Predictors of Asthma Control among Libyan Adolescents with Persistent Asthma

Main Article Content

Nadya Mohamed Elfeturi Elarusy
Shamsul Bahri Mohd Tamrin
Munn Sann Lye
Siti Irma Fadhillah Ismail

Abstract

Introduction: Among adolescents, asthma is an important public health burden that is associated with high morbidity and mortality. Poor asthma control is likely in this age group. Our aim was to identify the predictors of well con- trolled asthma among adolescents with persistent asthma in Northwest of Libya. Methods: A sample of 92 adoles- cents with persistent asthma were recruited from the respiratory clinic in Sabratha Teaching Hospital, and completed questionnaires measuring demographic and clinical characteristics, asthma knowledge, self-efficacy, and asthma control. Logistic regression analysis was carried out, taking the asthma control as the dependent variable. Results: Twenty-four percent of participants had well controlled asthma. In a bivariate analysis, well controlled asthma was significantly associated with adolescents having mild persistent asthma, not having allergic rhinitis, using preventive inhalers regularly, reporting higher level asthma knowledge, and higher self-efficacy. However, in multiple logistic model, only self-efficacy was an independent predictor of asthma control, with higher self-efficacy associated with well-controlled asthma (Adjusted OR= 1.107, 95% CI: 1.012 – 1.210, p= 0.026). Conclusion: Identifying and tar- geting modifiable predictors of well controlled asthma could improve asthma control. In adolescents with asthma, enhancing self-confidence of adolescents to undertake health behaviour modification seems to be an important step toward a better asthma control.

Downloads

Download data is not yet available.

Article Details

How to Cite
Mohamed Elfeturi Elarusy, N., Mohd Tamrin, S. B., Lye, M. S., & Ismail, S. I. F. (2023). Predictors of Asthma Control among Libyan Adolescents with Persistent Asthma. Malaysian Journal of Medicine and Health Sciences, 19(1), 224–231. https://doi.org/10.47836/mjmhs.19.1.30
Section
Original Articles

References

Adeloye D, Chan KY, Rudan I, Campbell H. An estimate of asthma prevalence in Africa: a systematic analysis. Croatian medical journal. 2013;54(6):519-31. doi: 10.3325/cmj.2013.54.519

Lai CK, Beasley R, Crane J, Foliaki S, Shah J, Weiland S, ISAAC Phase Three Study Group. Global variation in the prevalence and severity of asthma symptoms: phase three of the International Study of Asthma and Allergies in Childhood (ISAAC). Thorax. 2009;64(6):476-83. doi:10.1136/ thx.2008.106609

To T, Stanojevic S, Moores G, Gershon AS, Bateman ED, Cruz AA, et al. Global asthma prevalence in adults: Findings from the cross-sectional world health survey. BMC public health. 2012;12(1):1-8. doi:10.1186/1471-2458-12-204

Iesa MA, Awooda HA, Konozy EH, Musa OA. Wheezing alone is not enough to validate asthma diagnosis among Libyan adults: A questionnaire- based study reinforced with pulmonary function test. Sudan Medical Monitor. 2017;12(1):25-29. doi:10.4103/summ.summ_12_17

Nafti S, Taright S, El Ftouh M, Yassine N, Benkheder A, Bouacha H, et al. Prevalence of asthma in North Africa: the Asthma Insights and Reality in the Maghreb (AIRMAG) study. Respiratory medicine. 2009;103:S2-11. doi:10.1016/S0954- 6111(09)70022-8

Reddel HK, Bateman ED, Becker A, Boulet LP, Cruz AA, Drazen JM, et al. A summary of the new GINA strategy: A roadmap to asthma control. European Respiratory Journal. 2015;46(3):622-39. doi: 10.1183/13993003.00853-2015

Demoly P, Paggiaro P, Plaza V, Bolge SC, Kannan H, Sohier B, et al. Prevalence of asthma control among adults in France, Germany, Italy, Spain and the UK. European Respiratory Review. 2009;18(112):105-112. doi: 10.1183/09059180.00001209

