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Childhood asthma at Kenyatta National Hospital, Nairobi
W M Macharia1, N M Mirza, E M Wafula
1Department of Paediatrics, University of Nairobi.
Insights
Early childhood asthma attacks are common, with over 21% starting before six months. This study highlights the need to recognize pediatric asthma onset in infants, challenging previous beliefs.
Area of Science:
- Pediatric Pulmonology
- Allergy and Immunology
- Epidemiology
Background:
- Bronchial asthma is a significant respiratory condition in children.
- Understanding the early onset and triggers of pediatric asthma is crucial for effective management.
Purpose of the Study:
- To evaluate the onset age and clinical characteristics of bronchial asthma in children under 14.
- To identify common triggers and associated conditions in pediatric asthma patients.
Main Methods:
- A retrospective evaluation of 356 children diagnosed with bronchial asthma.
- Data collection included age of initial attack, triggers, time of attacks, and personal history of atopic conditions.
Main Results:
- 21.3% of children experienced their first asthma attack before six months of age, and 55.1% before two years.
- Physical exercise triggered or worsened attacks in 43.4%, with 71.6% experiencing nocturnal or evening attacks.
- A history of atopic dermatitis (18.5%) and allergic rhinitis (42.9%) was noted in a significant portion of patients.
Conclusions:
- A substantial number of pediatric asthma cases begin in early infancy, earlier than previously thought.
- Nocturnal symptoms and exercise-induced asthma are prevalent, alongside a high comorbidity with allergic rhinitis.
Abstract:
Between January 1986 and July 1988, 356 children with bronchial asthma below 14 years of age were evaluated at the Kenyatta National Hospital. 21.3% experienced initial asthmatic attacks before the age of six months and 55.1% before 2 years. Only 8% of the study patients were below the age of 2 years at recruitment. The male:female ratio was 1:1. Physical exercise led to precipitation or worsening of attacks in 43.4% while 71.6% of the patients experienced attacks in the evening or at night. 18.5% and 42.9% had personal history of atopic dermatitis and allergic rhinitis respectively. The study shows that a substantial number of patients experience initial asthmatic attacks before the age of 6 months contrary to what has been previously believed.