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Taherian MR, Fatemian F, Halimi A, Soleimani Y, Jorjani G, Nozari P, Mosavi Jarrahi A, Nazari SSH, Al-Yateem N, Al-Marzouqi A, Humid A, Rahman SA. Prevalence of asthma among children and adolescents in WHO's Eastern Mediterranean Region: a meta-analysis of over 0.5 million participants. BMC Public Health 2024; 24:2148. [PMID: 39112964 PMCID: PMC11308745 DOI: 10.1186/s12889-024-18716-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 04/25/2024] [Indexed: 08/10/2024] Open
Abstract
OBJECTIVE This study aims to evaluate the epidemiology of asthma among children and adolescents in the Eastern Mediterranean Region. METHODS Exhaustive searches were conducted across databases, including PubMed, Scopus, Web of Knowledge Core Collection, Embase, and Google Scholar. The selection criteria included studies reporting asthma prevalence in individuals aged 0 to 19 years, using validated questionnaires. Data were extracted and synthesized using the DerSimonian and Laird random effects model. RESULTS The overall prevalence of asthma in Eastern Mediterranean Regional Office (EMRO) countries, among the 514,468 children and adolescents included in this meta-analysis, was 10.61%, synthesized from 95 studies. Among the countries studied, Qatar exhibited the highest prevalence at 16.69%, followed by Saudi Arabia at 16.57%, Iraq at 16.22%, Oman at 15.20%, and Afghanistan at 14.90%. Adolescents showed a slightly higher prevalence of asthma at 10.10% compared to children at 9.70%. Boys exhibited a higher prevalence at 11.48% compared to girls at 9.75%. Urban areas demonstrated a higher prevalence at 11.27% than rural areas at 8.29%. CONCLUSION Efforts to reduce asthma prevalence in Arab countries and address underdiagnosis in African nations within the EMRO are crucial. Targeted interventions should focus on addressing environmental triggers and improving access to healthcare. Enhanced diagnostic capabilities and healthcare infrastructure are necessary in African countries. Collaborative action is essential to alleviate the asthma burden and promote respiratory health across the EMRO region.
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Affiliation(s)
- Mohammad Reza Taherian
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farbod Fatemian
- Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Aram Halimi
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Yaser Soleimani
- Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Goljamal Jorjani
- Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Parisa Nozari
- Medical School, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Seyed Saeed Hashemi Nazari
- Prevention of Cardiovascular Disease Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Safety Promotion and Injury Prevention Research Center, Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nabeel Al-Yateem
- Department of Nursing, College of Health Sciences, University of Sharjah, Sharjah, UAE
| | | | - Aysha Humid
- College of Health Sciences, University of Sharjah, Sharjah, UAE.
| | - Syed Azizur Rahman
- Department of Health Care Management, College of Health Sciences, University of Sharjah, University of Sharjah, UAE.
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Dastoorpoor M, Khodadadi N, Madadizadeh F, Raji H, Shahidizadeh E, Idani E, Shoushtari MH. Assessing the prevalence and severity of asthma, rhinitis, and eczema among schoolchildren (6-7 and 13-14 years old) in Khuzestan, Iran: a cross-sectional survey. BMC Pediatr 2022; 22:463. [PMID: 35918674 PMCID: PMC9344770 DOI: 10.1186/s12887-022-03520-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/26/2022] [Indexed: 11/25/2022] Open
Abstract
Background Asthma and allergic complications are the most common chronic disorders in children and adolescents. This study aimed to determine the prevalence and severity of asthma, allergic rhinitis, eczema among schoolchildren, and some related risk factors. Methods The cross-sectional study was performed in 2019 and involved 4000 students aged 6–7 years and 4000 students aged 13–14 years (both girls and boys) from urban schools in Khuzestan Province, southwestern Iran. We used the multi-stage sampling method. Data were collected using the Persian version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Results The prevalence of current wheeze, wheeze ever and asthma ever in the age group of 6–7 years was 3.8, 4.5, and 1.8%, respectively; in the age group of 13–14 years, it was 4.4, 5.9, and 3.4, respectively. In terms of gender, males (4.9, 6.0, and 2.7 percent, respectively) had substantially higher rates of current wheeze, wheeze ever, and asthma ever compared to the girls (2.8, 3.6, and 2.0 percent, respectively) (p < 0.001). The prevalence of rhinitis, Hay fever, and eczema among young people was 5.3%, 3.5%, and 1.0%, respectively. Current wheeze was more common in children with allergic rhinitis in the last 12 months (30.3% vs. 2.7%, p < 0.001), Hay fever (32.8% vs. 0.3%, p < 0.001) and eczema (27.8% vs 3.8%, p < 0.001), compared to children who did not. Conclusions The prevalence and severity of asthma symptoms were significantly associated with allergic rhinitis, eczema, and gender. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03520-x.
