months posttreatment compared with those of pretreatment (all P < 0.05). FeNO levels, induced sputum EOS%, and total serum IgE were significantly lower, whereas C-ACT scores were significantly higher in the glucocorticoid group compared with those of the nonglucocorticoid group (all P < 0.05). In the glucocorticoid group, induced sputum EOS% and total serum IgE showed significantly positive correlations with FeNO levels (r = 0.73, P < 0.01; r = 0.56, P < 0.01), whereas C-ACT scores were negatively correlated with FeNO levels (r = -0.67, P < 0.01). FeNO levels might be correlated with efficacy of inhaled corticosteroids in children with bronchial asthma.

The Relation between Asthma Control and Quality of Life in Children

BACKGROUND

Asthma is a common chronic illness worldwide. Asthmatic children are forced to alter their way of living to avoid its complications or exacerbations, which negatively affects their psychological and social well-being. High prevalence of behavioral and emotional difficulties was noticed among children with asthma.

METHODS

Cross-sectional study that was conducted over 8 months involving asthmatic children within the ages of 7-17 years presenting to two governmental hospitals in Jeddah, Saudi Arabia. Three questionnaires were used: asthma control test, the strengths and difficulties questionnaire, and the pediatrics asthma quality of life questionnaire. Using SPSS, Pearson's chi-square and independent sample t-tests were used to find associations.

RESULTS

Among the 106 respondents, 84% of the sample had poor asthma control. Significantly poorer quality of life was observed in children with uncontrolled asthma (p = <0.001). Children with controlled and uncontrolled asthma were equally affected psychosocially with no relation between asthma control and their psychosocial well-being (p = 0.58).

CONCLUSION

The majority of asthmatic children were uncontrolled with poor quality of life. This study recommends that the psychosocial well-being should be assessed during clinic visits for a better holistic approach and effective improvement of outcome. Further researches are needed to study the psychological effect of asthma.