Introduction
In a prevalence study, high rates of bronchial asthma (12.6%) were found among Jeddah children. Asthma also accounted for 5.72% of the total attendances to Accident and Emergency department of King AbdulAziz University Hospital in Jeddah. Children spend 75-90% of their time indoors. Indoor allergen exposure is an important risk factor for sensitization and asthma. A case control study was conducted to determine home related risk factors for asthma among Jeddah children.
Methodology
Parents of 119 asthmatic and 119 control children were interviewed. An asthmatic child was any child between 1 and 12 years who had at least three attacks of bronchial asthma which responded to bronchodilators and was assigned to the special asthma clinic. A control child was any child of the same age, with no personal or family history of bronchial asthma who visited the outpatient pediatric clinics in the same hospital during the same time period. Both case and control children resided in Jeddah. The project was designed to compare general house characteristics, indoor environmental risk factors, and family habits of asthmatic and non-asthmatic children, and to study other personal predisposing factors in children.
Results
Adequate ventilation (measured by frequency of opening house windows throughout the year) was protective (odds ratio [OR] = 0.27, 95% confidence interval [CI] = 0.12-0.58). In the absence of adequate ventilation, indoor air fresheners (OR = 1.91, 95% CI = 1.1-3.32), burning incense (OR = 1.84, 95% CI=1.02-3.31), and passive smoking (OR = 1.72, 95% CI = 0.99-2.98) were associated with increased risk. Bed mattress covers were protective (OR = 0.46, 95% CI = 0.22-0.94). The study found a strong association between asthma and chest infection during the first year of life (OR = 10.57, 95% CI = 3.36-37.1) and other allergic illnesses: allergic rhinitis (OR = 8.14, 95% CI = 2.29-25.46), food allergy (OR = 6.28, 95% CI = 2.29-18.13), allergic conjunctivitis (OR = 4.52, 95% CI = 1.07-21.95) and eczema (OR = 3.92, 95% CI = 1.67-9.36). Asthma was also associated with low parental education, and having a mother or father with no or low level of education (OR = 1.95, 95% CI = 1.11-3.4 and OR = 1.74, 95% CI = 1.14-1.86 respectively). Severe asthma was associated with family income less than 2000 SR (OR = 4.7, 95% CI = 1.97-11.31).
Conclusion
The role of ventilation in reducing indoor allergens and pollutants is emphasized in this study. This study was consistent with previous studies; there is an association between asthma and past history of chest infection and atopy, and family history of asthma and atopy. Our findings are consistent with other studies with regard to the protective effect of mattress covers. As in some parts of the world, children of lower socioeconomic groups were at higher risk of the disease.