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Table of Content - Volume 3 Issue 3- September 2016


 


A study of prevalence of bronchial asthma and associated precipitating factors in children at tertiary health care center

 

Sanjay Dattu Mahajan 1, Deepak Onkar Patil2*

 

1Associate Professor, 2Professor, Department of Respiratory Medicine, Dr. Ulhas Patil Medical College and Hospital, Jalgaon, Maharashtra, INDIA.

Email: drdopatil@gmail.com

 

Abstract              Background: Asthma is a common chronic respiratory disease affecting children; it is a major health problem in both developed and developing countries Aims and Objectives: To Study of Prevalence of Bronchial Asthma and associated precipitating factors in Children at tertiary health care center. Methodology: After approval from ethical institutional committee a cross-sectional study was carried out in the Children who referred to the department of pulmonology of a tertiary health care center for the symptoms of asthma during the one year period i.e. January 2016 to January 2017. As per International Study Asthma and Allergy in Children (ISAAC). The data was expressed in proportions and percentages. Result: The overall prevalence of asthma in our study was 7% all children attending OPD. The majority of the patients were in the age group of 9-12 were 35.85%, followed by 6-9 -26.42%,3-6-20.75%, 0-3 were 16.98%. The majority of the patients were male i.e. 60.38 % followed by Female 39.62%. The majority of the clinical features were Frequent coughing spells in 90%. Followed by Chronic cough -89%, Less energy during play in 75%, Chest tightening in 69%, Breathless ness in 63%, Wheezing in 56%, Cough with Itching of Skin in 49 %, Cough with Wheeze and Fever in 39%. The majority of the Factors associated with Frequent acute attacks of Bronchial asthma were Family History were 80 %, H/o Pneumonia in 65%, H/o Antibiotics and Paracetamol in 52%, H/o Other Allergic Diseases in 48%, Poor Socio-Economic Status in 42%, H/o Pet animals in the house in 38% Conclusion: It can be concluded from our study that The majority of the clinical features were Frequent coughing spells, Followed by Chronic cough, Chest tightening etc. The majority of the Factors associated with Frequent acute attacks of Bronchial asthma were Family History were-H/o Pneumonia, H/o Antibiotics and Paracetamol, H/o Other Allergic Diseases, Poor Socio-Economic Status, H/o Pet animals in the house etc.

Key Words: Prevalence of Bronchial Asthma, Factors associated with Frequent acute attacks of Bronchial asthma, Pneumonia, Allergic Problems in Children.

 

INTRODUCTION

Asthma is a common chronic respiratory disease affecting children; it is a major health problem in both developed and developing countries1–3. The prevalence of childhood asthma and the morbidity related to asthma are both increasing, and occur in approximately 7–10% of the pediatric population and it is the leading cause of childhood morbidity 4–8. This chronic disease of the airways may cause wheezing, breathlessness, chest tightness and night time or early morning coughing, it is often reversible either spontaneously or with treatment 2

 

MATERIAL AND METHODS

After approval from ethical institutional committee a cross-sectional study was carried out in the Children who referred tot the department of pulmonology of a tertiary health care center for the symptoms of asthma during the one year period i.e. January 2016 to January 2017. As per International Study Asthma and Allergy in Children (ISAAC) 10The patients of asthma were diagnosed and included into study, So during one year after written consent of the parents 52 Children included into, All details of the study, like age, sex, Clinical features, any associated illness and risk factors of acute attack etc. was noted. The data was expressed in proportions and percentages

 

RESULT

 

Table 1: Distribution of the patients as per the age

Age

No.

Percentage (%)

0-3

9

16.98

3-6

11

20.75

6-9

14

26.42

9-12

19

35.85

Total

53

100.00

The overall prevalence of asthma in our study was 7% all children attending OPD. The majority of the patients were in the age group of 9-12 were35.85%, followed by 6-9 -26.42%,3-6-20.75%, 0-3 were 16.98%.

 

Table 2: Distribution of the patients as per the sex

Sex

No.