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Affiliation(s)
- Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khodadadi
- Department of Biostatistics and Epidemiology, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Farzan Madadizadeh
- Research Center of Prevention and Epidemiology of Non-Communicable Disease, Department of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hanieh Raji
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Elham Shahidizadeh
- Department of Environmental Health Engineering, Faculty of Medical Sciences, School of Health, Abadan, Iran
| | - Esmaeil Idani
- Department of Internal Medicine, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| | - Maryam Haddadzadeh Shoushtari
- Department of Internal Medicine, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Ravindra K, Goyal A, Mor S. Pollen allergy: Developing multi-sectorial strategies for its prevention and control in lower and middle-income countries. Int J Hyg Environ Health 2022; 242:113951. [PMID: 35334435 DOI: 10.1016/j.ijheh.2022.113951] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 02/25/2022] [Accepted: 03/06/2022] [Indexed: 10/18/2022]
Abstract
Pollen allergy is considered a major public health problem that causes morbidity and subsequently affects a patient's quality of life. Pollen due to their large size cannot enter the thoracic regions of the respiratory tract but can affect the nasopharyngeal mucous membrane. At the same time, the submicronic-pollen particles can act as respirable particles reaching deeper into the upper airways leading to exacerbation of asthma, chronic obstructive pulmonary disease (COPD) and other allergic reactions. Based on the existing literature, expanding evidence shows that climate change and air pollutants could affect the pollen number, morphology, season, allergen content, and distribution pattern. Hence, this will influence the prevalence and occurrence of allergies linked to pollen exposure. Being a part of biogenic pollutants, pollen allergens are not expected to diminish in the foreseeable future. Therefore, it is imperative that steps need to be strengthened to improve and optimize preventive/adaptive strategies. This paper aims to review the major causes of widespread allergy, identify the major gaps, and suggest key preventive/adaptive measures to address the onset and exacerbation of pollen-related allergic diseases with a major focus on lower and middle-income countries. The study also discusses how-to implement the prevention and control measures at the individual, health care communities and organizations, Local Governments, National/International Governments levels to decrease the risk of illnesses associated with pollen allergy.
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Affiliation(s)
- Khaiwal Ravindra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012, India.
| | - Akshi Goyal
- Department of Environment Studies, Panjab University, Chandigarh, 160014, India
| | - Suman Mor
- Department of Environment Studies, Panjab University, Chandigarh, 160014, India.
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Rajapakse S, Amarasiri L, Yasaratne D, Warnasekara J, Agampodi S. Temporal Variation and Factors Associated with Allergic Rhinitis in a Cohort of Rural Preschool Children from Sri Lanka. J Trop Pediatr 2022; 68:6533388. [PMID: 35188209 DOI: 10.1093/tropej/fmac017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Allergic rhinitis is a common chronic childhood disease with a low diagnosis rate, causing poor quality of life, absenteeism, decreased school performance and significant healthcare cost. However, data on the prevalence of allergic rhinitis is sparse in preschoolers of rural geography, especially in developing countries. AIM To describe the epidemiology of allergic rhinitis in preschoolers from a rural geography of a developing country. METHODS A population-based cross-sectional study was conducted in Anuradhapura district, Sri Lanka using the WHO-30 cluster methodology with probability proportionate to size sampling. The International Study of Asthma and Allergy in Childhood questionnaire was used to assess symptomatology. RESULTS The response rate was 91.8%, with 548 (51.7%) male and 512 (48.3%) female participants. The mean age was 4.4 (± 0.7) years. Allergic rhinitis was reported in 123 (11.6%; 95% CI 9.7-13.5), and eye symptoms were reported in 41 (3.9%; 95% CI 2.8-5.2) children. Activities of daily living were disturbed due to nasal symptoms in 113 (10.7%; 95% CI 8.8-12.5). Allergic rhinitis was independently associated with severe asthma (OR 6.26; 95% CI 3.54-11.06), sleeping on the floor (OR 4.79; 95% CI 1.33-17.25) and having cats in the households (OR 1.86; 95% CI 1.18-2.91). Nasal symptoms were more common in January and August to October months. The standardized local highest monthly temperature, lowest monthly temperature, highest monthly humidity and dew point strongly predicted allergic rhinitis symptom exacerbation (F=4.8, p=0.036, adjusted R square=57.8%, VIF≤2.259, DW=2.1). CONCLUSIONS Allergic rhinitis affects 1 in 10 preschool children of rural Sri Lanka. The factors associated and environmental factor model developed to predict symptom exacerbation could be used to prevent allergic rhinitis exacerbations.
