Asthma Exacerbation in Indonesia: Analysis of Mental, Socio-demographic, Behavioral, and Biological Risk Factors Using the 2018 Indonesian Basic Health Research

Objectives: Asthma represents a significant global health burden, with exacerbations impacting quality of life. Although risk factors for asthma exacerbation (AE) have been identified, data specific to Indonesia remain scarce. We investigated risk factors for AE among Indonesian adolescents and adults. Methods: A cross-sectional analysis of the 2018 National Health Survey was conducted, including Indonesian participants aged 15 and older with diagnosed asthma. Logistic regression was employed to identify risk factors for AE. Results: A total respondents aged 15 years or older were 706 689 participants. The prevalence of asthma was 2.6% (18 574 participants). Among individuals with asthma, 59.7% experienced exacerbation, and 21.4% reported symptoms indicating emotional distress (ED). Both ED and diagnosed heart disease (DHD) were linked to increased odds of AE, with adjusted odds ratios (aORs) of 1.27 (95% confi dence interval [CI], 1.18 to 1.37) and 1.21 (95% CI, 1.06 to 1.38), respectively. Being diagnosed with asthma at age 15 or older was as sociated with an aOR of 1.56 (95% CI, 1.45 to 1.66). Those with lower socioeconomic status (SES) also faced comparatively high risk (aOR, 1.37; 95% CI, 1.23 to 1.52). In contrast, physical activity was inversely related to AE (aOR, 0.72; 95% CI, 0.64 to 0.81). Conclusions: ED, DHD, lower SES, and later-onset asthma were identified as significant risk factors for AE. This underscores the need for comprehensive asthma management strategies that prioritize mental health, cardiovascular health, and early intervention. Ad dressing these factors could substantially reduce the burden of AE in Indonesia. Further longitudinal studies are necessary to eluci date the causal relationships involved and evaluate the effectiveness of targeted interventions