High Asthma Prevalence and Associated Factors in Urban Malagasy Schoolchildren

Abstract

Introduction. Studies about bronchial asthma in Africa are impeded by the dearth of reliable data for the vast majority of countries on the continent. This study was conducted to establish the first epidemiological data concerning bronchial asthma in urban Malagasy schoolchildren. Methods. From three public and five private schools 1236 students aged 7–14 years were recruited and examined using a modified International Study of Asthma and Allergies in Childhood (ISAAC) questionnaire. In a subgroup of 111 schoolchildren from two schools, lung function tests were conducted together with bronchodilator response (BDR) to establish reversible obstruction (change in FEV1 ≥ 12%). Results. The overall prevalence of wheezing in schoolchildren was 25.2%, with strikingly more wheezing in children attending private schools than public schools (p = .0012). The risk was diminished in students with older siblings (p < .03), but was not affected by other variables like smoking habits at home, body mass index, or cooking fuel. In the schools where BDR was performed, we found a point prevalence for reversible bronchial obstruction of 9% through lung function tests. Conclusion. Bronchial asthma is of great relevance for schoolchildren living in urban Madagascar. Socioeconomic factors and air pollution seem to have a major impact in addition to the number of older siblings.

• Africa
• lung function
• pollution
• poverty
• socioeconomic

Acknowledgments

We thank the schoolchildren taking part in the study and their teachers in supporting us.

We gratefully acknowledge the dedication of Tsilavy Ernaivo, who organized this study under politically difficult circumstances. We thank Sonja Eberle, Norbert Banik, Sanja Stanojevic, Isabella Annesi-Maesano, Immanuel Wolff, and Laura Wolff for the technical assistance.

Declaration of Interest

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