Thompson PJ, Salvi S, Lin J, Cho YJ, Eng P, Abdul Manap R, et al. Insights, attitudes and perceptions about asthma and its treatment: Findings from a multinational survey of patients from 8 Asia- Pacific countries and Hong Kong. Respirology. 2013;18(6):957-967. doi:10.1111/resp.12137

Nathan RA, Thompson PJ, Price D, Fabbri LM, Salvi S, González-Díaz S, et al. Taking aim at asthma around the world: global results of the asthma insight and management survey in the Asia- Pacific region, Latin America, Europe, Canada, and the United States. The Journal of Allergy and Clinical Immunology: In Practice. 2015;3(5):734-42. doi:10.1016/j.jaip.2015.04.013

Sadof M, Kaslovsky R. Adolescent asthma: a developmental approach. Current opinion in pediatrics. 2011;23(4):373-8. doi: 10.1097/ MOP.0b013e32834837cb

Asher I, Pearce N. Global burden of asthma among children. The international journal of tuberculosis and lung disease. 2014;18(11):1269-78. doi: 10.5588/ijtld.14.0170

Rhee H, Wicks MN, Dolgoff JS, Love TM, Harrington D. Cognitive factors predict medication adherence and asthma control in urban adolescents with asthma. Patient preference and adherence. 2018;12:929-937. doi: 10.2147/PPA.S162925

Ayala GX, Yeatts K, Carpenter DM. Brief report: Factors associated with asthma management self- efficacy among 7th and 8th grade students. Journal of paediatric psychology. 2009;34(8):862-868. doi:10.1093/jpepsy/jsn134

Naimi DR, Freedman T, Ginsburg KR, Bogen D, Apter AJ. Adolescents and Asthma: Why Bother with Our Meds?. Journal of Allergy and Clinical Immunology. 2009;123(6):1335-1341. doi:10.1016/j.jaci.2009.02.022

Van der Meer V, Van Stel HF, Detmar SB, Otten W, Sterk PJ, Sont JK. Internet-based self-management offers an opportunity to achieve better asthma control in adolescents. Chest. 2007;132(1):112-119. doi:10.1378/chest.06-2787

Rhee H, Belyea MJ, Ciurzynski S, Brasch J. Barriers to asthma self-management in adolescents: Relationships to psychosocial factors. Pediatric pulmonology. 2009;44(2):183-91. doi:10.1002/ ppul.20972

Akinbami LJ, Moorman JE, Garbe PL, Sondik EJ. Status of childhood asthma in the United States, 1980–2007. Pediatrics. 2009;123(3):S131-45. doi:10.1542/peds.2008-2233C

Hennessy-Harstad E. Asthma and adolescents: review of strategies to improve control. The Journal of School Nursing. 2013;29(1):39-51. doi:10.1177/1059840512454546

Braido F. Failure in asthma control: reasons and consequences. Scientifica. 2013; 2013:1-15. doi:10.1155/2013/549252

Fehrenbach H, Wagner C, Wegmann M. Airway remodelling in asthma: what really matters. Cell and tissue research. 2017;367(3):551-569. doi:10.1007/s00441-016-2566-8

Lemeshow, S., Hosmer, D. W., Klar, J., Lwanga, S. K., & World Health Organization. (1990). Adequacy of sample size in health studies. West Sussex P019 1 UD, England: John Wiley & Sons

National Heart, Lung, and Blood Institute. National Asthma Education and Prevention Program. (2007). Expert panel report 3: Guidelines for the diagnosis and management of asthma. Retrieved from:https:// www.nhlbi.nih.gov/files/docs/guidelines/asthgdln. pdf

Juniper EF, O’Byrne PM, Guyatt GH, Ferrie PJ, King DR. Development and validation of a questionnaire to measure asthma control. European respiratory journal. 1999;14(4):902-7. doi: 10.1034/j.1399- 3003.1999.14d29.x

Juniper EF, O’Byrine PM, Roberts JN. Measuring asthma control in group studies: do we need airway calibre and rescue β2-agonist use?. Respiratory medicine. 2001;95(5):319-323. doi:10.1053/ rmed.2001.1034

