# Determinants of Asthma Control in Jordanian Children: The Role of Comorbidities and FeNO Levels

## TL;DR

This study in Jordan finds that comorbidities and high FeNO levels are linked to poor asthma control in children, highlighting the need for personalized asthma management.

## Contribution

The study identifies specific comorbidities and FeNO as novel predictors of asthma control in Jordanian children.

## Key findings

- 62.6% of children in the study had uncontrolled asthma.
- Comorbidities like obstructive sleep apnea and allergic rhinitis were significantly associated with poor asthma control.
- Elevated FeNO levels were linked to lower odds of asthma control despite showing potential as a biomarker.

## Abstract

Background/Objectives: Asthma is a prevalent chronic respiratory disease in children, and poor asthma control remains a major clinical challenge worldwide. In Jordan, the rising prevalence of pediatric asthma highlights a need to better understand the factors influencing asthma control and to evaluate new assessment tools. Methods: This cross-sectional study aimed to identify predictors of asthma control and to assess the clinical utility of fractional exhaled nitric oxide (FeNO) as a supplementary biomarker. A total of 329 children with physician-diagnosed asthma, aged 7–17 years, were recruited from Jordan University Hospital. Clinical history, spirometry, FeNO measurements, and Asthma Control Test scores were collected. Results: Overall, 62.6% of participants had uncontrolled asthma. Logistic regression analysis revealed that comorbidities such as obstructive sleep apnea, gastroesophageal reflux disease, allergic rhinitis, and bronchiolitis obliterans were significantly associated with poorer asthma control. Antihistamine use and elevated FeNO levels were also linked to lower odds of asthma control. Conclusions: While FeNO showed promise as a non-invasive marker of airway inflammation, its clinical application remains limited due to variability and confounding factors. A comprehensive, individualized approach to asthma management, considering comorbidities and conventional assessments, is essential. Larger, longitudinal studies are needed to establish the role of FeNO in routine pediatric asthma care.