Socioeconomic factors associated with asthma prevalence and severity among children living in low-income South African communities

Yakubovich, Alexa R.; Cluver, Lucie; Gie, Robert P.

doi:10.7196/samj.2016.v106i4.10168

Cited by 19 publications

(11 citation statements)

References 14 publications

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“… 1 In this study, potential risk factors associated with allergic diseases were male gender, consuming fast food, trucks passing near houses, having a dog or cat at home, and a positive SPT for Bermuda grass or cat fur. Although part of these findings have already been described in previous studies investigating the epidemiology of asthma among children, 33 , 34 our results extend these findings to other allergic diseases.…”

Section: Discussionsupporting

confidence: 89%

Asthma and other allergic diseases among Saudi schoolchildren in Najran: the need for a comprehensive intervention program

Alqahtani

2016

Annals of Saudi Medicine

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BACKGROUNDIn the last three decades, an increasing incidence of allergic diseases has been associated with increasing morbidity and mortality in children and young adults.OBJECTIVESThe study aimed to investigate the prevalence and risk factors associated with allergic diseases among Saudi schoolchildren in the southwestern Saudi region of Najran, and to determine the sensitization of patients to a set of allergens.DESIGNCross-sectional observational study.SETTINGPrimary, intermediate and secondary schools, Najran, Saudi Arabia.SUBJECTS AND METHODSAll participants completed the Arabic version of the International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. Skin prick tests (SPT) were performed, using a panel of standardized allergenic extracts.MAIN OUTCOME MEASURE(S)Prevalence and risk factors associated with pediatric allergic diseases.RESULTSThe study included 1700 Saudi schoolchildren. The overall prevalence of physician-diagnosed asthma, allergic rhinitis and atopic dermatitis was 27.5%, 6.3% and 12.5%, respectively. Multivariate analysis showed that male gender (adjusted odds ratio [aOR], 1.27), fast food consumption (aOR, 1.53), trucks passing near houses (aOR, 1.86), and having a dog or cat at home (aOR, 1.85) were significant risk factors. A total of 722 (42.5%) children had a positive SPT result to at least one allergen. The most prevalent allergens were grass pollens (60%), cat fur (41.6%), and house dust mites (25%).CONCLUSIONSThe findings of this study highlight the urgent need for developing an effective intervention program including several components working in harmony to control and reduce the burden of allergic diseases.LIMITATIONSThese results may not be generalizable to the rest of Saudi Arabia.

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Section: Discussionsupporting

confidence: 89%

Asthma and other allergic diseases among Saudi schoolchildren in Najran: the need for a comprehensive intervention program

Alqahtani

2016

Annals of Saudi Medicine

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“…[22] In another South African study using self-reported questionnaires amongst 6002 children from both rural and urban settings to investigate socioeconomic risk factors for childhood asthma, asthma severity increased with socioeconomic deprivation. [23] This association may be attributable to both the inequitable distribution of health care, poor access to diagnosis and care and environmental factors, such as increased exposure to indoor pollution and smoking. [22,23] Self-reported smoking was an important risk factor with almost 9% of participants self-reporting smoking at a relatively young age.…”

Section: Discussionmentioning

confidence: 99%

“…[23] This association may be attributable to both the inequitable distribution of health care, poor access to diagnosis and care and environmental factors, such as increased exposure to indoor pollution and smoking. [22,23] Self-reported smoking was an important risk factor with almost 9% of participants self-reporting smoking at a relatively young age. While self-reported smoking is an imperfect measure, this probably represents the lowest estimate of adolescents who are currently smoking in this population.…”