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Affiliation(s)
- Shashanka Rajapakse
- Department of Physiology, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
| | - Lakmali Amarasiri
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Duminda Yasaratne
- Department of Medicine, Faculty of Medicine, University of Peradeniya, Peradeniya, Sri Lanka
| | - Janith Warnasekara
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
| | - Suneth Agampodi
- Department of Community Medicine, Faculty of Medicine and Allied Sciences, Rajarata University of Sri Lanka, Saliyapura, Anuradhapura, Sri Lanka
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Aslam R, Shahid M, Bano I, Ayoub M, Sabar MF, Altaf S, Kousar S, Ghani MU, Husnain T, Shahid AA. Major histocompatibility complex class II polymorphic variants are associated with asthma predisposition in the Punjabi population of Lahore, Pakistan. THE CLINICAL RESPIRATORY JOURNAL 2021; 15:374-381. [PMID: 33211378 DOI: 10.1111/crj.13309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 10/09/2020] [Accepted: 11/13/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Various genome wide association studies have manifested that Major Histocompatibility Complex (MHC) region on chromosome 6p21 houses many potential candidate genes for asthma. OBJECTIVE This Case-Control association study was planned to determine the association of 10 Single Nucleotide Polymorphisms (SNPs), residing within and around MHC genes' region on chromosome 6p21, with Asthma in Punjabi population of Lahore, Pakistan. METHODS A total of 161 subjects, 61 physician-diagnosed asthma patients and 100 age-matched healthy controls, were recruited from Lahore, a city in Punjab. Ten single nucleotide polymorphisms (SNPs) (rs9378249, rs2070600, rs404860, rs6689, rs1049124, rs1063355, rs1049225, rs1049219, rs7773955 and rs928976) located within or near AGER, NOTCH and HLA genes in MHC region, were genotyped in both patients and controls using single base extension reaction and capillary electrophoresis-based genetic analyser. Statistical models were applied using SHEsis Plus. Results were adjusted for various cofactors (age, gender and environment) and by applying multiple corrections. Haplotype and linkage disequilibrium analyses were performed on Haploview software v4.1. RESULTS Three of the studied SNPs rs1049124, rs1049219 and rs7773955 show independent significant association with asthma under allelic and genotypic models. Two of the haplotypes, H7 and H13, "CTAATTT" and "CCACTAT", respectively, for rs2070600, rs404860, rs6689, rs1049124, rs1063355, rs1049219 and rs7773955, are found to be significantly associated with the disease. CONCLUSION This study reports association of SNP variants residing on HLA-DQB1 and HLA-DQA2 genes and haplotypes H7 and H13 on genomic region 6p21 with Asthma in the Punjabi population of Lahore, Pakistan.
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Affiliation(s)
- Raheela Aslam
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Mariam Shahid
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Iqbal Bano
- The Children's Hospital and The Institute of Child Health, Pediatric Pulmonology, Lahore, Pakistan
| | - Muhammad Ayoub
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | | | - Saba Altaf
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Samra Kousar
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Muhammad Usman Ghani
- Centre for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Tayyab Husnain
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Ahmad Ali Shahid
- Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
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Aslam R, Shahid M, Bano I, Ayoub M, Sabar MF, Altaf S, Kousar S, Ghani MU, Husnain T, Shahid AA. Major histocompatibility complex class II polymorphic variants are associated with asthma predisposition in the Punjabi population of Lahore, Pakistan. THE CLINICAL RESPIRATORY JOURNAL 2021. [DOI: https:/doi.org/10.1111/crj.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Raheela Aslam
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Mariam Shahid
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Iqbal Bano
- The Children’s Hospital and The Institute of Child Health, Pediatric Pulmonology Lahore Pakistan
| | - Muhammad Ayoub
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | | | - Saba Altaf
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Samra Kousar
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | | | - Tayyab Husnain
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Ahmad Ali Shahid
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
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7
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Aslam R, Shahid M, Bano I, Ayoub M, Sabar MF, Altaf S, Kousar S, Ghani MU, Husnain T, Shahid AA. Major histocompatibility complex class II polymorphic variants are associated with asthma predisposition in the Punjabi population of Lahore, Pakistan. THE CLINICAL RESPIRATORY JOURNAL 2020. [DOI: https://doi.org/10.1111/crj.13309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Raheela Aslam
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Mariam Shahid
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Iqbal Bano
- The Children’s Hospital and The Institute of Child Health, Pediatric Pulmonology Lahore Pakistan
| | - Muhammad Ayoub
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | | | - Saba Altaf
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Samra Kousar
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | | | - Tayyab Husnain
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
| | - Ahmad Ali Shahid
- Centre of Excellence in Molecular Biology University of the Punjab Lahore Pakistan
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Ahmed M, Billoo AG, Iqbal K. Efficacy of probiotic in perennial allergic rhinitis under five year children: A randomized controlled trial. Pak J Med Sci 2019; 35:1538-1543. [PMID: 31777489 PMCID: PMC6861497 DOI: 10.12669/pjms.35.6.744] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective: To determine the efficacy of probiotic (Lactobacillus Paracasei, LP-33) and compare it with cetirizine for the treatment of perennial allergic rhinitis in under five year’s children. Methods: The randomised clinical trial was conducted at Kharadar General Hospital, Karachi, from Dec 2016 to Nov 2017. Children aged 6 to 60 months, clinically presented with allergic rhinitis were included in the study. Total 212 children, randomized into intervention group A (received probiotic LP-33) and control group B (received cetirizine) for six weeks, were included in the analysis. Baseline allergic rhinitis symptoms (rhinorrhea, sneezing, nasal blocking, coughing, feeding & sleeping difficulties) were assessed after two and six weeks follow up and correlated both groups by using Pearson chi-square test. A p value of <0.05 were considered statistically significant. Results: Total 212 children were analysed, out of them 113 (53.3%) were male. Mean age of study participant was 26 ± 16.64 months and mean body weight was 10.1 ± 3.26 Kg. More than 95% cases have shown significant improvement in their baseline symptoms (rhinorrhea, sneezing, nasal blocking, coughing, feeding difficulties and sleeping difficulties) in both intervention (L-33 Probiotic) and control (Cetirizine) groups. Statistically there was no difference in effectiveness of probiotic and cetirizine treatment for perennial allergic rhinitis (P > 0.05). Conclusions: Probiotic (LP-33) was equally effective as cetirizine in under five year’s children for the treatment of perennial allergic rhinitis. Probiotic has additional benefit to treat allergic rhinitis without causing any major side effect in children reported by the study.
