The prevalence, severity and risk factors of asthma in school-going adolescents in KwaZulu Natal, South Africa.

Abstract

<b>Background:</b> Asthma remains highly prevalent, with more severe symptoms in low- to middle-income countries than high-income countries (Asher I, Lancet 2021;398:1569-80). Identification of risk factors for severe asthma symptoms can assist with improving outcomes. This study aimed to assess the prevalence of asthma and identify associated risk factors in adolescents in KwaZulu Natal, South Africa. <b>Methods:</b> A cross-sectional survey using the Global Asthma Network (GAN) written and video questionnaire in school-going adolescents between the ages of 13-and-14-years old from randomly selected schools in KwaZulu Natal was done from March 2019 to April 2021. <b>Results:</b> A total of 3957 adolescents were included, with 52.2% females. The prevalence of lifetime asthma, current asthma and severe asthma was 24.6%, 13.7% and 9.1%, respectively. Of those with current and severe asthma symptoms, 38.9% and 40.7% had doctor-diagnosed asthma, respectively. Only 8.1% reported inhaled medication use. Severe asthma was associated with rhinoconjunctivitis (adjusted OR [95% CI] 3.62 [2.81 - 4.67], eczema (2.22 [1.58 - 3.12], traffic pollution (1.41 [1.10 - 1.80]), and body mass index (BMI) &gt;25 (1.60 [1.20-2.11], all p &lt;0,01), Figure 1. <b>Conclusion:</b> Asthma prevalence in this population is similar to the global average. Severe asthma symptoms are more common and are associated with atopy, environment, and lifestyle.