Risk Factors of Childhood Asthma Among Patients Attending a Tertiary Care Centre in North-East India

Figures & data

Figure 1 Month-wise distribution of patients (OPD+IPD).

Table 1 Symptomatic Analysis of the Selected Asthma Cases (n=150)

Variables	Categories	Number	Percentage
Clinical symptoms	Cough	141	94.0
	Difficulty in breathing	123	82.0
	Wheeze	94	62.7
	Chest tightness	88	58.7
Frequency of attack	Episodic	116	77.3
	Persistent	34	22.7
Severity of disease	Mild	84	56.0
	Moderate	53	35.3
	Severe	13	8.7
Seasonality of asthma symptoms	Winter	29	19.3
	Spring	31	20.7
	Summer	11	7.3
	Autumn	45	30.0
	No seasonality	34	22.7
Time of occurrence of symptoms	Day time	27	18.0
	Night-time	58	38.7
	Throughout day and night	12	8.0
	Early morning	44	29.3

Table 2 Socio-Demographic and Environmental Profiles of Cases and Controls

Variable	Categories	Control(n=150)	Case(n=150)	OR (95% CI)	p-value
Age	3–7 years (89)	52(58.4%)	37(41.6%)	1(ref)	0.06
	7–12 years (n=211)	98(46.4%)	113(53.6%)	1.62(0.98–2.67)
Sex	Male (n=174)	82 (47.1%)	92 (52.9%)	1(ref)	0.24
	Female (n=126)	68 (54.0%)	58 (46.0%)	0.76(0.48–1.20)
Religion	Hindu (n=209)	112(53.6%)	97(46.4%)	1(ref)	0.11
	Muslim (n=88)	36 (40.9%)	52 (59.1%)	1.67(1.01–2.76)
	Christian (n=3)	2 (66.7%)	1 (33.3%)	0.58(0.05–6.46)
Tribe	Non-tribal (n=282)	137(48.6%)	145 (51.4%)	1(ref)	0.05
	Tribal (n=18)	13(72.2%)	5(27.8%)	0.36(0.13–1.05)
BMI	Healthy (n=86)	54(62.8%)	32(37.2%)	1(ref)	<0.01
	Underweight (n=59)	33(55.9%)	26(44.1%)	1.33(0.68–2.61)
	Overweight (n=74)	32(43.2%)	42(56.8%)	2.22(1.17–4.18)
	Obese (n=81)	31(38.3%)	50(61.7%)	2.72(1.46–5.09)
Location of house	Rural (n=134)	90(67.2%)	44(32.8%)	1(ref)	<0.01
	Urban (n=143)	49(34.3%)	94(65.7%)	3.92(2.38–6.46)
Type of family	Nuclear (n=162)	94(58.0%)	68(42.0%)	1(ref)	<0.01
	Joint (n=123)	50(40.6%)	73(59.4%)	2.02(1.25–3.25)
Type of house	Pucca (n=118)	70(59.3%)	48(40.7%)	1(ref)	0.02
	Semi Pucca (n=61)	26(42.6%)	35(57.4%)	1.96(1.05–3.67)
	Katcha (n=95)	40(42.1%)	55(57.9%)	2.00(1.16–3.47)
Damp Dwelling	No (n=151)	86(56.9%)	65(43.1%)	1(ref)	0.02
	Yes (n=110)	47(42.7%)	63(57.3%)	1.77(1.08–2.91)
Ventilation	Adequate (n=137)	89(65.0%)	49(35.0%)	1(ref)	<0.01
	Inadequate (n=146)	52(35.6%)	94(64.4%)	3.35(2.06–5.46)
Overcrowding	Absent (n=139)	72(51.8%)	67(48.2%)	1(ref)	0.46
	Present (n=133)	63(47.4%)	70(52.6%)	1.19(0.74–1.92)
Kitchen	Separated (n=127)	75(59.0%)	52 (41.0%)	1(ref)	<0.01
	Attached (n=162)	69(42.6%)	93(57.4%)	1.94(1.21–3.11)
Cooking Fuel	Gas (n=199)	107(53.8%)	92(46.2%)	1(ref)	0.03
	Wood (n=55)	20(36.4%)	35(63.6%)	2.03(1.10–3.77)
	Kerosene (n=34)	13(38.2%)	21(61.8%)	1.88(0.89–3.96)
Dhuna/Agarbattis	No (n=65)	44(67.7%)	21(32.3%)	1(ref)	<0.01
	Yes (n=212)	92(43.4%)	120(56.6%)	2.73(1.52–4.91)
Mosquito repellent	No (n=143)	94(65.7%)	49(34.3%)	1(ref)	<0.01
	Yes (n=141)	52(36.9%)	89(63.1%)	3.28(2.02–5.34)
Pets	No (n=136)	104(76.5%)	32(23.5%)	1(ref)	<0.01
	Yes (n=164)	46(28.0%)	118(72.0%)	8.34(4.94–14.06)
Cockroaches	Nil (n=152)	91(59.9%)	61(40.1%)	1(ref)	0.001
	Plenty (n=119)	45(37.8%)	74(62.2%)	2.45(1.50–4.01)

