Phenotypes of Asthma, Asthma Severity and Hospitalization in Children Attending a Respiratory Clinic at a Tertiary Hospital - Abstract
Objective: To describe the phenotypes of asthma, asthma severity and hospitalization in children presenting to the children’s respiratory clinic at a tertiary hospital Methods: A hospital based, 6month longitudinal study was conducted among asthmatic children aged 3 months to 18 years attending a respiratory out-patients clinic at Parirenyatwa, a tertiary hospital in Zimbabwe. A structured pretested questionnaire was used to collect demographic data, phenotypes, asthma control and frequency of hospitalization. Data was analysed using Statistical Software Package for Social Sciences (SPSS-16.0) Results: A total of 102 asthmatic patients were enrolled, of these 56(55%) were males. The age of the study participants ranged from 3 months to 18 years, with a median of 4years (Q1=2.75; Q3=6). Of the study participants 90 (88%) had early onset asthma, 19(19%) had cough variant asthma, 34(33%) had peripheral blood eosinophilia while 17(17%) had neutrophilia. Most of the study participants had allergic comorbidities: 61(60%) had allergic rhinitis, 56(55%) had atopic dermatitis, 22(22%) had allergic conjunctivitis and some had a combination of these. HIV infection was present in 3 patients and 4 of the study participants were ex pre-term. Sixty patients (59%) were sensitized to aeroallergens of these 48 were polysensitized. The most common sensitizations were to D. pteronyssinus 44(43%), D. farinae 42(41%), Bermuda grass 26(26%), Timothy grass 23(23%) and A.siro 20(20%). Eighty-six (84%) of the study population were hospitalised at least once. There was a significant association between peripheral blood eosinophilia or neutrophilia with poor asthma control and hospitalization. Conclusion: Most of the study participants had early onset asthma. Sensitization to aeroallergens and allergic comorbidities were common among the study participants. The presence of peripheral neutrophilia or eosinophilia were independently associated with poor asthma control and hospitalization. Asthmatic children should have their phenotypes characterized to guide patient tailored management.