A Studyof Effect of the Socioeconomic Status on Asthma Management in Children in South India

Aparna Gulvadi Aparna Gulvadi,Ramaraj S Ramaraj S,Sreenivasan V K Sreenivasan V K

doi:10.47009/ajmr.2020.9.1.pe1

Aparna Gulvadi Aparna Gulvadi, Ramaraj S Ramaraj S + Show 1 more

Open Access

https://doi.org/10.47009/ajmr.2020.9.1.pe1

Copy DOI

Abstract

Background: Asthma is a chronic and potentially seriousconditionwith most children developingit at an early age. Every decade globally the prevalenceis increasing by 50%. Long term management focuses on preventingacute exacerbations, emergency attendances, hospitalizations, morbidity and mortality. Control of asthma is achieved by long term inhalers and bypreventing therisk factors.Various risk factors influence the variation in prevalenceand the long term outcome.Socioeconomic status(SES) is considered a major risk factor and is linked to various health outcomes especially in chronic diseases.Aim: To study the effect of SES on long term management of childhoodasthma.Subjects and Methods: 500 parents of children attending the asthma outpatient clinic in a medical college were interviewed.Results: Based on the Revised Kuppuswamy’s SES scale it was noted that 1.4% were upper class,33.6% upper middle,47%lower middle, 18%lower class. Our data revealed that parents from lower SES are unaware of diagnosis (0%), are reluctant to accept diagnosis (26.6%), reluctant to start inhalers (84.4%) in comparison to upper and middle classes.Conclusion: Failure to diagnose asthma, lack of awareness of disease, poor understanding of the chronicity, and failure to initiate early inhaler therapy and poor adherence to inhalers was significantly noted in children from low socioeconomic background and this can adversely affect the long term outcome.

Highlights

Asthma is one of the most prevalent, chronic diseases among children, globally affecting at least 7-10 % of world’s population with almost 50% cases developing early by 10 years of age
[2] The presence of asthma and atopy in family members(especially maternal history of asthma) is one of the many risk factors reported in literature. [3]Despite this considerable genetic contribution there are other additional social and environmental factors in the cause and exacerbation of childhood asthma. [4]Several studies have tried to explain how low socio-economic status influences the development of asthma but with discrepant results
Most studies have shown children in families with low Socioeconomic status (SES)(measured by parental education, occupation and income) have an increased risk of asthma after adjustment of other variables[5,6,7]Other studies found no relationship with parental SES.[8,9,10]These diverse results could have been due to different study designs, small sample sizes or varying measures of SES.[11]

Summary

Introduction

Asthma is one of the most prevalent, chronic diseases among children, globally affecting at least 7-10 % of world’s population with almost 50% cases developing early by 10 years of age. Despite advances in diagnosis and treatment, this condition is known for its sudden acute exacerbations, frequent emergency attendances and hospitalizations, sometimes needing intensive care It is associated with long term morbidity and worsening pulmonary functions. Due to various ongoing risk factors, asthma patients get exacerbations with frequent worsening and loss of control of symptoms even if previously well controlled. These need to be recognised to prevent treatment failure and prevent long term morbidity. This descriptive study was conducted over a 4 year period from 2013 to 2017 at pediatric asthma clinic at Amala institute of medical sciences, Trichur, Kerala. 20% were from semi-urban, no families from rural area were noted in this study

Results

Conclusion

Limitations