Percentage (%)

Male

32

60.38

Female

21

39.62

Total

53

100.00

The majority of the patients were male i.e. 60.38 % followed by Female 39.62%.

 

Table 3: Distribution of the patients as per the clinical features

Clinical features

No.

Percentage (%)

Frequent coughing spells

48

90%

Chronic cough

47

89%

Less energy during play

40

75%

Chest tightening

37

69%

Breathless ness

33

63%

Wheezing

30

56%

Cough with Itching of Skin

26

49 %

Cough with Wheeze and Fever

21

39%

The majority of the clinical features were Frequent coughing spells in 90%  Followed by Chronic cough -89%, Less energy during play in75%, Chest tightening in 69%, Breathless ness in 63%, Wheezing in 56%, Cough with Itching of Skin in 49 %, Cough with Wheeze and Fever in 39%

 

Table 4: Factors associated with Frequent acute attacks of Bronchial asthma

Associated factors

No.

Percentage (%)

Family History

42

80 %

H/o Pneumonia

34

65%

H/o Antibiotics and Paracetamol

28

52%

H/o Other Allergic Diseases

25

48%

Poor Socio-Economic Status

22

42%

H/o Pet animals in the house

20

38%

The majority of the Factors associated with Frequent acute attacks of Bronchial asthma were Family History were80 %, H/o Pneumonia in 65%, H/o Antibiotics and Paracetamol in 52%, H/o Other Allergic Diseases in 48%, Poor Socio-Economic Status in 42%, H/o Pet animals in the house in 38%

 

DISCUSSION

Severe respiratory syncytial virus (RSV) bronchiolitis during first year of life is considered to be an important risk factor for the development of recurrent wheezing and asthma.10 In a predisposed host, an RSV infection may not only unmask latent asthma but also elicit a Th2 response,11 transiently enhance immunoglobulin E (IgE) production and thereby significantly add to the manifestation of the disease at an early age.12 Respiratory syncytical virus bronchiolitis is common in Bangladesh.9 Similar positive relationship between infections and asthma was reported from Western Sydney.13 In our study we have seen that, The overall prevalence of asthma in our study was 7% all children attending OPD. The majority of the patients were in the age group of 9-12 were 35.85%, followed by 6-9 -26.42%,3-6-20.75%, 0-3 were 16.98%. The majority of the patients were male i.e. 60.38 % followed by Female 39.62%. The majority of the clinical features were Frequent coughing spells in 90%. Followed by Chronic cough -89%, Less energy during play in 75%, Chest tightening in 69%, Breathless ness in 63%, Wheezing in 56%, Cough with Itching of Skin in 49 %, Cough with Wheeze and Fever in 39%. The majority of the Factors associated with Frequent acute attacks of Bronchial asthma were Family History were 80 %, H/o Pneumonia in 65%, H/o Antibiotics and Paracetamol in 52%, H/o Other Allergic Diseases in 48%, Poor Socio-Economic Status in 42%, H/o Pet animals in the house in 38% These findings are similar to M.R. Hassan et al 14 they found Presence of allergic problems was recognised as risk factors for the development of bronchial asthma. Concomitant existence of atopic diseases, like allergic rhinitis, eczema and allergic conjunctivitis were found to be significant risk factors in both the settings. History of early childhood lung infections, like pneumonia, bronchiolitis and intake of antibiotics and paracetamol in last 12 months were also observed to be the risk factors in both the areas. Though most of the so-called allergic foods were statistically found to be a protective factor in both the settings [odds ratio (OR) 0.48, 95% confidence intervals (CI) 0.37-0.63 in city area and OR 0.80, 95% CI 0.66-0.96 in coastal area], this was considered to be an artifact.

 

CONCLUSION

It can be concluded from our study that The majority of the clinical features were Frequent coughing spells, Followed by Chronic cough, Chest tightening etc. The majority of the Factors associated with Frequent acute attacks of Bronchial asthma were Family History were -H/o Pneumonia, H/o Antibiotics and Paracetamol, H/o Other Allergic Diseases, Poor Socio-Economic Status, H/o Pet animals in the house etc.

 

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