Prevalence of asthma and allergic disorders in regional, rural, and indigenous children aged 6–8 years in Tasmania

Abstract

Objective: Asthma and allergic diseases are poorly described in rural areas. The objective of this study was, therefore, to determine the prevalence of wheezing, asthma, and other allergic disorders among children living in regional and rural Tasmania. Methodology: Data from a cross-sectional survey using standardized questionnaires of asthma, allergic conditions and food allergies were collected from 39 primary schools across North West Tasmania. We enrolled 1075 children between 6 and 8 years. The main outcomes were prevalences of wheezing, asthma, and other allergic disorders further stratified by sex and indigenous status. Results: Baseline characteristics were as follows: median age 8.1 years (IQR: 7.6, 8.7) with equal sex distribution, most (80.1%) attended public schools and 11.0% identified as indigenous. We report prevalences of current wheezing (22.7%), allergic rhinoconjunctivitis (16.3%) and atopic eczema (16.6%), with higher prevalences among boys (except eczema). Food allergies were reported in 8.6% and food-related anaphylaxis in 1.6% of the sample. Indigenous children had significantly higher prevalence of current wheezing (indigenous 31.1% versus non-indigenous 21.6%; p = 0.02). Further, children with current wheezing and no asthma diagnosis, had similar prevalence of other atopic diseases (hayfever 31.4%, eczema 44.0%, and food reaction 23.2%) compared with diagnosed asthmatics, although likely shared the illness. Conclusions: Childhood asthma is more prevalent in regional Tasmania compared with national estimates, especially among indigenous children. This appears not to be driven by an allergic response. Also, a significant proportion of children are likely to have undiagnosed asthma which has implications for rural health service delivery.

Keywords:

• Asthma
• pediatrics/childhood
• allergies
• rural
• indigenous

Acknowledgements

The authors thank the following medical students who assisted with various phases of the study: Adrian Lee, Sanjay Dutt, Kaitlin Duell, Ashtyn Thomas, Alistair Dunbar, Victoria Jordan, Patrick Rasmussen and Brodie Carlon. A/Prof Lizzi Shires, Colleen Cheeck, and Richard Roozendal made a contribution on behalf of the Rural Clinical School, UTAS. Gaylene Bassett and Patrick Salter are thanked for their contributions. This study was funded with a research award from the Clifford Craig Research Trust. The authors further wish to thank the school personnel, school boards, parents/guardians, and the children who participated.

Disclosure statement

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.