The incidence of asthma and related hospital admissions among children have become pressing health issues worldwide, with unique patterns observed across different regions. A recent study has shed light on this topic, focusing on children diagnosed with asthma in Kazakhstan from 2014 to 2021. Utilizing data from the Unified National Electronic Health System (UNEHS), this research aimed to understand the epidemiological trends surrounding pediatric asthma, providing valuable insights for public health strategies.
This retrospective cohort study encompassed 53,463 children aged 0–17 years, diagnosed with asthma and registered under ICD-10 code J45.x. The findings were particularly significant, showing varied incidence rates and hospitalization patterns across different age groups and genders. Notably, 63.7% of the study cohort were male, 47.9% fell within the 5-11 year age range, and 74.1% resided in urban areas.
Throughout the study period, asthma incidence rates varied significantly, with the highest recorded among boys aged 5–11 years at 308-351 cases per 100,000 population. Comparatively, girls displayed lower incidence rates, ranging from 38.2 to 115.7 cases per 100,000 population. The incident asthma cases per year highlighted fluctuated rates between 2014 and 2019, followed by a notable decrease between 2020 and 2021. The authors noted this decline may be tied to the effects of the COVID-19 pandemic, which instituted various public health measures, such as wearing masks and increased attention to hygiene, potentially reducing allergenic exposures.
Among the outpatient cohort of 31,525 children, 915 (2.8%) were hospitalized for asthma-related issues, yielding an all-cause hospitalization incidence rate of 6.91 per 1,000 person-years. Alarmingly, those aged 5–11 years were found to face 2.59 times heightened hospitalization risks compared to the younger 0–4 years group. This was attributed to their increased susceptibility to environmental triggers and respiratory infections, common comorbidity factors exacerbated by the challenges of managing asthma at these ages.
The study brought to light specific associated conditions contributing to hospitalization risks. Among these, respiratory infections posed the most significant threat, resulting in 14.48 times higher hospitalization odds. Coupled with allergic rhinitis (12.95 times higher) and acute rhinosinusitis (7.28 times higher), these conditions highlighted the often-hidden interplay between asthma and other common illnesses. This interplay serves as a reminder of the necessity for comprehensive care strategies for children with asthma to mitigate their risk for significant complications.
This research surfaced from the UNEHS after establishing standards for documenting patient data across various healthcare facilities. This ensures the reliability of health information on the national scale and fosters transparency following international ethical guidelines. The study was approved exempt from oversight by the Nazarbayev University Institutional Research Ethics Committee, underlining the validity of the practices involved.
While this study has presented invaluable insights, it did face challenges inherent to retrospective analyses—such as reliance on secondary data, which may carry biases. Still, it strengthens the case for the importance of nationwide research efforts to understand asthma's impact on children fully. The results can encourage the implementation of targeted strategies, including education for caregivers and healthcare providers, to manage asthma effectively.
The findings captured not only the patterns of asthma and its complications but also prompted discussions on the need for health policy adjustments to improve pediatric asthma care. These discussions could involve enhancing diagnostic procedures, accessibility of asthma medications, and standardized management protocols to address the unique healthcare needs within the pediatric population of Kazakhstan.
Concluding, the study opens avenues for future research. The authors noted, "The incidence of asthma was higher among boys aged 5 to 11 years and remained relatively consistent from 2014 to 2019, decreasing substantially in 2020 and 2021, potentially reflecting the impact of the COVID-19 pandemic." Factors surrounding this age group and urban residency underline the complexity of asthma as it interfaces with environmental influences and healthcare access. Moving forward, comprehensive approaches will be needed to adequately address asthma management, emphasizing the intersection of care practices and socio-environmental determinants affecting pediatric health outcomes.