Clinical Features of Bronchial Asthma in Children with Different Frequencies of Exacerbations in Almaty, Kazakhstan

Abstract

Background. Bronchial asthma is one of the most common chronic respiratory diseases in children. Despite advances in modern diagnosis and treatment, frequent exacerbations remain one of the main causes of poor disease control, medical consultations, and hospitalization. In children, it is particularly important to identify the clinical features of the disease in patients who are prone to recurrent exacerbations.
Objective. To study the clinical features of bronchial asthma in children aged 5–15 years depending on the frequency of exacerbations based on a retrospective analysis of medical records from 2020 to 2025.
Materials and Methods. A retrospective comparative study of clinical data from 120 children with bronchial asthma aged 5–15 years was conducted. The main group included 50 children with frequent exacerbations, while the comparison group consisted of 70 children with infrequent exacerbations.
Results. Boys predominated among the study participants: 64.0% in the main group and 55.7% in the comparison group. Early disease onset before the age of 5 years was more common among children with frequent exacerbations—36.0% compared with 28.6%. Poor asthma control was identified in 62.0% of children in the main group and 22.9% of children in the comparison group. A positive allergic history was reported in 78.0% and 62.9% of patients, respectively. Allergic rhinitis and recurrent respiratory infections were also more common among children with frequent exacerbations. Regular controller therapy was received by 58.0% of children in the main group and 72.9% of those in the comparison group. Poor treatment adherence was observed in 52.0% and 32.9% of patients, respectively. The most pronounced differences were observed in hospitalization rates: hospitalization due to bronchial asthma exacerbation occurred in 62.0% of children in the main group compared with 20.0% in the comparison group.
Conclusion. Children with frequent bronchial asthma exacerbations more often had poor disease control, a more severe course of the disease, a positive allergic history, concomitant allergic rhinitis, and recurrent respiratory infections. In addition, irregular use of controller therapy and poor treatment adherence were more common in this group. Frequent exacerbations were associated with a higher rate of hospitalization. The findings highlight the need for closer monitoring of children with recurrent exacerbations, including assessment of asthma control, adherence to prescribed treatment, and concomitant conditions.