Asthma in rural Bangladeshi children

Objective. Although bronchial asthma causes a great deal of morbidity among children in Bangladesh, few epidemiological studies addressed this problem. The study aims to determine the prevalence of wheezing and its association with environmental and host factors. Methods. A total of 1587 children aged 60-71 mth living in 50 villages in rural Bangladesh at Matlab was studied. Trained field workers interviewed caretakers of these children to diagnose wheezing using an adopted questionnaire of the International Studies of Asthma and Allergies in Childhood (ISAAC). History of pneumonia among wheezing and non-wheezing children during their childhood was obtained from the surveillance records. Results. The prevalence of wheezing in the last 12 mth prior to survey was 16.1% (95% Cl: 14.3%, 18.0%), significantly higher among children who had attacks of pneumonia during their infancy compared to children who did not (23.0% vs 14.6%, p<0.0001). Risk factors associated with wheezing were pneumonia at ages 0-12m (OR= 1.50, 95% Cl 1.08, 2.10) and 13-24m (OR= 2.12, 1.46, 3.08), maternal asthma (OR=3.01, 95% Cl 2.02, 4.47), paternal asthma (OR= 3.12, 95% Cl 1.85, 5.26), maternal eczema (OR=1.81, 95% Cl 1.14, 2.87) and family income ≤ 100 US$ (OR for US$ 51-99= 1.63, 95% Cl 1.05, 2.53; OR for US ≤ 50= 2.12, 95% Cl 1.31, 3.44). Conclusion. Our results suggest that wheezing is a significant cause of morbidity among children in rural Bangladesh. Greater efforts are needed to prevent pneumonia among children during their infancy to reduce the chances of subsequent development of wheezing.