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EG |
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| Egypt J Pediatr Allergy Immunol |
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2007 |
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5 |
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11-19 |
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ESP - 77 |
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| Epidemiological study of risk factors in pediatric asthma |
| Mohamed A. Tageldin |
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Gamal S. Aly |
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Salah Mostafa |
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Hany Khalil |
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| Background: Childhood asthma is a major public health problem in Egypt
and worldwide. Epidemiologic, physiologic, and social factors appear to be
associated with an increased risk of asthma.
Objective: The aim of the study was to determine the most frequent risk
factors of childhood asthma exacerbation and severity in our community.
Methods: This cross sectional study involved 206 asthmatic children, 5 to 15
years old. They were enrolled from the School Students Health Insurance
facility of El-Matareya Teaching Hospital and from the Pediatric Outpatient
Clinic of Saint Mark Charity Hospital representing several social and
residential classes. They were assessed clinically and by peak expiratory
flow rate (PEFR). Parents of children were interviewed for symptoms and
some demographic, social, environmental, housing and familial data as well
as asthma triggers through a comprehensive detailed questionnaire.
Results: Residential distribution and social status were significantly
associated with asthma severity as most moderate persistent asthmatics lived
in semi-urban areas (70.8%) and belonged to the low-level segment of social
classification (47.9%). In the majority of the study population (69.9%), a
family member or more had a positive history of bronchial asthma, and this
was especially evident in moderate persistent cases (70.8%). Passive
smoking and dust triggered exacerbations in 48.6% and 65% of the studied
sample respectively and in most moderate persistent asthmatics (83.4% and
93.7%). Most houses of moderate asthmatics were infested with cockroaches
(91.7%) and domestic animals were present in 56.2%. Recurrent chest
infections and cold/flu attacks were strongly associated with asthma
exacerbation and severity (93.8% and 93.7% of moderate persistent cases
respectively). Most moderate persistent asthmatics (91.7%) reported
exercise-induced asthma while 64.6% stated that emotional stress triggered
their symptoms. Indoor pollutants such as insecticides, household chemicals
and odors were strongly associated with asthma severity and exacerbation
especially in moderate persistent cases (triggered symptoms in 66.7%,
52.1% and 58.3% of cases respectively).
Conclusion: Smoking, emotional stress and dust were the most significant
triggers of asthma exacerbation and severity in our series. Identification and
avoidance of risk factors for persistent asthma, combined with early
institution of pharmacologic and other intervention strategies, may lead to a
better outcome. |
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