Asthma in School Children: Assessment of Prevalence And Risk Factors Among Rural and Urban Settings from the Western Part of India

Abstract

Background: Asthma in children remains a significant global public health challenge, contributing extensively to paediatric hospitalizations, increased healthcare utilization, missed school days, and reduced caregiver productivity, apart from the problem of underdiagnosis and undertreatment of asthma. This study aimed to assess the prevalence of asthma in school children aged 5 to 15 years in urban and rural areas of the western part of India.
Methods: The study was conducted to assess the prevalence and associated risk factors of asthma among school-going children aged 5 to 15 years in urban and rural regions. The cross-sectional survey included 6,959 children, with 4,553 from urban schools and 2,416 from rural schools. Data collection was based on a modified version of a standardized and validated questionnaire developed by the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh.
Results: Among urban children, 645 (14.2%) were found to have different allergic disorders, with a higher prevalence among females (15.9%) compared to males (11.3%). The rural population showed a lower overall prevalence of allergic disorders (5.1%), again with female predominance (6.1 vs. 4.2% in males). In urban children, asthma was present in 26% of those with allergies compared to just 0.8% among non-allergic peers. 44.7% of rural children with allergic conditions had asthma, compared to 1.2% among those without allergic conditions. In urban areas, asthma was diagnosed in 8.7% of children with environmental tobacco smoke exposure compared to 5.9% in rural children. 278 (6.1%) urban children reported biomass fuel exposure, with an asthma prevalence of 4.3% (n = 8). 48.7% (n=1177) of rural children were exposed to biomass fuel, with an asthma prevalence of 6.03% in the exposed group.
Conclusion: The prevalence of allergic disorders was significantly higher in urban children compared to their rural counterparts. The overall prevalence of asthma was markedly higher among children with allergic conditions. Exposure to environmental tobacco smoke was found to be a significant risk factor for asthma in both urban and rural populations. Biomass smoke exposure was significantly associated with increased asthma prevalence among rural female children.