Introduction: Acute asthma attack is one of the most common causes of visits to hospital emergency departments in all age groups of the population and accounts for the greater part of healthcare burden from the disease. Despite, Acute asthma attack is an important public health problem that affects not only the patients, but also to the family, health professionals, health care institutions and development of the nation, little is known about the risk factors of acute asthma attack. Therefore, this study is aimed to investigate the determinants of acute asthma attack among

Objective: The aim of this study was to assess the determinant factors of acute asthma attack among adult asthmatic patients visiting general hospitals of central zone, Tigray, Ethiopia, 2019.

Method: Hospital based unmatched case control study design was conducted in general hospitals of central zone of Tigray, Ethiopia 2019. Data were collected using pretested interviewer administered questionnaire. A total of 289 study subjects (96 cases &193 controls) were selected by systematic random sampling. Data were entered to Epi data version 3.1 then exported to SPSS  version 23 for analysis. Bivariate logistic regression was employed to examine the statistical  association between dependent and independent variables.

Variables with p value < 0.05 was taken as significant determinants of the outcome variable.

Result: A total of 96 adult asthmatic patients who have acute asthma attack (cases) and 193 adult  asthmatic patients without attack (controls)) with 100% response rate were participated in this  study. Upper Respiratory tract Infection [AOR=6.835,95% CI= 3.285,14.222], Season [AOR  =2.204,95% CI=1.011,4.805] kitchen smoke[AOR=2.307,95%CI1.010,5.272]& sleep apnea  [AOR= 9.254, 5%CI =3.563,25.460] were significantly associated with acute asthma  exacerbation.

Conclusion : In this study the determinant factors of acute asthma attack were spring season, presence of  upper respiratory tract infection (URTI), having no Kitchen smoke in their kitchen and having  obstructive sleep apnea.

Key Words: Acute asthma attack, Adult, Determinants, Ethiopia