Sociodemographic predictors of asthma control and exacerbation among children in Central Kenya: A hospital-based cross-sectional study

Abstract

Abstract Introduction Childhood asthma remains a major public health challenge in low- and middle-income countries, where social and economic factors influence disease outcomes. This study examined the sociodemographic determinants of asthma exacerbation among children attending clinic at Thika Level 5 Hospital, Kenya. Methods This study employed a hospital-based cross-sectional study involving 108 caregivers– child dyads, each consisting of a child with confirmed asthma and their primary caregiver. The dyads were recruited from the pediatric asthma clinic from 31 st March 2025 to 30 th April 2025 then follow up was conducted for six months’ form 1 st May to 31st October 2025. Data were collected using structured questionnaires and clinic records. Descriptive statistics summarized sociodemographic characteristics, while chi-square tests and logistic regression assessed associations between caregiver factors and asthma control. Results The mean age of children was 8.1 years (range 3–17), with males comprising 57.4%. Most caregivers were mothers (88%), had secondary education (57.4%), and were in informal employment (75.9%). Household income was low for 59.3% of participants (<KES 30,000/month). Caregiver education (AOR=2.8; 95% CI:1.5–5.2; p=0.001) was the strongest predictor of asthma control, followed by medical insurance (χ 2 =10.41; p=0.001). Formal employment and higher income were significantly associated with controlled asthma (χ 2 =6.45; p=0.04 and χ 2 =9.72; p=0.02 respectively). Urban residence modified the positive effect of education on asthma management (interaction AOR=1.9; p=0.03). Conclusion Caregiver education level, employment, income, and medical insurance significantly influence asthma control among children. Enhancing health literacy and expanding insurance coverage under the Social Health Authority (SHA) can improve asthma outcomes in Kenyan children.