Prevalence and risk factors for wheezing in children from rural areas of north India

Phase I of the International Study of Asthma and Allergies in Childhood (ISAAC) showed marked variability in the global pattern of allergic disorders. Risk factors for asthma in children from rural areas of developing countries have not been studied. The purpose of this study was to document the prevalence of asthma-associated symptoms in children residing in rural areas and to determine risk factors for its development. We studied 8470 school children, aged 6-7 years and 13-14 years, from 10 villages on the outskirts of Delhi, India, over a 6-month period. The study was performed using the Hindi translated version of Phase III of the ISAAC questionnaires. All of the questionnaires were self-reported by children and/or parents. Frequent passage of trucks through the street near home (odds ratio [OR]: 95% CI, 1.7 [1.2-2.4]), maternal smoking (OR: 95% CI, 1.5, [1.1-2.1]), paternal smoking (OR: 95% CI, 1.3 [1.0-1.8]), total number of cigarettes smoked by both parents of more than seven per day (OR: 95% CI, 1.9 [1.3-2.7]), paracetamol intake of more than once a month (OR: 95% CI, 1.9 [1.4-2.6]), and current exposure to cats (OR: 95% CI, 1.5 [1.1-1.9]) were independently associated with occurrence of recent wheezing (in the last 12 months), whereas fruit intake of more than twice a week had a protective effect (OR: 95% CI, 0.7 [0.5-0.9]). There is a significant burden of asthma-associated symptoms in children of rural areas of north India. Occurrence of wheezing among children from rural areas of Delhi is determined by a complex interplay of environmental agents that induce allergic sensitization and are proinflammatory and environmental agents that supplement the antioxidant stores.