Abstract
BackgroundAsthma is a common chronic disease of childhood that is associated with significant morbidity and mortality. We aimed to estimate the prevalence of asthma among secondary school pupils in urban and rural areas of coast districts of Tanzania. The study also aimed to describe pupils’ perception towards asthma, and to assess their knowledge on symptoms, triggers, and treatment of asthma.MethodsA total of 610 pupils from Ilala district and 619 pupils from Bagamoyo district formed the urban and rural groups, respectively. Using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire, a history of “diagnosed” asthma or the presence of a wheeze in the previous 12 months was obtained from all the studied pupils, along with documentation of their perceptions regarding asthma. Pupils without asthma or wheeze in the prior 12 months were subsequently selected and underwent a free running exercise testing. A ≥ 20% decrease in the post-exercise Peak Expiratory Flow Rate (PEFR) values was the criterion for diagnosing exercise-induced asthma.ResultsThe mean age of participants was 16.8 (±1.8) years. The prevalence of wheeze in the past 12 months was 12.1% in Bagamoyo district and 23.1% in Ilala district (p < 0.001). Self-reported asthma was found in 17.6% and 6.4% of pupils in Ilala and Bagamoyo districts, respectively (p < 0.001). The prevalence of exercise-induced asthma was 2.4% in Bagamoyo, and 26.3% in Ilala (P < 0.002). In both districts, most information on asthma came from parents, and there was variation in symptoms and triggers of asthma reported by the pupils. Non-asthmatic pupils feared sleeping, playing, and eating with their asthmatic peers.ConclusionThe prevalence rates of self-reported asthma, wheezing in the past 12 months, and exercise-induced asthma were significantly higher among urban than rural pupils. Although bronchial asthma is a common disease, pupils’ perceptions about asthma were associated with fear of contact with their asthmatic peers in both rural and urban schools.
Highlights
Asthma is a common chronic disease of childhood that is associated with significant morbidity and mortality
The study has shown that asthma was more prevalent among pupils living in urban areas than among those living in rural areas
The reported prevalence rates for both urban and rural self-reported asthma in our study are higher than the prevalence of 1.9–5.2% that was previously estimated in Tanzania in 2004 [16]
Summary
Asthma is a common chronic disease of childhood that is associated with significant morbidity and mortality. There are variations in beliefs and perceptions on asthma, due to differences in the level of education between urban and rural areas [14]. These differences affect treatment of asthma, and contribute to the increase in morbidity and mortality of the disease [14]. This study sought to estimate the prevalence of asthma, and to assess perceptions with regards to asthma among secondary school pupils in the rural and urban coast of Tanzania
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