Clinical Presentation and Risk Factors of Bronchial Asthma in Yemeni Children
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- Category: Vol. 84, June 2016
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Clinical Presentation and Risk Factors of Bronchial Asthma in Yemeni Children, ALI AL-ERYANI, AHMED AL-KHORASANI, NAJLA AL-SONBOLI and NASHER AL-AGHBARI
Abstract
Background: Asthma is a disorder defined by its clinical, physiological, and pathological characteristics. The predom-inant feature of the clinical history is episodic shortness of breath, particularly at night, often accompanied by cough. Wheezing appreciated on auscultation of the chest is the most common physical finding. The main physiological feature of asthma is episodic airway obstruction characterized by expir-atory airflow limitation. Factors influencing the development and expression of asthma includes host factors such as atopy, male gender and environmental factors such as tobacco smoke, airborne allergens, viral respiratory infections and the diet.
Objective: To explore the clinical profile and identify the risk factors for developing bronchial asthma among asthmatic children in comparison with age-matched healthy control group in Sana'a City.
Methods: It was a hospital based prospective case control study. The target population was children of an age group 5- 15 years in Sana'a, Yemen attending two referral pediatrics hospitals: Al-Sabeen for Maternity & Childhood and Al-Thawra General Modern Hospital. Data collection was for a period of 12 month. The cases were children with confirmed asthma of an age group of 5-15 years old, and the age matched controls were children without respiratory signs or symptoms and attending for day care surgery. The data was collected according to a structured questionnaire and the pulmonary function tests was conducted by using the Vitalgraph Spirotrac version 4.36 (UK). Analysis was conducted using Epi-info 2000-Version 1.02 programs.
Results: Fifty asthmatic children and 50 age matched (5- 15y) healthy controls were enrolled.
The mean (SD) age of asthmatic children was (8.54± 3.04) years and of the control group was (8.05±2.6). Recurrent wheeze, shortness of breath and nocturnal cough were the most frequent symptoms they were found in 50 (100%), 46 (92%) and 46 (92%) of the cases respectively. Wheeze and tachypnea were the most common physical signs 47 (94.0%) and 31 (62.0%). Univariate analysis showed that family history of asthma, family history of atopic disease, male gender, personal history of atopic disease, prematurity, early weaning, severe LRTI in early life, birth at winter season, low birth weight, and exclusive breast-feeding duration <4 months were all significant risk factors of childhood asthma. However the multivariate analysis showed that the independent risk factors for childhood asthma in a descending order of significance were: Positive family history of asthma, exclusive breast-feeding duration <4 months, history of atopic disease, low birth weight and prematurity.
Conclusion: Asthma can't always be prevented, but it is thought that early identification of children at high risk for asthma may improve their management. Some of the risk factors of childhood asthma are preventable such as respiratory infections in early life, lack of exclusive breast feeding and early weaning, thus permitting a possible reduction of the prevalence of asthma in children.