Uncontrolled asthma: Frequency and associated factors

##plugins.themes.academic_pro.article.sidebar##

Published Apr 1, 2026
https://doi.org/10.62438/tunismed.v104i02.6392
Download
PDF
Vol. 104 No. 02 (2026): Tunis Med Fev 2026

##plugins.themes.academic_pro.article.main##

Sarra Maazaoui
Department of Pulmonology and Interventional Endoscopy, Pavilion 2, Abderrahman Mami Hospital, Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
Chirine Moussa
Department of Respiratory Medicine, Pavilion 3, Abderrahman Mami Hospital, Ariana, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
Nawel Chaouch
Department of Pulmonology and Interventional Endoscopy, Pavilion 2, Abderrahman Mami Hospital, Ariana, Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia
https://orcid.org/0000-0001-5323-3025
Sonia Maalej
Department of Respiratory Medicine, Pavilion 3, Abderrahman Mami Hospital, Ariana, Faculty of Medicine, University of Tunis El Manar, Tunis, Tunisia
https://orcid.org/0000-0002-4001-3776

Abstract

Introduction: The real challenge with asthma consists essentially in the control of this one. The objectives of our work were to describe the level
of asthma control in a Tunisian population and to search the factors associated with uncontrolled asthma.
Methods: This was a descriptive observational cross-sectional study that was conducted in a pneumology department over 2 months. Were
included patients seen at the allergology consultation aged 15 years or over with a confirmed diagnosis of asthma and under anti-asthmatic treatment for at least 6 months. Uncontrolled asthma was defined by an asthma control test score under 20.
Results: One hundred and thirteen patients were included. The mean age of the population was 45 ± 15 years. Thirteen percent of the patients
were active smokers. The main comorbidities associated with asthma were obesity (34.5%), gastroesophageal reflux disease (GERD) (17%). Thirty- seven patients (32.8%) were compliant with treatment. Asthma was classified as well controlled in 64 patients (56.6%). Factors associated with
poor asthma control according to the univariate study were: active smoking (p= 0.04); exposure to passive smoking (p= 0.02); poor socio-economic
conditions (p=0.003); certain comorbidities such as GERD, obesity, younger age of onset of the disease (p= 0.008) as well as with therapeutic
compliance (p= 0,008) and the technique of inhalation (p= 0,002).
Conclusion: Adequate management of asthma must necessarily be multidisciplinary considering comorbidities and tobacco contr

Keywords:

