Epidemiological study of risk factors in pediatric asthma

Abstract

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.

Keywords: asthma severity; asthma triggers; children; residence; risk factors; smoking; social status

Egypt J Pediatr Allergy Immunol 2007; 5(1): 11-19