Bronchial asthma in Nigerian children.

Abstract

SUMMARY Clinical and laboratory studies on bronchial asthma in 200 Nigerian children who were seen during a 2k-year period in Ibadan are described. Contrary to reports that the condition is rare in African children, after pulmonary tuberculosis, asthma is the next most common chronic chest disease in Ibadan. While many features of the disease are similar to those seen elsewhere, skin tests indicate that ascaris is the most common antigen associated with asthma, followed by Dermatophagoides pteronyssinus.Bronchial asthma, a common childhood chronic respiratory problem in the West (Godfrey, 1974), is reported to be rare among African children (Wesley et al., 1969;Godfrey, 1975;Warrell et al., 1975).While studies by Mitchell (1970), Sofowora (1970), Anim and Edoo (1972), and Buchanan and Jones (1972) showed that the condition is common in African adults, Wesley et al. (1969) reported that bronchial asthma is extremely rare among Bantu children in South Africa. In Nigeria, Warrell et al. (1975) reported that asthma is rarely seen in children living in the savanna region of the country. Our experience at this hospital in Ibadan during the last few years indicates that the condition is far more common in children here than these reports suggest. This paper gives the results of studies on 200 asthmatic children seen at this hospital during a 2j-year period (June 1974 to December 1976). Materials and methodsThe patients in this study were referred to the chest clinic mainly from the general outpatient department of the hospital but some came from private clinics and hospitals in Ibadan and nearby. Diagnosis of asthma was based on a history of at least three attacks of breathlessness and wheezing (Blair, 1969), often associated with cough, and usually supported at the time of initial examination or during subsequent follow-up, by the auscultatory finding of widespread respiratory rhonchi. In some patients who presented in acute attacks, the diagnosis was further supported by the demonstration of at least Laboratory investigations carried out on the patients included packed cell volume, white blood count-total and differential-stool microscopical examination, chest x-rays, and in a few children, the radiology of the paranasal sinuses. Skin sensitivity tests were done by the prick method, using a selected range of commercially prepared allergen extracts (Bencard). The weal diameter of the reaction recorded was the difference in mm between it and the control. Weals of at least 2 mm in diameter were regarded as positive (Pearson, 1973).The children were classified into three groups according to the severity of the disease. This grading system was modified from one described by Dawson et al. (1969). The severe group consisted of patients with more than 10 acute attacks a year with or without complete clinical recovery between attacks. The moderate group had 5 to 10 attacks a year and usually showed complete or partial freedom from wheezing between attacks, while the mild group had I to 5 attacks a year with complete clini...

Socio-demographic and clinical characteristics of asthmatic children seen at Aminu Kano Teaching Hospital, Kano, Nigeria

“…This may be partly due to the fact that most children with asthma tend to present with symptoms by six years of age 3,5 and also children of this age group are of school age with likelihood of exposure to trigger factors at school such as exercise, dust and contagious viral respiratory tract infections. Many of these children may be walking to school which may serve as a form of exercise and hence trigger asthma attack.…”

“…However not all children who experience recurrent wheezing will go on to have persistent asthma in later childhood 4 . Aderele 5 reported 63% of asthmatic children seen in Ibadan had their first attack before the age of three years and 97% of study population were under the age of 5years.…”

“…Beyond adolescence however, the prevalence is higher in women than men 3 . Most surveys of childhood asthma suggest that boys are more frequently affected than girls before puberty 5,6 . Mielcket al 7 found prevalence of severe asthma to be significantly higher in the low as compared with the high socioeconomic group.…”

The challenges of diagnosing bronchial asthma in very young infants in Calabar, Nigeria

“…Studies have since shown that asthma is far more common in the Nigerian child than previously thought 3 and that it can start at any age. 4 The challenges of diagnosing asthma in this group of infants are enormous and have been repeatedly documented.…”

“…2 It was initially reported to be rare among African children but studies in Nigeria have shown that asthma is far more common than previously thought, being second to pulmonary tuberculosis as the next most common chronic chest disease in children. 3 Asthma can start at any age and is suggested by a chronic or recurrent nature, frequently associated with family history of allergic sensitization and atopic dermatitis. 4 The diagnosis of asthma in infants is more difficult than in older children or adults.…”