Emergency care re-attendance for acute childhood asthma in a low-resource setting: The Childhood Asthma Re-attendance Assessment (CARA) Study (360G-Wellcome-099938_B_12_Z)

Asthma is the most common chronic disease in children. Its prevalence in LatinAmerica is now as high as in traditionally high prevalence countries and is still rising. Asthma exacerbations are common, cause great anxiety in patientsand are associated with potential severe complications, risk of death, loss oflung function, and high direct and indirect costs. A tool to enable cliniciansidentify asthmatic children at a greater risk and help patients understand their risk of suffering acute exacerbations is lacking. Such a tool could helpoptimise treatment and address modifiable risk factors, preventing future asthma attacks. Research question: What factors are associated with emergency care re-attendance for acute asthma exacerbations in children in the city of Esmeraldas, Ecuador? A cohort of children treated for an asthma exacerbation at the emergency department will be followed-up to study factors (demographics, history, symptoms and knowledge, comorbidities, environmental exposures) and biomarkers(blood eosinophilia, atopy, nasal eosinophilia, exhaled nitric oxide and lung function) associated with the time to a subsequent asthma exacerbation requiring emergency re-attendance during the following 6 months following. We will then combine these factors into a risk score and evaluate its practicality and applicability through a qualitative study involving patients and health-care workers.