Burden of asthma among children in a developing megacity: Childhood asthma study, Pakistan

Abstract

Background: Global burden of childhood asthma has increased in the last few decades particularly in low-income countries. In Pakistan there is a lack of community based epidemiological studies estimating the burden of asthma among children. Objective: This study determined the prevalence and predictors of asthma among children 3-17 years of age in Karachi, Pakistan. Methods: A two-stage community based representative cross-sectional survey was conducted in Karachi from March 2012-April 2013 comprising 1046 children aged 3-17 years.Out of 7500 clusters, 80 were randomly selected and out of these 15 children per cluster were enrolled randomly. A translated and pre-tested version of ISAAC (International Study of Asthma and Allergies in Children) questionnaire was administered. Results: The overall prevalence of asthma among study participants was 10.2% (95% CI: 8.4-12.0). Asthma was more likely to occur among boys (adj. OR: 2.5, 95% CI: 1.6-4.0), children in the younger age group (3-7 years) (adj. OR 2.9, 95% CI: 1.7-4.8), those living in households with ill-ventilated kitchens (adj. OR 1.8, 95% CI: 1.1-3.1), having family history of asthma (adj. OR 2.3, 95% CI: 1.3-3.9) and those of the Sindhi ethnicity (adj. OR 2.2, 95% CI: 1.1-4.4). Conclusion: This study is the first robust evidence regarding asthma among children in Pakistan, reporting a high burden in this group. Family history, male gender, Sindhi ethnicity and ill-ventilated kitchen were identified as important predictors of asthma. Targeted preventive measures and further intervention studies are required to better understand and reduce the burden of asthma among children in Pakistan.