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Affiliation(s)
- Mubashir Ahmed
- Mubashir Ahmed, MBBS. Kharadar General Hospital, Aga Khan Road, Kharadar, Karachi, Pakistan
| | - Abdul Gaffar Billoo
- Abdul Gaffar Billoo, FRCP. Kharadar General Hospital, Aga Khan Road, Kharadar, Karachi, Pakistan
| | - Khalid Iqbal
- Khalid Iqbal, MBBS, DCH. Kharadar General Hospital, Aga Khan Road, Kharadar, Karachi, Pakistan
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Ainuddin J, Javed F, Kazi S. Oral labetalol versus oral nifedipine for the management of postpartum hypertension a randomized control trial. Pak J Med Sci 2019; 35:1428-1433. [PMID: 31489020 PMCID: PMC6717493 DOI: 10.12669/pjms.35.5.812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 06/24/2019] [Accepted: 06/26/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To compare the efficacy of oral Labetalol versus oral Nifedipine for the treatment of postpartum hypertension. METHODS A prospective randomized controlled trial with parallel assignment was conducted in the department of Obstetrics and Gynecology, Dow University of Health Sciences Karachi, Pakistan, 124 patients with post partum hypertension were selected and randomized into two groups with 62 patients receiving Labetalol and 62 receiving long acting nifedipine. Initial blood pressures were recorded, and the respective drug was administered. Dose adjustments were performed in the initial 24 hours. The outcome was measured in the form of drug efficacy by lowering of systolic blood pressure less than 140mm of Hg and diastolic less than 90mm of Hg up to 48 hours after starting treatment. Data was entered and analyzed through SPSS version 20. RESULTS Our study randomized 62 women to oral labetalol and 62 women to oral long acting nifedipine. The time required to achieve blood pressure control was 35.6±2.8 hours in labetalol group and 30.4±1.9 hours in nifedipine group (p=0.04).length of hospital stay, need of additional antihypertensive medications were same in both groups. Minor side effects were observed more in nifedipine group. CONCLUSION We conclude that both oral labetalol and oral long acting nifedipine are effective and well tolerated interventions for the management of post-partum hypertension. However we found Nifidipine more effective in the management of postpartum hypertension.
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Affiliation(s)
- Jahanara Ainuddin
- Prof. Dr. Jahanara Ainuddin FCPS, Ph.D. Department of Obstetrics and Gynecology, Dow University of Health Sciences, Karachi, Pakistan
| | - Fariha Javed
- Dr. Fariha Javed, MBBS. Postgraduate Resident, Department of Obstetrics and Gynecology, Dow University of Health Sciences, Karachi, Pakistan
| | - Sarah Kazi
- Dr. Sarah Kazi, MRCOG, FCPS. Associate Professor, Department of Obstetrics and Gynecology, Dow University of Health Sciences, Karachi, Pakistan
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Nabi FG, Sundaraj K, Lam CK, Palaniappan R. Analysis of wheeze sounds during tidal breathing according to severity levels in asthma patients. J Asthma 2019; 57:353-365. [PMID: 30810448 DOI: 10.1080/02770903.2019.1576193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed to statistically analyze the behavior of time-frequency features in digital recordings of wheeze sounds obtained from patients with various levels of asthma severity (mild, moderate, and severe), and this analysis was based on the auscultation location and/or breath phase. Method: Segmented and validated wheeze sounds were collected from the trachea and lower lung base (LLB) of 55 asthmatic patients during tidal breathing maneuvers and grouped into nine different datasets. The quartile frequencies F25, F50, F75, F90 and F99, mean frequency (MF) and average power (AP) were computed as features, and a univariate statistical analysis was then performed to analyze the behavior of the time-frequency features. Results: All features generally showed statistical significance in most of the datasets for all severity levels [χ2 = 6.021-71.65, p < 0.05, η2 = 0.01-0.52]. Of the seven investigated features, only AP showed statistical significance in all the datasets. F25, F75, F90 and F99 exhibited statistical significance in at least six datasets [χ2 = 4.852-65.63, p < 0.05, η2 = 0.01-0.52], and F25, F50 and MF showed statistical significance with a large η2 in all trachea-related datasets [χ2 = 13.54-55.32, p < 0.05, η2 = 0.13-0.33]. Conclusion: The results obtained for the time-frequency features revealed that (1) the asthma severity levels of patients can be identified through a set of selected features with tidal breathing, (2) tracheal wheeze sounds are more sensitive and specific predictors of severity levels and (3) inspiratory and expiratory wheeze sounds are almost equally informative.
