RT Journal Article
SR Electronic
T1 Urban-rural differences in questionnaire-derived markers of asthma in Kenyan school children
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1105
OP 1112
DO 10.1183/09031936.98.12051105
VO 12
IS 5
A1 JA Odhiambo
A1 LW Ng'ang'a
A1 MW Mungai
A1 CM Gicheha
A1 JK Nyamwaya
A1 F Karimi
A1 PT Macklem
A1 MR Becklake
YR 1998
UL http://erj.ersjournals.com/content/12/5/1105.abstract
AB Grade 4 Kenyan children attending 10 randomly selected public primary schools in Nairobi (urban) and the Muranga District (rural) were surveyed to establish the prevalence of symptom markers of asthma and to assess the impact of urbanization. A respiratory health and home environment questionnaire was administered at school to parents or guardians. The questionnaire response rates were 94.2% (568/ 603) for Nairobi and 89.6% (604/674) for Muranga. The prevalence rates for asthma, defined as "attacks of shortness of breath with wheeze", were 95% for urban and 3.0% for rural children (odds ratio (OR) urban versus rural: 3.42; 95% confidence interval (CI): -1.96-5.91). This urban-rural gradient persisted after adjusting for urban-rural differences in host factors (including duration of breastfeeding and family history of asthma and/or allergy), but was largely explained by urban-rural differences in environmental factors, including indoor animals, sharing a bedroom with a smoker, parental education, house ventilation and exposure to motor vehicle fumes en route to school (adjusted OR: 1.59; 95% CI: 0.70-3.55). Similar results were obtained for all other symptoms. These findings confirm the clinical impression that asthma is an important illness in Kenya and underline the need for the further study of environmental factors amenable to intervention, particularly in urban areas.