Control of asthma in children: still unacceptable? A French cross-sectional study

Respir Med. 2009 Sep;103(9):1383-91. doi: 10.1016/j.rmed.2009.03.006. Epub 2009 Apr 9.


Background: The goal of asthma management focuses on adequate control of asthma, although little is known about the optimal level of asthma control to be reached. The ELIOS study was conducted in France to address this lack of information.

Methods: Cross-sectional study of asthmatic children (4-15 years) visiting their medical practitioner. The primary objective was to assess the level of asthma control with a 3-level composite score based on French (ANAES) guidelines criteria (optimal, acceptable, and unacceptable).

Results: Asthma control was assessed in 3431 children and classified as optimal (26%), acceptable (41.3%), and unacceptable (32.7%). When PEFR was studied, asthma control was optimal in 23.0%, acceptable in 35.8% and unacceptable in 41.2% (p<0.001) of children. Unacceptable asthma control was significantly associated with higher BMI (p=0.002), more recent diagnosis of asthma (p=0.008), passive exposure to parental tobacco smoke (p<0.001), number of associated allergic diseases (p<0.001), frequent respiratory tract infections (p<0.001) and low socioeconomic status (p<0.001). Multivariate analysis identified presence of respiratory tract infections (p<0.0001), passive exposure to parental tobacco smoke (p=0.009) and low socioeconomic status (p=0.042) as variables associated with unacceptable asthma control.

Conclusions: There is room for improvement in France as only 25% of asthmatic children are optimally controlled. Public health strategies should increase awareness among physicians and parents about the importance of using asthma control tools, eliminating exposure to tobacco smoke and treating associated allergic diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anti-Asthmatic Agents
  • Asthma / drug therapy*
  • Asthma / epidemiology
  • Asthma / prevention & control
  • Child
  • Child, Preschool
  • Cross-Sectional Studies
  • Female
  • France / epidemiology
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Inhalation Exposure / adverse effects*
  • Inhalation Exposure / prevention & control
  • Male
  • Parents / education
  • Practice Guidelines as Topic / standards*
  • Risk Factors
  • Severity of Illness Index
  • Smoking / adverse effects*
  • Smoking / epidemiology
  • Smoking Prevention
  • Surveys and Questionnaires
  • Tobacco Smoke Pollution / adverse effects*
  • Tobacco Smoke Pollution / prevention & control


  • Anti-Asthmatic Agents
  • Tobacco Smoke Pollution