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Epidemiology of asthma in India
1Pediatric Pulmonologist, Lakeside Medical Center and Hospital, Bangalore, India. dr_paramesh1@yahoo.com
Insights
Childhood asthma prevalence is rising globally, significantly linked to urbanization and pollution. A Bangalore study found asthma rates increased from 9% in 1979 to 29.5% in 1999, correlating with city growth.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Epidemiology
- Public Health
Background:
- Allergic respiratory disorders, particularly asthma, represent a growing global health concern.
- While genetics play a role, urbanization, air pollution, and environmental tobacco smoke are significant contributors to increased childhood asthma prevalence.
- Demographic shifts in urban environments appear to correlate with rising asthma rates.
Purpose of the Study:
- To investigate the prevalence and epidemiological trends of asthma in children in Bangalore over two decades.
- To identify environmental and socioeconomic factors associated with asthma prevalence in urban and rural pediatric populations.
- To analyze the progression of persistent and severe asthma in children.
Main Methods:
- A longitudinal hospital-based study of 20,000 children under 18 years old, with data collected in 1979, 1984, 1989, 1994, and 1999.
- A school-based survey of 6,550 children (ages 6-15) categorized by school location (traffic density) and socioeconomic status.
- Comparative analysis of asthma prevalence in urban versus rural settings and tracking of persistent asthma rates.
Main Results:
- Hospital-based asthma prevalence in children rose from 9% in 1979 to 29.5% in 1999.
- School survey revealed higher prevalence in children from heavy traffic areas (19.34%) and low socioeconomic groups in heavy traffic zones (31.14%) compared to low traffic areas (11.15%).
- Rural asthma prevalence was significantly lower (5.7%), and persistent asthma increased from 20% to 27.5% between 1994-1999.
Conclusions:
- Urbanization and associated environmental factors are strongly linked to the escalating prevalence of childhood asthma.
- Socioeconomic status and exposure to traffic pollution are critical determinants of asthma risk in children.
- The increasing trend in persistent and severe asthma necessitates targeted public health interventions.
Abstract:
Allergic respiratory disorders, in particular asthma are increasing in prevalence, which is a global phenomenon. Even though genetic predisposition is one of the factors in children for the increased prevalence - urbanisation, air pollution and environmental tobacco smoke contribute more significantly. Our hospital based study on 20,000 children under the age of 18 years from 1979,1984,1989,1994 and 1999 in the city of Bangalore showed a prevalence of 9%,10.5%,18.5%, 24.5% and 29.5% respectively. The increased prevalence correlated well with demographic changes of the city. Further to the hospital study, a school survey in 12 schools on 6550 children in the age group of 6 to 15 years was undertaken for prevalence of asthma and children were categorized into three groups depending upon the geographical situation of the school in relation to vehicular traffic and the socioeconomic group of children. Group I-Children from schools of heavy traffic area showed prevalence of 19.34%, Group II-Children from heavy traffic region and low socioeconomic population had 31.14% and Group III-Children from low traffic area school had 11.15% respectively. (P: I & II; II & III <0.001). A continuation of study in rural areas showed 5.7% in children of 6-15 years. The persistent asthma also showed an increase from 20% to 27.5% and persistent severe asthma 4% to 6.5% between 1994-99. Various epidemiological spectra of asthma in children are discussed here.