Study On Risk Factors Of Childhood Asthma In Karachi,Pakistan

Objective: To investigate and determine the risk factor involved in the development of childhood asthma in Karachi,Pakistan.Materials and methods: This clinical-based study was conducted at the Agha Khan University Hospital in Karachi from November 2020 to November 2021.The participants were the 500 children of age 1 year to 14 years who attended the pediatrics Department of Agha Khan University Hospital in Karachi.Children were divided into two groups based on observations and clinical records,one group of asthmatic patients consist of 250 participants while the second control group also contain 250 non-asthmatic patients and all 500 children were residents of Karachi and nearby areas,Pakistan.Results: Table.1 elucidate all the factors in the two groups.Of the 500 cases,250(50%)were asthmatic cases and 250(50%)were non-asthmatic.Among the asthmatic cases,146(58.4%)were females and 104(41.6%)were males,138(55.2%)had a family history of allergies and 149(59.6)had a family history of asthma,asthmatic patients were influenced by other factors including Environmental factors(Passive smoking 155(62%),new house renovation 111(44.4%),Pet feeding history 93(37.2)。Self-factors(obesity 89(35.6%),Early exposure to antibiotics in infants and young children 104(41.6%),repeated respiratory infections 151(60.4%).Pregnancy factors(Cesarean section 97(38.8%),Premature delivery 46(18.4%).Low birth weight 73(29.2%)and while breastfeeding had no association with asthma(p= 0.081),112(44.8%)asthmatic patients who had no history of allergies and 101(40.4%)had no history of asthma were significantly associated with childhood asthma(P<0.05).Multiple regression analysis(Table.2)was performed on all given factors and concluded that patients had history of allergies(OR= 3.51,95 % Cl = 2.67-4.78),and asthma(OR= 4.6,95% Cl=2.51-5.62,P<0.05)were strongly associated with development of asthma in childhood.From the environmental factors passive smoking had great contribution to develop childhood asthma(OR=3.14,95%Cl=(2.21-4.42)),new house renovation(OR= 1.45,95%CI=1.31-1.69),and pet feeding history(OR= 1.14,95% Cl= 0.73-1.75),also had significant association with childhood asthma.Modestly association was found with obesity(OR=1.3,95%CI= 0.92-1.95),Repeated respiratory infections(OR=2.56,95%CI= 1.04-3.35).Early exposure to antibiotics in infants and young children(OR=1.46,95%CI= 1.14-2.99)had significant association.Cesarean section(OR= 1.47,95% Cl= 1.02-2.1).Premature delivery(OR=2.61,95%CI=1.09-3.02)low birth weight(OR=2.90,95%CI=2.31-2.62).Table.3 all the factors had an indispensable role in enhanced asthma in children.Family history had a mean value 149.5 ± 0.59 with p-value <0.001 that mean patients with a family history of asthma were greater,similarly environmental factor was found more common in asthma patients(119.6 ±0.52).Self-factor(123.6 ± 0.77)and pregnancy factor(93 ± 0.65)also had significant impact p<0.05Conclusion: The current study indicates that asthma is a multi-factorial disease related to both familial and environmental influences.Childhood asthma was strongly associated with a family history,environmental factor and self –factor.Pregnancy factors were linked to varying degree of risk of developing asthma.Breast feeding had no significant impact on developing childhood asthma.Children living with at least one smoker was the worst risk factor among all the environmental factors that induce asthma in children.The study also highlights the need to educate the parents about the risk of smoking in development of Asthma.