Asthma, therapeutic compliance, questionnaire, passive smoking

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Global Initiative forAsthma.Global strategy for asthmamanagement and prevention, 2024. Available from: www.ginasthma.org.
  2. Global burden of 369 diseases and injuries in 204 countries and territories, 1990– 2019: a systematic analysis for the global burden of disease study 2019. Lancet. 2020 Oct 17;396(10258):1204–22.
  3. Mjid M, Taboubi A, Mokkadem S, Hedhli A, Cheikh Rouhou S, Ouahchi Y, et al. Évaluation de la connaissance de l’asthme chez les étudiants en médecine à Tunis. Rev Fr Allergol. 1 mar 2018;58(2):77–85.
  4. Davitte J, DeBarmore B, Hinds D, Zhang S, Chao J, Sansbury L. Asthma control among treated US asthma patients in practice fusion’s electronic medical record research database. npj Prim Care Respir Med. 2023 Apr 27;33(1):1–9.
  5. Belachew EA, Tadess S, Alemayehu M, Ayele EM. Level of asthma control and its determinants among adults living with asthma attending selected public hospitals in northwestern, Ethiopia: using an ordinal logistic regression model. Asthma Res Pract. 2022 Aug 27;8(1):5.
  6. Nathan RA, Sorkness CA, Kosinski M, Schatz M, Li JT, Marcus P, et al. Development of the asthma control test: a survey for assessing asthma control.J Allergy Clin Immunol. 2004 Jan;113(1):59–65.
  7. Ilmarinen P, Juboori H, Tuomisto LE, Niemelä O, Sintonen H, Kankaanranta H. Effect of asthma control on general health-related quality of life in patients diagnosed with adult-onset asthma. Sci Rep. 2019 Nov 6;9:16107.
  8. Allegra L, Cremonesi G, Girbino G, Ingrassia E, Marsico S, Nicolini G, et al. Real-life prospective study on asthma control in Italy: Cross- sectional phase results. Respir Med. 2012 Feb;106(2):205–14.
  9. Benkheder A, Bouacha H, Nafti S, Taright S, El Ftouh M, Yassine N, et al. Control of asthma in the Maghreb: results of the AIRMAG study. Respir Med. 2009 Dec;103:S12–20.
  10. Cazzola M, Segreti A, Calzetta L, Rogliani P. Comorbidities of asthma: current knowledge and future research needs. Curr Opin Pulm Med. 2013 Jan;19(1):36- 41.
  11. Togias A. Systemic effects of local allergic disease. J Allergy Clin Immunol. 2004 Jan;113(1 Suppl):S8-14.
  12. Higashimoto Y, Yamagata Y, Taya S, Iwata T, Okada M, Ishiguchi T, et al. Systemic inflammation in chronic obstructive pulmonary disease and asthma: Similarities and differences. Respirology. 2008 Jan;13(1):128–33.
  13. Ammar M, Bahloul N, Amri O, Omri R, Ghozzi H, Kammoun S, et al. Oxidative stress in patients with asthma and its relation to uncontrolled asthma. J Clin Lab Anal. 2022 May;36(5):e24345.
  14. Su X, Ren Y, Li M, Zhao X, Kong L, Kang J. Prevalence of comorbidities in asthmaand non asthma patients. Medicine (Baltimore). 2016 May;95(22):e3459.
  15. Boulet LP, Boulay MÈ. Asthma-related comorbidities. Expert Rev Respir Med. 2011 Jun 1;5(3):377–93.
  16. Ahsino F, Zegmout A, Souhi H, Elouazzani H, Rhorfi I, Abid A. Comorbidités associées à l’asthme : quel impact sur le contrôle ? Rev Fr Allergol. 2021 May 1;61(4):298.
  17. Zhou X, Ding F ming, Lin J tao, Yin K sheng, Chen P, He Q ying, et al. Validity of asthma control test in Chinese patients. Chin Medical J. 2007 Jun 20;120(12):1037-4.
  18. Aït-Khaled N, Enarson DA, Bencharif N, Boulahdib F, Camara LM, Dagli E, et al.Implementation of asthma guidelines in health centres of several developing countries. Int J Tuberc Lung Dis. 2006 Jan;10(1):104–9.
  19. Al-Jahdali HH, Al-Hajjaj MS, Alanezi MO, Zeitoni MO, Al-Tasan TH. Asthma control assessment using asthma control test among patients attending 5 tertiary care hospitals in Saudi Arabia. Saudi Med J. 2008 May;29(5):714–7.
  20. Hugo MNB, Walter PYE, Maïmouna M, Malea NM, Ubald O, Adeline W, et al. Assessment of asthma control using asthma control test in chest clinics in Cameroon: a cross-sectional study. Pan Afr Med J. 2016 Mar 9;23:70.
  21. Jumbo J, Adeniyi BO, Erhabor GE. Assessment of asthma control using asthma control test (ACT) and its relationship with lung function parameters. GJMS. 2013 Oct 20;3(8):276–82.
  22. Corrado A, Renda T, Polese G, Rossi A. Assessment of asthma control: the SERENA study. Respir Med. 2013 Nov 1;107(11):1659–66.
  23. Milanese M, Di Marco F, Corsico AG, Rolla G, Sposato B, Chieco-Bianchi F, et al.Asthma control in elderly asthmatics. An Italian observational study. Respir Med.2014 Aug 1;108(8):1091–9.