Genetic, familial and environmental correlates of asthma among early adolescents in Sri Lanka: a case control study

Abstract

BackgroundDespite advances in management, the mortality and morbidity due to asthma are increasing globally. Identification of specific correlates in the local context is useful in disease management. The objective of this study was to estimate the prevalence and to describe selected correlates of asthma among12-14 year old school children in a district in Sri Lanka.MethodA school based cross-sectional study was conducted using a self administered questionnaire. Multi-staged stratified cluster sampling was used to select 42 classes in grades 7, 8 and 9. “Current asthma” (CA)(case) was defined as ‘having Physician Diagnosed Asthma (PDA) and having had wheezing during the previous 12 months’. For each case, two healthy controls were selected from the same class to assess correlates. Information on correlates was collected by trained field midwives during home visits. Backward stepwise logistic regression model was used for analysis of correlates. Skin Prick Testing was carried out among asthmatics together with their healthy siblings using standard extracts of House Dust Mite (HDM), cockroach and Blomia. Ethical clearance was obtained from Ethical Review Committee, Faculty of Medicine, Colombo.ResultsOut of 1483 subjects participated, 753 were females (50.8%). The prevalence rates for current wheezing (CW), ever wheezing (EW), current asthma (CA), and physician diagnosed asthma (PDA) were 16.7%, 19.4%, 10.7% and 14.5% respectively. A total of 158 CA cases were identified. Information on correlates of asthma was collected for 145 CA cases (97.9%) and for 285 controls (96.6%). The unconfounded predictors of having CA among adolescents in the present sample were; only child in the family (OR = 4.2, 95% CI: 1.7-9.9); first born of the family (OR = 2.6 95% CI: 1.3-5.2); presence of allergic rhinitis (OR = 2.7, 95% CI: 1.6-4.6); family history of asthma (OR = 1.8, 95% CI: 1.1-3.2); family history of allergic rhinitis (OR = 1.9, 95% CI: 1.1-3.2); family history of eczema (OR = 1.8, 95% CI: 1.0-3.2). Higher risk of sensitization to cockroach, HDM and Blomia was seen among asthmatics compared to healthy siblings.ConclusionA significant proportion of students reported to have asthma. Atopy and other genetic and environmental correlates should be considered as important correlates in asthma management among early adolescents in Sri Lanka.

Association between functional abdominal pain disorders and asthma in adolescents: A cross-sectional study

“…Regional differences in the dietary patterns, life styles, differences in survey methods, inclusion of different age groups, and changing diagnostic criteria would have contributed to these differences. The prevalence of asthma in this study is more than that previously reported by Danansuriya et al[21] (10.7%) in Sri Lankan adolescents aged 12-14 years. However, the prevalence rate of asthma reported in this study is within the range reported by the ISAAC studies carried out throughout the world, which ranged between 0.8% to 32.6% among adolescents aged 13 to 14 years[4].…”

“…Consent was obtained from the school administration, parents, and the children themselves. Previously translated and validated Rome III questionnaire (self-reported form for children above 10 years)[7,19] and International Study on Asthma and Allergies in Childhood (ISAAC) questionnaire[20,21] were used to diagnose FAPDs and asthma, respectively. HRQoL was evaluated using translated and pretested Pediatric Quality of Life Inventory 4.0 (PedsQL - Generic Core Scales) self-report form for teens[7,22].…”

Cesarean section without medical indication and risks of childhood allergic disorder, attenuated by breastfeeding

“…Finally, our study did not collect data on family history of allergic disorders. Previous study found that children with family history of allergy had a higher risk of asthma than those without family history 28 . Since family history of asthma isn’t related with CS, it may not confound the association between CS and the risks of childhood asthma and allergic rhinitis.…”

Differences in serum markers of oxidative stress in well controlled and poorly controlled asthma in Sri Lankan children: a pilot study

“…The full scope of molecular mechanisms underpinning the changes seen in asthma is still unclear. Plausible contributory mechanisms include genetic predisposition [5][6][7][8][9], epigenetic alterations [10,11], exposure to environmental pollutants [12,13], chemicals [14] and viral infections [15] acting as triggers of inflammation.…”