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Epidemiology of bronchial asthma in school children (10-16 years) in Srinagar.
OBJECTIVES: To assess the epidemiological profile of asthma in school going children in Srinagar, Kashmir.
STUDY DESIGN: Cross-sectional study.
SETTING: Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools.
PARTICIPANTS: School children aged 10-16 years with equal representation of sex and all ages.
MAIN OUTCOME MEASURE: Prevalence of current and past asthma.
METHODS AND RESULTS: After administering a modified pretested questionnaire, peak expiratory flow measurement was carried. Children who had asthma-like symptoms or positive family history of asthma or physician-labeled asthma were subjected to spirometry and bronchodilator reversibility. Out of 806 children, bronchial asthma was seen in 60 (prevalence of 7.4%) which included 34 boys and 26 girls. Majority of asthmatic children (78.3% [n = 47]) had probable asthma; 6.7% (n = 4) had definite asthma; and 15% (n = 9) had physician-diagnosed asthma. Majority of children had intermittent asthma (78.3% [n = 47]). Mild persistent asthma was seen in 12.7% (n = 7) and 10% (n = 6) had moderate persistent asthma. None of the children had severe persistent asthma. The prevalence of current asthma was 3.2% (n = 26). On univariate analysis, the factors found to be statistically significant were family history of asthma (odds ratio [OR] =8.174; confidence interval [CI] =4.403-15.178), seasonal cough (OR = 4.266; CI = 2.336-7.791), allergic rhinitis (OR = 2.877; CI = 1.414-5.852), atopic dermatitis (OR = 6.597; CI = 2.72-16.004), and obesity (OR = 6.074; CI = 2.308-18.034). On multivariate analysis, family history, seasonal cough, allergic rhinitis, atopic dermatitis, and obesity were found to be significant independent risk factors.
CONCLUSIONS: Srinagar qualifies as a low prevalence area for bronchial asthma in the age group of 10-16 years. Majority of children had mild intermittent asthma resulting in under diagnosis and wrong treatment.
STUDY DESIGN: Cross-sectional study.
SETTING: Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools.
PARTICIPANTS: School children aged 10-16 years with equal representation of sex and all ages.
MAIN OUTCOME MEASURE: Prevalence of current and past asthma.
METHODS AND RESULTS: After administering a modified pretested questionnaire, peak expiratory flow measurement was carried. Children who had asthma-like symptoms or positive family history of asthma or physician-labeled asthma were subjected to spirometry and bronchodilator reversibility. Out of 806 children, bronchial asthma was seen in 60 (prevalence of 7.4%) which included 34 boys and 26 girls. Majority of asthmatic children (78.3% [n = 47]) had probable asthma; 6.7% (n = 4) had definite asthma; and 15% (n = 9) had physician-diagnosed asthma. Majority of children had intermittent asthma (78.3% [n = 47]). Mild persistent asthma was seen in 12.7% (n = 7) and 10% (n = 6) had moderate persistent asthma. None of the children had severe persistent asthma. The prevalence of current asthma was 3.2% (n = 26). On univariate analysis, the factors found to be statistically significant were family history of asthma (odds ratio [OR] =8.174; confidence interval [CI] =4.403-15.178), seasonal cough (OR = 4.266; CI = 2.336-7.791), allergic rhinitis (OR = 2.877; CI = 1.414-5.852), atopic dermatitis (OR = 6.597; CI = 2.72-16.004), and obesity (OR = 6.074; CI = 2.308-18.034). On multivariate analysis, family history, seasonal cough, allergic rhinitis, atopic dermatitis, and obesity were found to be significant independent risk factors.
CONCLUSIONS: Srinagar qualifies as a low prevalence area for bronchial asthma in the age group of 10-16 years. Majority of children had mild intermittent asthma resulting in under diagnosis and wrong treatment.
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