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Affiliation(s)
- Fizza Ghulam Nabi
- School of Mechatronic Engineering, Universiti Malaysia Perlis, Malaysia
| | - Kenneth Sundaraj
- Centre for Telecommunication Research & Innovation, Fakulti Kejuruteraan Elektronik & Kejuruteraan Komputer, Universiti Teknikal Malaysia Melaka, Malaysia
| | - Chee Kiang Lam
- School of Mechatronic Engineering, Universiti Malaysia Perlis, Malaysia
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Zahid W, Rozi S, Khan FR, Zahid N, Kadir M. Association between Asthma and Dental Caries amongst 12 - 15 Years Old Children: A School-Based Cross-Sectional Study in Karachi, Pakistan. ACTA ACUST UNITED AC 2019. [DOI: 10.4236/ojepi.2019.91010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Abstract
Objective: The purpose of the study was to examine the relationship of maternal complications during pregnancy and prenatal exposures with childhood asthma among low-income families in Karachi, Pakistan. Methods: Parents/guardians of children with and without asthma visiting a charity hospital were enrolled. Information about prenatal and perinatal exposures was collected. Univariable and multiple stepwise logistic regression analysis were conducted to explore the relationship of socio-demographic, maternal complications during pregnancy, access to prenatal care, and exposure to animals and pests while pregnant with childhood asthma. Results: Maternal symptoms of nocturnal cough (adjusted OR [aOR = 2.87, 95% CI = 1.60-5.14) and wheezing (aOR = 5.57, 95% CI = 2.32-13.37) during pregnancy significantly increased the odds of childhood asthma. The family history of asthma or hay fever, also elevated the odds of childhood asthma (adjusted OR [aOR] = 5.86 (3.03-11.34). The odds of asthma among children whose mothers received prenatal care by Dai, an unskilled health worker, were significantly elevated. Lastly, prenatal exposure to rats/mice and contact with goats while pregnant was significantly associated with childhood asthma. Whereas, prenatal exposure to cows/cattle reduces the odds of childhood asthma. Conclusions: This study identified important maternal and prenatal risk factors for childhood asthma, the majority of which are avoidable. Appropriate steps are needed to create awareness about the prenatal risk factors in this population.
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Affiliation(s)
- Ahmed A Arif
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | - Shelby D Veri
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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Sombans S, Lohana P. Finding a Better Solution for Asthma Control in Children. Cureus 2018; 10:e3344. [PMID: 30473977 PMCID: PMC6248683 DOI: 10.7759/cureus.3344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Asthma is a chronic respiratory condition that is very common among children. With proper management and follow-ups, this condition can be easily controlled in a child. However, there are several factors that are negatively influencing a proper care of asthmatic children throughout the world. In this mini-review, the roles of the parents, the schools and the child himself were analyzed and several possible solutions to improve those hurdles were discussed.
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Affiliation(s)
- Shaheen Sombans
- Internal Medicine, Bharati Vidyapeeth University Medical College and Hospital, Pune, IND
| | - Petras Lohana
- Internal Medicine, Liaquat University of Medical and Health Sciences Hospital, Karachi, PAK
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Mejias SG, Ramphul K. Prevalence and Associated Risk Factors of Bronchial Asthma in Children in Santo Domingo, Dominican Republic. Cureus 2018; 10:e2211. [PMID: 29686953 PMCID: PMC5910008 DOI: 10.7759/cureus.2211] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Bronchial asthma is an important health problem worldwide. There is insufficient data on the prevalence of bronchial asthma among school children in Santo Domingo, Dominican Republic. Objective The objective of this study is to assess the prevalence of asthma and its related risk factors among school children in Santo Domingo, Dominican Republic. Materials and methods A cross-sectional study using a modified questionnaire was conducted in Santo Domingo among 600 children aged three to 11 eleven years. The prevalence of asthma and its associated risk factors such as birth order, family history of asthma, family history of allergy, exposure to pets at home, exposure to tobacco smoke, and source of fuel used at home were collected. The relevant data collected was analyzed using the Statistical Package for the Social Sciences (SPSS) 24.0. (IBM Corp., Armonk, NY) software. Results The prevalence of asthma was found to be 22.0%. Age, family history of asthma, family history of allergy, exposure to tobacco smoke, and birth order showed statistical significance. The source of fuel used at home, gender, and exposure to pets were not statistically significant to be considered as risk factors associated with asthma in the population studied. Conclusion With an asthma prevalence of 22.0% in the pediatric population, the Dominican Republic has one of the highest national rates of asthma in the pediatric population in Latin America. Proper education, screening, and prevention can help lower the burden of this disease economically and socially.
