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Prevalence of asthma among Middle Eastern children: A systematic review
Masoud Mirzaei1, Mehran Karimi2, Shima Beheshti3
1Yazd Cardiovascular Research Centre, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Insights
This systematic review found the prevalence of childhood asthma in the Middle East to be 7.53%. While lower than in developed countries, more longitudinal data is needed for trend analysis.
Area of Science:
- Pediatric Allergy and Immunology
- Epidemiology
- Public Health
Background:
- Global rise in childhood asthma and allergy necessitates regional data.
- Limited epidemiological data exists for asthma prevalence in Middle Eastern children.
- This review addresses the knowledge gap regarding childhood asthma in the Middle East.
Purpose of the Study:
- To systematically review and estimate the prevalence of asthma among children in the Middle East.
- To synthesize existing epidemiological data on childhood asthma in the region.
- To identify potential variations in prevalence based on age and sex.
Main Methods:
- Systematic search of local and international databases (SID, Iranmedex, Medline, Science Direct) from 1996-2011.
- Inclusion of studies meeting defined criteria, including those using International Study of Asthma and Allergies in Childhood (ISAAC) criteria.
- Meta-analysis using a random-effect model, with heterogeneity and publication bias assessed.
Main Results:
- Fifty studies encompassing 289,717 children were included, with asthma prevalence ranging from 0.7% to 22.3%.
- The overall pooled prevalence of diagnosed asthma was 7.53% (95% CI: 6.38-8.75).
- Prevalence was similar in 6-7 year olds (7.43%) and 13-14 year olds (7.57%), with higher rates in boys (8.91%) than girls (6.30%).
Conclusions:
- Childhood asthma prevalence in the Middle East is lower compared to many developed nations.
- Current data is insufficient for longitudinal trend analysis of asthma prevalence over time.
- Standardized epidemiological studies are recommended for accurate regional estimates and public health planning.
Abstract:
Background: The prevalence of asthma and allergy has increased during the last decades, especially in children. However, little is known about it in the Middle East region. This systematic review is aimed to estimate the prevalence of asthma among the Middle Eastern children. Methods: Local and international scientific databases including SID, Iranmedex, Medline and Science Direct were systematically searched for relevant keywords including; asthma, prevalence, children, International Study of Asthma and Allergies in Childhood (ISACC) and the names of Middle Eastern countries for the period of 1996-2011. Papers in Persian and English which met the defined criteria were included into the study. Bibliographies of the extracted articles were also searched. After extraction of data, heterogeneity between studies and publication bias were measured using Egger's-test. Effect size was pooled by the random-effect model. Since significant heterogeneity was found between studies, univariate meta-regression analyses were done to assess the association of variables with the overall results. Results: Fifty studies in the Middle East examined the prevalence of asthma and allergy in children under the age of 18 years according to the ISAAC criteria and were included. A total number of 289,717 children were examined in the included studies and the prevalence varied from 0.7 % in Isfahan to 22.3 % in Bagdad. The total prevalence of diagnosed asthma was calculated 7.53 % (95% Cl: 6.38-8.75). Prevalence of asthma in the 13-14 years age group was 7.57% (95% Cl: 5.78-9.29) and in 6-7 years age group was 7.43% (95% Cl: 5.75-9.10). The prevalence of asthma among girls, based on random effect model, was 6.30% (95% Cl: 4.97-7.61) and among boys, it was 8.91% (95% Cl: 6.80-11.04). Conclusion: The prevalence of asthma in the Middle East is lower than most developed countries. However, there is not enough longitudinal data to estimate the trend over time. In order to have more accurate estimates and to provide evidence for proper planning, standard epidemiologic studies should be conducted in countries of the region.
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