Environmental, Socio-Demographic, and Clinical Factors Influencing Childhood Asthma Control: A Cross-Sectional Study in Industrial Suburbs of Southern India

Childhood asthma remains a significant global health issue, especially in rapidly urbanizing and industrializing regions. In areas like Patancheru, Hyderabad, environmental pollutants and socio-demographic factors contribute to the growing burden of poorly controlled asthma in children. This cross-sectional study aimed to evaluate the environmental, socio-demographic, and clinical determinants of asthma control in children aged 6-14 years. A total of 80 children diagnosed with asthma, according to the Global Initiative for Asthma (GINA) 2024 guidelines, were recruited from two different centers Maheshwara Medical College, Patancheru & Florets Children's Hospital, Karimnagar between October 2023 and November 2024. Data were collected on socio-demographic factors (age, sex, socio-economic status, and place of residence), environmental exposures (industrial pollutants, second-hand smoke, and incense use), and clinical parameters (inhaler technique, vitamin D levels, peripheral eosinophilia). Asthma control was assessed using the GINA 2024 criteria, and logistic regression analyses were conducted to identify significant predictors of poor asthma control. The results revealed that urban residence, exposure to industrial pollutants, low socio-economic status, improper inhaler technique, vitamin D deficiency, and peripheral eosinophilia were all significantly associated with poor asthma control. Specifically, children from urban areas had 2.5 times higher odds of poor asthma control than their rural counterparts. Moreover, environmental exposures, such as industrial pollutants (OR: 3.2), incense stick use (OR: 2.1), and second-hand smoke, were significantly correlated with inadequate asthma control. Clinical factors such as improper inhaler technique were observed in 70% of poorly controlled asthma cases, and vitamin D deficiency was found in 75% of these children. These findings underscore the need for a multifaceted approach to asthma management in resource-constrained settings like Patancheru. Interventions focusing on reducing environmental risks, improving inhaler technique, and addressing vitamin D deficiency are essential for better asthma control.