Received: June 10, 2026
Accepted for publication: July 13, 2026
Published online: September 30, 2026
UDC: 616.248-053.2:616.2-022
DOI: 10.26212/2227-1937.2026.94.27.005
CLINICAL FEATURES OF ACUTE RESPIRATORY INFECTIONS IN CHILDREN WITH BRONCHIAL ASTHMA
Turlykozhaev A.M.¹, Balmukhanova A.V.¹, Balmukhanova A.M.², Nurzhanova R.B.³, Berkinbay A.B.³, Aibolova G.K.⁴, Ilyassova G.T.⁴, Ergesh Sh.S.³
1Caspian International School of Medicine, Caspian University, Almaty, Republic of Kazakhstan
2Al-Farabi Kazakh National University, Almaty, Republic of Kazakhstan;
3Asfendiyarov Kazakh National Medical University, Almaty, the Republic of Kazakhstan;
4Akhmet Yassawi International Kazakh-Turkish University, Turkistan, the Republic of Kazakhstan
Background. Acute respiratory infections (ARIs) are the leading cause of asthma exacerbations in children; however, the factors associated with their frequent and severe course remain insufficiently studied.
The purpose of the study. To investigate the clinical features of ARIs in children with bronchial asthma and to identify factors associated with frequent infectious episodes.
Materials and methods. A retrospective study included 113 children aged 3–18 years with bronchial asthma who were followed at ASMED Polyclinic in Almaty between 2023 and 2025. Group I consisted of 65 children with 1–5 ARI episodes per year, whereas Group II included 48 children with ≥6 episodes annually. The clinical phenotype of asthma, frequency and severity of ARIs, laboratory findings, spirometry parameters, and maintenance therapy were assessed. Statistical analysis was performed using the χ² test, Student’s t-test, Mann–Whitney U test, and odds ratio (OR) calculation with 95% confidence intervals.
Results. Frequent ARIs were identified in 42.5% of children. In Group II, the duration of a single ARI episode was significantly longer than in Group I (9.6±2.8 vs. 5.8±1.9 days; p<0.001). Bronchitis occurred in 60.4% versus 18.5% (p<0.001), pneumonia in 22.9% versus 4.6% (p=0.004), and asthma exacerbations in 77.1% versus 32.3%, respectively (p<0.001). Eosinophilia >5% was observed in 58.3% of children in Group II compared with 29.2% in Group I (p=0.003), while elevated IgE >100 IU/mL was found in 64.6% and 36.9%, respectively (p=0.005). The strongest associations with frequent ARIs were observed for irregular maintenance therapy (OR=6.34; 95% CI 2.68–15.00; p<0.001), elevated eosinophilic cationic protein >24 ng/mL (OR=4.96; 95% CI 1.88–13.10; p=0.001), and impaired lung function (OR=4.62; 95% CI 2.08–10.27; p<0.001).
Discussion. The findings indicate that frequent acute respiratory infections in children with bronchial asthma are associated with inadequate disease control, a higher rate of complications, and more pronounced allergic inflammation. The main factors associated with an unfavorable course were irregular maintenance therapy, elevated eosinophilic cationic protein levels, and impaired lung function. These results emphasize the importance of early identification of high-risk children and timely optimization of maintenance therapy.
Conclusions. Frequent ARIs in children with bronchial asthma are associated with a more severe disease course and inadequate asthma control.
Key words: bronchial asthma, children, acute respiratory infections, IgE, eosinophilia, factors associated with frequent ARIs.
