Virus infection and severe asthma exacerbations: A cross-sectional study in Children’s Hospital 1, Ho Chi Minh City, Vietnam

T. Nguyen, Tuan-Anh Tran, V. Le, K. To
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Abstract

Context: Virus infection is a well-known risk factor for asthma exacerbations in temperate and subtropical countries, particularly in atopic children. However, the risk has not been well-described in tropical countries including Vietnam. Aims: To compare the odds of virus infection in hospitalized children with severe versus moderate asthma exacerbations. Settings and Design: A cross-sectional study was conducted at Children’s Hospital 1, Ho Chi Minh City, Vietnam. Children who were admitted to the hospital and diagnosed with severe or moderate asthma exacerbations were recruited for the study. Materials and Methods: Data were collected from interviews and medical records. Virus infection was confirmed by multiplex real-time polymerase chain reaction. Inhalant allergy was confirmed by a skin prick test with common indoor aeroallergens. Statistical Analysis Used: Associations among age, gender, passive smoking, child’s history of eczema, family history of asthma, virus infection, and inhalant allergy with the odds of severe asthma exacerbations were tested by binary logistic regressions. Multivariable logistic regression was done to measure the association between virus infection with the odds of severe asthma exacerbations adjusted for passive smoking. The odds ratio (OR) and its 95% confidence interval (CI) were reported to show the strength of the associations. Results: Nearly half of the children were infected by a virus (48.5%) and had passive smoking (49.2%). The percentage of children with a positive skin prick test was 83%. The most common indoor aeroallergen was house dust mites (81.1%). The odds of severe asthma exacerbations in children with virus infection was three times higher than that in those without virus infection (OR: 3.21, 95% CI: 1.20‐8.60, P = 0.021). Conclusions: Immunization and other healthcare programs should be deployed to prevent asthmatic children from virus infection and passive smoking to reduce the risk of severe asthma exacerbations.
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病毒感染和严重哮喘加重:越南胡志明市第一儿童医院的横断面研究
背景:病毒感染是温带和亚热带国家哮喘恶化的一个众所周知的危险因素,特别是在特应性儿童中。然而,在包括越南在内的热带国家,这种风险还没有得到很好的描述。目的:比较重症和中度哮喘急性发作住院儿童病毒感染的几率。环境和设计:在越南胡志明市第一儿童医院进行了一项横断面研究。该研究招募了入院并被诊断为严重或中度哮喘加重的儿童。材料与方法:通过访谈和病历资料收集资料。多重实时聚合酶链反应证实病毒感染。吸入性过敏是通过皮肤点刺试验与常见的室内空气过敏原确认。统计分析方法:采用二元logistic回归检验年龄、性别、被动吸烟、儿童湿疹史、哮喘家族史、病毒感染和吸入剂过敏与哮喘严重发作几率的关系。采用多变量逻辑回归来衡量病毒感染与被动吸烟调整后严重哮喘发作几率之间的关系。比值比(OR)及其95%置信区间(CI)显示了相关性的强度。结果:近半数儿童感染病毒(48.5%),有被动吸烟(49.2%)。皮肤点刺试验阳性的儿童比例为83%。室内最常见的空气过敏原是室内尘螨(81.1%)。病毒感染儿童发生严重哮喘发作的几率是未感染儿童的3倍(OR: 3.21, 95% CI: 1.20‐8.60,P = 0.021)。结论:应采取免疫接种等卫生保健措施,预防哮喘儿童感染病毒和被动吸烟,以降低哮喘严重发作的风险。
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