Prevalence of bronchial asthma and factors associated with it among higher secondary school children in Ernakulam district, Kerala, Southern India.

Context: Bronchial asthma is one of the leading causes of hospitalization and cause of frequent absenteeism among children and adolescents. Studies reporting the prevalence of bronchial asthma among adolescents from India are limited and the available studies report wide geographic variations in the prevalence of bronchial asthma.

Aims: The current study was aimed to estimate the prevalence of bronchial asthma among higher secondary school children and to identify various factors associated with it in Ernakulam district, Kerala, Southern India.

Settings and Design: The study was conducted in Ernakulam district, the industrial capital of Kerala. A school-based cross-sectional study was conducted.

Subjects and Methods: Data were collected from 629 students from 4 randomly selected higher secondary schools using a structured questionnaire. Section on details of respiratory symptoms was adapted from International Union Against Tuberculosis and Lung Disease bronchial symptoms questionnaire.

Statistical Analysis Used: Descriptive statistics was done with frequencies and percentages and confidence intervals (CIs) were calculated. Univariate and multivariate analysis was done for factors associated with bronchial asthma generating odds ratios (ORs) and 95% CIs.

Results: A total of 629 students participated in this study. The prevalence of bronchial asthma was estimated to be 9.9% (95% CI = 7.53%-12.27%). Students residing in a rural area (adjusted OR = 1.95, 95% CI = 1.10-3.46) having family history of bronchial asthma (adjusted OR = 2.84, 95% CI = 1.57-5.11) and usual exposure to friend's smoke (adjusted OR = 2.16, 95% CI = 1.17-3.97) were significantly associated with bronchial asthma.

Conclusions: The prevalence of bronchial asthma was higher among higher secondary school students of Ernakulam district. Considering high prevalence and its contributions to morbidity and mortality, a comprehensive program to tackle the issue of chronic respiratory diseases may be needed. The issue of active and passive smoking at schools exists and need to be resolved.