O’Byrne PM, Reddel HK, Eriksson G, Östlund O, Peterson S, Sears MR, Jenkins C, Humbert M, Buhl R, Harrison TW, Quirce S. Measuring asthma control: a comparison of three classification systems. European Respiratory Journal. 2010;36(2):269-76. doi: 10.1183/09031936.00124009

Rhee H, Love T, Mammen J. Comparing asthma control questionnaire (ACQ) and national asthma education and prevention program (NAEPP) asthma control criteria. Annals of Allergy, Asthma & Immunology. 2019;122(1):58-64. doi:10.1016/j. anai.2018.09.448

Hallit S, Raherison C, Waked M, Salameh P. Validation of asthma control questionnaire and risk factors affecting uncontrolled asthma among the Lebanese children’s population. Respiratory medicine. 2017;122:51-57. doi:10.1016/j. rmed.2016.11.018

Fitzclarence CA, Henry RL. Validation of an asthma knowledge questionnaire. Journal of paediatrics and child health. 1990;26(4):200-4. doi:10.1111/j.1440-1754.1990.tb02429.x

Espinosa L, AM SS. The Spanish version of the Newcastle Asthma Knowledge Questionnaire for parents of children with asthma (NAKQ). Transcultural adaptation and reliability analysis. In Anales De Pediatria (Barcelona, Spain: 2003) 2009:70 (3): 209-217. doi: 10.1016/j.anpedi.2008.10.013

Bursch B, Schwankovsky L, Gilbert J, Zeiger R. Constructionandvalidationoffourchildhoodasthma self-management scales: parent barriers, child and parent self-efficacy, and parent belief in treatment efficacy. Journal of Asthma. 1999;36(1):115-28. doi:10.3109/02770909909065155

World Health Organization. (2013). Process of translation and adaptation of instruments. Retrieved from http://www.who. int/substance_ abuse/research_tools/translation/en/.

Tabachnick BG, Fidell LS. Using multivariate statistics, 6th (ed.), 2013, Boston, MA.

Lavoie KL, Bouchard A, Joseph M, Campbell TS, Favreau H, Bacon SL. Association of asthma self-efficacy to asthma control and quality of life. Annals of Behavioral Medicine. 2008;36(1):100-6. doi:10.1007/s12160-008-9053-8

Wood MR, Price JH, Dake JA, Telljohann SK, Khuder SA. African American parents’/guardians’ health literacy and self-efficacy and their child’s level of asthma control. Journal of pediatric nursing. 2010;25(5):418-27. doi:10.1016/j. pedn.2009.05.003

Yawn BP, Rank MA, Bertram SL, Wollan PC. Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from The Asthma Tools Study. NPJ primary care respiratory medicine. 2015;25(1):1-7. doi:10.1038/ npjpcrm.2015.58

Harris K, Mosler G, Williams SA, Whitehouse A, Raine R, Grigg J. Asthma control in London secondary school children. Journal of Asthma. 2017;54(10):1033-40. doi:10.1080/02770903.2017.1299757

Stanford RH, Gilsenan AW, Ziemiecki R, Zhou X, Lincourt WR, Ortega H. Predictors of uncontrolled asthma in adult and pediatric patients: analysis of the Asthma Control Characteristics and Prevalence Survey Studies (ACCESS). Journal of Asthma. 2010;47(3):257-62. doi:10.3109/02770900903584019

Vandenplas O, Dramaix M, Joos G, Louis R, Michils A, Verleden G, Vincken W, Vints AM, Herbots E, Bachert C. The impact of concomitant rhinitis on asthma-related quality of life and asthma control. Allergy. 2010; 65(10):1290-7. doi:10.1111/j.1398- 9995.2010.02365.x

Rege S, Kavati A, Ortiz B, Mosnaim G, Cabana MD, Murphy K, Aparasu RR. Documentation of asthma control and severity in pediatrics: analysis of national office-based visits. Journal of Asthma. 2020;57(2):205-16. doi:10.1080/02770903.2018.1554069

Dalcin PD, Menegotto DM, Zanonato A, Franciscatto L, Soliman F, Figueiredo MD, Pereira RP. Factors associated with uncontrolled asthma in Porto Alegre, Brazil. Brazilian Journal of Medical and Biological Research. 2009;42(11):1097-103. doi: 10.1590/S0100-879X2009005000035