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Affiliation(s)
- Stephanie G Mejias
- Department of Pediatrics, Robert Reid Cabral Children's Hospital Affiliated to the University Iberoamericana Unibe School of Medicine
| | - Kamleshun Ramphul
- Department of Pediatrics, Shanghai Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Alavinezhad A, Boskabady MH. The prevalence of asthma and related symptoms in Middle East countries. CLINICAL RESPIRATORY JOURNAL 2017; 12:865-877. [PMID: 28544458 DOI: 10.1111/crj.12655] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 04/11/2017] [Accepted: 05/09/2017] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Asthma is a chronic inflammatory airway disease characterized by reversible airway constriction and airway hyperresponsiveness. Asthma is a worldwide problem and its prevalence varies among different parts of the world. There are insufficient data about the prevalence and risk factors of this disease in Middle East countries. DATA SOURCE The objective of this review article was to determine the prevalence of asthma in Middle East countries by searching EMBASE, Medline, Web of Science and Google Scholar for articles about asthma prevalence in children and adults in this region. STUDY SELECTION The prevalence of asthma in different countries and different cities of each country in the Middle East was reviewed in children and adults of both sexes. The possible risk factors for asthma in different areas were also reviewed from 1985 to 2012. RESULTS The highest asthma prevalence in children and adults was 35.4% in Tehran, Iran by ISAAC phase I and 15% in Kuwait by self-designed questionnaire and the lowest prevalence was 1% in Kermanshah, Iran by ISAAC and 2% in Tehran, Iran by ECRHS questionnaire, respectively. Most studies showed that the prevalence of this common disease declines with increasing age. CONCLUSION The data showed that the prevalence of asthma varies among different countries and even among different cities of the same country. The common risk factors for this disease were genetic predisposition, cigarette smoking, family history of asthma and allergic diseases.
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Affiliation(s)
- Azam Alavinezhad
- Neurogeneeic Inflammation Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mohammad Hossein Boskabady
- Neurogeneeic Inflammation Research Centre, Mashhad University of Medical Sciences, Mashhad, Iran.,Department of Physiology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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Mebrahtu TF, Feltbower RG, Parslow RC. Incidence and Burden of Wheezing Disorders, Eczema, and Rhinitis in Children: findings from the Born in Bradford Cohort. Paediatr Perinat Epidemiol 2016; 30:594-602. [PMID: 27500464 DOI: 10.1111/ppe.12310] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Bradford city has high infant mortality and there is a major health concern in the community due to environmental pollution. The aim of the study was to investigate the incidence and burden of wheezing disorders, eczema, and rhinitis in children aged 3-7 years . METHODS It is a prospective cohort study; the participants were 13 734 children from the Born in Bradford cohort. RESULTS There were a total of 22.1% (95% Confidence Interval (CI) 21.4, 22.8%), 52.4% (95% CI 51.5%, 53.2%), and 19.3% (95% CI 18.6, 19.9%) incidence cases of wheezing disorders, eczema, and rhinitis respectively. A total of 37% (95% CI 36.2%, 37.8%), 19.5% (95% CI 18.9%, 20.2%,) and 5.9% (95% CI 5.5%, 6.3%) of the children were affected by only one, two, and three diseases respectively. Boys to girls incidence rate ratios for wheezing disorders, eczema, and rhinitis was 1.41 (95% CI 1.31, 1.51), 1.02 (95% CI 0.97, 1.07), and 1.18 (95% CI 1.09, 1.28) respectively. The respective incidence rate ratios of Pakistani to White British were 0.94 (95% CI 0.87, 1.02), 1.31 (95% CI 1.24, 1.39), and 2.03 (95% CI 1.83, 2.25) respectively. CONCLUSION This study shows that the burden of wheezing disorders, eczema, and rhinitis in this cohort is higher than previously reported in earlier studies. In addition, it indicates that while boys are more likely to suffer from wheezing disorders, rhinitis, and multiple diseases than girls, Pakistani children are more likely to suffer from eczema, rhinitis, and multiple diseases than White British children.
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Affiliation(s)
| | - Richard G Feltbower
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
| | - Roger C Parslow
- Division of Epidemiology and Biostatistics, School of Medicine, University of Leeds, Leeds, UK
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Gomes de Luna MDF, Gomes de Luna JR, Fisher GB, de Almeida PC, Chiesa D, Carlos da Silva MG. Factors associated with asthma in adolescents in the city of Fortaleza, Brazil. J Asthma 2014; 52:485-91. [PMID: 25405360 DOI: 10.3109/02770903.2014.984841] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Asthma is a chronic inflammatory airway disease. In Brazil, little is known about factors associated with this disease. This study aimed to identify factors associated with asthma in 13- to 14-year-old adolescents in Fortaleza, Ceará, Brazil. METHODS It is a cross-sectional population-based study, with a probability sample of 3015 students in 2006-2007. We used the questionnaires about asthma, rhinitis and socio-demographic/environmental factors from the International Study for Asthma and Allergies in Childhood (ISAAC) protocol. Current asthma was defined as physician-diagnosed asthma and wheezing in the previous 12 months. Bivariate analysis was performed between asthma and factors included in the study, using prevalence ratio and Chi-square test. Confidence intervals (95%) and odds ratio (OR) were also calculated. Factors associated with asthma in bivariate analysis were then assessed using logistic regression. RESULTS Final sample was composed by 694 adolescents, 179 with asthma. Rhinoconjunctivitis and consumption of stuffed biscuits and fried snacks three or more times per week were independently and positively associated with asthma; consumption of fruits three or more times per week was negatively associated with asthma. CONCLUSIONS Dietary factors were the most associated with asthma in this study. Besides rhinoconjunctivitis, consumption of stuffed biscuits and fried snacks (foods with high content of saturated fat) three or more times per week were independently associated with asthma as aggravating factors, while the consumption of fruits three or more times per week was associated with asthma as protective factor. Interventions acting on these factors may decrease the occurrence of asthma in this population.
