Asthma in Pediatrics: A Biopsychosocial Analysis of Factors Influencing Control in Northwest Mexico

Background: Asthma is a chronic disorder of airways in which many factors play a major role. Chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent episodes of wheezing, dyspnea, chest tightness and coughing. Asthma treatment requires a therapeutic intervention developed between doctor, patient and family. Aim: So the purpose of this study is to determinate factors associated with asthma uncontrolled in pediatric patients in Northwest México. Design and Setting: Comparative cross-sectional study. Methods: In 116 pediatric patients with asthma in the Regional General Hospital #1, Cd. Obregon, Sonora, Mexico. There were two groups (controlled and uncontrolled) based on asthma control questionnaire (CAN) test results, surveys were conducted to obtain demographic, medical and family information; it was used 90% statistical power and 95% interval confidence; association was established by calculating odds ratios, chi-squared test for statistical significance (p<0.05) and logistic regression analysis. Results: 69% were men, mean age 9.9 years (±2.6), mean points in CAN 6.9 (DE±5.0). The association between asthma uncontrolled and associated factors reported the following results: immunotherapy (OR=10.2, p<0.001), socioeconomic status (OR=9.5, p<0.001), pets (OR=7.2, p<0.001), therapeutic adherence (OR=6.3, p<0.001), nutritional status (OR=5.9, p<0.001 ), smoking (OR= 4.7, p<0.001), family functionality (OR=4.7, p<0.001), acute rhino sinusitis (OR=4.3, p=0.004), eosinophilia (OR=4.2, p<0.001), food allergens (OR=2.9, p=0.006) and gender (OR=2.7, p=0.016). However, to clarify the results, we submitted these 11 factors to logistic regression analysis, reporting only five variables as the main factors influencing uncontrolled asthma. Conclusion: Immunotherapy and characteristics such as gender, socioeconomic status, adherence and comorbidities are key factors for asthma control in pediatric patients.