ASTHMA,
ATOPIC ECZEMA AND ALLERGIC RHINO-CONJUNCTIVITIS IN SCHOOL CHILDREN OF
DHAKA, BANGLADESH USING INTERNATIONAL STUDY OF ASTHMA AND ALLERGIES IN
CHILDHOOD (ISAAC) PROTOCOL
ARM Luthful Kabir, AKM Fazlur Rahman, Quamrul
Hassan, Farid Ahamed
Institute of Child and Mother Health, Matuail,
Dhaka, Bangladesh
Objective: To determine the prevalence of asthma, allergic
rhinitis and eczema in urban and rural school children of Dhaka district
using ISAAC protocol. Methodology: A school based
cross sectional study done by using both written questionnaires (WQ) and
video questionnaires (VQ). Students of class-VIII (13-14 years) filled up
both the WQ and VQ and the parents of class I (6-7 years) filled up only
the WQ on behalf of the students.
65 primary schools and 39 high schools were randomly selected from
all 19 thanas to cover equally both the urban and rural schools of the
entire area of Dhaka district.
A total of 6260 written questionnaires were eligible for the
analysis (3029 form 6-7 years of class I and 3231 from 13-14 years of class
VIII). In addition, the validated international video questionnaires were
used for the older age group (3231).
Results:
The life time (ever) and
12-month period (recent) prevalence of three allergic conditions
were as follows : wheezing 13.8%, 7.6%; allergic rhinitis 25.0%, 20.0% and
eczema 8.7%, 6.5% respectively. On comparison between recall asthma
features (WQ) and the video features (VQ), all the video features were
found significantly less than the recall asthma features. The prevalence of
wheezing and other atopic features in both age groups of 6-7 years and
13-14 years showed higher features of wheeze in the younger children than
in the older children, ever wheeze 16.6% Vs 11.1%, p<0.001; recent
wheeze 9.1% Vs 6.1%; perceived asthma (perception of having asthma in
children either by the children themselves or by their parents) 10.1% Vs
6.4%, p<0.001; But the other atopic features were found lower in younger
age group, ever rhinitis 20.7% Vs 29%, p<0.001; recent rhinitis 16.3% Vs
23.5%; recent conjunctivitis
6.4% Vs 8.3%; ever eczema 8.5%
Vs 8.9%; recent eczema 6% Vs 7.1%, p<0.001. Male children were found to
be more suffering from all types allergic conditions than their female
peers: recent wheeze 9.0% Vs 5.9%, recent rhinitis 21.9% Vs 17.9%, recent
allergic conjunctivitis 8.7% Vs 6.7% and recent eczema 6.8% Vs 6.2%). There
was no difference in the prevalence of recent wheeze, recent rhinitis,
recent eczema and play wheeze in urban and rural areas. Conclusion: Though the
prevalence of asthma and atopic eczema was lower than those of developed
countries but still appeared to be a major health problem for our children.
Allergic rhinitis was the commonest of all atopic problems in children. The
younger children (6-7 years) were more likely to suffer from wheeze
(asthma) but other allergic problems were more in older group of children
(13-14 years). Male children were more prone to all types of allergic
problems than the female peers.