Abstract
Background—The Global Asthma Network (GAN) Phase I is surveying school pupils in high-income and low- or middle-income countries using the International Study of Asthma and Allergies in Childhood (ISAAC) methodology. Methods—Cross-sectional surveys of participants in two age groups in randomly selected schools within each centre (2015–2020). The compulsory age group is 13–14 years (adolescents), optionally including parents or guardians. Six to seven years (children) and their parents are also optional. Adolescents completed questionnaires at school, and took home adult questionnaires for parent/guardian completion. Children took home questionnaires for parent/guardian completion about the child and also adult questionnaires. Questions related to symptoms and risk factors for asthma and allergy, asthma management, school/work absence and hospitalisation. Results—53 centres in 20 countries completed quality checks by 31 May 2020. These included 21 centres that previously participated in ISAAC. There were 132,748 adolescents (average response rate 88.8%), 91,802 children (average response rate 79.1%), and 177,622 adults, with >97% answering risk factor questions and >98% answering questions on asthma management, school/work absence and hospitalisation. Conclusion—The high response rates achieved in ISAAC have generally been maintained in GAN. GAN Phase I surveys, partially overlapping with ISAAC centres, will allow within-centre analyses of time-trends in prevalence.
Highlights
The Global Asthma Network (GAN) [1,2] was formed in 2012 as a joint initiative by members of the International Study of Asthma and Allergies in Childhood (ISAAC) and the International Union Against Tuberculosis and Lung Disease, following their co-production of the first Global Asthma Report (GAR), launched in 2011 at the time of the United Nations high-level meeting on non-communicable diseases [3]
GAN Phase I was developed to address this information gap, with these hypotheses: (1) Globally, the burden of asthma is changing in adults and children; (2) There is large variation in the diagnosis of asthma; (3) In many locations, asthma is under-diagnosed and its management is suboptimal; and (4) There are potentially modifiable risk factors for asthma
Modelled closely on the study design and methodology of ISAAC Phase III, GAN Phase I has extended its scope to include adults, for whom there are limited global data on asthma prevalence [8], severity and risk factors, and to assess asthma management, which is commonly suboptimal in low-income settings [7]
Summary
The Global Asthma Network (GAN) [1,2] was formed in 2012 as a joint initiative by members of the International Study of Asthma and Allergies in Childhood (ISAAC) and the International Union Against Tuberculosis and Lung Disease, following their co-production of the first Global Asthma Report (GAR), launched in 2011 at the time of the United Nations high-level meeting on non-communicable diseases [3]. (1) To conduct asthma surveillance around the world in two age groups of school pupils, and their parents, measuring prevalence, severity, management and risk factors, following the methods of ISAAC Phase III;. (2) To examine time trends in prevalence, severity, management and risk factors from centres which completed ISAAC Phase III; and (3) To evaluate the appropriateness of asthma management, especially access to quality-assured essential asthma medicines, as defined by WHO [9]. Modelled closely on the study design and methodology of ISAAC Phase III, GAN Phase I has extended its scope to include adults, for whom there are limited global data on asthma prevalence [8], severity and risk factors, and to assess asthma management, which is commonly suboptimal in low-income settings [7]. GAN Phase I surveys, partially overlapping with ISAAC centres, will allow within-centre analyses of time-trends in prevalence
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