World Journal of Pediatrics

, Volume 14, Issue 5, pp 482–491 | Cite as

Determinants for asthma control, quality of life and use of complementary and alternative medicine in asthmatic pediatric patients in four cities

  • Kam Lun HonEmail author
  • Yan Min Bao
  • Kate C. Chan
  • Kin Wai Chau
  • Rong-Shan Chen
  • Kun Tat Gary Cheok
  • Wa Keung Chiu
  • Li Deng
  • Chun-Hui He
  • Kin Mui Ieong
  • Jeng Sum C. Kung
  • Ping Lam
  • Shu Yan David Lam
  • Qun Ui Lee
  • So Lun Lee
  • Ting Fan Leung
  • Theresa N. H. Leung
  • Lei Shi
  • Ka Ka Siu
  • Wei-Ping Tan
  • Maggie Haitian Wang
  • Tak Wai Wong
  • Bao-Jing Wu
  • Ada Y. F. Yip
  • Yue-Jie Zheng
  • Daniel K. Ng
Original Article



Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta.


The conjoint survey involved ten Hong Kong pediatric hospitals/units, two Shenzhen hospitals, two Macau hospitals, and two Guangzhou hospitals on asthma control (using Asthma Control Test) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ). Acceptability of a treatment is graded as very good/good/fair/poor.


Good asthma control was only reported in 80% subjects in Hong Kong, but higher in sister cities (85–94%, P < 0.001). Allergic rhinitis, “incense burning”, and “smoker in family” were prevalent among the four cities. Logistic regression showed better control of asthma was associated with better PADQLQ (B = − 0.029, P < 0.001), better acceptability of bronchodilator (B = − 1.488, P = 0.025), negatively with “smoker in family” (B = − 0.83, P = 0.015) and various PADQLQ domains. Conversely, worse PADQLQ was associated with allergic rhinitis severity (B = 4.77, P < 0.001), poor control of asthma (B = 7.56, P < 0.001), increased frequency of traditional Chinese medicine use (B = 1.7, P < 0.05), increased frequency of bronchodilator usage (B = 1.05, P < 0.05), “smoker in family” (B = 4.05, P < 0.05), and incense burning at home (B = 3.9, P < 0.05).


There are some clinical and cultural differences among the four southern Chinese cities within the Guangdong province. This study identifies potentially modifiable environmental and treatment factors associated with poor asthma control and QoL for health-care interventions. Having a smoker in the family is independently associated with poor asthma control and QoL.


Asthma Complementary and alternative medicine Control Inhaled bronchodilator Inhaled corticosteroid Pediatric Allergic Disease Quality of Life Questionnaire Smoking  Traditional Chinese medicine 


Author contributions

KLH is the principal author who coordinated this survey. All co-authors obtained ethical approval from their respective centers and collected and contributed data to this survey. JSCK and MHW were involved in statistical analysis.


A small research grant was provided by Hong Kong Society of Pediatric Respirology and Allergy.

Compliance with ethical standards

Ethical approval

Ethical approval was obtained from NTEC CREC for the principal author and the respective ethics committees of all participating centers.

Conflict of interest

The authors report no conflicts of interest.

Supplementary material

12519_2018_167_MOESM1_ESM.doc (512 kb)
Supplementary material 1 (DOC 511 kb)


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Copyright information

© Children's Hospital, Zhejiang University School of Medicine 2018

Authors and Affiliations

  • Kam Lun Hon
    • 1
    Email author
  • Yan Min Bao
    • 2
  • Kate C. Chan
    • 1
  • Kin Wai Chau
    • 3
    • 4
  • Rong-Shan Chen
    • 5
  • Kun Tat Gary Cheok
    • 6
  • Wa Keung Chiu
    • 7
  • Li Deng
    • 5
  • Chun-Hui He
    • 5
  • Kin Mui Ieong
    • 8
  • Jeng Sum C. Kung
    • 1
  • Ping Lam
    • 9
  • Shu Yan David Lam
    • 10
  • Qun Ui Lee
    • 11
  • So Lun Lee
    • 12
    • 13
  • Ting Fan Leung
    • 1
  • Theresa N. H. Leung
    • 13
    • 14
    • 15
  • Lei Shi
    • 14
  • Ka Ka Siu
    • 15
  • Wei-Ping Tan
    • 16
  • Maggie Haitian Wang
    • 17
    • 18
  • Tak Wai Wong
    • 19
  • Bao-Jing Wu
    • 17
  • Ada Y. F. Yip
    • 16
  • Yue-Jie Zheng
    • 2
  • Daniel K. Ng
    • 16
  1. 1.Department of PediatricsThe Chinese University of Hong Kong 6/F Prince of Wales HospitalHong Kong SARChina
  2. 2.Department of Respiratory DiseasesShenzhen Children’s HospitalShenzhenChina
  3. 3.Hong Kong Society of Pediatric Respirology and AllergyHong Kong SARChina
  4. 4.Pediatric Respiratory and Sleep Disorders CenterHong Kong SARChina
  5. 5.Department of RespirationGuangzhou Women and Children’s Medical CenterGuangzhouChina
  6. 6.Department of PediatricsKiang Wu HospitalMacauChina
  7. 7.Department of Pediatrics and Adolescent MedicineUnited Christian HospitalHong Kong SARChina
  8. 8.Department of PediatricsCentral Hospital Conde S. JanuarioMacauChina
  9. 9.Department of Pediatrics and Adolescent MedicineCaritas Medical CenterHong Kong SARChina
  10. 10.Department of Pediatrics and Adolescent MedicineTuen Mun HospitalHong Kong SARChina
  11. 11.Department of Pediatrics and Adolescent MedicinePrincess Margaret HospitalHong Kong SARChina
  12. 12.Department of Pediatrics and Adolescent MedicineQueen Mary HospitalHong Kong SARChina
  13. 13.Department of Pediatrics and Adolescent MedicineThe University of Hong KongHong Kong SARChina
  14. 14.Department of Pediatrics and Adolescent MedicinePamela Youde Nethersole Eastern HospitalHong Kong SARChina
  15. 15.Department of PediatricsThe University of Hong Kong-Shenzhen HospitalShenzhenChina
  16. 16.Department of Pediatrics and Adolescent MedicineKwong Wah HospitalKLN Hong Kong SARChina
  17. 17.Department of PediatricsSun Yat-sen Memorial Hospital, Sun Yat-sen UniversityGuangzhouChina
  18. 18.JC School of Public Health and Primary Care, Faculty of MedicineThe Chinese University of Hong KongHong Kong SARChina
  19. 19.Department of Pediatrics and Adolescent MedicineAlice Ho Miu Ling Nethersole HospitalHong Kong SARChina

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