Validation of asthma control questionnaire and risk factors affecting uncontrolled asthma among the Lebanese children's population

•This is the first study that validates the asthma control test in Lebanon and studies the risk factors associated to it.•Waterpipe smoking during pregnancy, considered safe by some mothers, was associated with a higher risk of uncontrolled asthma.•Cigarette smoking during breastfeeding and a low mother's educational level are risk factors for uncontrolled asthma.

ObjectivesTo validate the Arabic version of the Asthma Control Test (ACT) in asthmatic children in Lebanon and identify risk factors that might affect asthma control in these children.MethodsThis study, conducted between December 2015 and April 2016, included 300 children.ResultsA high Cronbach's alpha was found for the full scale (0.959). The correlation factors between each item of the ACT scale and the whole scale ranged between 0.710 and 0.775(p < 0.001 for all items). Low mother's educational level as well as the history of asthma in the mother and the father would significantly increase the risk of uncontrolled asthma (p = 0.001; Beta = 1.862; p < 0.001; Beta = 3.534; p < 0.001; Beta = 1.885respectively). Cigarette smoking during breastfeeding and waterpipe smoking by the mother during pregnancy were both significantly associated with uncontrolled asthma (p = 0.005; Beta = 2.105 and p = 0.041; Beta = 2.325 respectively). The high mother's level of education was significantly associated with more asthma control (p = 0.008; Beta = −0.715).ConclusionThe Arabic version of the asthma control questionnaire is a valid tool to use in pediatric patients in the Lebanese population to assess asthma control. Waterpipe smoking during pregnancy and cigarette smoking during breastfeeding, as well as the lower education level are risk factors for uncontrolled asthma. Spreading awareness among health care professionals, as well as reinforcing health education seem to be an important step toward a better asthma control.