Determinants of asthma control among hospital-admitted patients: a multicenter retrospective study from Egypt

Abstract

Background
Bronchial asthma (BA) is a common chronic disease that undermines patients’ quality of life and represents a challenge to healthcare systems. Investigating determinants of BA control is essential for better management. This study aimed to investigate sociodemographic and clinical factors associated with BA control among Egyptian patients.


Methods
Data were extracted from medical records of BA patients admitted to 16 Ministry of Health Chest Hospitals across 15 Egyptian governorates between December 2019 and April 2020. Unadjusted and multivariable logistic regression models were used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with BA control.


Results
Among 3,248 participants, 54.4% were male, 4.8% were ≤ 20 years, 36.6% were current smokers, and 41.6% had a positive family history of BA. Common presentations included cough at night (82.1%), wheezes or cough after exercise (81.0%), and wheezes, cough, or chest tightness after exposure to allergens/pollutants (80.7%). Overall, 53.3% had controlled BA. In the multivariable model, age ≥ 61 years (adjusted OR [aOR] 1.51, 95% CI 1.04–2.29) was positively associated with BA control. Conversely, current smoking (aOR 0.51, 95% CI 0.41–0.64), chronic sinusitis (aOR 0.36, 95% CI 0.28–0.47), hypertension (aOR 0.59, 95% CI 0.49–0.71), diabetes (aOR 0.78, 95% CI 0.62–0.97), allergic sinusitis (aOR 0.38, 95% CI 0.26–0.54), and a family history of BA (aOR 0.68, 95% CI 0.58–0.79) were negatively associated with BA control.


Conclusion
A significant proportion of BA patients in Egypt presented with uncontrolled BA. Chronic comorbidities, smoking, and family history were linked to poorer control. These findings underscore the need for targeted interventions to improve BA management, particularly among patients with comorbidities.