Control of asthma in children: still unacceptable? A French cross-sectional study.
BACKGROUND
The goal of asthma management focuses on adequate control of asthma, although little is known about the optimal level of asthma control to be reached. The ELIOS study was conducted in France to address this lack of information.


METHODS
Cross-sectional study of asthmatic children (4-15 years) visiting their medical practitioner. The primary objective was to assess the level of asthma control with a 3-level composite score based on French (ANAES) guidelines criteria (optimal, acceptable, and unacceptable).


RESULTS
Asthma control was assessed in 3431 children and classified as optimal (26%), acceptable (41.3%), and unacceptable (32.7%). When PEFR was studied, asthma control was optimal in 23.0%, acceptable in 35.8% and unacceptable in 41.2% (p<0.001) of children. Unacceptable asthma control was significantly associated with higher BMI (p=0.002), more recent diagnosis of asthma (p=0.008), passive exposure to parental tobacco smoke (p<0.001), number of associated allergic diseases (p<0.001), frequent respiratory tract infections (p<0.001) and low socioeconomic status (p<0.001). Multivariate analysis identified presence of respiratory tract infections (p<0.0001), passive exposure to parental tobacco smoke (p=0.009) and low socioeconomic status (p=0.042) as variables associated with unacceptable asthma control.


CONCLUSIONS
There is room for improvement in France as only 25% of asthmatic children are optimally controlled. Public health strategies should increase awareness among physicians and parents about the importance of using asthma control tools, eliminating exposure to tobacco smoke and treating associated allergic diseases.
Université Paris Descartes; Hôpital Necker Enfants Malades, Service de Pneumologie et d'Allergologie Pédiatriques, 149 rue de Sèvres, Paris, France. j.deblic@nck.aphp.fr
Jacques
J
de Blic
Isabelle
I
Boucot
Céline
C
Pribil
Jacques
J
Robert
Dominique
D
Huas
Christophe
C
Marguet
D000293:Adolescent; D018927:Anti-Asthmatic Agents; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects* / Q000517:prevention & control; D008297:Male; D010290:Parents / Q000193:education; D017410:Practice Guidelines as Topic / Q000592:standards*; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D000074606:Smoking Prevention; D011795:Surveys and Questionnaires; D014028:Tobacco Smoke Pollution / Q000009:adverse effects* / Q000517:prevention & control
D018927:Anti-Asthmatic Agents; D014028:Tobacco Smoke Pollution