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Firoz T, Magee LA, MacDonell K, Payne BA, Gordon R, Vidler M, von Dadelszen P. Oral antihypertensive therapy for severe hypertension in pregnancy and postpartum: a systematic review. BJOG 2014; 121:1210-8; discussion 1220. [PMID: 24832366 PMCID: PMC4282072 DOI: 10.1111/1471-0528.12737] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pregnant and postpartum women with severe hypertension are at increased risk of stroke and require blood pressure (BP) reduction. Parenteral antihypertensives have been most commonly studied, but oral agents would be ideal for use in busy and resource-constrained settings. OBJECTIVES To review systematically, the effectiveness of oral antihypertensive agents for treatment of severe pregnancy/postpartum hypertension. SEARCH STRATEGY A systematic search of MEDLINE, EMBASE and the Cochrane Library was performed. SELECTION CRITERIA Randomised controlled trials in pregnancy and postpartum with at least one arm consisting of a single oral antihypertensive agent to treat systolic BP ≥ 160 mmHg and/or diastolic BP ≥ 110 mmHg. DATA COLLECTION AND ANALYSIS Cochrane RevMan 5.1 was used to calculate relative risk (RR) and weighted mean difference by random effects. MAIN RESULTS We identified 15 randomised controlled trials (915 women) in pregnancy and one postpartum trial. Most trials in pregnancy compared oral/sublingual nifedipine capsules (8-10 mg) with another agent, usually parenteral hydralazine or labetalol. Nifedipine achieved treatment success in most women, similar to hydralazine (84% with nifedipine; relative risk [RR] 1.07, 95% confidence interval [95% CI] 0.98-1.17) or labetalol (100% with nifedipine; RR 1.02, 95% CI 0.95-1.09). Less than 2% of women treated with nifedipine experienced hypotension. There were no differences in adverse maternal or fetal outcomes. Target BP was achieved ~ 50% of the time with oral labetalol (100 mg) or methyldopa (250 mg) (47% labetelol versus 56% methyldopa; RR 0.85 95% CI 0.54-1.33). CONCLUSIONS Oral nifedipine, and possibly labetalol and methyldopa, are suitable options for treatment of severe hypertension in pregnancy/postpartum.
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Affiliation(s)
- T Firoz
- Department of Medicine, University of British ColumbiaVancouver, BC, Canada
- Child and Family Research Institute, University of British ColumbiaVancouver, BC, Canada
| | - LA Magee
- Department of Obstetrics and Gynaecology, University of British ColumbiaVancouver, BC, Canada
- Department of Medicine, British Columbia Women's Hospital and Health Sciences CentreVancouver, BC, Canada
| | - K MacDonell
- College of Physicians & Surgeons of British ColumbiaVancouver, BC, Canada
| | - BA Payne
- Child and Family Research Institute, University of British ColumbiaVancouver, BC, Canada
- Department of Obstetrics and Gynaecology, University of British ColumbiaVancouver, BC, Canada
| | - R Gordon
- Department of Obstetrics and Gynaecology, University of British ColumbiaVancouver, BC, Canada
| | - M Vidler
- Child and Family Research Institute, University of British ColumbiaVancouver, BC, Canada
- Department of Obstetrics and Gynaecology, University of British ColumbiaVancouver, BC, Canada
| | - P von Dadelszen
- Child and Family Research Institute, University of British ColumbiaVancouver, BC, Canada
- Department of Obstetrics and Gynaecology, University of British ColumbiaVancouver, BC, Canada
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Khan AA, Tanzil S, Jamali T, Shahid A, Naeem S, Sahito A, Siddiqui FA, Nafees AA, Fatmi Z. Burden of asthma among children in a developing megacity: childhood asthma study, Pakistan. J Asthma 2014; 51:891-9. [PMID: 24894743 DOI: 10.3109/02770903.2014.930882] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES Global burden of childhood asthma has increased in the past few decades, particularly in low-income countries. In Pakistan, there is a lack of community-based epidemiological studies estimating the burden of asthma among children. This study determined the prevalence and predictors of asthma among children 3-17 years of age in Karachi, Pakistan. METHODS A two-stage community-based representative cross-sectional survey was conducted in Karachi from March 2012 to April 2013 comprising 1046 children aged 3-17 years. Of 7500 clusters, 80 were randomly selected, and of these, 15 children per cluster were enrolled randomly. A translated and pre-tested version of International Study of Asthma and Allergies in Children questionnaire was administered. RESULTS The overall prevalence of asthma among study participants was 10.2% (95% CI: 8.4-12.0). Asthma was more likely to occur among boys (adj. OR: 2.5, 95% CI: 1.6-4.0), children in the younger age group (3-7 years) (adj. OR: 2.9, 95% CI: 1.7-4.8), those living in households with ill-ventilated kitchens (adj. OR: 1.8, 95% CI: 1.1-3.1), having family history of asthma (adj. OR: 2.3, 95% CI: 1.3-3.9) and those of the Sindhi ethnicity (adj. OR: 2.2, 95% CI: 1.1-4.4). CONCLUSION This study is the first robust evidence regarding asthma among children in Pakistan, reporting a high burden in this group. Family history, male gender, Sindhi ethnicity and ill-ventilated kitchen were identified as important predictors of asthma. Targeted preventive measures and intervention studies are required to better understand and reduce the burden of asthma among children in Pakistan.
