الفهرس 
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Abstract
Asthma is a chronic inflammatory disorder of the airway in which many cells and cellular elements play a role. The chronic inflammation causes an associated increase in airway hyperresponsiveness that lead to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in early morning. These episodes are usually with wide spread but variable airflow obstruction that is often reversible either spontaneously or with treatment. The aim of asthma management is control of the disease.The attainment of asthma control correlates with improved quality of life and reduced health care use.Each patient should be assessed for his asthma control to establish his current treatment regimen,adherence to the current regimen and level of asthma control. The C-ACT is a simple, self-administered questionnaire with seven items that assessed asthma symptoms and the effect of asthma on daily functioning in preceding 4 weeks.It comprises four questions for the child (how is your asthma today?; exercise-induced symptoms; cough; and night waking) with picture prompts for responses, plus three questions for the parents (days in the last month with daytime asthma symptoms;wheezing; and night-time wakening because of asthma). Each item includes three response options for children and five response options for parents, corresponding to a 3- or 5-point Likert-type rating scale. The lowest and highest C-ACT scores were thus 7 (poor control of asthma) and 27 (complete control of asthma). Childhood Asthma Control Test (C-ACT) was recently published to be a simple tool for assessing disease control in young children. This study investigated C-ACT and other disease-related factors for indicating longitudinal changes in asthma status and predicting asthma exacerbations. During the same clinic visit at baseline and follow-up after 6 months from the baseline visit , asthma patients aged 4–11 years completed the C-ACT ,spirometric parameters were measured and sputum samples were obtained. Blinded to these results, the Disease Severity Score (DSS) was assigned and asthma control according to Global Initiative for Asthma was rated. Asthma exacerbations during the next 6 months were recorded. Seventy-four patients were recruited to the 6-month follow-up visit, The mean ±SD age of participants was 9.5±2.25. twenty-four patients (32.4%) had uncontrolled asthma at baseline. C-ACT, DSS, FEV1% ,PEF% and sputum eosinophils% were significantly different among patients with uncontrolled, partly controlled, and controlled asthma. while FEV1/FVC and sputum neutrophils% had no significant difference.
The changes in C-ACT scores from baseline to follow-up differed significantly among patients with different changes in asthma control status, DSS and FEV1% during our 6-month study.There was significant correlation between Changes in C-ACT Scores and sputum eosinophils% and no correlation between Changes in C-ACT Scores and sputum neutrophils%. Thirty-two patients had asthma exacerbations during the 6-month follow-up. Baseline C-ACT was significantly lower among patients with asthma exacerbations than the stable patients While the mean values of DSS were significantly higher among patients with asthma exacerbations than the stable patients. There were significant higher level of sputum eosinophils% among patients with asthma exacerbation than the stable patients,while that of sputum neutrophils% showed no significant difference. A cut-off C-ACT score of 22 or less was able to identify patients with exacerbations with sensitivity and specificity of 73.8% and 65.7%, respectively . In conclusion, the simple, seven-item C-ACT is responsive to changes in asthma control status during this 6-month study. C-ACT may also be able to improve the prediction of childhood asthma exacerbations in busy clinical practice.