Prevalence, Management, and Risk Factors of Asthma Among School-Age Children in Yogyakarta, Indonesia

Abstract

Childhood asthma in developing countries has been increasing, but underdiagnosed and undertreated. We reported prevalence, management, and risk factors of asthma among school-age children in Yogyakarta, Indonesia. Patients and Methods: We recruited children aged 6-7 years and 13-14 years attending schools in all districts in Yogyakarta, Indonesia. The schools were randomly selected via cluster random sampling. We used the Indonesian version of the Global Asthma Network (GAN) questionnaire, and the methodology employed by this study was in accordance with the GAN's protocol. Results: A total of 2106 children aged 6-7 years and 3142 adolescents aged 13-14 years were eligible for analysis. The prevalence of current wheeze in children and adolescents was similar, which was 4.6%. Inhalation therapy was reported in <30% of those with asthma. Risk factors for current wheeze in children were wheezing in infancy period, ever had pneumonia, the house was passed by trucks every day, and fast-food consumption in the previous 12 months; whereas exclusive breastfeeding for more than 6 months decreased the risk of current wheeze. In adolescence, obesity, consumption of fast food once or twice a week, and paracetamol in the previous 12 months increased the risk of current wheeze. Conclusion:The prevalence of current wheeze in children and adolescents in Indonesia was quite low. The use of inhalation therapy was limited. Respiratory problems during infancy, environmental, and nutritional factors play a role in the development of asthma.

Prevalence, Management, and Risk Factor of Asthma Among School-Age Children in Yogyakarta, Indonesia [Letter]

“…We have read a paper by Rina Triasih et al on Prevalence, Management, and Risk Factors of Asthma Among School-Age Children in Yogyakarta, Indonesia. 1 We congratulate the authors for their invaluable findings in the world of health which provide information regarding asthma, especially in children whose cases have not gone away. We would like to share our views on this study as well as provide input that can build on and develop this research if it is to be continued in the future by other researchers who also want to conduct studies on the prevalence of asthma, especially in school-age children.…”

Asthma in developing countries in the Asia‐Pacific Region (APR)

“…The meta‐analysis by Sio et al 27 demonstrated that PM 10 increased the overall risk of asthma by 1.22‐fold ( n = 8 studies) in Asian countries. In India and Indonesia, frequent passage of trucks near residential houses has been associated with a 1.7 times higher risk of wheezing in children 39,40 …”

“…On the other hand, poor diet such as fast‐food consumption was associated with increased risk of current wheeze, while fruit intake of more than twice a week was protective 39,40 . Higher intake of polyunsaturated fatty acids may provoke Th2‐related asthma by increasing the production pro‐inflammatory mediators 45 .…”

“…In India and Indonesia, frequent passage of trucks near residential houses has been associated with a 1.7 times higher risk of wheezing in children. 39,40 Aeroallergens such as pollen, mould/fungi, house dust mites, pets and cockroach particles are important risk factors of asthma. Increased allergen exposure can lead to sensitisation, and constant re-exposure to allergens in sensitized individuals can induce asthma and other allergic conditions.…”

“…44 On the other hand, poor diet such as fast-food consumption was associated with increased risk of current wheeze, while fruit intake of more than twice a week was protective. 39,40 Higher intake of polyunsaturated fatty acids may provoke Th2-related asthma by increasing the production pro-inflammatory mediators. 45 In Bangladesh, stunting was a prominent risk factor for wheezing in children living in rural areas, suggesting that poor nutrition can result in detrimental health effects.…”