Vol. 7, Issue 2, Part D (2025)

Background: Asthma exacerbations impose significant morbidity on preschool children, particularly in resource-variable settings. In Basrah, Iraq, where wheezing prevalence reaches 15.8% among children aged 1-6 years, region-specific trigger data remain scarce.
Objective: To identify modifiable and non-modifiable risk factors associated with acute asthma exacerbations in children aged 1-6 years in Basrah, Iraq.
Methods: A case-control study conducted between January and August 2024 enrolled 208 children at Basrah Maternity and Children Hospital and primary health centers. Cases included 100 children with recurrent wheeze and clinically diagnosed asthma; controls comprised 108 healthy children without chronic respiratory disease. Structured questionnaires assessed demographics, medical history, environmental exposures, and family history. Statistical analysis employed Chi-square tests with significance set at p<0.05.
Results: Strong genetic predisposition was evident, with maternal (OR=11.8) and paternal (OR=7.09) allergy history significantly associated with asthma. Rural residence conferred protection (OR=0.535). Comorbid GERD (OR=12.43) and overweight status (OR=3.78) increased risk. Indoor environmental hazards showed striking associations: cooking/heating fumes (OR=44.31), passive tobacco smoke (OR=8.54), and cockroach infestation (OR=11.05). Outdoor triggers demonstrated extreme significance: weather variability (OR=494.3), upper respiratory tract infections (OR=44.6), physical exertion (OR=32.6), pollen (OR=22.8), and cold air (OR=22.6). Psychological triggers including strong crying (OR=14.46) and anxiety (OR=9.05) were notable. Pet ownership and food allergies showed no significant association.
Conclusions: Acute asthma exacerbations in Basrah's preschool children result from complex interactions between genetic susceptibility and environmental triggers. Modifiable indoor air quality factors and climatic exposures represent critical intervention targets. These findings provide essential evidence for developing targeted, context-specific prevention strategies in resource-variable Middle Eastern settings.