Section: Discussionmentioning

confidence: 99%

Asthma in South African adolescents: a time trend and risk factor analysis over two decades

et al. 2020

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BackgroundSouth Africa has undergone major economic and health system changes impacting the epidemiology of childhood asthma. This study aimed to investigate prevalence time-trends of asthma in South African adolescents over 2 decades and to identify associated risk-factors.MethodsA cross-sectional survey was conducted in 2017, in a randomised sample of 13–14 year-old Cape Town adolescents, using the standardised Global Asthma Network written, video, and environmental questionnaires. Using time-trend analysis, the prevalence and severity of asthma were compared with data from the 2002 ISAAC phase III study. Environmental and social risk-factors were analysed.Results3979 adolescents were included. Prevalence of lifetime and current asthma were 34.5% and 21.3%, respectively, on the self-report written questionnaire, similar to 2002 results. The prevalence of severe asthma in the last 12 months increased, measured by wheeze limiting speech (7.8% to 11.8%), ≥4 attacks of wheezing (5.0% to 5.8%) or ≥1 night·week−1 waking from wheezing (5.0% to 6.9%). The video questionnaire revealed increases in lifetime (16.9% to 22.5%), current (11.2% to 18.7%), or severe asthma (12.1% to 14.8%). Multivariate analysis showed associations between current asthma and smoking, female sex, pet exposure or higher socioeconomic status. Severe asthma was associated with smoking, pet exposure, outdoor pollution exposure or informal housing. 33% of those with severe or current asthma had been diagnosed.ConclusionThe prevalence of asthma is high, with increasing rates of severe asthma in adolescents. Underdiagnosis is a major concern and reduction in exposure to environmental factors, particularly smoking, and improved socioeconomic development are needed.

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“…Economically disadvantaged people disproportionately affected by asthma and asthma severity are often exposed to chronic psychosocial stressors. 1,2 Within the psychosocial factors, there are studies assessing the caregiver's mental health, particularly the mother's, as a predictor of asthma morbidity. [3][4][5] In this sense, maternal depressive symptoms are associated with increased number of visits to the emergency department (ED), 6,7 higher number of hospitalizations, 3,5 and worsening pulmonary function in asthmatic children.…”

Section: Introductionmentioning

confidence: 99%

Maternal common mental disorder over time and asthma control: The role of social support

Costa

Santos

Feitosa

et al. 2020

Pediatric Allergy Immunology

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Background Despite therapeutic advances, asthma prevalence remains high. Psychosocial factors, including maternal mental disorders, may be involved. This study aims to evaluate the association of maternal common mental disorders (CMDs) and their change over time with asthma morbidity in the child and to observe the effect of social support on this association. Methods This prospective study involved 189 dyads of mothers and their asthmatic children aged between 2 and 14 years, assisted in specialized outpatient clinics. We measured the association of maternal CMD evolution (absent, maintained, or improved over time) with asthma control and visits to the emergency department (ED) due to asthma attacks through Poisson regression analysis. We further stratified the sample according to social support levels to identify a possible effect of this variable on the association of maternal psychological symptoms with asthma morbidity. Results Compared with mothers who maintained CMD over time, maternal CMD absence had a protective effect on the occurrence of visits to the ED (RR: 0.45; 95% CI: 0.26‐0.79) and maternal CMD improvement was associated with lower risk of uncontrolled asthma in the child (RR: 0.60; 95% CI: 0.37‐0.97). There was a stronger association of maternal CMD improvement with asthma control in the child only for the stratum of mothers with high social support in its three dimensions (affective‐social interaction, emotional‐informational, and material dimensions). Conclusions Maternal CMD absence and improvement over the study period were protective factors for uncontrolled asthma in the child, mainly in the presence of high social support.

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Socioeconomic factors associated with asthma prevalence and severity among children living in low-income South African communities

Cited by 19 publications

References 14 publications

Asthma and other allergic diseases among Saudi schoolchildren in Najran: the need for a comprehensive intervention program

Asthma and other allergic diseases among Saudi schoolchildren in Najran: the need for a comprehensive intervention program

Asthma in South African adolescents: a time trend and risk factor analysis over two decades

Maternal common mental disorder over time and asthma control: The role of social support

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