Table 3 Socioeconomic and Parental Educational Status Among Cases and Controls

Variable	Categories	Control(n=150)	Case(n=150)	p-value
Socio-economic status	Upper Middle (n=27)	26(17.3%)	1(0.7%)	<0.01
	Lower middle (n=66)	31(20.7%)	35(23.3%)
	Upper Lower (n=87)	43(28.7%)	44(29.3%)
	Lower (n=120)	50(n=33.3%)	70(46.7%)
Paternal education	Illiterate (n=152)	77(25.7%)	75(25.0%)	0.98
	Primary level (n=87)	42(14.0%)	45(15.0%)
	Up to HSLC (n=48)	24(8.0%)	24(8.0%)
	Higher (n=13)	7(2.3%)	6(2.0%)
Maternal education	Illiterate (n=152)	28(9.3%)	74(24.7%)	<0.01
	Primary level (n=87)	86(28.7%)	51(17.0%)
	Up to HSLC (n=48)	34(11.3%)	24(8.0%)
	Higher (n=13)	2(0.7%)	1(0.3%)

Table 4 Birth and Feeding History Among Cases and Controls

Variable	Category	Control	Case	OR	p-value
Mode of delivery	Normal (n=180)	106(58.9%)	74(41.1%)	1(ref)	<0.01
	CS or Others (n=120)	44(36.7%)	76(63.3%)	2.47(1.54–3.98)
History of birth asphyxia	No (n=227)	129(56.8%)	98(43.2%)	1(ref)	<0.01
	Yes (n=73)	21(7.0%)	52(17.3%)	3.26(1.84–5.77)
Type of feeding	Exclusive breastfeeding (n=146)	101(69.2%)	45(30.8%)	1(ref)	<0.01
	Top/mixed feeding (n=154)	49(31.8%)	105(68.2%)	4.81(2.95–7.84)

Table 5 History of Allergy and Substance Use Among Cases and Controls

Variable	Categories	Control	Case	OR	p-value
History of food allergy in a child	No (n=192)	102(53.1%)	90(46.9%)	1(ref)	0.026
	Yes (n=90)	35(38.9%)	55(61.1%)	1.78(1.07–2.96)
History of allergy/ atopy in child	No (n=127)	89(70.1%)	38(29.9%)	1(ref)	<0.01
	Yes (n=142)	48(33.8%)	94(66.2%)	4.59(2.74–7.68)
Substance use among mothers	No (n=243)	120(49.4%)	123(50.6%)	1(ref)	0.66
	Yes (n=57)	30(52.6%)	27(47.4%)	0.88(0.49–1.56)
Family history of asthma	No (n=231)	133(57.6%)	98(42.4%)	1(ref)	<0.01
	Yes (n=69)	17(24.6%)	52(75.4%)	4.15(2.26–7.61)
Family history of allergy	No (n=243)	128(52.7%)	68(47.3%)	1(ref)	<0.01
	Yes (n=57)	22(38.6%)	82(61.4%)	7.02(4.03–12.22)
Family history of smoking	No (n=255)	144(56.5%)	111(43.5%)	1(ref)	<0.01
	Yes (n=45)	6(13.3%)	39(86.7%)	8.43(0.49–1.56)

Table 6 Multivariate Logistic Regression Analysis to Assess the Significant Factors Affecting Childhood Asthma

Variables	Categories	Control (n=150)	Case (n=150)	Adjusted OR (95% CI)	p-value
Location of house	Rural (n=134)	90(67.2%)	44(32.8%)	1(ref)	<0.001
	Urban (n=143)	49(34.3%)	94(65.7%)	4.53 (1.57–13.09)
Dwelling environment (Dampness)	No (n=151)	86(56.9%)	65(43.1%)	1(ref)	<0.01
	Yes (n=110)	47(42.7%)	63(57.3%)	5.21(1.23–22.10)
Socioeconomic status	Upper Middle (n=27)	26(96.3%)	1(3.7%)	1(ref)	<0.05
	Lower middle (n=66)	31(47.0%)	35(53.0%)	3.21(0.51–20.17)
	Lower/Upper Lower (n=87)	43(49.4%)	44(50.6%)	6.71(1.11–40.43)
	Lower (n=120)	50(n=41.7%)	70(58.3%)	3.48(1.34–9.01)
Pets	No (n=136)	104(76.5%)	32(23.5%)	1(ref)	<0.05
	Yes (n=164)	46(28.0%)	118(72.0%)	6.77(1.76–25.99)
Family history of atopy/ allergy	No (n=243)	128(52.7%)	68(47.3%)	1(ref)	<0.05
	Yes (n=57)	22(38.6%)	82(61.4%)	43.29(5.80–323.15)
Family history of smoking	No (n=255)	144(56.5%)	111(43.5%)	1(ref)	<0.05
	Yes (n=45)	6(13.3%)	39(86.7%)	23.54(1.41–394.21)
Type of feeding	Exclusive breastfeeding (n=146)	101(69.2%)	45(30.8%)	1(ref)	<0.001
	Top/mixed feeding (n=154)	49(31.8%)	105(68.2%)	4.47(1.46–13.63)