Correspondence Address:
Pradeepa P Narayana
Institute of Applied Dermatology, Kasaragod District, Kerala State
India

Full Text

Sir,

Asthma is one of the most important chronic diseases of childhood, causing substantial morbidity. Increase in the rates of hospital admission and primary care contacts for asthma in childhood has led to concern regarding prevalence or severity of increasing wheezing illness in children. [1] There is paucity of studies in India regarding asthma in children. Recent report shows wide variation (4-19%) in the prevalence of asthma in school-going children from different geographic areas in India. [2] Recognizing the problem in children is very essential, since the spectrum of presentation is variable and multiple for proper management. [3] The International Study of Asthma and Allergy in Childhood (ISAAC) developed a standardized method for describing the prevalence of asthma and other atopic disorders. [4] We carried out this study in three schools of Subramanya, a rural area in Dakshina Kannada District of Karnataka state in India. The schools in the study belonged to Government-aided and unaided managements. Hence, the study population included all the socio-economic strata. Study population included school children between 10-18 years. The total number of subjects in our study was 573. Overall, there were 55.1% males and 44.9% females. The mean age of the study population was 13.4 years (SD = 1.5). Majority of subjects belonged to 13-15 years age group in both the genders (53.5% among males and 46.5% among females).

The prevalence of ever wheezers in our study is 8.4% and current wheezers is 5.2% and among them 16.7% had one to three episodes in a year on an average. The wheezing was more prevalent among the 10-12 years age group (11.5%) compared to others. Among the 573 subjects, 18.5% had allergic rhinitis. Among them, 12% gave history of nasal block, sneezing in the absence of seasonal rhinitis and 7.3% had history of lacrimation. As shown in [Table 1], the history of ever wheezing was more among males (11.7% compared to 4.3% among females). This difference was statistically significant (P = 0.01). The wheezing in the past 12 months was more among males among those who had a past history of wheeze (64.9% compared to 54.5% among females). This difference was not statistically significant (P = 0.72). The wheezing frequency was not different among the genders to attain a statistical significance (P = 1). Similarly, with regard to the severity of the symptoms during the attacks of Asthma, there was no gender difference.

The presence of dry cough in the past 12 months was significantly (P P P P et al, [5] studied the overall prevalence of asthma by dividing the subjects as those having wheezing at the time of survey and were on medication (current wheezers) and those gave a history of wheeze but were not suffering at the time of survey (Ever wheezed). There was overall prevalence of 5.2% to 6.1% of current wheezers and 10.2% to 13.8% of ever wheezed patients. Paramesh H et al., [3] in Bangalore did a hospital based study on 20,000 children under the age of 18 years from 1979,1984,1989,1994 and 1999 in the city of Bangalore, and showed a prevalence of 9%, 10.5%,18.5%, 24.5% and 29.5% respectively. The increased prevalence correlated well with demographic changes of the city. Further to the hospital study, a school survey in 12 schools on 6550 children in the age group of 6 to 15 years was undertaken for prevalence of asthma; Children from schools of heavy traffic area showed prevalence of 19.34%; Children from low traffic area school had 11.15% respectively (P et al, [6] in Chandigarh, studied the prevalence of asthma and its association with environmental factors, where males had more prevalence than females. This study showed a high prevalence of asthma among the school children in a rural area. Also there was gender difference in the symptoms and prevalence of asthma and allergic rhinitis. This calls for further evaluation of genetic and environmental factors which determine the prevalence, exacerbations of these allergic diseases. The environmental determinants of the allergic diseases among the children can be studied, compared to the national and international studies. This would also guide for the future measurement of the trend in the disease over a period of time.

 Acknowledgments

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