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Affiliation(s)
- Adeel Ahmed Khan
- Department of Community Health Sciences, Aga Khan University , Karachi , Pakistan and
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Abbasi IN, Ahsan A, Nafees AA. Correlation of respiratory symptoms and spirometric lung patterns in a rural community setting, Sindh, Pakistan: a cross sectional survey. BMC Pulm Med 2012; 12:81. [PMID: 23249311 PMCID: PMC3552941 DOI: 10.1186/1471-2466-12-81] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Accepted: 12/14/2012] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Symptom-based questionnaires can be a cost effective tool enabling identification and diagnosis of patients with respiratory illnesses in resource limited setting. This study aimed to determine the correlation of respiratory symptoms and spirometric lung patterns and validity of ATS respiratory questionnaire in a rural community setting. METHODS This cross sectional survey was conducted between January - March 2009 on a sample of 200 adults selected from two villages of district Khairpur, Sindh, Pakistan. A modified version of the American thoracic society division of lung disease questionnaire was used to record the presence of respiratory symptoms. Predicted lung volumes i.e. forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and their ratio (FEV1/FVC) were recorded using portable spirometer. RESULTS In the study sample there were 91 (45.5%) males and 109 (54.5%) females with overall mean age of 34 years (±11.69). Predominant respiratory symptom was phlegm (19%) followed by cough (17.5%), wheeze (14%) and dyspnea (10.5%). Prevalence of physician diagnosed and self-reported asthma was 5.5% and 9.5% respectively. Frequency of obstructive pattern on spirometry was 28.72% and that of restrictive pattern was 19.68%. After adjustment for age, gender, socioeconomic status, spoken dialect, education, smoking status, height, weight and arsenic in drinking water, FVC was significantly reduced for phlegm (OR 3.01; 95% CI: 1.14 - 7.94), wheeze (OR 7.22; 95% CI: 2.52 - 20.67) and shortness of breath (OR 4.91; 95% CI: 1.57 - 15.36); and FEV1 was significantly reduced for cough (OR 2.69; 95% CI: 1.12 - 6.43), phlegm (OR 3.01; 95% CI: 1.26 - 7.16) and wheeze (OR 10.77; 95% CI: 3.45 - 33.6). Presence of respiratory symptoms was significantly associated with restrictive and/or obstructive patterns after controlling for confounders. Similar findings were observed through linear regression where respiratory symptoms were found to be significantly associated with decrements in lung volumes. Specificity and positive predictive values were found to be higher for all the symptoms compared to sensitivity and negative predictive values. CONCLUSION Symptoms based respiratory questionnaires are a valuable tool for screening of respiratory symptoms in resource poor, rural community setting.
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Affiliation(s)
- Imran Naeem Abbasi
- Community Medicine residents, Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Adeel Ahsan
- Community Medicine residents, Department of Community Health Sciences, The Aga Khan University, Karachi, Pakistan
| | - Asaad Ahmed Nafees
- Division of Environmental Health Sciences, Department of Community Health Sciences, The Aga Khan University, Stadium Road, P.O.Box-3500, Karachi, Pakistan
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Pegas PN, Alves CA, Scotto MG, Evtyugina MG, Pio CA, Freitas MC. [Risk factors and prevalence of asthma and rhinitis among primary school children in Lisbon]. REVISTA PORTUGUESA DE PNEUMOLOGIA 2011; 17:109-16. [PMID: 21549669 DOI: 10.1016/j.rppneu.2011.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Accepted: 08/02/2010] [Indexed: 10/18/2022] Open
Abstract
AIMS A cross-sectional study was carried out with the objective of identifying nutrition habits and housing conditions as risk factors for respiratory problems in schoolchildren in Lisbon. MATERIAL AND METHODS Between October and December 2008, parents of 900 students of the basic schools of Lisbon were invited to answer a questionnaire of the International Study of Asthma and Allergies in Childhood Program (ISAAC). The response rate was 40%. Logistic regression was used in the analysis of results. RESULTS The prevalence of asthma, allergic rhinitis and wheeze was 5.6%, 43.0% and 43.3%, respectively. Risk factors independently associated with asthma were wheezing attacks, and dry cough at night not related to common cold in the last 12 months. Wheezing crises were found to affect children daily activities. Risk factors for wheeze were hay fever and the presence of a pet at home. A risk factor for rhinitis was cough at night. The frequent consumption of egg was also associated with increased risk of rhinitis. CONCLUSION Contrarily to asthma, the prevalence of allergic rhinitis and wheeze increased in comparison with previous ISAAC studies. Wheezing attacks were associated with asthma and hay fever was identified as a risk factor of manifesting wheezing symptoms. Having pets at home was pointed out as a significant risk factor for rhinitis, but not smoking exposure, mould, plush toys, diet (except egg consumption), breastfeeding or other conditions.
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Affiliation(s)
- P N Pegas
- Centro de Estudos do Ambiente e do Mar, Departamento de Ambiente e Ordenamento, Universidade de Aveiro, Aveiro, Portugal.
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